Deck 25: Burns, Adverse Effects, and Poisonings

Question 1

A patient was admitted because of an intentional overdose of Valium. The patient is in a coma. GCS at the time of admission was 4.

A)T42.4x4S, R40.20, R40.2424
B)T42.4x1A, R40.3, R40.2424
C)T42.4x2A, R40.20, R40.2433
D)T42.4x1A, R40.20, R40.2433

Answer 1

C

Question 2

Through the acute and recovery stages of a burn victim, which of the following will most likely assist the victim?

A)Plastic surgeons
B)Anesthesiologists
C)Physical therapists
D)All of the above

Answer 2

D

Question 3

The patient was brought to the ER by her mother. The patient admits to being beaten by her husband. X-rays showed three fractured ribs on the right and a spiral fracture of the right humerus. The humeral fracture was manipulated and was found to be in alignment on follow-up x-rays. The patient was given pain medications and was discharged to the care of her mother.Final Diagnosis: Fracture of three ribs and shaft of humerus due to spousal abuse Procedure: Closed reduction of fracture right humerus

A)T74.11xD, S42.342S, S22.49xS, Y07.01, Y04.0xxS, 0PSCXZZ
B)T74.91xA, S42.341S, S22.42xS, Y07.11, Y04.0xxS, 0PSF0ZZ
C)T74.12xA, S42.342A, S22.42xA, Y07.410, Y09, 0PSGXZZ
D)T74.11xA, S42.341A, S22.41xA, Y07.01, Y09, 0PSFXZZ

Answer 3

D

Question 4

Patient was admitted with second-degree burns of the left hand and first-degree burns of the left forearm. The patient touched a hot steam pipe.

A)T23.202A, T22.111A, X16.xxxA
B)T23.202A, T22.112A, X16.xxxA
C)T23.202D, T22.112D, X16.xxxD
D)T22.112A, T23.202A, X16.xxxA

Question 5

Patient was seen in the ER for superficial frostbite, both ears. Patient was exposed to cold weather.

A)T31.011A, X31.xxxA
B)T33.012S, T33.011S, X31.xxxS
C)T33.011A, T33.012A, X31.xxxA
D)T33.011D, T33.012D, X31.xxxD

Question 6

External cause code(s) are never used to identify the cause and intent of the injury or poisoning.

Question 7

The patient was admitted with acute renal failure. The patient had been treated by Home Health with IV gentamicin for Pseudomonas pneumonia. The patient was experiencing some edema and decreased urine output. Blood was drawn, and the physician admitted the patient for IV fluids and investigation of the patient's renal status. Gentamicin was stopped, and another antibiotic was started. The patient's renal function returned to normal.Final Diagnosis: Acute renal failure due to gentamicin Recent pneumonia, still on antibiotic

A)N17.9, T36.5x5D, J15.0,
B)T36.5x3A, N17.9, J15.1,
C)N17.9, T36.5x5A, J15.1
D)T36.5x4A, N18.9, J15.3

Question 8

A 2-year-old child was admitted with an accidental electrical burn to the upper lip. The child was at home (single family) and had bitten on an electrical cord. The mother immediately sought medical attention. The burn was a full-thickness burn. Local wound care was performed. The patient was not having any breathing problems. Further intervention will depend on how the burn heals.Final Diagnosis: Full-thickness burn to upper lip due to electrical current

A)T20.42xA, W86.1xxA, Y92.010
B)T20.32xA, W86.0xxA, Y92.019
C)T20.32xD, W85.xxxD, Y92.020
D)T20.32xS, W86.0xxS, Y92.016

Question 9

Which of the following can be used to treat burns?

A)Antibiotics
B)Antiinflammatories
C)Corticosteroids
D)All of the above

Question 10

Which of the following is true when a poisoning or reaction to the improper use of medication is coded?

A)The poisoning T code is sequenced first, followed by a code for the manifestation.
B)The code for the manifestation is sequenced first, followed by the poisoning T code.
C)The poisoning T code is sequenced second, followed by a third code for the manifestation.
D)None of the above is correct.

Question 11

A patient has SIRS caused by an accidental burn from the flames from a single-family house fire. The patient has full-thickness skin loss burns of the legs (11%) with second-degree burns of the trunk (4%).

A)T24.302A, T24.301A, T21.20xA, R65.10, T31.11, X00.0xxA, Y92.019
B)T24.302S, T24.301S, T21.20xS, R65.11, T31.11, X00.0xxS, Y92.019
C)T24.302D, T24.301D, T21.20xD, R65.10, T31.11, X00.0xxD, Y92.019
D)T24.302A, T21.20xA, R65.11, T31.11, X00.0xxA, Y92.019

Question 12

Z codes are never assigned in relation to injuries, burns, adverse effects, and poisoning.

Question 13

The patient reported to the ER with nausea, vomiting, and weakness. The patient is taking OxyContin for chronic pain due to unresectable pancreatic cancer. The patient was in extreme pain and decided to double the OxyContin dosage. When this did not relieve the pain, the patient decided to drink a couple of shots of whiskey. The patient got very weak and called 911. The patient was volume depleted and was treated with IVs; his pain medications were adjusted.Final Diagnosis: Accidental overdose of OxyContin Pain due to pancreatic cancer

A)T40.2x2A, T51.0x2A, C25.8, G89.4, R53.1, R11.0, E86.1
B)T40.2x1A, T51.0x1A, C25.9, G89.3, R53.1, R11.2, E86.9
C)T40.2x4A, T41.0x4A, C25.0, G89.3, R53.1, R11.10, E89.9
D)T40.2x5A, T41.0x5A, C25.8, G89.4, R53.0, R11.11, E86.0

Question 14

The patient was admitted with hematemesis. The patient has been taking NSAIDs as directed by the physician for arthritis pain. EGD showed that the patient had an acute erosive gastritis, most likely due to NSAIDs, which is the likely cause of the bleeding.Final Diagnosis: Erosive gastritis with hemorrhage due to NSAIDs Procedure: EGD with gastric biopsy

A)K29.01, T39.395A, M19.90, 0DB68ZX
B)T39.395A, K29.61, M19.90, 0DB78ZZ
C)T49.0x2A, K29.00, M19.90, 0DB78ZX
D)T49.0x1D, K29.71, M19.90, 0DB67ZZ

Question 15

Patient was admitted with cocaine-induced chest pain. Patient has a history of cocaine abuse.

A)T40.5x1A, R07.9, F14.10
B)R07.9, T40.5x1A, F14.10
C)T40.5x1A, R07.2, F14.20
D)T40.5x1S, R07.9, F14.10

Question 16

All of the following are true of the "rule of nines" EXCEPT ____.

A)the genitalia are 1%
B)the head and neck are 9%
C)each arm is 9%
D)the anterior trunk is 9%
E)each leg is 18%

Question 17

All of the following are to be considered when one is questioning whether a poisoning has occurred EXCEPT whether the ____.

A)wrong medication was taken
B)wrong dose was taken
C)medication belongs to another person
D)medication was taken 30 minutes after the scheduled time

Question 18

Patient is being treated with hyperbaric oxygen therapy (HBOT) for decompression sickness when surfacing while scuba diving in the ocean.

A)T70.3xxA, W94.21xA, Y92.832, Y93.15, 6A150ZZ
B)T70.3xxD, W94.21xD, Y92.832, Y93.15, 6A150ZZ
C)T70.3xxS, W94.21xS, Y92.832, Y93.15
D)T70.9xxA, W94.21xA, Y92.832, Y93.15, 6A150ZZ

Question 19

Patient admitted for a suicide attempt with multiple medications, including Naproxen, Keppra, and acetaminophen mixed with beer. Patient was somnolent on arrival in the ER.

A)T39.312S, T42.6x2S, T51.0x2S
B)T39.312A, T42.6x2A, T39.1x2A, T51.0x2A, R40.0
C)R40.0, T39.312A, T42.6x2A, T51.0x2A
D)T39.312D, T42.6x2D, T51.0x2D, R40.0

Question 20

A patient combined prescription Percodan with beer and became stuporous and drowsy.

A)T40.2x1A, T51.0x1A, R40.1, R40.0
B)T40.2x1D, T51.0x1D, R40.1, R40.0
C)T40.2x1S, T51.0x1S, R40.1, R40.0
D)T40.2x1A, T51.0x1A

Question 21

When the reason for the admission or encounter is to provide treatment for external multiple burns, sequence first the code that reflects the burn of the highest degree.

Question 22

Match each definition to one of the following items.
a.Z69.020
b.Z88.8
c.Z91.030
d.Z88.7
e.Z91.010
f.Z91.89
g.Z91.011
h.Z91.410
History of poisoning

Question 23

Match each definition to one of the following items.
a.First-degree
b.Second-degree
c.Third-degree
d.Fourth-degree
Blisters have formed, and there is epidermal loss

Question 24

What are the four major types of abuse?

Question 25

Match each definition to one of the following items.
a.Z69.020
b.Z88.8
c.Z91.030
d.Z88.7
e.Z91.010
f.Z91.89
g.Z91.011
h.Z91.410
Allergy other than to medicinal agents-bees

Question 26

Match each definition to one of the following items.
a.Z69.020
b.Z88.8
c.Z91.030
d.Z88.7
e.Z91.010
f.Z91.89
g.Z91.011
h.Z91.410
History of physical abuse, adult

Question 27

In a toxic poisoning the toxic poisoning code (T36-T50) should be sequenced first, followed by the external cause code(s).

Question 28

Match each definition to one of the following items.
a.Z69.020
b.Z88.8
c.Z91.030
d.Z88.7
e.Z91.010
f.Z91.89
g.Z91.011
h.Z91.410
Personal history of allergy to medicinal agents-serum or vaccine

Question 29

Match each definition to one of the following items.
a.Z69.020
b.Z88.8
c.Z91.030
d.Z88.7
e.Z91.010
f.Z91.89
g.Z91.011
h.Z91.410
Allergy other than to medicinal agents-peanuts

Question 30

Match each definition to one of the following items.
a.Z69.020
b.Z88.8
c.Z91.030
d.Z88.7
e.Z91.010
f.Z91.89
g.Z91.011
h.Z91.410
Counseling for victim of child abuse (nonparental)

Question 31

Debridement is one of the most common procedures performed on burn victims.

Question 32

The abbreviation OR stands for ____________________.

Question 33

When the patient is admitted for burn injuries and other related conditions such as smoke inhalation, the circumstances of admission govern the selection of the principal or first-listed diagnosis.

Question 34

Match each definition to one of the following items.
a.First-degree
b.Second-degree
c.Third-degree
d.Fourth-degree
Erythema or redness of the skin

Question 35

Match each definition to one of the following items.
a.Z69.020
b.Z88.8
c.Z91.030
d.Z88.7
e.Z91.010
f.Z91.89
g.Z91.011
h.Z91.410
Personal history of allergy to medicinal agents-other specified medicinal agents

Question 36

Match each definition to one of the following items.
a.First-degree
b.Second-degree
c.Third-degree
d.Fourth-degree
Deep necrosis of underlying tissues

Question 37

A side effect or reaction to a drug that has been taken properly is called a(n) ____________.

Question 38

Match each definition to one of the following items.
a.First-degree
b.Second-degree
c.Third-degree
d.Fourth-degree
Full-thickness skin loss

Question 39

Debridements must always be done in the OR.

Question 40

Match each definition to one of the following items.
a.Z69.020
b.Z88.8
c.Z91.030
d.Z88.7
e.Z91.010
f.Z91.89
g.Z91.011
h.Z91.410
Allergy other than to medicinal agents-milk products

Question 41

Active treatment of nonhealing second-degree burn to right forearm due to hot iron while ironing (accidental): __________

Question 42

First- and second-degree burn of face due to gas flame from stove in kitchen at patient's house while cooking: __________

Question 43

A patient is admitted to the hospital after being found by family members in her bedroom at her house (single family). They were unable to awaken her. A note and an empty bottle of antifreeze (ethylene glycol) were found by her bed. Patient is intubated and admitted to the ICU for mechanical ventilation and treatment. The patient's condition deteriorated with multisystem failure, and she expired on day 2. Ventilator time was longer than 24 hours.Discharge Diagnoses:
Suicide by antifreeze
Multisystem organ failure, including acute respiratory, acute liver, and acute kidney failure

Question 44

Spontaneous hematoma in right thigh muscle due to anticoagulant; patient is taking Coumadin as prescribed for mechanical mitral valve replacement: __________

Question 45

A patient is admitted to the hospital with dizziness. She recently had her Catapres dosage increased for labile hypertension. The patient has a past medical history of hypertensive cardiomegaly and irritable bowel syndrome. It is determined that the dizziness was due to patient's Catapres.

Question 46

Sunburned chest: __________

Question 47

Hives due to penicillin taken for strep throat. Patient took the medication as prescribed: __________

Question 48

Are healthcare providers required to report suspicion of abuse to the authorities?

Question 49

Battered spouse syndrome: Confirmed abuse by her husband: __________

Question 50

During hospital stay, in the patient's room, the nurse accidentally administered insulin, and this caused hypoglycemia; patient does not have diabetes, and no insulin was ordered: __________

Question 51

Patient had an adverse reaction to Cipro, which was taken as prescribed: __________

Question 52

Patient has itching due to oxycodone, which was taken as prescribed: __________