Deck 45: Smoke Inhalation, Thermal Injuries, and Carbon Monoxide Intoxication

Question 1

What COHb level is associated with a throbbing headache, nausea, vomiting, and impaired judgment?

A) 1% to 10%
B) 10% to 20%
C) 20% to 30%
D) 30% to 50%

Answer 1

20% to 30%

Question 2

A 10-year-old patient has inhaled hot gases, and an inspection of her mouth shows edema and blisters. What should the respiratory therapist recommend?

A) Perform a bronchoscopy to evaluate the trachea.
B) Perform endotracheal intubation.
C) Monitor her SpO₂ once per shift.
D) Administer an aerosol treatment with racemic epinephrine.

Answer 2

Perform endotracheal intubation.

Question 3

Which of the following classes of medications are commonly used in the care of patients with smoke inhalation injury?
1) Parasympatholytics
2) Mucolytics
3) Sympathomimetics
4) Monoclonal antibody

A)1, 3
B)1, 2, 4
C)2, 3, 4
D)1, 2, 3

Answer 3

1, 2, 3

Question 4

Which portion of the pulmonary system will be affected by the inhalation of low-water solubility gases such as hydrogen chloride and phosgene?

A) Distal airways and alveoli
B) Pulmonary vascular bed
C) Upper airway
D) Pulmonary lymphatic system

Question 5

A patient with carbon monoxide poisoning has a COHb level of 20%. If the patient is given 100% oxygen, what will the approximate COHb level be in 1 hour?

A) 15%
B) 10%
C) 5%
D) 2.5%

Question 6

Which of the following will be typically found in the air of an enclosed house fire?
1) Steam
2) Carbon monoxide
3) Hydrogen cyanide
4) Hydrogen chloride

A)1, 3
B)1, 2, 4
C)2, 3, 4
D)1, 2, 3

Question 7

Clinical signs of an upper airway thermal injury include:
1) facial burns.
2) atelectasis.
3) mucosal edema.
4) epithelial sloughing.

A)3
B)1, 4
C)1, 3, 4
D)2, 3, 4

Question 8

A 65-year-old patient has third-degree skin burns over 30% of his body and a smoke inhalation injury. How does the combination of skin burns and smoke inhalation affect his prognosis?

A) It quadruples the mortality rate.
B) It more than triples the mortality rate.
C) It almost doubles the mortality rate.
D) There is no mortality change between having one or two concurrent problems.

Question 9

Which of the following conditions occurs in 20% to 30% of hospitalized fire victims with facial burns?

A) Acute respiratory distress syndrome (ARDS)
B) Upper airway obstruction
C) Pneumonia
D) Pulmonary embolism

Question 10

According to the Parkland formula, what is the recommended volume of fluid that should be infused over a 24-hour period for each percent of body surface burned?

A) 1 mL/kg of body weight
B) 4 mL/kg of body weight
C) 6 mL/kg of body weight
D) 10 mL/kg of body weight

Question 11

Which of the following would be recommended for the treatment of cyanide poisoning?

A) Aztreonam
B) Albuterol sulfate
C) Amyl nitrate
D) Aclidinium bromide

Question 12

In an industrial accident, an adult incurred burns over his head and neck, both arms, and his anterior trunk. What percent of his BSA was burned?

A) 27%
B) 36%
C) 45%
D) 54%

Question 13

Late-stage complications of extensive body surface burns include:
1) sepsis.
2) upper airway obstruction.
3) pneumonia.
4) pulmonary embolism.

A)1, 2
B)3, 4
C)2, 3
D)1, 3, 4

Question 14

The long-term effects of a smoke inhalation injury are:

A) obstructive lung disorders.
B) restrictive lung disorders.
C) obstructive and restrictive lung disorders.
D) neither obstructive nor restrictive lung disorders, since there is normally complete recovery.

Question 15

Clinical signs associated with acute upper airway obstruction due to thermal injury include:
1) pleural friction rub.
2) inspiratory stridor.
3) pulmonary edema.
4) painful swallowing.

A)1, 3
B)2, 4
C)2, 3, 4
D)1, 2, 3

Question 16

What level of carbon monoxide toxicity is associated with coma, convulsions, and Cheyne-Stokes respiration?

A) 10% to 20% COHb
B) 20% to 30% COHb
C) 30% to 50% COHb
D) 50% to 60% COHb

Question 17

Which of the following radiographic findings would be associated with the intermediate stage of recovery from a serious smoke inhalation injury?

A) Pulmonary edema/ARDS
B) Patchy or segmental infiltrates
C) Empyema
D) Normal/full recovery

Question 18

A patient has been brought to the emergency department after inhaling superheated steam. Pulmonary injuries unique to this situation include:
1) atelectasis.
2) pulmonary edema.
3) thick secretions.
4) pharyngeal edema.

A)3
B)1, 2
C)2, 3, 4
D)1, 2, 3