WorksheetsAEMT Chapter 28 Soft Tissue Injuries Quiz
Total questions: 75
Worksheet time: 38mins
A 28-year-old female was the unrestrained driver of a car that struck the rear end of another car while traveling at 35 mph. She is conscious and alert and complains of pain to the anterior chest. During your assessment, you note a large ecchymotic area over the superior aspect of the anterior chest. As your partner assumes manual stabilization of her head, you should:
obtain vital signs to assess for signs of shock.
rapidly extricate her from the car and transport.
open her airway with the jaw-thrust maneuver.
apply 100% oxygen via a nonrebreathing mask.
A 22-year-old male, who was trapped in a confined space during a structural fire, is conscious and alert and refuses EMS treatment and transport. He is breathing without difficulty, but has singed nasal hair and facial redness. Which of the following statements regarding this patient is correct?
Signs and symptoms of upper airway swelling are rapidly progressing.
You should encourage this patient to drive himself to the hospital.
The patient may die several hours later due to pulmonary complications.
It is likely that this patient has not experienced a serious airway burn.
After ensuring your and your partner's safety, the next step in caring for a patient with any burn is to:
perform a rapid head-to-toe assessment.
move the patient to a place of safety.
ensure the burning process has stopped.
open and maintain the patient's airway.
An elderly male was removed from his burning house by firefighters. He has extensive full-thickness burns; is semiconscious; and has shallow, stridorous respirations. The firefighters have already stopped the burning process. After ensuring an open airway, you should:
apply 100% oxygen via a nonrebreathing mask and keep him warm
assist his ventilations with a bag-mask device and 100% oxygen.
insert a supraglottic airway device to protect the patient's airway
estimate the severity of his burns and begin IV fluid replacement.
Compartment syndrome is caused by:
excessive blood or fluid collection within the abdominal musculature.
permanent nerve and tissue damage proximal to an injury site.
severe increased intracranial pressure following blunt head trauma.
tissue compression and damage due to fluid trapped in a confined space.
Following an electrical burn, estimating the extent of the BSA involved is:
difficult because the degree and depth may be greater internally than externally
not possible in the prehospital setting and can only be determined by a physician.
easy because the external wound is often more dramatic than any internal injury.
extremely difficult and should not be assessed in the field by the AEMT.
Heat that is generated by an electrical injury can cause coagulation and vascular occlusion, resulting in:
spinal cord inflammation.
massive infection.
compartment syndrome
spontaneous hemorrhage.
The layer of the skin that plays a key role in the cooling of the body is the:
epidermis
sebaceous layer
germinal layer
dermis
When managing a critically burned patient, it is important to:
break the integrity of any formed blisters because these can result in infection
rapidly estimate the burn's severity and then cover with dry, sterile dressings
administer topical analgesia to the burned areas to afford the patient pain relief
perform a detailed physical exam at the scene to look for occult injuries
When managing an adult patient with an inhalation injury, inspiratory stridor, and an altered mental status, you should:
apply ice packs to the neck to reduce swelling
give humidified oxygen via a nonrebreathing mask
ventilate at a rate of 20 breaths per minute
prepare for early definitive airway management
Which of the following weapons would most likely result in the largest surface area of tissue damage?
22-caliber handgun
.357 Magnum
9.0-mm handgun
12-gauge shotgun
A 34-year-old male was involved in a motor-vehicle crash. During the crash, his vehicle caught fire. Bystanders removed the patient from his vehicle prior to your arrival. The patient is conscious with adequate breathing. He has partial-thickness burns to his face and neck, and an open femur fracture with severe bleeding. Immediate management for this patient should include:
maintaining body temperature
providing assisted ventilation
controlling the bleeding from his leg
performing a secondary assessment
A 4-year-old boy pulled a pot of boiling water from the stovetop. He has superficial and partial-thickness burns to his head, left anterior trunk, and entire left arm. On the basis of the “rule of nines,” what percentage of this child's body surface area (BSA) has been burned?
30%
27%
36%
45%
A 40-year-old patient has sustained circumferential burns to the chest. The most serious complication associated with this type of burn injury is:
cardiac dysrhythmias
ventilatory insufficiency
compartment syndrome
increased chest excursion
A 55-year-old male sustained partial-thickness burns to his face and neck when he opened the hot radiator cap on his car. He is conscious and alert, but complains of dyspnea and difficulty swallowing. His oxygen saturation is 96% on room air. You should be most concerned about the:
risk of infection
degree of burns
possibility of blindness
status of his airway
A 60-year-old male has sustained partial- and full-thickness burns to his anterior chest, head, and both anterior arms. On the basis of the “rule of nines,” what percentage of his body surface area (BSA) has been burned?
36%
18%
45%
27%
A 62-year-old female with a history of type 2 diabetes has sustained partial-thickness burns to 27% of her body surface area (BSA). This burn should be classified as a:
minor burn
first-degree burn
moderate burn
major burn
A full-thickness burn is typically characterized by all of the following, except:
eschar
muscle involvement
intense pain
leathery skin
A utility worker was trimming branches away from a high power line when he accidentally cut the power line. He is unresponsive, apneic, and pulseless. You should begin CPR and then:
apply full spinal motion restriction precautions
establish two large-bore IV lines
apply the AED as soon as possible
assess for an entrance and exit wound
All of the following are characteristic of a closed soft tissue injury, except:
a history of blunt trauma
swelling beneath the skin
pain at the site of injury
deformity of a short bone
All of the following signs are indicative of upper airway burns due to an inhalation injury, except:
an altered mental status
wheezing or rhonchi
carbonaceous sputum
dyspnea and hypoxia
All patients with closed soft-tissue injuries should be assessed for:
intra-abdominal bleeding
serious hidden injuries
signs of impending infection
trauma to the spinal cord
Appropriate management for a patient with a serious closed injury and signs of shock includes all of the following, except:
high-flow oxygen or assisted ventilation
15- to 20-inch elevation of the lower extremities
prompt transport to a local trauma center
IV fluid boluses to maintain perfusion
Appropriate management of a patient with an abdominal evisceration includes:
avoiding flexion of the patient's knees because this may exacerbate bleeding and enlarge the evisceration
carefully irrigating the exposed organs with sterile saline and replacing them back into the abdomen
positioning the patient onto his or her side, covering the exposed organs with a dry dressing, and transporting
covering the exposed organs with a moist, sterile dressing and securing the dressing in place with a dry, sterile dressing
Cardiac arrest following a crush injury is most often the result of:
hypovolemia
hyperkalemia
renal failure
hypothermia
Common prehospital treatment for patients with severe burns includes all of the following, except:
crystalloid fluid boluses
advanced airway care
contamination prevention
tetanus prophylaxis
Death immediately following a burn is most commonly the result of:
toxic chemical inhalation
severe hypovolemic shock
massive bacterial infection
incineration of the patient
During a lengthy transport of a 120-lb, 29-year-old female with partial- and full-thickness burns to 45% of her BSA, medical control orders you to begin IV fluid replacement based on the Consensus formula. What volume of IV crystalloid should you administer per hour?
620 mL
780 mL
690 mL
720 mL
High-voltage burn injuries occur most frequently in:
children in the home
industrial plant workers
utility workers
adults in the workplace
Not yet answered Question text How much IV fluid (per bolus) should you administer to a 65-kg patient with extensive burns and severe shock?
1,410 mL
. 1,350 mL
1,300 mL
1,435 mL
Immediate treatment for a patient with an open soft-tissue injury includes:
wound decontamination
. prevention of hypothermia
V crystalloid fluid boluses
control of active bleeding
In addition to improving systemic perfusion following an electrical burn injury, you should administer IV crystalloid fluid boluses in order to:
abruptly increase the blood pressure
prevent the occurrence of dysrhythmias
maintain adequate urine output
concentrate myoglobin in the renal tubules
In order for electricity to flow through the body and cause injury
there must be an insulator in between the patient and the electrical source
. a patient must be in direct contact with the electrical source for at least 30 seconds
there must be a complete circuit between the electrical source and the ground
the source of the electricity must be high voltage, such as a high power line
In which of the following circumstances should you remove an impaled object?
Ice pick in the chest of an unconscious breathing patient
Metal shard in the cheek and inadequate respiratory effort
Knife in the abdomen of a pulseless and apneic patient
Metal rod in the thigh with severe arterial hemorrhage
Lymphangitis is characterized by:
pus draining from the wound
red streaks adjacent to the wound
redness and swelling of the wound
pain and edema around the wound
Patients with electrical burns should be given enough isotonic crystalloid to maintain a urine output of _______ mL/kg per hour.
1
2
4
4
Small muscles within the dermis that pull the hair into an erect position when you are cold or frightened are called the:
erector pili
hair follicles
erector ducts
sebum muscles
Static tension lines are present on the:
face
legs
scalp
arms
The degradation of dead muscle tissue is called:
rhabdomyolysis
crush syndrome
glycolysis
hemolysis
The hallmark sign of compartment syndrome is:
disproportionate pain
absent distal pulses
extremity swelling
an absence of pain
The layer of skin that lies below the germinal layer and contains nerves, sebaceous glands, and blood vessels is called the:
melanin layer
dermis
epidermis
subcutaneous layer
The mouth, nose, and other body orifices are lined with _______, which secrete a watery substance and provide a protective barrier against harmful agents.
germinal cells
melanin granules
sebaceous glands
mucus membranes
The skin sends messages to the brain to regulate various functions via:
sensory nerves
motor nerves
axonal nerves
efferent nerves
The three basic pathways by which radiation enters the body are:
inhalation, ingestion, and direct exposure
inhalation, absorption and direct exposure
. ingestion, direct exposure, and injection
absorption, inhalation, and injection
Upon arriving at the scene of a motor-vehicle crash involving a telephone pole, you note that the driver appears unconscious and is bleeding heavily from the mouth. There is a power line across the hood and roof of the car. You should:
attempt to safely remove the patient from the car
remove the power lines with a nonconductive object
ensure that the power line is not electrically active
carefully remove the power line with rubber gloves
Upon arriving at the scene of a motorcycle crash, you find the patient, a young male, lying supine approximately 10 feet from his bike. An emergency medical responder is manually stabilizing the patient's head. You note an obvious open injury to the patient's left lower leg with severe bleeding. Your most appropriate initial action should be to:
have your partner assume control of the patient's head as you open the airway
open the patient's airway and assess respiratory rate, regularity, and depth
direct your partner to control the bleeding as you assess the patient's airway
locate and control all obvious bleeding and then perform a primary assessment
When a person is exposed to cold temperatures, blood vessels in the skin:
dilate and divert blood to the core of the body
dilate and draw blood to the surface of the skin
constrict and divert blood away from the skin
constrict and draw blood to the skin's surface
When assessing a conscious patient who experienced an electrical injury, you note irregularity in his pulse. This is most indicative of:
impending respiratory arrest
decreased perfusion
a cardiac dysrhythmia
ventricular fibrillation
When assessing a patient with multiple gunshot wounds, you should:
control the bleeding that you see and then transport
carefully assess the patient to predict the bullet's path
identify the number and location of all wounds
distinguish between entrance and exit wounds
When caring for a patient with multiple abrasions, you should:
give a 500-mL crystalloid bolus
be alert for underlying injuries
transport to a local trauma center
clean the wounds with sterile water
When caring for an open wound that has small pieces of glass and other debris inside of it, you should:
remove the glass and debris with hemostats
irrigate the wound with sterile water
leave the wound open unless it is bleeding
cover the wound with a sterile dressing
Which of the following has the most impact on the severity of radiation injury or type of health effect?
The amount and duration of exposure
Type of radiation and the patient's age
The presence of any underlying medical conditions
The distance between the patient and the source
Which of the following is not a function of the skin?
Destruction of sebum
Maintenance of water balance
Temperature regulation
Protection from harmful agents
Which of the following is the most acute and serious complication associated with a break in the integrity of the skin?
Loss of fluids
Vasodilation
Severe infection
Hyperthermia
Which of the following is the most significant acute complication associated with a laceration to the forearm?
Internal bleeding
Severe pain
External bleeding
Severe infection
Which of the following patients has experienced a major burn?
A 50-year-old with 9% full-thickness burns involving an upper extremity
A 31-year-old with 27% partial-thickness burns who takes antidepressants
A 10-year-old with 45% superficial burns involving the chest and back
A 65-year-old with 18% partial-thickness burns to both upper extremities
Which of the following physiologic responses occurs initially following a burn injury?
An inflammatory response and increased capillary permeability
Electrolyte derangements and significant hypovolemia
Vasoconstriction and decreased blood flow to the burned area
Massive edema as the fluid shifts into the extravascular space
Which of the following statements regarding electrical burns is correct?
The size of entrance and exits wounds provides an indicator as to the degree of internal injury
When exposed to electricity, the human body is an excellent insulator because it is composed primarily of water
Internal injury caused by an electrical burn is usually more severe than the external burns indicate
Ordinary household current can cause an electrical injury, but the burns are usually not severe
Which of the following statements regarding severe burns is correct?
Sodium is shunted away from the burned area as the body attempts to compensate
Following the burn, there is an immediate shift of fluid out of the vascular space
Immediately following the burn, fluid shifts to the injured area and creates edema
Significant hypovolemia may not occur for several hours following the burn injury
Which of the following types of burns is characterized by intense pain and destruction of a portion of the dermis?
Partial-thickness burn
Third-degree burn
Full-thickness burn
First-degree burn
Which of the following would be classified as a moderate burn in an infant or a child?
Partial-thickness burns covering 15% of the BSA
Full-thickness burns covering 1% of the BSA
Partial-thickness burns to the hands, face, or genitalia
Superficial burns covering 30% of the BSA
Why does the skin become flushed or red when a person is exposed to a hot environment?
Sweat glands produce sebum, resulting in heat evaporation
The blood is hyperoxygenated and assumes a bright color
Blood vessels dilate and heat radiates to the skin surface
Vasoconstriction shunts blood to the surface of the skin
You are assessing a 4-year-old male who was electrocuted when he stuck a pin into an electrical socket. He is conscious and alert and complains of pain to his left hand, where you find a small entrance wound. When treating this child, you should:
apply an AED and monitor the child
flush the wound with sterile saline
anticipate extensive internal injuries
fully immobilize his spinal column
You are dispatched to an industrial plant for a worker who was exposed to an unknown chemical. Upon arrival, you find the patient sitting outside of the plant. He has a white, dry powder covering his right arm. Care for this patient's exposure includes:
brushing the chemical from the patient's arm and then irrigating with water
removing the patient's clothing and flushing with copious amounts of water
removing the patient's clothing and immersing his arm in a container of water
immediately flushing the area with sterile saline to stop the burning process
You arrive at the scene of a residential fire where the occupant, a 48-year-old male, has sustained partial- and fullthickness burns to his lower extremities and lower torso. Firefighters removed the patient's smoldering clothing and stopped the burning process prior to your arrival. The patient is conscious, but restless, and complains of intense pain to the burned areas. After taking the standard precautions, you should:
immerse the burned areas in sterile water
apply supplemental oxygen and monitor his airway
perform a secondary assessment and start an IV
rapidly estimate the extent of the patient's burns
You respond to a domestic dispute, where a middle-aged male was stabbed in the chest by his wife. Your assessment reveals that the patient is pulseless and apneic. The knife is impaled in the center of his chest. You should:
stabilize the knife with bulky dressing, initiate CPR, and transport
carefully remove the knife, control the bleeding, and perform CPR
leave the knife in place, control the bleeding, and initiate CPR
turn the patient onto his side, stabilize the knife, and begin CPR
A burn occurs when the soft tissue of the skin:
is severely damaged by thermal or friction heat
is exposed to caustic or corrosive chemicals
receives more energy than it can absorb without injury
degrades due to exposure to radioactive substances
A young male tripped on a garden hose, fell, and struck his head on a concrete sidewalk. He is unresponsive and has a large hematoma to his forehead. His respirations are slow and shallow. You should:
start an IV and administer a 20-mL/kg bolus
apply ice to the injury to reduce bleeding
assist his ventilations with 100% oxygen
administer oxygen via nonrebreathing mask
Common signs and symptoms of radiation sickness include:
thickening of the skin
increased visual acuity
hyperactive organ function
hair loss and skin burns
During an explosion, a metal worker sustained a large laceration to the left side of his neck by flying debris. He is conscious, but restless; the wound is moderately bleeding. Appropriate care for this patient's injury includes:
controlling the bleeding by applying direct pressure to both carotid arteries
preventing air from entering the wound and applying a pressure dressing
applying a pressure dressing to the wound and then applying a cervical collar
circumferentially wrapping the neck with gauze to secure a dressing in place
In contrast to upper-airway injury following a burn, lower-airway injury is usually the result of:
inhalation of chemicals and particulate matter
inhalation of superheated gases
interstitial fluid shifts and pulmonary edema
diffuse collapsing of the alveoli
The “rule of palms” for estimating the extent of the body surface area (BSA) burned is especially useful with:
partial-thickness burns
irregularly shaped burns
burns to multiple body sites
circumferential burns
Which of the following statements regarding the dermal layer of the skin is correct?
Cells of the dermis are constantly worn away and replaced
The dermis forms a watertight covering for the body
Blood vessels in the dermis do not penetrate into the epidermis
Most of the skin's melanin granules are contained in the dermis
You and your partner are caring for a 30-year-old female who sustained extensive partial- and full-thickness burns when she was near a gas heater that exploded. Your primary assessment reveals that the patient is semiconscious with profoundly labored and stridorous respirations. Immediate management of this patient should include:
covering her with dry, sterile dressings and applying oxygen.
100% oxygen via a nonrebreathing mask and rapid transport
assisting her breathing with a bag-mask device and oxygen
insertion of a supraglottic airway to protect her from aspiration.
You are dispatched to the scene of a shooting. Upon arrival, you are directed by law enforcement to the patient, a 44-year-old male, who is unconscious. He is lying in an impressive pool of blood, and you can hear gurgling from his mouth when he breathes. After your partner opens the patient's airway, you should:
suction the patient's oropharynx
assess respiratory rate and quality
locate the source of the bleeding
perform a secondary assessment
