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WorksheetsCBRN Practice Questions 4
Total questions: 50
Worksheet time: 13hrs 30mins
1. The primary purpose of wound debridement is:
Reduction in pain
Minimization of scarring
Prevention of wound infection
A decrease in evaporative fluid loss
2. Aside from reducing infections, a dressing applied to a burn one should:
Decrease the incidence of hypothermia
Remove excess exudate, leaving the wound dry
Adhere to the wound to facilitate wound debridement
Apply direct pressure, reducing the incidence of bleeding
3. Mafenide acetate (Sulfamylon), when used in large areas of the body as an antimicrobial, is associated with:
Coagulopathies
Neuropathic pain
Metabolic Acidosis
Increase intraocular pressure
4. Negative pressure wound therapy is most likely to be considered to:
Improve circulation and superficial burns
Decrease incidence of seroma/hematoma at autograph site
Desensitize nerve endings and superficial burns reducing pain
Debrided necrotic tissue and deep partial thickness and full thickness burns
5. The patient with deep partial thickness burns has a wound excision to the dermis. What color would the wound bed appear after the excision?
Pink
White
Yellow
Dark red
6. What is the purpose of a bolster?
Reduces procedural pain
Increases serum glucose levels
Protects the area over a skin graft
Decreases the incidence of contractures
7. Which of the following parameters is most likely to be altered as they complication after wound debridement?
Serum glucose
Respiratory rate
Hemoglobin level
Level of consciousness
8. A major risk factor that may need to be addressed immediately after surgical debridement is:
Hypothermia
Hypernatremia
Respiratory alkalosis
Increase intraabdominal pressures
9. An effective dressing placed over a skin donor site should:
Reduce pain
Be loosely applied
Maintain a dry wound surface
Apply direct pressure to the site
10. Placement of an allograft should:
Replace missing dermis
Decrease localized scarring
Absorb access wound exudate
Reduce electrolyte disturbances
11. An allograft is most likely to be chosen in which of the following scenarios?
Cover superficial partial thickness burns
Stimulate the inflammatory response in wounds with indications of infection
Treat a patient with partial and full thickness burns on all areas of the body except for the head and neck
Provide a temporary dressing over deep partial or full thickness wounds awaiting wound debridement
12. A common source of skin utilized in xenograft is:
Pigs
A human cadaver
Synthetic manufacturing
Skin from the patient's thigh
13. An advantage of using a biodegradable temporizing matrix (BTM) as a temporary dermal substitute is:
Its antimicrobial properties
Eliminating the need for a skin graft
An improved final cosmetic appearance
Reduced infection when compared to skin grafting
14. Which of the following activities must take place before a cultured epidermal autograph (CEA) may be placed on the patient?
Skin must be procured from the patient
The patient must receive platelet transfusions
A wound adhesive must be placed over the site
The wound bed must be mechanically or chemically abraded
15. When caring for a patient following application of a cultured epidermal autograph (CEA), which of the following complications must be most closely monitored for the graft site?
Bleeding
Blistering
Allergic reaction
Compartment syndrome
16. When developing a teaching plan for a patient with superficial partial thickness burns on the arms, the burn nurse should tell the patient that these burns tend to heal in what time frame after the burn?
48 - 72 hours
7 - 10 days
2 - 3 weeks
2 - 4 months
17. A patient requires an autograft to cover burns on the face. Which of the following factors is most likely to be considered for this procedure?
A meshed graft is most likely to be chosen
Tissue will be taken from above the nipple line if possible
The patient will need to be conscious throughout the procedure
Only half of the burned area will be grafted initially with the other half grafted at a later date
18. What is the purpose of utilizing a silver-impregnated dressing in the treatment of burns?
Serves as a local anesthetic
Prevents hypertrophic scarring
Reduces the incidence of wound infection
Increases the rate of wound epithelialization
19. The site of a graft appears pale after placement. At what time interval after placement does continuation of the pale appearance become concerning?
4 hours
24 hours
48 hours
96 hours
20. An elevation in which of the following values may indicate significant blood loss following wound debridement?
Serum pH
Hemoglobin
Serum lactate
Mean arterial pressure
21. A xenograft is most likely to be chosen in which of the following scenarios?
To cover superficial partial thickness burns
Cover burn wounds with indications of infection
As a temporary dressing over deep partial or full thickness wounds awaiting wound debridement
A patient with partial and full thickness burns on all areas of the body except for the head and neck
22. One advantage of utilizing a biodegradable temporizing matrix (BTM) is:
Its ease of removal
Protection of underlining skin grafts
Elimination of the need for dressing
Reduction in fluid and electrolyte imbalances
23. The wound care plan of a patient with burns is to utilize both a biological temporizing matrix (BTM) and split thickness skin grafts. In what order would these two interventions be completed?
BTM would be placed two to three weeks before the skin graft
BTM would be placed 5 to 7 days after placement of the skin graft
BTM would be placed over top of the skin graft during the same surgical procedure
The skin graft would be placed over top of the BTM during the same surgical procedure
24. Wound depth assessment is best accomplished using:
Palpation
Visualization
Ultrasonography
Computerized tomography
25. Amnion, a biologic dressing, is applied to a burn wound. What is the source of this dressing?
Pig skin
Amniotic sac
A human cadaver
Skin from the patient's thigh
26. Persistent blistering in a burn wound is associated with:
Superficial burns
Tertiary wound healing
Fungal wound infection infections
Burns on posterior surfaces
27. An advantage of utilizing a full thickness skin graft instead of a split thickness skin graft is that there is:
Normal pigmentation with a split thickness skin graft
Less scarring at the graft site with a full thickness skin graft
A higher degree of graft take with a full thickness skin graft
Prolonged healing time at the donor site with a split thickness skin graft
28. Tweezers are used to pull non-viable skin from burn wounds as part of a mechanical wound debridement process shortly after a patient sustains a burn wound. Burnt skin on the back of the patient's hand does not easily come off utilizing the tweezers. What is the most appropriate course of action?
Utilize a scalpel to excise the tissue at the point where the skin does not easily separate from the underlying tissue
Apply chemical debriding agent to the area for 15 to 20 minutes then attempt to remove the skin with the tweezers again
Leave skin that is not easily separated from underlying tissue intact until other methods of debridement can be initiated
Continue applying traction different directions utilizing the tweezers until the skin separates from the underlying tissue
29. Which of the following would make the most appropriate primary dressing following mechanical debridement of a burn wound?
Paraffin gauze
Bromelain (BRM)
Small weave gauze
Large weave gauze
30. A patient with extensive superficial burns to legs ask if the burns will leave scars. What is the most appropriate response?
The burns you have do not leave scars
The burns that you have may leave some scar but it tends to be minimal
The burns you have do leave a lot of scarring but fortunately your burns on your legs will be covered by clothing
The burns you have can leave significant scarring but the dressings we are putting on them will minimize the severity of scarring
31. Silver sulfadiazine (SSD) is most likely to be used for which of the following purposes?
Perform chemical debridement on partial and full thickness burns
Prevent infection on partial and full thickness burns awaiting debridement
Reduce pain on superficial burns by reducing air currents on exposed nerve endings
Apply a protective layer over burn wounds that have been debrided and have signs of new skin growth
32. During a mass casualty incident, pre-hospital personnel provide fluids to a patient awaiting transport to the hospital at 600 mL per hour. The patient’s estimated weight is 60 kg. If the “Rules of 10’s” was used to calculate this rate, what is the estimated body surface area burned in this patient?
25%
40%
60%
80%
33. When comparing disaster triage with non-disaster triage, which of the following statements is most accurate?
Non-disaster triage always involves five levels of priority; Disaster triage always involves 4 levels of priority
Non-disaster triage requires a more thorough assessment and will take longer than disaster triage
Disaster triage does not take place in a hospital setting; Non-disaster triage takes place in the hospital
Disaster triage is designed to provide the best care for the most number of people; Non-disaster triage is designed to provide the best care to everyone
34. The burn nurse is asked to report to the "red" or "resuscitation" area of the hospital during a disaster drill. The nurse knows this is a part of which stage of disaster management?
Rescue
Isolation
Mitigation
Preparedness
35. When utilizing sort-assess-life saving interventions-treatment/triage (SALT) disaster triage, which of the following parameters is used to assign a disaster triage priority?
Capillary refill
Pulse pressure
Respiratory rate
Ability to obey commands
36. Lobbyists successfully guide legislation through state government forcing insurance companies to reduce home insurance rates for homeowners who have an annual fire safety check. This is an example of what type of injury prevention program?
Education
Engineering
Enforcement
Economic incentives
37. When evaluating the effectiveness of a secondary injury prevention program, success would be measured by a reduction in the:
Transport times to the hospital
Incidence of the burn injury that the program targeted
Prevalence of those affected by the burn injury that the program targeted
Severity of the burns experienced by those injured by the mechanism targeted by the program
38. One symptom that is common to post traumatic stress disorder, compassion fatigue and burnout is:
Denial
Loss of job satisfaction
Filling estranged from others
Recurrent nightmares about an event
39. The first step in improving diversity, equity and inclusion (DEI) in a burn center is to:
Assess the current culture of the unit
Ensure all staff have regular DEI training
Appoint a staff person to oversee DEI efforts in the unit
Hire staff that are representative of the patient population served
40. Diversity in the provision of burns care involves:
Providing patients a voice in ensuring they receive the highest quality care
Giving healthcare workers what they need to adequately perform their roles
Knowledge of a patient's background such as culture and sexual orientation
Ensuring patients have what they need to benefit from best evidence-based care
41. Which of the following statements regarding a quality improvement program is most accurate?
Establishes evidence based practice
Involves an Institutional Review Board
Uses retrospective review to stimulate change
Puts patient care at risk if carried out incorrectly
42. What is the primary goal of palliative care?
Providing death with dignity
Relief of distressing symptoms
Prolonging patient independence
Accelerating movement through the stages of grief
Pre-hospital personnel estimate that a patient requiring transport during a mass casualty incident is burned over approximately 50% of the body surface area. It is also estimated that the patient weighs approximately 90 kg. If the “Rule of 10’s” for fluid replacement is used and it takes 60 minutes for the patient to arrive in the burn center, how much fluid will the patient have received when they reached the burn center?
500 mL
600 mL
900 mL
1350 mL
44. JumpSTART triage is used to determine the acuity of patients injured in a multi-casualty incident. The nurse approaches an adult patient who is non-ambulatory and determines the patient is breathing 20 breaths per minute. What is the next appropriate course of action?
Established the patient's heart rate
Check the patient's capillary refill
Assess the patient's mental status
Assigning triage level of yellow and move to the next patient
45. A burn unit runs radio ads annually reminding people to check fire extinguishers in homes and workplaces, ensuring they are working properly. This is an example of what type of injury prevention program
Primary
Secondary
Tertiary
Quaternary
46. Results obtained in performance improvement programs are useful:
To reduce healthcare costs
To credential new providers at an institution
For framing the work of an institutional review board
For improving the efficiency of direct-patient care staff
47. Which of the following is considered a primary competency for a professional delivering palliative care?
Ensuring death with dignity
Organizing patient care activities
Facilitating care in the patient's home
Leading discussion regarding goals of care
48. A patient receives a score of 11 on the Abbreviated Burn Severity Index. How is this interpreted?
The burn poses a very low threat to the patient's life
The burn poses a moderate threat to the patient's life
The burn poses a severe threat to the patient's life
The burn poses a severe threat to the patient's life
49. Of the following four types of injury prevention programs, which one tends to be the least effective for influencing the greatest number of people?
Education
Engineering
Enforcement
Economic incentives
50. In a mass casualty incident, a patient receiving 400 mL of fluid per hour based on the "Rule of 10s". Once hour after fluid resuscitation is started, the patient's urinary output is noted to be 40mL. What action should occur at the point?
The fluid rate should be decreased to 300 mL/hour
Fluid resuscitation should be continued at 400 mL/hr
The fluid rate should be increased to 500 mL/hr
The fluid rate should be doubled to 800 mL/hr
