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CBRN Practice Questions Part 1 (2)

Total questions: 50

Worksheet time: 8hrs 20mins

Name
Class
Date
1.

Which patient is most likely to present with an oral commissure burn?

a)

2-year-old child

b)

15-year-old adolescent

c)

41-year-old housekeeper

d)

80-year-old retiree

2.

Which type of MVC is most likely to result in care fires and burns?

a)

Rollover

b)

Frontal collision


c)

Rear-end collision

d)

Side-impact collision

3.

The burn nurse should focus on which element to reduce the severity of a chemical burn?

a)

Length of exposure

b)

Quantity of chemical

c)

Specific tissue involvement

d)

Type of chemical agent

4.

Aggressive fluid resuscitation following a burn injury is known to:

a)

Extend the zone of hyperemia

b)

Reduce tissue death in the zone of statis

c)

Reverse tissue damage in the zone of coagulation

d)

Convert the zone of coagulation in a zone of hyperemia

5.

The release of inflammatory mediators following a burn injury is known to cause:

a)

Ileus

b)

Local anesthesia

c)

Vasoconstriction

d)

Capillary permeability

6.

What is the treatment of choice for a systemic inflammatory response syndrome (SIRS) secondary to a burn?


a)

Skin grafting

b)

Vasoactive drugs


c)

Prone positioning

d)

Intravenous analgesia

7.

Expected changes to the gastrointestinal system following a significant burn injury?

a)

Mucosal atrophy

b)

Increased motility

c)

Increased insulin production

d)
  • Thickening of pylorus muscle


8.

  • Effective treatment for burn shock should cause what value to decrease?

a)

Hematocrit

b)

Urinary output

c)

Mean arterial pressure

d)
  • Serum magnesium levels


9.

Which medication is most likely to be considered to reduce the negative effects of the hypermetabolic phase?

a)

Sodium bicarbonate

b)

Diltiazem

c)

Methylprednisolone

d)

Recombinant Human Growth Hormone (rhGH)

10.

Muscle catabolism following a burn increases the risk of:


a)

Scarring

b)

Depression

c)

Coagulopathies

d)

Ventilatory dependence

11.

The severity of scarring following a burn becomes most apparent in which phase of wound healing?

a)

Remodeling

b)

Proliferation

c)

Inflammation

d)

Regeneration

12.

Which diagnostic tests helps identify an inhalation injury during resuscitation phase of a burn injury?

a)

FAST exam

b)

Chest x-ray

c)

Hematocrit

d)

Partial pressure of oxygen (PaO2)

13.

Which scenario is most likely to cause burns to the lower respiratory tract?

a)

Severe burns to the upper body after being blasted with steam

b)

Burns to the anterior torso displaced from a propane explosion

c)

Child with oropharynx after hot liquids forced in the mouth by caregiver

d)

80% burn after being extricated from a burning vehicle

14.
  • The primary treatment for carbon monoxide poisoning treatment is:


a)

Chest physiotherapy

b)

100% humidified oxygen

c)

Nebulized albuterol

d)

Intravenous hydroxocobalamin (Cyanokit)

15.

A burn patient's carboxyhemoglobin level is 8%, this level is:

a)

Incompatible with life

b)

Does not require acute intervention

c)

Will likely increase in the first two hours after the burn injury

d)

Should result in emergent transfer to a hyperbaric chamber

16.

Hydroxocobalamin is given for cyanide poisoning. Which parameter is most likely to change as a side effect of this drug?

a)

Blood Pressure

b)

Urinary output

c)

Oxygen saturations

d)

Level of consciousness

17.

Which of the following parameters is most likely to increase along with intra-abdominal pressures?

a)

Tidal Volumes

b)

Pulse Pressure

c)

Urinary output


d)

Central venous pressure

18.

Which of the following is associated with successful treatment of for acute respiratory distress syndrome?

a)

Declining PaCO2:FiO2 ratio

b)

Arterial PaCO2 of 30 mm Hg

c)

Increasing pulmonary artery wedge pressures

d)

PaO2 of 90 mm Hg on a positive end-expiratory pressure (PEEP) of 5 cm H2O

19.

What is the priority of hot tar spilled over 40% of the body surface would be to:

a)

Cover patient in warm blankets

b)

Prepare for endotracheal intubation


c)

Relocate patient to a cool shower

d)

Use towels/absorbent material to wipe away as much of the tar as possible

20.

Topical steroids are most likely to be used after burn injury to:

a)

Accelerate the acceptance of skin grafts

b)

Reduce pruritis in the recovery phase of burns

c)

Reverse muscular contractures associated with scarring

d)

Enhance wound healing in the early phases after a burn

21.

The nurse urges family to bring in a patient's eyeglasses for a patient with burns to the back of the legs in order to:

a)

Reduce the symptoms of delirium

b)

Decrease analgesia the patient will require

c)

Reduce survival guilt in members of the family

d)

Enhance the relationship between the patient and the family

22.

High triglycerides levels may occur in patients receiving which of the following medications?

a)

Methadone

b)

Propofol

c)

Midazolam

d)

Duloxetine

23.

Antidepressants may be included in the treatment plan of a patient with burns for which of the following reasons?

a)

Increase stamina for therapy sessions

b)

Improve the chance of graft integration

c)

Decrease the severity of neuropathic pain

d)

Reduce the risk of nephrotoxic acute renal injury

24.

For which of the following reasons may dexmedetomidine (Precedex) be prescribed for a patient being treated for burns?

a)

Improve patient's appetite

b)

Wean a patient from opioids

c)

Elevation of a patient's blood pressure

d)

Reduce the severity of muscles wasting

25.

A burn patient is suspected of experiencing a panic attack, which will be most helpful in substantiating this suspicion?

a)

Ivy Index

b)

Cardiac Monitor

c)

Ophthalmoscope

d)

Glasgow Coma Score

26.

Nitric Oxide is administered as part of procedural sedation. What side effect is likely to occur with this medication?

a)

Pruritis

b)

Bronchoconstriction

c)

Nausea & Vomiting

d)

Increased intraocular pressure

27.

The use of NSAIDs to control pain with burn wounds increases the risk of a patient developing:

a)

Tinnitus

b)

Pruritis

c)

Hyperkalemia

d)

Renal Dysfunction

28.

Changing a patient's analgesia regimen from opioids to a non-opioid alternative as early as possible reduces the patient developing:

a)

Hyperalgesia

b)

Coagulopathies

c)

Thrombocytopenia

d)

Hypertrophic scarring

29.

The use of intramuscular pain medication in the treatment of a burn injury is:

a)

Most effective after skin grafting

b)

Unreliable due to altered absorption

c)

The delivery route of choice in the first 24hrs

d)

An effective way to administer opioids with less side effects

30.

The most effective means of reducing pain is:

a)

Opioids

b)

Wound Closure

c)

Distraction therapy

d)

Non-steroidal anti-inflammatory drugs

31.

Which of the following side effects is most likely when using ketamine?

a)

Hypertension

b)

Coagulopathies

c)

Hypermagnesemia

d)

Respiratory Suppression

32.

A patient experiencing neuropathic pain is most likely to the describe the pain as?

a)

"Cold"

b)

"Tight"

c)

"Sharp"

d)

"Burning"

33.

Breakthrough pain may be caused by:

a)

Anxiety

b)

Poor Nutrition

c)

Ambient Temperature

d)

Inadequate control of background pain

34.

Which of the following parameters is assess when utilizing the FLACC score to assess a patient's pain?

a)

Heart Rate

b)

UOP

c)

Movement of legs

d)

Subjective rating of pain

35.

A patient lacks sensation at the site of a full thickness burn. This lack of sensation is:

a)

Permanant

b)

Transient with periods of intense discomfort

c)

Transitory with sensation returning after fluid resuscitation

d)

Temporary, pain will be experienced as tissue regranulates and reorganize

36.

Which of the following stimuli is known to increase sensation of pain in the superficial and partial thickness burns?


a)

Air Currents

b)

Hypovolemia

c)

Ambient room temperature

d)

Decreased oxygen saturation

37.

Which best describes allodynia?

a)

The process of chemically debriding the wound

b)

The scar pattern that develops when meshing autographs

c)

The splinting of a limb to prevent contractures post-burn

d)

A patient experiences pain when clothing rubs along a sunburn

38.
  • Management of pruritis in the chronic phase of burn recovery will reduce the incidence of:


a)

Hair Loss

b)

Contractures

c)

Wound Infection

d)

Post-Traumatic stress syndrome

39.
  • The cause of delirium may be found by reviewing a patient's:


a)

Burn Depth

b)

Family History

c)

List of allergies

d)

Medication profile

40.

Ensuring euvolemia through administration of intravenous fluid is associated with treatment and prevention of:

a)

Pain

b)

Delirium

c)

Hypertrophic Scarring

d)

Post-traumatic stress syndrome

41.

The use of a xenograft is known to reduce:

a)

Pain

b)

Hypokalemia

c)

Extension of the zone of stasis

d)

The amount of fluids utilized during resuscitation

42.

Which of the following parameters would provide the best feedback regarding effectiveness for breakthrough pain?

a)

Ivy Index

b)

Color of Skin

c)

Urinary Output

d)

Visual analogue scale

43.

Which of the following descriptions is consistent with hypertrophic scarring?

a)

Develop within months of injury inside the original boarders of the burn

b)

Develop within years of injury inside the original boarders of the burn


c)

Develop within days of the injury extending beyond the original boarders

d)

Develop within weeks of the injury extending beyond the original boarders

44.
  • At what point following a burn injury is the use of silicone sheets most likely to be used?


a)

After evidence of skin graft take

b)

From the time of the burn until wound debridement

c)

From the time of the burn wound until the application of skin grafts

d)

Between wound debridement and the application of skin grafts

45.

Triamcinolone (TAC) is used for the prevention and treatment of scars following a burn. How will it be administered?

a)

Orally

b)

Topically

c)

Intravenously

d)

Intralesional injection

46.

Undergoing fat grafting after a burn injury, which outcome would be considered an effective outcome?

a)

Decrease in pruritis

b)

Reduction in localized Scarring

c)

Stabilization of serum potassium levels

d)

Area is ready for the application of an autologous skin graft

47.

At what point should laser therapy be used?

a)

In the week following the application of skin grafts

b)

During inpatient care to reduce background pain

c)

Early after the burn injury to facilitate wound debridement

d)

Following patient discharge as part of the reconstruction process

48.

Teaching in preparation for laser therapy to reduce scarring, a potential warning should be to inform the patient of?

a)

Bruising

b)

Numbness

c)

Skin Peeling

d)

Dyspigmentation

49.

A long-term complication related to significant burns wounds is

a)

Bruising

b)

Heart Failure

c)

Heart Failure

d)

Cold Intolerance

50.

Neuropathic pain may be relieved by:

a)

Benzodiazepines

b)

Autologous fat grafting

c)

Topical anesthetic creams

d)

Application of split thickness skin graft