Paramedic Quiz Chapter 20

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Quizzes Created: 13 | Total Attempts: 14,197
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Paramedic Quizzes & Trivia

Based on Nancy Carolines Emergency Care in the streets Chapter 20 Burns


Questions and Answers
  • 1. 

    The least significant complication associated with damage to the skin following a burn injury is 

    • A.

      Decreased melanin granules

    • B.

      Disturbances in fluid balance

    • C.

      Difficulty with thermoregulation

    • D.

      Susceptibility to bacterial invasion

    Correct Answer
    A. Decreased melanin granules
    Explanation
    Damage to the skin following a burn injury can lead to various complications. One of the least significant complications is the decreased melanin granules. Melanin is responsible for giving color to the skin and protecting it from the harmful effects of the sun. While decreased melanin granules may affect the appearance of the skin, it is not a major concern compared to other complications such as disturbances in fluid balance, difficulty with thermoregulation, and susceptibility to bacterial invasion, which can have more significant impacts on the overall health and well-being of the individual.

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  • 2. 

    The severity of a thermal burn correlates directly with 

    • A.

      The body's ability to effectively dissipate significant heat energy and the patient's general state of health

    • B.

      The presence of any underlying medical problems, the duration of exposure, and the temperature of the heat source.

    • C.

      The duration of exposure, the physical size of the patient, and the presence of concomitant traumatic injuries.

    • D.

      The temperature of the heat source of the heat source, amount of heat energy possessed by the object or substance and the duration of exposure

    Correct Answer
    D. The temperature of the heat source of the heat source, amount of heat energy possessed by the object or substance and the duration of exposure
    Explanation
    The severity of a thermal burn is determined by the temperature of the heat source, the amount of heat energy possessed by the object or substance, and the duration of exposure. These factors directly affect the extent of tissue damage and the depth of the burn. The higher the temperature and the longer the exposure, the more severe the burn will be. Additionally, the amount of heat energy possessed by the object or substance also contributes to the severity of the burn.

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  • 3. 

    Which of the following statements regarding scald burns is most correct

    • A.

      Once hot liquids come in contact with clothing, heat is rapidly dissipated

    • B.

      Scald burns often cover large surface areas because liquids spread quickly

    • C.

      Scald burns caused by grease or oil are typically limited to the epidermis

    • D.

      Scald burns are less commonly seen in pediatric patients that adult patients

    Correct Answer
    B. Scald burns often cover large surface areas because liquids spread quickly
    Explanation
    Scald burns often cover large surface areas because liquids spread quickly. When hot liquids come in contact with the skin, they transfer heat rapidly, causing the burn to spread over a larger area. This is because liquids have the ability to flow and spread easily, increasing the contact area with the skin. As a result, scald burns can cover a larger surface area compared to other types of burns.

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  • 4. 

    What type of thermal burn is most commonly associated with inhalation injury

    • A.

      Steam burns

    • B.

      Flame burns

    • C.

      Scald burns

    • D.

      Arc burns

    Correct Answer
    A. Steam burns
    Explanation
    Steam burns are the most commonly associated type of thermal burn with inhalation injury. When steam comes into contact with the skin, it transfers its heat rapidly, causing severe burns. In addition to causing skin damage, inhalation of steam can also lead to damage in the respiratory system. Steam burns are often seen in situations where there is exposure to hot liquids or steam, such as in industrial accidents or kitchen mishaps. The high temperature and moisture content of steam make it particularly damaging to the skin and respiratory system.

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  • 5. 

    Burn shock is caused by

    • A.

      A massive infection that occurs when microorganisms breach burned skin

    • B.

      Renal failure secondary to excess myoglobin production from burned muscle

    • C.

      Fluid loss across damaged skin and volume shifts within the rest of the body

    • D.

      Acute dehydration, and it commonly manifests within 30 minutes after the burn

    Correct Answer
    C. Fluid loss across damaged skin and volume shifts within the rest of the body
    Explanation
    Burn shock is caused by fluid loss across damaged skin and volume shifts within the rest of the body. When the skin is burned, it loses its barrier function, leading to the loss of fluids and electrolytes. This fluid loss can result in a decrease in blood volume, leading to a decrease in blood pressure and inadequate tissue perfusion. Additionally, the body may undergo volume shifts, with fluid moving from the intravascular space to the interstitial space, further exacerbating the decrease in blood volume. These factors contribute to the development of burn shock.

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  • 6. 

    Upper airway damge following a burn is most often caused by 

    • A.

      The inhalation of superheated gases

    • B.

      Exposure to carbon monoxide or cyanide

    • C.

      The inhalation of hot particulate steam

    • D.

      Direct flame exposure to the oropharynx

    Correct Answer
    A. The inhalation of superheated gases
    Explanation
    Upper airway damage following a burn is most often caused by the inhalation of superheated gases. When a person inhales superheated gases, such as those produced during a fire, the high temperature can cause severe damage to the upper airway. The heat can cause burns to the lining of the airway, leading to swelling, inflammation, and potential obstruction. This can result in difficulty breathing, coughing, and other respiratory symptoms. In contrast, exposure to carbon monoxide or cyanide can cause damage to the body's tissues and organs, but they do not specifically target the upper airway. The inhalation of hot particulate steam or direct flame exposure to the oropharynx can also cause burns and damage to the airway, but superheated gases are more commonly associated with upper airway damage in burn cases.

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  • 7. 

    Which of the following statements regarding carbon monoxide poisoning is most correct

    • A.

      Never rule out CO poisoning because of the absence of cherry red skin

    • B.

      The most common symptom of CO poisoning is chest pressure

    • C.

      CO results in systemic hypoxia by disintegrating red blood cells

    • D.

      Hyperbaric therapy is beneficial only if CO levels are above 40%

    Correct Answer
    A. Never rule out CO poisoning because of the absence of cherry red skin
    Explanation
    The correct answer is "never rule out CO poisoning because of the absence of cherry red skin." This means that even if a person does not have cherry red skin, it does not necessarily mean that they are not suffering from carbon monoxide poisoning. This is important because cherry red skin is not always present in cases of CO poisoning, and relying solely on this symptom can lead to misdiagnosis or delayed treatment. Other symptoms and factors should also be considered when assessing for CO poisoning.

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  • 8. 

    The degree of absorption of a corrosive chemical determines

    • A.

      The type of liquid used to irrigate the burn

    • B.

      Whether the burn should be flushed

    • C.

      Whether toxicity is local or systemic

    • D.

      The antidote required to reverse the effects

    Correct Answer
    C. Whether toxicity is local or systemic
    Explanation
    The degree of absorption of a corrosive chemical determines whether toxicity is local or systemic. If the chemical is minimally absorbed, the toxicity is likely to be local, meaning it affects only the area of contact. In this case, irrigating the burn with a suitable liquid would be sufficient to flush out the chemical. However, if the chemical is highly absorbed, it can cause systemic toxicity, meaning it affects the entire body. In such cases, an antidote may be required to reverse the effects of the chemical.

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  • 9. 

    Phosphorus is found in_______ and burns when exposed to ________

    • A.

      Fireworks,air

    • B.

      Oven cleaner, water

    • C.

      Drain cleaner, air

    • D.

      Battery acid, water

    Correct Answer
    A. Fireworks,air
    Explanation
    Phosphorus is found in fireworks and burns when exposed to air. This is because phosphorus is highly reactive and easily oxidizes in the presence of oxygen in the air. When ignited, the phosphorus in fireworks undergoes a chemical reaction with the oxygen in the air, releasing energy in the form of heat and light. This reaction is what causes the bright and colorful display seen in fireworks.

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  • 10. 

    Which of the following chemicals corrode the skin and cause massive protein denaturing

    • A.

      Chlorine

    • B.

      Ammonium

    • C.

      Sulfur mustard

    • D.

      Hydrogen peroxide

    Correct Answer
    B. Ammonium
    Explanation
    Ammonium is a chemical that can corrode the skin and cause massive protein denaturing. It is a highly reactive compound that can cause severe burns and tissue damage upon contact with the skin. Ammonium has the ability to disrupt the structure of proteins, leading to their denaturation. This can result in the destruction of cells and tissues, causing further damage to the skin. Therefore, ammonium is the correct answer as it is a chemical that can corrode the skin and cause massive protein denaturing.

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  • 11. 

    A person who is exposed to cement 

    • A.

      Typically only experiences burns to the epidermal layer because calcium oxide is a weak chemical

    • B.

      Often does not experience a burn unless he or she is exposed to the cement for longer than 2 hours

    • C.

      May not notice a skin burn for hours because cement penetrates through clothing and reacts with sweat

    • D.

      Experiences immediate pain and inflammation to the area because of the calcium oxide in the cement

    Correct Answer
    C. May not notice a skin burn for hours because cement penetrates through clothing and reacts with sweat
    Explanation
    The correct answer is that a person may not notice a skin burn for hours because cement penetrates through clothing and reacts with sweat. This explanation suggests that the cement is able to penetrate through the clothing and come into contact with the skin, causing a burn. Additionally, the reaction with sweat may further exacerbate the burn, leading to delayed symptoms that may not be immediately noticeable.

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  • 12. 

    The outer zone of an entrance or exit wound caused by a contract electrical burn is

    • A.

      The red zone of coagulation necrosis

    • B.

      Simply caused by local inflammation

    • C.

      A charred area of full thickness burn

    • D.

      Characterized by cold, gray, dry tissue

    Correct Answer
    A. The red zone of coagulation necrosis
    Explanation
    The correct answer is the red zone of coagulation necrosis. In electrical burns, the passage of electrical current through tissues causes coagulation necrosis, which is characterized by the red zone. This zone is where the tissue has been irreversibly damaged due to the heat generated by the electrical current. It is important to note that electrical burns can also cause other zones of injury, such as the central zone of coagulation necrosis and the outer zone of stasis, which are not mentioned in the options provided.

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  • 13. 

    Victims standing near an object that is struck by lightning 

    • A.

      Most commonly experience blast type injuries

    • B.

      Often have areas of burns that resemble a fine red rash

    • C.

      Typically experience intractable ventricular fibrillation

    • D.

      Experience full thickness burns that require debridement

    Correct Answer
    B. Often have areas of burns that resemble a fine red rash
    Explanation
    When lightning strikes an object near victims, it can cause burns on their bodies. These burns often appear as a fine red rash on the affected areas. This is because the intense heat generated by the lightning can cause the skin to burn, leading to the appearance of a rash-like pattern. Therefore, victims standing near an object struck by lightning often have areas of burns that resemble a fine red rash.

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  • 14. 

    Damage to the kidneys follows an electrical injury

    • A.

      Is caused by excess serum potassium levels

    • B.

      Occurs when damaged muscle produces myoglobin

    • C.

      Can be prevented with boluses of lactated ringers

    • D.

      Is the result of electricity passing through the kidneys

    Correct Answer
    B. Occurs when damaged muscle produces myoglobin
    Explanation
    When muscle tissue is damaged due to an electrical injury, it releases a substance called myoglobin into the bloodstream. This can lead to kidney damage because myoglobin can block the small blood vessels in the kidneys, impairing their function. Therefore, the occurrence of kidney damage following an electrical injury is attributed to the release of myoglobin from damaged muscle tissue.

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  • 15. 

    Most lighting related injuries occur when the victim 

    • A.

      Experiences a direct hit while standing in a large open area

    • B.

      Is talking on a phone and a utility pole is truck by lighting

    • C.

      Is attempting to escape an oncoming thunderstorm by running

    • D.

      Receives a splash effect after lighting strikes a nearby object

    Correct Answer
    D. Receives a splash effect after lighting strikes a nearby object
    Explanation
    The correct answer suggests that most lighting related injuries occur when a person receives a splash effect after lightning strikes a nearby object. This means that the person is not directly hit by the lightning itself, but rather experiences the effects of the electrical discharge that occurs when lightning strikes an object nearby. This can result in injuries such as burns, electrical shock, or being thrown off balance due to the force of the splash effect.

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  • 16. 

    After an adult victim is struck by lighting and experiences cardiac arrest

    • A.

      Five minutes of CPR generally restores a pulse

    • B.

      Perform a compression to ventilate ratio of 15:2

    • C.

      His or her heart may resume beating spontaneously

    • D.

      The ECG usually shows an organized cardiac rythm

    Correct Answer
    C. His or her heart may resume beating spontaneously
    Explanation
    After an adult victim is struck by lightning and experiences cardiac arrest, five minutes of CPR generally restores a pulse. This means that the actions taken during CPR, such as chest compressions and rescue breaths, can often revive the heart and restore its normal rhythm. Therefore, it is likely that the victim's heart may resume beating spontaneously without any further intervention. The mention of an organized cardiac rhythm on the ECG further supports the idea that the heart may start beating on its own again.

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  • 17. 

    Compared to beta radiation particles, alpha radiation particles

    • A.

      Have minimal penetrating energy

    • B.

      Easily pass through solid materials

    • C.

      Are able to travel much farther in air

    • D.

      Are not dangerous if they are ingested

    Correct Answer
    A. Have minimal penetrating energy
    Explanation
    Alpha radiation particles have minimal penetrating energy compared to beta radiation particles. This means that alpha particles are less able to penetrate through solid materials and travel far in air. Additionally, alpha particles are more dangerous if they are ingested, as they can cause damage to living tissue.

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  • 18. 

    Many of the physiologic changes cause dby acute radiation syndrome

    • A.

      Can be reversed if chemotherapy is administered within 24 hours

    • B.

      Occur over time and will not be apparent in the prehospital setting

    • C.

      Are a direct result of beta particles and are usually life threatening

    • D.

      Manifest with lethal cardiac dysrhythmias and sudden cardiac arrest

    Correct Answer
    B. Occur over time and will not be apparent in the prehospital setting
    Explanation
    The correct answer is that the physiologic changes caused by acute radiation syndrome occur over time and will not be apparent in the prehospital setting. This means that the effects of radiation exposure may not be immediately visible or detectable in the early stages, especially in a prehospital setting where immediate medical intervention may not be available. It highlights the importance of early recognition and appropriate medical management of radiation exposure to prevent further complications.

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  • 19. 

    Unlike chemical burns, radiation burns

    • A.

      Generally extended into the dermal layer

    • B.

      May appear hours or days after exposure

    • C.

      Are typically confined to the epidermis

    • D.

      Are immediately apparent after exposure

    Correct Answer
    B. May appear hours or days after exposure
    Explanation
    Radiation burns may appear hours or days after exposure, unlike chemical burns. This is because radiation damage takes time to manifest and may not be immediately apparent. The effects of radiation exposure can gradually develop and become visible on the skin over time. In contrast, chemical burns typically occur immediately upon contact with the harmful substance. Therefore, the correct answer is that radiation burns may appear hours or days after exposure.

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  • 20. 

    While standing by at the scene of a structual fire, it is most important to remember that

    • A.

      Toxic gases are often present, even after the fire is out

    • B.

      The lead paramedic determines where you should stage

    • C.

      Most fabric materials release cyanide when they burn

    • D.

      You may need to provide rehabilitation for fire fighters

    Correct Answer
    A. Toxic gases are often present, even after the fire is out
    Explanation
    When standing by at the scene of a structural fire, it is important to remember that toxic gases are often present, even after the fire is out. This is crucial because these gases can be harmful and pose a risk to the health and safety of individuals at the scene. It is necessary to take necessary precautions and ensure the proper use of protective equipment to prevent exposure to these toxic gases.

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  • 21. 

    If a burn patient presents with a hoarse voice and states "I'm cold" your most immediate concern should be

    • A.

      Hypothermia

    • B.

      Burn shock

    • C.

      Inhalation injury

    • D.

      Cyanide toxicity

    Correct Answer
    C. Inhalation injury
    Explanation
    The correct answer is inhalation injury. A burn patient presenting with a hoarse voice and stating "I'm cold" indicates that they may have inhaled smoke or toxic fumes during the burn incident. Inhalation injury can cause damage to the airways and lungs, leading to respiratory distress and potentially life-threatening complications. Therefore, it is crucial to immediately address and treat any potential inhalation injury in burn patients.

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  • 22. 

    With regard to thermal burn injury, the zone of coagulation 

    • A.

      May undergo necrosis within 24-48 hours after the burn

    • B.

      Surrounds the central part of the burn and is often inflamed

    • C.

      Is the area least affected by the burn and will likely recover

    • D.

      Is the central part of the burn and suffers the most damage

    Correct Answer
    D. Is the central part of the burn and suffers the most damage
    Explanation
    The zone of coagulation refers to the central part of the burn and is the area that suffers the most damage. This is because it is the area that is directly exposed to the highest temperature and longest duration of heat. As a result, the cells in this zone are killed and undergo necrosis within 24-48 hours after the burn. The surrounding area, known as the zone of stasis, is often inflamed and may also undergo necrosis if not properly treated. The zone of hyperemia, which surrounds the other two zones, is the least affected by the burn and is likely to recover.

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  • 23. 

    Which of the following statements regarding partial-thickness burns is most correct

    • A.

      Partial thickness burns are usually extremely painful for the patient

    • B.

      They are difficult to distinguish from a superficial burn in the field

    • C.

      The majority of partial thickness burns are caused by an open flame

    • D.

      Is the central part of the burn and suffers the most damage

    Correct Answer
    A. Partial thickness burns are usually extremely painful for the patient
    Explanation
    Partial-thickness burns are usually extremely painful for the patient. This is because these burns involve damage to both the outer layer of skin (epidermis) and the underlying layer of skin (dermis). The nerve endings in the skin are affected, leading to pain and sensitivity. Unlike superficial burns, which only affect the epidermis and are less painful, partial-thickness burns cause significant discomfort and can be quite painful for the patient.

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  • 24. 

    According to the rule of nines, an adult man with partial and full thickness burns to his head, face and anterior chest has burns to __% of his TBSA

    • A.

      18

    • B.

      27

    • C.

      36

    • D.

      45

    Correct Answer
    A. 18
    Explanation
    According to the rule of nines, the head, face, and anterior chest each account for 9% of the total body surface area (TBSA). Therefore, if a person has burns to these areas, it would amount to a total of 27% (9% + 9% + 9%) of their TBSA. Since the question specifies "partial and full thickness burns," it is likely that the burns are deeper and would cover a larger area. However, the given answer of 18% is incorrect and does not align with the rule of nines.

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  • 25. 

    The purpose of estimating a patient's TBSA burns in the prehospital setting is to

    • A.

      Obtain an accurate calculation of how severe the patient's burns are

    • B.

      Determine whether the patient should be transported via helicopter

    • C.

      Ascertain how much IV fluid the patient should receive during transport

    • D.

      Help the paramedic determine the most appropriate destination hospital

    Correct Answer
    D. Help the paramedic determine the most appropriate destination hospital
    Explanation
    Estimating a patient's TBSA burns in the prehospital setting helps the paramedic determine the most appropriate destination hospital. This is because the severity of the burns can vary, and different hospitals may have different levels of burn care expertise and resources. By estimating the TBSA burns, the paramedic can assess the extent of the patient's injuries and choose a hospital that is equipped to provide the necessary specialized care for the patient's specific burn severity. This ensures that the patient receives the most appropriate and effective treatment for their burns.

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  • 26. 

    Full thickness circumfrential burns to the chest

    • A.

      Require the paramedic to incise the burn to decompress it

    • B.

      May cause significant restriction of respiratory excursion

    • C.

      Are generally not significant unless the skin is unyielding

    • D.

      Necessitate immediate intubation and ventilatory support

    Correct Answer
    B. May cause significant restriction of respiratory excursion
    Explanation
    Full thickness circumferential burns to the chest may cause significant restriction of respiratory excursion. This means that the burns can limit the ability of the chest to expand and contract during breathing, leading to difficulty in breathing properly. This restriction can be due to the tightness and stiffness of the burned skin. It is important for paramedics to be aware of this potential complication and provide appropriate interventions to ensure adequate ventilation and oxygenation for the patient.

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  • 27. 

    Assessment of a patient who many have been exposed to radiation begins by

    • A.

      Determining if the scene is safe to enter

    • B.

      Thoroughly decontaminating the patient

    • C.

      Quickly moving the patient to a safe area

    • D.

      Evaluating airway, breathing, and circulation

    Correct Answer
    A. Determining if the scene is safe to enter
    Explanation
    The correct answer is determining if the scene is safe to enter. When assessing a patient who may have been exposed to radiation, it is crucial to ensure the safety of the healthcare provider and anyone else involved. This involves evaluating the scene for any potential hazards or ongoing radiation exposure before entering. By doing so, the healthcare provider can minimize their own risk and provide appropriate care to the patient. Thorough decontamination, moving the patient to a safe area, and evaluating airway, breathing, and circulation are all important steps in the assessment process, but they come after ensuring scene safety.

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  • 28. 

    The most acute complication associated with large body surface area burns is

    • A.

      Infection

    • B.

      Hypovolemia

    • C.

      Hypothermia

    • D.

      Myoglobinemia

    Correct Answer
    C. Hypothermia
    Explanation
    Hypothermia is the most acute complication associated with large body surface area burns. When a person sustains severe burns, their body loses heat rapidly, leading to a drop in body temperature. This can result in various complications, such as impaired blood clotting, increased risk of infection, and impaired immune function. Hypothermia can also cause shivering, confusion, and organ dysfunction. Therefore, it is crucial to prevent and manage hypothermia in burn patients to minimize further complications and promote healing.

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  • 29. 

    If intubation of a burn patient becomes necessary, you should avoid cutting the ET tube down to make it shorter because

    • A.

      This increases the risk of intubating the right mainstream bronchus

    • B.

      Facial edema may cause tube dislodgement 2-3 days after the burn

    • C.

      Drugs given via the ET tube will not adequately disperse in the lungs

    • D.

      It may result in excessive volumes of air being delivered to the patient

    Correct Answer
    B. Facial edema may cause tube dislodgement 2-3 days after the burn
    Explanation
    Cutting the ET tube down to make it shorter is not recommended for intubation of a burn patient because facial edema may cause tube dislodgement 2-3 days after the burn. This means that as the patient's facial edema subsides, the tube may become loose or dislodged, compromising the airway and potentially leading to respiratory distress. Therefore, it is important to ensure that the ET tube is of the appropriate length and properly secured to prevent any complications.

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  • 30. 

    When considering analgesia for a burn patient who is in severe pain, you must remember that

    • A.

      Due to the risk of causing hemodynamic compromise,analgesia should be avoided in the field

    • B.

      One half of the usual dose of narcotic analgesics should be given in order to avoid drug toxicity

    • C.

      Benzodiazepines are preferred over narcotics because they are less likely to cause hypotension

    • D.

      Burns increase the metabolic rate, which may necessitate higher than normal doses of analgesia

    Correct Answer
    D. Burns increase the metabolic rate, which may necessitate higher than normal doses of analgesia
    Explanation
    Burns increase the metabolic rate, which may necessitate higher than normal doses of analgesia. This means that burn patients may require higher doses of pain medication to effectively manage their pain due to the increased metabolic rate caused by the burn injury.

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  • 31. 

    A patient with full thickness burns surrounded by areas of superficial and partial-thickness burns should be treate with all of the following except 

    • A.

      Analgesia

    • B.

      High flow oxygen

    • C.

      Moist dressings

    • D.

      Sterile burn pads

    Correct Answer
    C. Moist dressings
    Explanation
    Moist dressings are not recommended for a patient with full thickness burns surrounded by areas of superficial and partial-thickness burns. Moist dressings are typically used for superficial and partial-thickness burns to promote healing and prevent infection. However, in the case of full thickness burns, the skin is completely destroyed and requires a different approach to treatment, such as surgical intervention or specialized dressings. Therefore, moist dressings would not be appropriate in this situation.

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  • 32. 

    Specific treatment for a hydrofluoric acid burn is 

    • A.

      Calcium chloride

    • B.

      Sodium bicarbonate

    • C.

      Magnesium sulfate

    • D.

      Viscous lidocaine gel

    Correct Answer
    A. Calcium chloride
    Explanation
    Calcium chloride is the correct answer because it is the specific treatment for a hydrofluoric acid burn. Hydrofluoric acid is a highly corrosive substance that can cause severe burns and tissue damage. Calcium chloride works by binding to the fluoride ions in the acid, forming a less harmful compound that can be easily removed from the body. It helps to neutralize the acid and minimize the damage caused by the burn.

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  • 33. 

    A partial thickness burn is considered to be critical if it

    • A.

      Occurs in any patient over the age of 45 years

    • B.

      Is located to the proximal aspect of an extrmity

    • C.

      Is rated as at least a 5 on a pain scale of 0-10

    • D.

      Involves more than 30% of the body surface area

    Correct Answer
    D. Involves more than 30% of the body surface area
    Explanation
    If a partial thickness burn involves more than 30% of the body surface area, it is considered critical. This means that a large portion of the body has been affected by the burn, which can lead to serious complications such as fluid loss, infection, and impaired organ function. The extent of the burn is an important factor in determining the severity and potential risks associated with it.

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  • 34. 

    A 30 year old man presents with jaw and neck stiffness and fever. During your assessment, he tells you that he cut his hand on a piece of metal about a week ago. ou should be most suspicious that this patient has 

    • A.

      Tetanus

    • B.

      Meningitis

    • C.

      A viral infection

    • D.

      A staph infection

    Correct Answer
    A. Tetanus
    Explanation
    Based on the symptoms of jaw and neck stiffness, along with a history of a recent cut on the hand, the most likely explanation for the patient's condition is tetanus. Tetanus is caused by a bacterial infection from the Clostridium tetani bacteria, which can enter the body through a wound or cut. The bacteria produce a toxin that affects the nervous system, leading to muscle stiffness and spasms. Fever is also a common symptom of tetanus. Meningitis, a viral infection, and staph infection are less likely based on the given symptoms and history.

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  • 35. 

    You are dispatched to a residence for a man who has cut his hand with a chainsaw. Upon arriving at the scene, your first action should be to

    • A.

      Immediately gain access to the patien

    • B.

      Apply gloves, a gown and facial protection

    • C.

      Determine if air medical transport is available

    • D.

      Carefully assess the scene for safety hazards

    Correct Answer
    D. Carefully assess the scene for safety hazards
    Explanation
    The correct answer is to carefully assess the scene for safety hazards. This is the first action that should be taken upon arriving at the scene of a man who has cut his hand with a chainsaw. Assessing the scene for safety hazards is crucial to ensure the safety of both the patient and the first responder. By identifying any potential dangers or hazards, appropriate measures can be taken to mitigate risks and provide a safe environment for providing medical care.

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  • 36. 

    A 22 year old man was struck in the forehead by a softball. He is conscious and alert, but complains of a severe headache. Your assessment reveals a large hematoma to his forehead. His vital signs are stable and his breathing is adequate. You should

    • A.

      Apply firm manual pressure to the hematoma to reduce internal bleeding

    • B.

      Place him in a sitting position and apply a chemical heat pack to his head

    • C.

      Apply an icepack to the hematoma and monitor his level of consciousness

    • D.

      Start an IV of normal saline and administer 2 mg of morphine for the pain

    Correct Answer
    C. Apply an icepack to the hematoma and monitor his level of consciousness
    Explanation
    The correct answer is to apply an icepack to the hematoma and monitor his level of consciousness. This is the appropriate action because the icepack will help reduce swelling and pain in the affected area. Monitoring his level of consciousness is important to ensure that there are no signs of a more serious head injury, such as a concussion or brain bleed. Starting an IV and administering morphine is not necessary at this time as his vital signs are stable and his breathing is adequate. Placing him in a sitting position and applying a chemical heat pack may exacerbate the swelling and should be avoided.

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  • 37. 

    A young woman attempted to commit suicide by cutting her wrist. Bright red blood is spurting from the injury site. After applying direct pressure you should

    • A.

      Apply supplemental oxygen and keep her warm

    • B.

      Elevate her extremity above the level of her heart

    • C.

      Apply a pressure dressing and start a large bore IV

    • D.

      Locate and apply digital pressure to the brachial artery

    Correct Answer
    B. Elevate her extremity above the level of her heart
    Explanation
    Elevating the extremity above the level of the heart helps to reduce blood flow to the injured area. This can help to slow down the bleeding and reduce the amount of blood loss. By elevating the extremity, gravity assists in reducing the pressure and flow of blood, allowing the body to naturally clot and stop the bleeding. This can be a helpful initial step in managing the bleeding before seeking further medical assistance.

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  • 38. 

    You are treating a 20 year old man with a large laceration involving the brachial artery. The patient is confused, pale, and has a weak carotid pulse. Your initial attempts to control the bleeding have failed you should

    • A.

      Apply and inflate the PASG, start two large bore IV lines with an isotonic crystalloid, and transport.

    • B.

      Give oxygen via non rebreathing mask, start a large bore IV of lactated ringers or normal saline, and transport

    • C.

      Administer high flow oxygen, transport immediately, and attempt other bleeding control methods en route

    • D.

      Perform endotracheal intubation, administer crystalloid fluids until his carotid pulse strengthens, and transport at once

    Correct Answer
    C. Administer high flow oxygen, transport immediately, and attempt other bleeding control methods en route
    Explanation
    In this scenario, the patient is presenting with signs of shock, such as confusion, pallor, and a weak carotid pulse. These symptoms indicate significant blood loss and hypoperfusion. Administering high flow oxygen is necessary to improve oxygenation and support vital organ function. Immediate transportation is crucial to ensure timely access to advanced medical care. Attempting other bleeding control methods en route is necessary to minimize further blood loss and stabilize the patient's condition.

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  • 39. 

    A 22 year old man was kicked in the abdomen several times during an assault. Your initial assessment reveals that he is responsive only to pain, has poor respiratory effort, and a pulse rate that is rapid and weak. Further assessment reveals abrasions with minimal bleeding to his upper extremities and face, no other gross external bleeding is present. You should

    • A.

      Protect his spine, insert a nasal airway, assist ventilations with a BVM and 100% O2. keep him warm and elevate his legs, transport at once, and establish vascular access en route to a trauma center

    • B.

      Perform immediate endotracheal intubation, apply a cervical collar, establish two large bore IV lines and give a fluid bolus at the scene, apply warm blankets, and transport expeditiously to a trauma center

    • C.

      Apply high flow oxygen via nonrebreathing mask, apply blankets, elevate his lower extremities 12 inches, insert bilateral intraosseous catheters, deliver a 500mL fluid bolus, and begin transport to a trauma center

    • D.

      Insert an oral airway, hyperventilate him with a BVM at 24 breaths/min, keep him warm and elevate his legs, transport at once, and establish at least one large bore IV line of normal saline while en route to a trauma center

    Correct Answer
    A. Protect his spine, insert a nasal airway, assist ventilations with a BVM and 100% O2. keep him warm and elevate his legs, transport at once, and establish vascular access en route to a trauma center
    Explanation
    The correct answer is to protect his spine, insert a nasal airway, assist ventilations with a BVM and 100% O2, keep him warm and elevate his legs, transport at once, and establish vascular access en route to a trauma center. This is the most appropriate course of action for a patient who has suffered multiple blows to the abdomen and is showing signs of poor respiratory effort, weak pulse, and unresponsiveness. Protecting the spine helps prevent further injury, while inserting a nasal airway and assisting ventilations with a BVM and 100% O2 ensures adequate oxygenation. Keeping the patient warm and elevating his legs can help improve circulation, and transporting him to a trauma center with established vascular access allows for further evaluation and treatment.

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  • 40. 

    A woman finds her 50 year old husband unresponsive on the couch. When you arrive and begin your assessment, the wife tells you that her husband experienced an episode of chest discomfort 2 days prior, but refused to seek medical attention. The patient is unconsious and unresponsive, is breathing with a marked reduction in tidal volume, and has a rapid thready radial pulses. Your partner reports that the patients systolic BP is 70 mm Hg. The most appropriate treatment for this patient involves-

    • A.

      Administering high flow oxygen via nonrebreathing mask, monitoring his cardiac rhythm, starting a large bore IV and giving a 20 ml/kg crystalloid bolus, initiating transport and infusing dopamine at 10-20 mcg/kg/min while en route to the closest facility

    • B.

      Applying a CPAP device, monitoring his cardiac rhythm for dysrhythmias, establishing IV or IO access at the scene, administering a 500 mL crystalloid bolus, initiating transport, and administering atropine en route to prevent bradycardia

    • C.

      Hyperventilating him with a BVM device for 2-3 minutes, intubating his trachea, establishing vascular access, administering prophylactic amiodarone to prevent ventricular dysrhythmias, and transporting him while infusing crystalloid fluid boluses en route to the hospital

    • D.

      Assisting his ventilations, applying a cardiac monitor, intubating if necessary, auscultating his lungs, transporting at once, establishing vascular access en route, administering a 200 mL crystalloid bolus if his lungs are clear and considering a dopamine infusion

    Correct Answer
    B. Applying a CPAP device, monitoring his cardiac rhythm for dysrhythmias, establishing IV or IO access at the scene, administering a 500 mL crystalloid bolus, initiating transport, and administering atropine en route to prevent bradycardia
    Explanation
    The most appropriate treatment for this patient involves applying a CPAP device, monitoring his cardiac rhythm for dysrhythmias, establishing IV or IO access at the scene, administering a 500 mL crystalloid bolus, initiating transport, and administering atropine en route to prevent bradycardia. This treatment plan is based on the patient's presentation of unresponsiveness, reduced tidal volume, rapid thready radial pulses, and low systolic blood pressure. The use of CPAP helps improve oxygenation and ventilation, monitoring cardiac rhythm allows for early detection of dysrhythmias, establishing IV or IO access allows for fluid administration, and administering atropine helps prevent bradycardia during transport.

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  • 41. 

    A 19 year old man fell approximately 20 feet, landing on a hard surface. Your assessment reveals that he is consious, is unable to move his lower extremities, and has pale, clammy skin above the level of his umbilicus. His respirations are 24 breaths/min and shallow, pulse rate is 50 beats/min and weak, and BP is 75/56mm Hg As your partner maintains stabilization of the patient's head, you perform a rapid trauma assesment, which reveals no obvious signs of hypovolemia. You should

    • A.

      Apply high flow oxygen, attempt transcutaneous pacing to increase his heart rate, apply spinal motion restriction precautions, establish vascular access and administer a crystalloid bolus of 10-20 mL/kg, begin transport, and infuse dopamine at 2 mcg/kg/min en route

    • B.

      Consider immediate intubation to protect his airway, apply spinal motion restriction precautions, apply warm blankets, begin transport, establish IV or IO access en route, and administer up to 4 liters of normal saline or lactated Ringer's solution to increase his BP and improve perfusion

    • C.

      Assist ventilations as needed, apply spinal motion restriction precatutions, keep him warm, begin transport, establish vascular access en route, administer crystalloid boluses in 200 mL increments, consider atropine for his bradycardia, and infuse dopamine if his blood pressure is refractory to fluid boluses.

    • D.

      Provide ventilatory assistance with a BVM device, establish immediate vascular access and infuse normal saline wide open, apply spinal motion restrictions, administer 1 mg of atropine to increase his heart rate above 60 beats/min, begin transport, and perform transcutaneous pacing en route if he remains bradycardic

    Correct Answer
    C. Assist ventilations as needed, apply spinal motion restriction precatutions, keep him warm, begin transport, establish vascular access en route, administer crystalloid boluses in 200 mL increments, consider atropine for his bradycardia, and infuse dopamine if his blood pressure is refractory to fluid boluses.
    Explanation
    The patient's presentation suggests that he may have suffered a spinal cord injury due to the fall. His inability to move his lower extremities and the pale, clammy skin above the level of his umbilicus indicate possible spinal cord damage. The priority in managing this patient is to stabilize his spine and provide ventilatory support as needed. Keeping him warm is important to prevent hypothermia. Establishing vascular access and administering crystalloid boluses in 200 mL increments will help maintain his blood pressure and improve perfusion. Atropine can be considered for his bradycardia, and dopamine can be infused if his blood pressure does not improve with fluid administration.

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  • 42. 

    A 49 year old woman presents with a systolic BP of 70 mm Hg, a pulse rate of 130 beats/min and irregular, labored respirations of 28 breaths/min, and coarse crackles in her lungs. You should suspect _________shock and treat her with high-flow oxygen and____________

    • A.

      Cardiogenic,dopamine

    • B.

      Neurogenic,a beta blocker

    • C.

      Hypovolemic, saline boluses

    • D.

      Distributive, an antidysrhythmic

    Correct Answer
    A. Cardiogenic,dopamine
    Explanation
    Based on the symptoms described, including low blood pressure, high heart rate, irregular breathing, and crackles in the lungs, it suggests that the woman is experiencing cardiogenic shock. Cardiogenic shock occurs when the heart is unable to pump enough blood to meet the body's needs. To treat this condition, high-flow oxygen is administered to increase oxygen levels in the blood, and dopamine is given to improve heart function and increase blood pressure.

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  • 43. 

    While attempting to start an IV on a patient with large proturuding veins, you note that the vein rolls from side to side during your cannulation attempt. The best way to remedy this situation is to

    • A.

      Apply downward manual traction below the venipuncture site to stabilize the vein in position.

    • B.

      Apply the constricting band to a distal location

    • C.

      Use a through the needle IV catheter in order to gain better control over the rolling vein

    • D.

      Place a chemical heat pack over the vein for 10 minutes in order to decrease movement of the vein

    Correct Answer
    A. Apply downward manual traction below the venipuncture site to stabilize the vein in position.
    Explanation
    When a vein rolls from side to side during a cannulation attempt, it indicates that the vein is not stable enough to be punctured. Applying downward manual traction below the venipuncture site helps to stabilize the vein in position, making it easier to successfully insert the IV needle. This technique ensures that the vein remains steady and minimizes the chances of the needle slipping or causing any damage. Applying a constricting band to a distal location or using a through the needle IV catheter may not address the issue of vein instability. Placing a chemical heat pack over the vein is not recommended as it may cause discomfort or potential burns.

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  • 44. 

    After starting an IV in an arm vein for a patient with chest pain, and properly securing the catheter in place, you not that the IV is not flowing. You should

    • A.

      Gently manipulate the catheter and reassess the flow

    • B.

      Discontinue the IV and reestablish it in the other arm

    • C.

      Ensure that the constricting band has been removed

    • D.

      Use a pressure infuser device to improve the IV flow

    Correct Answer
    C. Ensure that the constricting band has been removed
    Explanation
    The correct answer is to ensure that the constricting band has been removed. The constricting band may be preventing the flow of the IV by obstructing the blood flow. By removing the band, the flow should be able to resume. Manipulating the catheter may cause damage or dislodgement, so it is not the appropriate action. Discontinuing the IV and reestablishing it in the other arm would be unnecessary if the issue is simply the constricting band. Using a pressure infuser device may be a potential solution, but it should not be the first step taken before ensuring the constricting band has been removed.

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  • 45. 

    Approximately 20 minutes after starting an IV on a 40 year old man, he begins complaining of a backache and chills. You should most be suspicious of 

    • A.

      An air embolus

    • B.

      An allergic reaction

    • C.

      Circulatory overload

    • D.

      A pyrogenic reaction

    Correct Answer
    D. A pyrogenic reaction
    Explanation
    A pyrogenic reaction is a possible explanation for the symptoms of backache and chills that the 40-year-old man is experiencing approximately 20 minutes after starting an IV. A pyrogenic reaction occurs when pyrogens, substances that can cause fever, are introduced into the body. This can happen if the IV fluid or equipment is contaminated with bacteria or endotoxins. The symptoms of backache and chills are consistent with a systemic inflammatory response caused by the introduction of pyrogens.

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  • 46. 

    While establishing IO access in a critically ill patient, you locate the appropriate anatomic landmark, cleanse the site, and insert the IO catheter at a 45 degree angle. After attaching the IV line and turning the flow on, you note edema developing on the opposite side of the extremity. What has most likely happened

    • A.

      Extravasation due to an inappropriate angle of IO catheter insertion

    • B.

      Inadvertent entry of a large vein, causing infiltration

    • C.

      Fracture of the bone with leakage of bone marrow into the soft tissue

    • D.

      Acute osteomyelitis 2nd to inappropriate cleansing of the site

    Correct Answer
    A. Extravasation due to an inappropriate angle of IO catheter insertion
    Explanation
    The most likely explanation for the edema developing on the opposite side of the extremity after inserting the IO catheter at a 45 degree angle is extravasation due to an inappropriate angle of IO catheter insertion. This means that the catheter was not inserted correctly, causing the fluid to leak into the surrounding tissue instead of entering the vein. This can result in swelling and edema on the opposite side of the extremity.

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  • 47. 

    During the attempted resuscitation of a man in V-fib cardiac arrest, your protocols call for the administration of 1.5 mg/kg of lidocaine. You have prefilled syringes of lidocaine in a concentration of 100 mg/5 ml. The patient weighs 180 lbs. How many mL will you administrer.

    • A.

      5.5

    • B.

      6.2

    • C.

      6.5

    • D.

      6.8

    Correct Answer
    B. 6.2
    Explanation
    To determine the mL of lidocaine to be administered, we need to calculate the total dose of lidocaine required for the patient's weight. The patient weighs 180 lbs, so we need to convert this to kg by dividing by 2.2 (180 lbs / 2.2 = 81.82 kg). The protocol calls for a dose of 1.5 mg/kg, so we multiply the weight in kg by the dose (81.82 kg * 1.5 mg/kg = 122.73 mg).

    Next, we need to calculate the mL of lidocaine using the concentration of the prefilled syringes. The concentration is 100 mg/5 mL, so we divide the total dose (122.73 mg) by the concentration (122.73 mg / 100 mg/5 mL = 6.1365 mL).

    Rounding to the nearest tenth, the mL of lidocaine to be administered is 6.2.

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  • 48. 

    While consulting with the attending physician at the receiving facility about a patient with symptomatic bradycardia, the physician orders you to administer 0.5 mg/kg of atropine to the patient. After recognizing that this is an inappropriate dose of atropine, you should

    • A.

      Contact your medical director at once

    • B.

      Ask the physician to repeat the order

    • C.

      Refuse to administer the ordered dose

    • D.

      Confirm the correct dose in your field guide

    Correct Answer
    B. Ask the physician to repeat the order
    Explanation
    The correct answer is to ask the physician to repeat the order. This is because the physician has ordered an inappropriate dose of atropine for the patient with symptomatic bradycardia. It is important to clarify the order with the physician to ensure the correct dose is administered. Contacting the medical director may also be necessary, but the immediate action should be to ask the physician for clarification.

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  • 49. 

    You reassess your patient after administering a medication via the IV bolus route and note that his clinical condition is unchanged. What is the least likely cause of the patient's unchanged condition

    • A.

      The patient may require another dose of the same drug

    • B.

      The dose was too low for the patient's clinical condition

    • C.

      The IV tubing was occluded proximal to the injection

    • D.

      You diluted the bolus by following it with a 20 mL saline flush

    Correct Answer
    C. The IV tubing was occluded proximal to the injection
    Explanation
    The least likely cause of the patient's unchanged condition is that the IV tubing was occluded proximal to the injection. This means that the IV tubing was not blocked or obstructed, which would have prevented the medication from reaching the patient's bloodstream. Therefore, the lack of improvement in the patient's clinical condition is unlikely to be due to a blockage in the IV tubing.

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  • 50. 

    When administerd, epinephrine produces a/an _________effect

    • A.

      Anticholineric

    • B.

      Sympathomimetic

    • C.

      Sympatholytic

    • D.

      Parasympatholytic

    Correct Answer
    B. Sympathomimetic
    Explanation
    Epinephrine is a medication that acts as a sympathomimetic, meaning it mimics the effects of the sympathetic nervous system. This leads to an increase in heart rate, blood pressure, and dilation of the airways. Epinephrine is commonly used in emergency situations, such as anaphylaxis or cardiac arrest, to stimulate the sympathetic response and counteract the effects of an allergic reaction or cardiac failure. Therefore, the correct answer is sympathomimetic.

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Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

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  • Mar 22, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Apr 29, 2011
    Quiz Created by
    Jbouren
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