Paramedic Quiz Chapter 20

50 Questions | Total Attempts: 248

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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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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%

  • 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

  • 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

  • 10. 
    Which of the following chemicals corrode the skin and cause massive protein denaturing
    • A. 

      Chlorine

    • B. 

      Ammonium

    • C. 

      Sulfur mustard

    • D. 

      Hydrogen peroxide

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 28. 
    The most acute complication associated with large body surface area burns is
    • A. 

      Infection

    • B. 

      Hypovolemia

    • C. 

      Hypothermia

    • D. 

      Myoglobinemia

  • 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

  • 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

  • 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

  • 32. 
    Specific treatment for a hydrofluoric acid burn is 
    • A. 

      Calcium chloride

    • B. 

      Sodium bicarbonate

    • C. 

      Magnesium sulfate

    • D. 

      Viscous lidocaine gel

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 50. 
    When administerd, epinephrine produces a/an _________effect
    • A. 

      Anticholineric

    • B. 

      Sympathomimetic

    • C. 

      Sympatholytic

    • D. 

      Parasympatholytic