Question 1

All of the following will be typically found in the air of an enclosed house fire EXCEPT:

Accepted Answer

A)  steam. 
B)  carbon monoxide. 
C)  hydrogen cyanide. 
D)  hydrogen chloride. 
A)  steam. 
B)  carbon monoxide. 
C)  hydrogen cyanide. 
D)  hydrogen chloride. A

Question 2

A patient has been brought to the emergency department after inhaling superheated steam. Pulmonary injuries unique to this situation include:
1) atelectasis.
2) pulmonary edema.
3) thick secretions.
4) pharyngeal edema.

Accepted Answer

A)  3 
B)  1, 2 
C)  2, 3, 4 
D)  1, 2, 3 
A)  3 
B)  1, 2 
C)  2, 3, 4 
D)  1, 2, 3 B

Question 3

A 10-year-old patient has inhaled hot gases, and an inspection of her mouth shows edema and blisters. What should the respiratory therapist recommend?

Accepted Answer

A)  Perform a bronchoscopy to evaluate the trachea. 
B)  Perform endotracheal intubation. 
C)  Monitor her SpO2 once per shift. 
D)  Administer an aerosol treatment with racemic epinephrine. 
A)  Perform a bronchoscopy to evaluate the trachea. 
B)  Perform endotracheal intubation. 
C)  Monitor her SpO2 once per shift. 
D)  Administer an aerosol treatment with racemic epinephrine. B

Question 4

What COHb level is associated with a throbbing headache, nausea, vomiting, and impaired judgment?

Accepted Answer

A)  1% to 10% 
B)  10% to 20% 
C)  20% to 30% 
D)  30% to 50% 
A)  1% to 10% 
B)  10% to 20% 
C)  20% to 30% 
D)  30% to 50%

Question 5

What level of carbon monoxide toxicity is associated with coma, convulsions, and Cheyne-Stokes respiration?

Accepted Answer

A)  10% to 20% COHb 
B)  20% to 30% COHb 
C)  30% to 50% COHb 
D)  50% to 60% COHb 
A)  10% to 20% COHb 
B)  20% to 30% COHb 
C)  30% to 50% COHb 
D)  50% to 60% COHb

Question 6

Which of the following radiographic findings would be associated with the intermediate stage of recovery from a serious smoke inhalation injury?

Accepted Answer

A)  Pulmonary edema/ARDS 
B)  Patchy or segmental infiltrates 
C)  Empyema 
D)  Normal/full recovery 
A)  Pulmonary edema/ARDS 
B)  Patchy or segmental infiltrates 
C)  Empyema 
D)  Normal/full recovery

Question 7

Late-stage complications of extensive body surface burns include:
1) sepsis.
2) upper airway obstruction.
3) pneumonia.
4) pulmonary embolism.

Accepted Answer

A)  1, 2 
B)  3, 4 
C)  2, 3 
D)  1, 3, 4 
A)  1, 2 
B)  3, 4 
C)  2, 3 
D)  1, 3, 4

Question 8

Which portion of the pulmonary system will be affected by the inhalation of low-water solubility gases such as hydrogen chloride and phosgene?

Accepted Answer

A)  Distal airways and alveoli 
B)  Pulmonary vascular bed 
C)  Upper airway 
D)  Pulmonary lymphatic system 
A)  Distal airways and alveoli 
B)  Pulmonary vascular bed 
C)  Upper airway 
D)  Pulmonary lymphatic system

Question 9

Which of the following would be recommended for the treatment of cyanide poisoning?

Accepted Answer

A)  Aztreonam 
B)  Albuterol sulfate 
C)  Amyl nitrate 
D)  Aclidinium bromide 
A)  Aztreonam 
B)  Albuterol sulfate 
C)  Amyl nitrate 
D)  Aclidinium bromide

Question 10

Clinical signs of an upper airway thermal injury include:
1) facial burns.
2) atelectasis.
3) mucosal edema.
4) epithelial sloughing.

Accepted Answer

A)  3 
B)  1, 4 
C)  1, 3, 4 
D)  1, 2, 3, 4 
A)  3 
B)  1, 4 
C)  1, 3, 4 
D)  1, 2, 3, 4

Question 11

According to the Parkland Formula, what is the recommended volume of fluid that should be infused over a 24-hour period for each percent of body surface burned?

Accepted Answer

A)  1 mL/kg of body weight 
B)  4 mL/kg of body weight 
C)  6 mL/kg of body weight 
D)  10 mL/kg of body weight 
A)  1 mL/kg of body weight 
B)  4 mL/kg of body weight 
C)  6 mL/kg of body weight 
D)  10 mL/kg of body weight

Question 12

Clinical signs associated with acute upper airway obstruction due to thermal injury include:
1) pleural friction rub.
2) inspiratory stridor.
3) pulmonary edema.
4) painful swallowing.

Accepted Answer

A)  1, 3 
B)  2, 4 
C)  2, 3, 4 
D)  1, 2, 3, 4 
A)  1, 3 
B)  2, 4 
C)  2, 3, 4 
D)  1, 2, 3, 4

Question 13

Which of the following conditions occurs in 20% to 30% of hospitalized fire victims with facial burns?

Accepted Answer

A)  Acute respiratory distress syndrome (ARDS) 
B)  Upper airway obstruction 
C)  Pneumonia 
D)  Pulmonary embolism 
A)  Acute respiratory distress syndrome (ARDS) 
B)  Upper airway obstruction 
C)  Pneumonia 
D)  Pulmonary embolism

Question 14

A 65-year-old patient has third-degree skin burns over 30% of his body and a smoke inhalation injury. How does the combination of skin burns and smoke inhalation affect his prognosis?

Accepted Answer

A)  It quadruples the mortality rate. 
B)  It more than triples the mortality rate. 
C)  It almost doubles the mortality rate. 
D)  There is no mortality change between having one or two concurrent problems. 
A)  It quadruples the mortality rate. 
B)  It more than triples the mortality rate. 
C)  It almost doubles the mortality rate. 
D)  There is no mortality change between having one or two concurrent problems.

Question 15

In an industrial accident, an adult incurred burns over his head and neck, both arms, and his anterior trunk. What percent of his BSA was burned?

Accepted Answer

A)  27% 
B)  36% 
C)  45% 
D)  54% 
A)  27% 
B)  36% 
C)  45% 
D)  54%

Question 16

All of the following classes of medications are commonly used in the care of patients with smoke inhalation injury EXCEPT:

Accepted Answer

A)  parasympatholytics. 
B)  mucolytics. 
C)  sympathomimetics. 
D)  monoclonal antibody. 
A)  parasympatholytics. 
B)  mucolytics. 
C)  sympathomimetics. 
D)  monoclonal antibody.

Question 17

A patient with carbon monoxide poisoning has a COHb level of 20%. If the patient is given 100% oxygen, what will the approximate COHb level be in 1 hour?

Accepted Answer

A)  15% 
B)  10% 
C)  5% 
D)  2.5% 
A)  15% 
B)  10% 
C)  5% 
D)  2.5%

Question 18

The long-term effects of a smoke inhalation injury are:

Accepted Answer

A)  obstructive lung disorders. 
B)  restrictive lung disorders. 
C)  obstructive and restrictive lung disorders. 
D)  neither obstructive nor restrictive lung disorders, since there is normally complete recovery. 
A)  obstructive lung disorders. 
B)  restrictive lung disorders. 
C)  obstructive and restrictive lung disorders. 
D)  neither obstructive nor restrictive lung disorders, since there is normally complete recovery.

Exam 43: Smoke Inhalation, Thermal Injuries, and Carbon Monoxide Intoxication

All of the following will be typically found in the air of an enclosed house fire EXCEPT:

A patient has been brought to the emergency department after inhaling superheated steam. Pulmonary injuries unique to this situation include: 1) atelectasis. 2) pulmonary edema. 3) thick secretions. 4) pharyngeal edema.

A 10-year-old patient has inhaled hot gases, and an inspection of her mouth shows edema and blisters. What should the respiratory therapist recommend?

What COHb level is associated with a throbbing headache, nausea, vomiting, and impaired judgment?

What level of carbon monoxide toxicity is associated with coma, convulsions, and Cheyne-Stokes respiration?

Which of the following radiographic findings would be associated with the intermediate stage of recovery from a serious smoke inhalation injury?

Late-stage complications of extensive body surface burns include: 1) sepsis. 2) upper airway obstruction. 3) pneumonia. 4) pulmonary embolism.

Which portion of the pulmonary system will be affected by the inhalation of low-water solubility gases such as hydrogen chloride and phosgene?

Which of the following would be recommended for the treatment of cyanide poisoning?

Clinical signs of an upper airway thermal injury include: 1) facial burns. 2) atelectasis. 3) mucosal edema. 4) epithelial sloughing.

According to the Parkland Formula, what is the recommended volume of fluid that should be infused over a 24-hour period for each percent of body surface burned?

Clinical signs associated with acute upper airway obstruction due to thermal injury include: 1) pleural friction rub. 2) inspiratory stridor. 3) pulmonary edema. 4) painful swallowing.

Which of the following conditions occurs in 20% to 30% of hospitalized fire victims with facial burns?

A 65-year-old patient has third-degree skin burns over 30% of his body and a smoke inhalation injury. How does the combination of skin burns and smoke inhalation affect his prognosis?

In an industrial accident, an adult incurred burns over his head and neck, both arms, and his anterior trunk. What percent of his BSA was burned?

All of the following classes of medications are commonly used in the care of patients with smoke inhalation injury EXCEPT:

A patient with carbon monoxide poisoning has a COHb level of 20%. If the patient is given 100% oxygen, what will the approximate COHb level be in 1 hour?

The long-term effects of a smoke inhalation injury are:

The Patient Interview

The Physical Examination and Its Basis in Physiology

Pulmonary Function Study Assessments

Arterial Blood Gas Assessments

Oxygenation Assessments

Cardiovascular System Assessments

Radiologic Examination of the Chest

Other Important Tests and Procedures

The Therapist-Driven Protocol Program and the Role of the Respiratory Therapist

Respiratory Failure and the Mechanical Ventilation Protocol

Recording Skills: The Basis for Data Collection, Organization, Assessment Skill

Chronic Obstructive Pulmonary Disease (COPD), Chronic Bronchitis, and Emphysema

Asthma

Bronchiectasis

Cystic Fibrosis

Pneumonia

Lung Abscess

Tuberculosis

Fungal Diseases of the Lung

Pulmonary Edema

Pulmonary Vascular Disease: Pulmonary Embolism and Pulmonary Hypertension

Flail Chest

Pneumothorax

Pleural Effusion and Empyema

Kyphoscoliosis

Interstitial Lung Diseases

Cancer of the Lung

Acute Respiratory Distress Syndrome

Guillain-Barré Syndrome

Myasthenia Gravis

Sleep Apnea

Clinical Manifestations Common with Newborn and Early Childhood Respiratory Dis

Meconium Aspiration Syndrome

Transient Tachypnea of the Newborn

Respiratory Distress Syndrome

Pulmonary Air Leak Syndromes

Respiratory Syncytial Virus (Bronchiolitis or Pneumonitis)

Bronchopulmonary Dysplasia

Congenital Diaphragmatic Hernia

Congenital Heart Diseases

Croup Syndrome: Laryngotracheobronchitis and Acute Epiglottitis

Near Drowning/Wet Drowning

Atelectasis

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