PHTLS 10TH EDITION POST TEST EXAM 2026
UPDATED PRACTICE QUESTIONS AND
SOLUTIONS
◉ Third-degree burns (full-thickness burns) Answer: appear as
thick, dry-white, leathery burns. In severe cases skin will have a
charred appearance with visible thrombosis of blood vessels.
Involves entire thickness of skin. Can be disabling and life
threatening.
◉ Fourth-degree burns Answer: involves not only all layers of skin,
but also underlying fat, muscles, bone, or internal organs.
◉ Highest priority in burned PTs? Answer: Airway! Heat from fire
can cause edema of the airway above the level of the vocal cords and
can occlude the airway. Intubate as soon as airway swelling is
expected.
◉ Treatment for burns that involve >20% of body Answer:
Establishment of two large-caliber IV catheters capable of the rapid
flow rate needed for large-volume resuscitation.
,◉ Escharotomy Answer: a surgical procedure that involves making
an incision through the hardened burn eschar, allowing the burn and
chest to expand and move with the PT's respiratory movements.
◉ In "Disability" Assessment for burned PTs.. Answer: it is vital to
assess for other, less obvious internal injuries that may be more
immediately life threatening than the burn injuries. Evaluate the PT
for neurologic and motor deficits. Identify and splint long bone
fractures. Perform spinal immobilization of necessary.
◉ In "Expose" portion of assessment for burned PTs.. Answer: -every
square inch of the PT should be exposed.
-burned PTs are not able to retain their own body heat and are
extremely susceptible to hypothermia.
◉ Rule of Palms Answer: -Male Palm alone: 0.5% BSA
-Female Palm alone: 0.4% BSA
-Male full hand: 0.8%
-Female full hand: 0.7%
◉ Initial step in the care of a burn PT... Answer: to stop the burning
process by irrigating with copious volumes of room-temp water. In
PTs with large burns, cooling could cause hypothermia.
,◉ Administration of large amounts of IV fluids needed over course
of the first day post burns to prevent... Answer: hypovolemic shock.
After a burn, the victim loses a substantial amount of itravascular
fluid in the form of obligatory whole-body edema, as well as
evaporative losses at the site of the burn.
◉ Parkland formula Answer: -4ml/kg/% burned area
-Half of this fluid in first 8 hours
-Remaining in hours 8-24
-Lactated Ringers is preferred
◉ Burned Pediatric PTs require larger volumes of IV fluid. Children
have less metabolic reserves of the molecule glycogen in their livers
to maintain adequate blood glucose during the periods of burn
resuscitation. Answer: Children should receive 5% dextrose
containing IV fluids at a standard rate in addition to burn
resuscitation fluids.
◉ PTs with both thermal burns and smoke inhalation will require..
Answer: Significantly more fluid than the burn PT without smoke
inhalation.
◉ Why is it that in many cases the extent of apparent tissue damage
does not accurately reflect the magnitude of the injury? Answer: As
, the electricity courses through the PT's body, deep layers of tissue
are destroyed despite seemingly minor injuries on the surface.
◉ Electrical and crush injuries share many similarities. Answer: In
both injuries, there is massive destruction of large muscle groups
with resultant release of both potassium and myoglobin.
◉ Circumferential burns of the chest can constrict the chest wall and
prevent sufficient.. Answer: Tidal Volume
◉ Any PT with burns to the face or soot in the sputum is at risk for a
smoke inhalation injury; but absence of these signs does not exclude
the diagnosis of a toxic inhalation. Three elements of smoke
inhalation: Answer: thermal injury, asphyxiation, delayed toxic-
induced lung injury
◉ Carbon monoxide (CO) and cyanide gas (CN) Answer: -
Asphyxiants
-CO binds to hemoglobin with greater affinity than O2
-Treatment is 100% oxygen 40-60 min.
◉ Toxin-Induced Lung Injury Answer: -Takes several days for signs
and symptoms to occur
-Causes death of cilia cells and floods lungs. Could cause life-
threatentin pneumonia.
UPDATED PRACTICE QUESTIONS AND
SOLUTIONS
◉ Third-degree burns (full-thickness burns) Answer: appear as
thick, dry-white, leathery burns. In severe cases skin will have a
charred appearance with visible thrombosis of blood vessels.
Involves entire thickness of skin. Can be disabling and life
threatening.
◉ Fourth-degree burns Answer: involves not only all layers of skin,
but also underlying fat, muscles, bone, or internal organs.
◉ Highest priority in burned PTs? Answer: Airway! Heat from fire
can cause edema of the airway above the level of the vocal cords and
can occlude the airway. Intubate as soon as airway swelling is
expected.
◉ Treatment for burns that involve >20% of body Answer:
Establishment of two large-caliber IV catheters capable of the rapid
flow rate needed for large-volume resuscitation.
,◉ Escharotomy Answer: a surgical procedure that involves making
an incision through the hardened burn eschar, allowing the burn and
chest to expand and move with the PT's respiratory movements.
◉ In "Disability" Assessment for burned PTs.. Answer: it is vital to
assess for other, less obvious internal injuries that may be more
immediately life threatening than the burn injuries. Evaluate the PT
for neurologic and motor deficits. Identify and splint long bone
fractures. Perform spinal immobilization of necessary.
◉ In "Expose" portion of assessment for burned PTs.. Answer: -every
square inch of the PT should be exposed.
-burned PTs are not able to retain their own body heat and are
extremely susceptible to hypothermia.
◉ Rule of Palms Answer: -Male Palm alone: 0.5% BSA
-Female Palm alone: 0.4% BSA
-Male full hand: 0.8%
-Female full hand: 0.7%
◉ Initial step in the care of a burn PT... Answer: to stop the burning
process by irrigating with copious volumes of room-temp water. In
PTs with large burns, cooling could cause hypothermia.
,◉ Administration of large amounts of IV fluids needed over course
of the first day post burns to prevent... Answer: hypovolemic shock.
After a burn, the victim loses a substantial amount of itravascular
fluid in the form of obligatory whole-body edema, as well as
evaporative losses at the site of the burn.
◉ Parkland formula Answer: -4ml/kg/% burned area
-Half of this fluid in first 8 hours
-Remaining in hours 8-24
-Lactated Ringers is preferred
◉ Burned Pediatric PTs require larger volumes of IV fluid. Children
have less metabolic reserves of the molecule glycogen in their livers
to maintain adequate blood glucose during the periods of burn
resuscitation. Answer: Children should receive 5% dextrose
containing IV fluids at a standard rate in addition to burn
resuscitation fluids.
◉ PTs with both thermal burns and smoke inhalation will require..
Answer: Significantly more fluid than the burn PT without smoke
inhalation.
◉ Why is it that in many cases the extent of apparent tissue damage
does not accurately reflect the magnitude of the injury? Answer: As
, the electricity courses through the PT's body, deep layers of tissue
are destroyed despite seemingly minor injuries on the surface.
◉ Electrical and crush injuries share many similarities. Answer: In
both injuries, there is massive destruction of large muscle groups
with resultant release of both potassium and myoglobin.
◉ Circumferential burns of the chest can constrict the chest wall and
prevent sufficient.. Answer: Tidal Volume
◉ Any PT with burns to the face or soot in the sputum is at risk for a
smoke inhalation injury; but absence of these signs does not exclude
the diagnosis of a toxic inhalation. Three elements of smoke
inhalation: Answer: thermal injury, asphyxiation, delayed toxic-
induced lung injury
◉ Carbon monoxide (CO) and cyanide gas (CN) Answer: -
Asphyxiants
-CO binds to hemoglobin with greater affinity than O2
-Treatment is 100% oxygen 40-60 min.
◉ Toxin-Induced Lung Injury Answer: -Takes several days for signs
and symptoms to occur
-Causes death of cilia cells and floods lungs. Could cause life-
threatentin pneumonia.
