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Chapter: Smoke Inhalation, Thermal Injuries, and Carbon Monoxide Intoxication Des
Jardins: Clinical Manifestations and Assessment of Respiratory Disease, 8th Edition
MULTIPLE CHOICE
1. Clinical signs of an upper airway thermal injury include:
1. facial burns.
2. atelectasis.
3. mucosal edema.
4. epithelial sloughing.
a. 3
b. 1, 4
c. 1, 3, 4
d. 2, 3, 4
ANS: C
Clinical signs of an upper airway thermal injury include, but are not limited to, facial burns,
mucosal edema, and epithelial sloughing of the upper airway tissues.
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. NURSINGTB.COM a. 3
b. 1, 2
c. 2, 3, 4
d. 1, 2, 3
ANS: B
Inhaled superheated steam will burn all the way to the small airways and lungs. Injuries
unique to a steam inhalation include pulmonary edema and atelectasis.
3. Which of the following conditions occurs in 20% to 30% of hospitalized fire victims with
facial burns?
a. Acute respiratory distress syndrome (ARDS)
b. Upper airway obstruction
c. Pneumonia
d. Pulmonary embolism
, ANS: B
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burns is a classic predictor of thermal injury. Thermal injury to the upper airway results in
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blistering, mucosal edema, vascular congestion, epithelial sloughing, and accumulation of
thick secretions. Acute upper airway obstruction (UAO) occurs in about 20% to 30% of
hospitalized patients with thermal injury and is usually most marked in the supraglottic
structures.
4. Late-stage complications of extensive body surface burns include:
1. sepsis.
2. upper airway obstruction.
3. pneumonia.
4. pulmonary embolism.
a. 1, 2
b. 3, 4
c. 2, 3
d. 1, 3, 4
ANS: D
Late-stage complications are those that occur 5 days or longer after the initial injury occurred. During
the late stage following burns, a patient with extensive body surface burns (and prolonged
immobility) is at risk for sepsis, pneumonia, and a pulmonary embolism.
5. 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?
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.
ANS: C
The mortality rate almost doubles when a patient has third-degree burns and a smoke
inhalation injury compared
NU SwitRh h NaI viTnGg aO Bsin.gCle pMroblem.
6. Which portion of the pulmonary system will be affected by the inhalation of low–
water solubility gases such as hydrogen chloride and phosgene? a. Distal airways
and alveoli
b. Pulmonary vascular bed
c. Upper airway
d. Pulmonary lymphatic system
ANS: A Low–water solubility gases will penetrate and damage the distal airways
and alveoli.
7. Which of the following will be typically found in the air of an enclosed house fire?
1. Steam
2. Carbon monoxide
3. Hydrogen cyanide 4. Hydrogen chloride
a. 1, 3
b. 1, 2, 4
c. 2, 3, 4
d. 1, 2, 3
, ANS: D
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hydrogen cyanide, and hydrogen chloride.
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8. 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? 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.
ANS: B
Endotracheal intubation should be performed as soon as possible because the patient is at a
high risk for airway obstruction.
9. 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? a. 15 %
b. 10%
c. 5%
d. 2.5%
ANS: B
Breathing 100% oxygen at one atmosphere pressure will reduce the COHb by half in l hour. A 20%
COHb level will be reduced to about 10% after 1 hour of breathing FIO2 1.0.
10. Which of the following classes of medications are commonly used in the care of patients
with smoke inhalation injury?
1. Parasympatholytics
2.3. MucolyticsSympathomimetics NURSINGTB.COM
4. Monoclonal antibody
a. 1, 3
b. 1, 2, 4
c. 2, 3, 4
d. 1, 2, 3
ANS: D
A monoclonal antibody, such as omalizumab, would not be indicated in the treatment of a
smoke inhalation injury.
11. 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.
a. 1, 3
b. 2, 4
c. 2, 3, 4
d. 1, 2, 3
ANS: B
Inspiratory stridor and painful swallowing are two of the clinical signs associated with acute
upper airway obstruction due to thermal injury.
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Chapter: Smoke Inhalation, Thermal Injuries, and Carbon Monoxide Intoxication Des
Jardins: Clinical Manifestations and Assessment of Respiratory Disease, 8th Edition
MULTIPLE CHOICE
1. Clinical signs of an upper airway thermal injury include:
1. facial burns.
2. atelectasis.
3. mucosal edema.
4. epithelial sloughing.
a. 3
b. 1, 4
c. 1, 3, 4
d. 2, 3, 4
ANS: C
Clinical signs of an upper airway thermal injury include, but are not limited to, facial burns,
mucosal edema, and epithelial sloughing of the upper airway tissues.
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. NURSINGTB.COM a. 3
b. 1, 2
c. 2, 3, 4
d. 1, 2, 3
ANS: B
Inhaled superheated steam will burn all the way to the small airways and lungs. Injuries
unique to a steam inhalation include pulmonary edema and atelectasis.
3. Which of the following conditions occurs in 20% to 30% of hospitalized fire victims with
facial burns?
a. Acute respiratory distress syndrome (ARDS)
b. Upper airway obstruction
c. Pneumonia
d. Pulmonary embolism
, ANS: B
ba g
nk
st in Even though thermal injury may occur with or without surface burns, the presence of facial
Te urs
burns is a classic predictor of thermal injury. Thermal injury to the upper airway results in
N
blistering, mucosal edema, vascular congestion, epithelial sloughing, and accumulation of
thick secretions. Acute upper airway obstruction (UAO) occurs in about 20% to 30% of
hospitalized patients with thermal injury and is usually most marked in the supraglottic
structures.
4. Late-stage complications of extensive body surface burns include:
1. sepsis.
2. upper airway obstruction.
3. pneumonia.
4. pulmonary embolism.
a. 1, 2
b. 3, 4
c. 2, 3
d. 1, 3, 4
ANS: D
Late-stage complications are those that occur 5 days or longer after the initial injury occurred. During
the late stage following burns, a patient with extensive body surface burns (and prolonged
immobility) is at risk for sepsis, pneumonia, and a pulmonary embolism.
5. 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?
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.
ANS: C
The mortality rate almost doubles when a patient has third-degree burns and a smoke
inhalation injury compared
NU SwitRh h NaI viTnGg aO Bsin.gCle pMroblem.
6. Which portion of the pulmonary system will be affected by the inhalation of low–
water solubility gases such as hydrogen chloride and phosgene? a. Distal airways
and alveoli
b. Pulmonary vascular bed
c. Upper airway
d. Pulmonary lymphatic system
ANS: A Low–water solubility gases will penetrate and damage the distal airways
and alveoli.
7. Which of the following will be typically found in the air of an enclosed house fire?
1. Steam
2. Carbon monoxide
3. Hydrogen cyanide 4. Hydrogen chloride
a. 1, 3
b. 1, 2, 4
c. 2, 3, 4
d. 1, 2, 3
, ANS: D
ba g
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st in The burning of typical household materials will result in the release of carbon monoxide,
Te urs
hydrogen cyanide, and hydrogen chloride.
N
8. 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? 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.
ANS: B
Endotracheal intubation should be performed as soon as possible because the patient is at a
high risk for airway obstruction.
9. 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? a. 15 %
b. 10%
c. 5%
d. 2.5%
ANS: B
Breathing 100% oxygen at one atmosphere pressure will reduce the COHb by half in l hour. A 20%
COHb level will be reduced to about 10% after 1 hour of breathing FIO2 1.0.
10. Which of the following classes of medications are commonly used in the care of patients
with smoke inhalation injury?
1. Parasympatholytics
2.3. MucolyticsSympathomimetics NURSINGTB.COM
4. Monoclonal antibody
a. 1, 3
b. 1, 2, 4
c. 2, 3, 4
d. 1, 2, 3
ANS: D
A monoclonal antibody, such as omalizumab, would not be indicated in the treatment of a
smoke inhalation injury.
11. 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.
a. 1, 3
b. 2, 4
c. 2, 3, 4
d. 1, 2, 3
ANS: B
Inspiratory stridor and painful swallowing are two of the clinical signs associated with acute
upper airway obstruction due to thermal injury.
