Wound Management: Dressings, Bandaging, Irrigation, and Closure Practice Questions

25 multiple-choice questions on Wound management: dressings, bandaging, irrigation, and closure for paramedic and EMT students, from Chapter 32 (Soft-Tissue Trauma). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

25 practice questions

1. The three general goals of soft-tissue wound management in the field are to:

   1. A. Close, suture, and medicate the wound on scene
   2. B. Clean, cover, and discharge the patient at home
   3. C. Irrigate, debride, and apply topical antibiotics
   4. D. Control bleeding, keep it clean, and immobilize
   Show answer

   Answer: D. Control bleeding, keep it clean, and immobilize

   Prehospital care controls hemorrhage, keeps the wound clean, and protects it from further injury. Suturing and debridement are hospital procedures.

2. A dressing differs from a bandage in that a dressing:

   1. A. Covers the wound directly
   2. B. Holds a splint in place
   3. C. Secures gauze to the body
   4. D. Applies traction to a limb
   Show answer

   Answer: A. Covers the wound directly

   The dressing contacts the wound; the bandage holds the dressing in place. Securing gauze to the body is the bandage's job, which is why the two terms get confused.

3. A sterile dressing is one that:

   1. A. Has been washed with soap
   2. B. Is made of absorbent cotton
   3. C. Is free of all microorganisms
   4. D. Is sealed with an adhesive edge
   Show answer

   Answer: C. Is free of all microorganisms

   Sterile means no living organisms, protecting the wound from contamination. Clean or absorbent materials are not necessarily sterile.

4. An occlusive dressing is indicated for a:

   1. A. Small abrasion on the knee
   2. B. Large open neck wound
   3. C. Finger laceration
   4. D. Contusion of the forearm
   Show answer

   Answer: B. Large open neck wound

   An airtight occlusive dressing prevents air from being sucked into an open neck vein and causing an air embolism. Simple abrasions and lacerations need only standard sterile dressings.

5. A patient has a laceration on the back of the hand and is wearing two rings. The rings should be:

   1. A. Left on so they are not lost
   2. B. Taped in place against the finger
   3. C. Removed before swelling develops
   4. D. Removed only after hospital arrival
   Show answer

   Answer: C. Removed before swelling develops

   Swelling after a hand injury can turn a ring into a constricting band, and once the finger swells the ring may have to be cut off. Waiting until hospital arrival is tempting to avoid losing property, but swelling often makes removal impossible by then; document and secure the jewelry.

6. A pressure dressing is used to:

   1. A. Seal a sucking chest wound
   2. B. Control wound bleeding
   3. C. Hold a cold pack in place
   4. D. Keep a splint from slipping
   Show answer

   Answer: B. Control wound bleeding

   Firm, even pressure over bulky dressings helps stop bleeding. Sealing a sucking chest wound requires an occlusive or vented chest seal, not a pressure dressing.

7. When bandaging an arm laceration, the fingers should be left exposed so that you can:

   1. A. Monitor distal circulation
   2. B. Let the patient keep using his phone
   3. C. Allow the wound to drain more freely
   4. D. Keep the bandage from slipping off
   Show answer

   Answer: A. Monitor distal circulation

   Leaving the fingers or toes visible lets you detect a bandage that is too tight. Drainage occurs at the wound, not the fingertips.

8. A self-adhering roller bandage is applied too tightly around a forearm wound. The earliest signs would most likely include:

   1. A. Increased bleeding from the wound
   2. B. Warm, flushed skin distally
   3. C. A stronger radial pulse
   4. D. Tingling and pale, cool fingers
   Show answer

   Answer: D. Tingling and pale, cool fingers

   Excess pressure impedes venous return and arterial flow, causing numbness, tingling, pallor, and coolness distal to the bandage. Bleeding usually decreases, not increases, with tight wraps.

9. Elastic bandages must be used with caution on soft-tissue wounds because they:

   1. A. Can tighten as swelling develops
   2. B. Are too stiff to hold a dressing
   3. C. Are too loose to control bleeding
   4. D. Are made for joint injuries
   Show answer

   Answer: A. Can tighten as swelling develops

   Elastic wraps continue to compress as tissues swell and can act like a tourniquet. They do hold dressings, but their constricting effect requires frequent distal checks.

10. You are bandaging a laceration over the elbow joint. To keep the bandage in place you should:

    1. A. Wrap straight circles over the joint
    2. B. Tape the dressing without a bandage
    3. C. Apply a tourniquet above the elbow
    4. D. Use a figure-eight wrap
    Show answer

    Answer: D. Use a figure-eight wrap

    A figure-eight wrap crosses over the joint, allowing it to hold despite motion. Straight circles over a joint tend to slip and bunch.

11. A triangular bandage is commonly used to:

    1. A. Seal an open neck wound
    2. B. Make a sling or hold dressings
    3. C. Control arterial bleeding alone
    4. D. Measure wound size
    Show answer

    Answer: B. Make a sling or hold dressings

    Triangular bandages are versatile for slings, swathes, and holding dressings on the head or extremities. They are not airtight and cannot seal a neck wound.

12. When dressing a wound that is bleeding through the first dressing, you should:

    1. A. Remove the soaked dressing and start over
    2. B. Stop pressure and elevate the limb
    3. C. Add dressings and keep pressure
    4. D. Pack ice inside the wound
    Show answer

    Answer: C. Add dressings and keep pressure

    Removing a soaked dressing disrupts the forming clot and restarts bleeding; add layers and continue pressure, escalating per hemorrhage control protocol. Elevation alone has weak evidence.

13. Irrigation of a minor wound in the field is generally done with:

    1. A. Sterile saline or clean water
    2. B. Full-strength povidone-iodine
    3. C. Rubbing alcohol
    4. D. Chlorhexidine scrub
    Show answer

    Answer: A. Sterile saline or clean water

    Sterile saline or clean, drinkable water mechanically flushes out debris without harming tissue. Alcohol and full-strength antiseptics damage healing cells and are the most commonly misused choices.

14. Irrigation of a wound should not delay transport or be performed when the wound:

    1. A. Contains loose debris
    2. B. Has stopped bleeding
    3. C. Is a minor abrasion
    4. D. Is bleeding heavily
    Show answer

    Answer: D. Is bleeding heavily

    Irrigating a heavily bleeding wound washes away clot; hemorrhage control takes priority. Loose debris is exactly what irrigation is meant to remove.

15. Embedded gravel deep in an abrasion should be:

    1. A. Dug out with sterile forceps on scene
    2. B. Scrubbed out with a stiff surgical brush
    3. C. Left in place for hospital removal
    4. D. Rinsed away with hydrogen peroxide
    Show answer

    Answer: C. Left in place for hospital removal

    Prehospital care removes only loose surface debris; embedded material requires debridement with anesthesia. Scrubbing with a brush in the field causes pain and further tissue damage.

16. A 30-year-old has a clean, gaping 4-cm forearm laceration from 7 hours ago. Bleeding is controlled. He declines transport, saying it is too late for stitches. Your best response is that:

    1. A. Wounds older than 6 hours are always left open to heal alone
    2. B. Many wounds can still be closed, so he should be seen today
    3. C. He should tape the wound shut and watch it at home for a week
    4. D. He should wait 48 hours for the swelling to go down before repair
    Show answer

    Answer: B. Many wounds can still be closed, so he should be seen today

    There is no firm 'golden period' for closing simple lacerations. A multicenter cohort (Quinn 2014) found that contamination, diabetes, wound length, and leg location predicted infection, not time to closure, and systematic reviews have found no evidence for a strict 6-to-8-hour cutoff. Clean wounds are often closed many hours later, and face and scalp wounds later still, so the decision belongs to the receiving clinician; your job is to encourage prompt evaluation and document the time of injury. Leaving every wound older than 6 hours open is outdated dogma. Taping a gaping wound at home leads to a wide scar and missed tendon or nerve injury. Waiting 48 hours raises bacterial counts and makes primary closure less likely.

17. Which wound most needs evaluation for closure at the hospital?

    1. A. A small abrasion on the knee
    2. B. A minor bruise on the arm
    3. C. A gaping laceration on the face
    4. D. A superficial scratch on the hand
    Show answer

    Answer: C. A gaping laceration on the face

    Wounds that gape, are on the face for cosmetic reasons, or are over joints need closure for function and appearance. Small abrasions and bruises heal without closure.

18. Wounds over joints are more likely to need closure because they:

    1. A. Bleed less than wounds elsewhere do
    2. B. Resist infection better than others
    3. C. Lie under less skin tension
    4. D. Are pulled open by joint motion
    Show answer

    Answer: D. Are pulled open by joint motion

    Motion stretches wounds over joints and pulls the edges apart, delaying healing and widening scars, so they more often need closure. They do not bleed less than wounds elsewhere. They do not resist infection better than other wounds. They lie under more skin tension, not less, because the skin stretches with each movement.

19. When applying a dressing to a wound on the arm, you should:

    1. A. Cover the whole wound with sterile gauze
    2. B. Leave part of the wound open to air
    3. C. Use the patient's shirt as the dressing
    4. D. Place the bandage directly on the wound
    Show answer

    Answer: A. Cover the whole wound with sterile gauze

    Covering the whole wound with sterile material protects against contamination. Using a bandage directly on the wound is less protective because bandages are usually not sterile.

20. A 22-year-old has a 3-cm superficial laceration on the forearm with minimal bleeding. Vital signs are normal. The best field management is to:

    1. A. Apply a tourniquet just above the wound site
    2. B. Clean gently, apply a sterile dressing, bandage
    3. C. Pack the wound tightly with hemostatic gauze
    4. D. Close it with tape strips and release him on scene
    Show answer

    Answer: B. Clean gently, apply a sterile dressing, bandage

    Simple lacerations need gentle cleaning, a sterile dressing, and a bandage with distal checks. A tourniquet or hemostatic packing is for severe bleeding.

21. Hemostatic dressings are most appropriate for:

    1. A. Severe junctional bleeding
    2. B. Minor abrasions with capillary oozing
    3. C. Clean superficial forearm lacerations
    4. D. Small puncture wounds of the hand
    Show answer

    Answer: A. Severe junctional bleeding

    Hemostatic agents are packed into wounds where tourniquets cannot be used, such as the groin or axilla. Minor oozing wounds stop with simple direct pressure.

22. When wrapping a roller bandage around a lower-leg wound, you should begin:

    1. A. At the knee and work down toward the foot
    2. B. Distally and work upward toward the knee
    3. C. Directly over the wound, then go either way
    4. D. With tight turns that cover the toes too
    Show answer

    Answer: B. Distally and work upward toward the knee

    Wrapping from distal to proximal with even, overlapping turns avoids trapping blood and fluid below the bandage. Starting proximally can act like a venous tourniquet. Toes should be left exposed to check circulation, and turns should be snug but not tight.

23. Which dressing is most appropriate for a large abdominal evisceration?

    1. A. Dry gauze pressed gently into the abdomen
    2. B. A tight pressure bandage around the abdomen
    3. C. Moist sterile gauze under an occlusive layer
    4. D. Cold packs wrapped carefully around the organs
    Show answer

    Answer: C. Moist sterile gauze under an occlusive layer

    Moist sterile dressings keep exposed organs from drying, and an occlusive layer retains moisture and heat. Dry gauze sticks to the bowel and damages it.

24. Before applying a bandage to a wound on the lower leg, you should:

    1. A. Probe the wound to judge its depth
    2. B. Elevate the leg for 10 minutes
    3. C. Apply antibiotic ointment to the skin
    4. D. Check distal pulse, motor, sensation
    Show answer

    Answer: D. Check distal pulse, motor, sensation

    Baseline PMS lets you know whether a later change is due to the bandage or the injury. Probing can push contaminants deeper and restart bleeding, and elevation or ointment does not give you the baseline you need before wrapping the limb.

25. When securing a dressing on a forearm wound with adhesive tape, you should avoid:

    1. A. Leaving the fingertips uncovered
    2. B. Using sterile gauze under the tape
    3. C. Checking distal pulse afterward
    4. D. Taping all the way around the limb
    Show answer

    Answer: D. Taping all the way around the limb

    Tape wrapped fully around a limb cannot stretch as the limb swells and may act as a constricting band, cutting off circulation. Tape in strips that do not encircle the limb, or use a roller bandage. Leaving fingertips exposed, using sterile gauze, and checking the distal pulse are all correct practice.