Question 1

The nurse cares for an older patient with a burn injury. Because preexisting health conditions influence how the older patient responds to the resuscitative treatment, what should be the priority when caring for this patient?

Accepted Answer

A)  Calculating nutritional needs 
B)  Coordinating physical therapy 
C)  Managing pain 
D)  Fluid resuscitation

Question 2

The nurse plans care for a client with a major burn injury. What should the goal be for initial burn management? Select all that apply.

Accepted Answer

A)  Decrease the risk of developing compartment syndrome. 
B)  Promote physical/psychological comfort. 
C)  Prevent infection. 
D)  Reduce the degree of scarring. 
E)  Decrease fluid and electrolyte loss.

Question 3

Following establishment of an airway, adequate breathing, and circulation, the nurse should focus next on which assessment following a burn injury?

Accepted Answer

A)  Determining total body surface area of the burn 
B)  A quick check of neurologic status 
C)  Psychologic trauma resulting from the incident 
D)  Details of how the injury occurred

Question 4

During the acute phase of burn injury, the patient has the risk of developing complications. For what should the nurse assess the patient during this phase?

Accepted Answer

A)  Hypovolemic shock 
B)  Septic shock 
C)  Wound scarring 
D)  Urinary tract infection

Question 5

When assessing zone of coagulation of a third-degree burn injury, what should the nurse be alert for?

Accepted Answer

A)  The presence of pain 
B)  Brisk capillary refill 
C)  Surface of the wound that is dry and firm 
D)  A bright red wound color

Question 6

A middle-aged male patient weighing 220 pounds incurred burns to 40% of the total body surface area. Using the Parkland formula, what are this patient's fluid needs for the first 24 hours?

Accepted Answer

A)  3,520 mL 
B)  35,200 mL 
C)  1,600 mL 
D)  16,000 mL

Question 7

A patient rescued from a small house fire is brought to the emergency department. There is no burn injury to the skin; however, laboratory results show a CO level of 22%. Which intervention should the nurse expect to implement?

Accepted Answer

A)  Administer high-flow nebulizer treatment. 
B)  Infuse a fluid bolus of lactated Ringer's solution. 
C)  Begin a sodium bicarbonate drip. 
D)  Give 100% oxygen by mask.

Question 8

Which statement should the nurse use to explain skin-covering procedures to a burn patient?

Accepted Answer

A)  Autografts are permanent skin replacements for burns. 
B)  Meshed autografts are used for the face and hands. 
C)  Tissue typing is necessary for use of an allograft. 
D)  Cultured autologous epithelial cells provide a temporary wound covering.

Question 9

A patient in ICU with a burn circling the left upper leg suddenly experiences excruciating pain, pallor in the lower extremity, and loss of pedal pulse. Which health problem is this patient most likely developing?

Accepted Answer

A)  Compartment syndrome 
B)  Inability to perform ADLs 
C)  Nosocomial infection 
D)  A deep vein thrombosis

Question 10

The nurse reviews plans for wound and scar management for the rehabilitation phase with a patient recovering from an extensive burn. What complication should the nurse explain to the patient? Select all that apply.

Accepted Answer

A)  Neuropathies 
B)  Wound breakdown 
C)  Contractures 
D)  Hypertrophic scarring 
E)  Osteomyelitis

Question 11

The critical care nurse is concerned that a patient in the acute phase of a burn injury is experiencing metabolic changes because of which assessment finding? Select all that apply.

Accepted Answer

A)  Drop in body weight 
B)  Elevated creatinine levels 
C)  Urine output of 20 mL/hr 
D)  Abdominal pain 
E)  Stridor

Question 12

What interventions should the nurse plan to prevent the onset of contractures for a patient in the rehabilitation phase of burn care? Select all that apply.

Accepted Answer

A)  Conduct exercises. 
B)  Splint joints. 
C)  Follow body positioning recommendations. 
D)  Perform range-of-motion exercises. 
E)  Schedule surgery to release the joints.

Question 13

What should the nurse explain to a family member about the reason why older patients are at risk for scalding by hot water?

Accepted Answer

A)  This age group's adversity to taking showers 
B)  An inclination to test the water's temperature 
C)  Overall slower reaction time 
D)  Loss of elasticity of skin tissue

Question 14

A patient with 50% total body surface burns is recovering from graft surgery. What should the nurse identify as major goals of care for this patient? Select all that apply.

Accepted Answer

A)  Control infection. 
B)  Avoid wound breakdown. 
C)  Prevent hypertrophic scarring. 
D)  Ensure adequate fluid balance. 
E)  Encourage prescribed exercise.

Question 15

An 80-year-old patient is admitted for 39% TBSA burns. The nurse should assess for which risk factors that apply to this patient? Select all that apply.

Accepted Answer

A)  Higher sensitivity to pain 
B)  Delay seeking treatment 
C)  Thinner skin 
D)  Impaired vision 
E)  Concurrent respiratory problems

Question 16

Which patient situation presents the greatest risk for an inhalation injury?

Accepted Answer

A)  Second-degree electrical burn of the hand 
B)  Trapped on an elevator during a fire in a building 
C)  History of asthma who has extensive first-degree sunburn 
D)  Scalding injury from liquid splashed on the legs

Question 17

A patient weighing 80 kg is receiving resuscitative care for a burn to 46% of total body surface area. What finding indicates that resuscitation is effective? Select all that apply.

Accepted Answer

A)  Urine output 50 mL/hour 
B)  Heart rate 96 beats per minute 
C)  Blood pressure 138/88 mm Hg 
D)  Clear lung sounds 
E)  Bladder pressure 15 mm Hg

Question 18

The critical care nurse is aware that the depth of burn injury is determined by the depth of tissue destruction and which other factor? Select all that apply.

Accepted Answer

A)  Duration of the burn exposure 
B)  Additional chronic medical conditions 
C)  Skin thickness 
D)  The cause of the burn 
E)  Body part of the burn injury

Exam 17: Care of the Acutely Ill Burn Patient