Deck 36: Acute Burn Injury

Question 1

A patient,being treated for burns over 40% of the total body surface area,is experiencing a hypermetabolic state.The nurse anticipates the addition of which type of medication to help reduce muscle wasting and accelerate healing time?

A)Antibiotics
B)Cardiac glycosides
C)Insulin
D)Calcium channel blockers

Answer 1

Insulin

Question 2

A patient,recovering from being struck by lightning 36 hours prior to admission,is demonstrating an acute onset of confusion and muscle weakness.Which rationale would the nurse provide for this assessment?

A)The patient is suffering a stroke unrelated to the injury.
B)The patient likely has an electrolyte imbalance.
C)The patient has developed a seizure disorder from the injury.
D)The patient is having delayed onset of neurological symptoms,which are common after a lightning injury.

Answer 2

The patient is having delayed onset of neurological symptoms,which are common after a lightning injury.

Question 3

A patient comes into the emergency department with severe burns over the face,arms,legs,and back after spending the day boating with friends.The skin is dry and very red with brisk capillary refill.How would the nurse classify this patient's burn injuries?

A)Superficial
B)Deep partial thickness
C)Superficial partial thickness
D)Full thickness

Answer 3

Superficial

Question 4

The nurse is preparing to ambulate a patient who sustained burns over 20% of his lower extremities.Which intervention is most important to facilitate the success of the patient's ambulation?

A)Transfer the patient to a chair before ambulating.
B)Apply compression wraps to the lower extremities before getting out of bed.
C)Be certain the patient is well hydrated before ambulation.
D)Have the patient perform incentive spirometry.

Question 5

The nurse caring for a patient admitted for burns over his torso and upper arms has clothing adhered to the skin.Which nursing action is indicated?

A)Leave the clothing in place and flush the areas with cooled water.
B)Flush the clothing with hydrogen peroxide to clean the skin underneath.
C)Cover the areas with gauze.
D)Apply a topical antiseptic over the clothing areas.

Question 6

A patient with severe,deep partial-thickness burns experiences procedural,background,and breakthrough pain.What is the nurse's most important plan for controlling this patient's pain?

A)Administer pain medications prior to all procedures.
B)Maintain intravenous access for administration of pain medications.
C)Designate one pain assessment technique for use by all providers.
D)Expect that it will be necessary to exceed normally administered levels of analgesics.

Question 7

A civilian patient admitted with frostbite burns to her feet is receiving pain medication and fluid replacement and is being monitored for any signs of organ dysfunction.What rationale would the nurse provide for this conservative management?

A)Frostbite injuries are not as serious as thermal or chemical burns.
B)The extent of the injury is not obvious.
C)Little is known about other methods to treat frostbite.
D)Aggressive frostbite management is only done in specialty military hospitals.

Question 8

A patient is admitted with partial-thickness burns over the entire left arm and neck.Superficial burns are present on the face and scalp.The anterior trunk has patches of superficial burns.There are deep partial-thickness burns on the legs with full-thickness burns on both feet.The nurse using the Lund and Browder chart to estimate the total body surface area burned will include the burns on which body areas? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Left arm
B)Face
C)Legs
D)Feet
E)Trunk

Question 9

Victims of a house fire are being admitted through the emergency department.Of the patients,the nurse realizes that which will have the greatest general risk for mortality from the burn injuries?

A)25-year-old pregnant female
B)49-year-old male who smokes
C)75-year-old female with arthritis
D)50-year-old male with coronary artery disease

Question 10

A patient recovering from a burn to the left side of his face tells the nurse that he has no idea how he is going to return home and resume his regular life since he is so "ugly and disfigured." What nursing response is indicated?

A)"It is good that your work does not include having to meet the public every day."
B)"I don't think your scars are so bad."
C)"I think you should see a plastic surgeon before you try to go back to work."
D)"Would you like a referral to the Phoenix Society?"

Question 11

A patient is rehabilitating after a severe burn 6 months ago that left her with scars across her chest and abdomen.She says,"I don't care what people think,I am going to the beach in a bikini next week." What most important information should the nurse provide?

A)"This may be difficult since you are still supposed to be wearing your compression garment."
B)"You need to avoid sun exposure to your scars for at least one year."
C)"You should prepare yourself for how others will react to your scars."
D)"Remember that you are prone to getting too hot easily."

Question 12

A patient has been treated in the burn unit for 3 months.What characteristics of wound healing would the nurse evaluate as normal? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Breaking down of old collagen layers
B)Reepithelialization
C)Revascularization
D)Strengthening of the scar
E)Hypertrophic scar production

Question 13

The nurse is providing emergency care to patients injured in a house fire.Which patient would the nurse prepare for transfer to a burn center for additional care and treatment?

A)15-year-old child with 5% total body surface area burns to the left arm
B)10-year-old child with partial-thickness burns to the face and left hand
C)30-year-old female with superficial burns to the arms and neck
D)35-year-old male with partial-thickness burn to a part of his back

Question 14

The nurse is planning the care of a patient who has burns to the face,neck,upper chest,and both upper arms.To prevent contracture development,the nurse should include which interventions in the patient's plan of care? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Use a bed cradle over the burned areas.
B)Have patient assume the position of comfort while sleeping.
C)Administer analgesics prior to physical therapy.
D)Instruct the patient to avoid using pillows under the head.
E)Get the patient out of bed as soon as medically feasible.

Question 15

A 45-year-old patient who weighs 50 kg sustained partial thickness burns over 60% total body surface area (TBSA).This morning the patient's urine has a reddish brown color.Which interventions would the nurse anticipate? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Interventions to raise the urine pH to an alkaline level
B)Discussion of whether to change the patient's pain medication to a nonopioid
C)Irrigating the patient's bladder with a sodium bicarbonate solution
D)Management of intravenous fluids to achieve a urine output of at least 40 mL/hr
E)Requesting immediate measurement of serum potassium

Question 16

The nurse caring for a patient who sustained burns of 30% of the total body surface area 7 days ago is assessing the status of the patient's wounds.Which phase of wound healing would the nurse expect to be occurring?

A)Contraction
B)Inflammatory
C)Maturation
D)Proliferative

Question 17

The nurse is caring for a patient admitted with thermal burns.The nurse will plan to monitor the patient closely over the next 2 to 3 days for development of which most serious complication?

A)Pain
B)Burn shock
C)Continuation of the burn process below the level of obvious injury
D)Hypervolemia

Question 18

A patient is being admitted for treatment of deep partial-thickness burns.When doing this patient's initial assessment,the nurse would expect which burn characteristics? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Sluggish capillary refill
B)Leathery,white tissue
C)Significant edema
D)Blisters
E)Erythema

Question 19

The nurse is caring for a 154-pound patient with 50% total body surface area (TBSA)burns.If using the Parkland formula,the nurse will calculate which amount of intravenous solution to provide this patient in the first 24 hours of care?

A)14,000 mL
B)42,000 mL
C)3500 mL
D)7000 mL

Question 20

A patient has full-thickness burns of the right chest area,entire right arm,and deep partial-thickness burns of both upper anterior legs.Based on the rule of nines,which estimate of total body surface area burn would the nurse record?

A) 36%
B) 27%
C) 45%
D) 18%