BURNS ACTUAL EXAMINATION TEST 2026
SOLVED QUESTIONS GRADED A+
◉ 2. On admission to the burn unit, a patient with an approximate 25%
total body surface area (TBSA) burn has the following initial laboratory
results: Hct 58%, Hgb 18.2 mg/dL (172 g/L), serum K+ 4.9 mEq/L (4.8
mmol/L), and serum Na+ 135 mEq/L (135 mmol/L). Which action will
the nurse anticipate taking now?
a. Monitor urine output every 4 hours.
b. Continue to monitor the laboratory results.
c. Increase the rate of the ordered IV solution.
d. Type and crossmatch for a blood transfusion. ANS: C
The patient's laboratory data show hemoconcentration, which may lead
to a decrease in blood flow to the microcirculation unless fluid intake is
increased. Because the hematocrit and hemoglobin are elevated, a
transfusion is inappropriate, although transfusions may be needed after
the emergent phase once the patient's fluid balance has been restored. On
admission to a burn unit, the urine output would be monitored more
often than every 4 hours; likely every1 hour.
◉ 3. A patient is admitted to the burn unit with burns to the head, face,
and hands. Initially, wheezes are heard, but an hour later, the lung
sounds are decreased and no wheezes are audible. What is the best
action for the nurse to take?
,a. Encourage the patient to cough and auscultate the lungs again.
b. Notify the health care provider and prepare for endotracheal
intubation.
c. Document the results and continue to monitor the patient's respiratory
rate.
d. Reposition the patient in high-Fowler's position and reassess breath
sounds. ANS: B
The patient's history and clinical manifestations suggest airway edema
and the health care provider should be notified immediately, so that
intubation can be done rapidly. Placing the patient in a more upright
position or having the patient cough will not address the problem of
airway edema. Continuing to monitor is inappropriate because
immediate action should occur.
◉ 4. A patient with severe burns has crystalloid fluid replacement
ordered using the Parkland formula. The initial volume of fluid to be
administered in the first 24 hours is 30,000 mL. The initial rate of
administration is 1875 mL/hr. After the first 8 hours, what rate should
the nurse infuse the IV fluids?
a. 350 mL/hour
b. 523 mL/hour
c. 938 mL/hour
d. 1250 mL/hour. ANS: C
Half of the fluid replacement using the Parkland formula is administered
in the first 8 hours and the other half over the next 16 hours. In this case,
the patient should receive half of the initial rate, or 938 mL/hr.
, ◉ 5. During the emergent phase of burn care, which assessment will be
most useful in determining whether the patient is receiving adequate
fluid infusion?
a. Check skin turgor.
b. Monitor daily weight.
c. Assess mucous membranes.
d. Measure hourly urine output. ANS: D
When fluid intake is adequate, the urine output will be at least 0.5 to 1
mL/kg/hour. The patient's weight is not useful in this situation because
of the effects of third spacing and evaporative fluid loss. Mucous
membrane assessment and skin turgor also may be used, but they are not
as adequate in determining that fluid infusions are maintaining adequate
perfusion.
◉ 6. A patient has just been admitted with a 40% total body surface area
(TBSA) burn injury. To maintain adequate nutrition, the nurse should
plan to take which action?
a. Insert a feeding tube and initiate enteral feedings.
b. Infuse total parenteral nutrition via a central catheter.
c. Encourage an oral intake of at least 5000 kcal per day.
d. Administer multiple vitamins and minerals in the IV solution. ANS: A
Enteral feedings can usually be initiated during the emergent phase at
low rates and increased over 24 to 48 hours to the goal rate. During the
emergent phase, the patient will be unable to eat enough calories to meet
SOLVED QUESTIONS GRADED A+
◉ 2. On admission to the burn unit, a patient with an approximate 25%
total body surface area (TBSA) burn has the following initial laboratory
results: Hct 58%, Hgb 18.2 mg/dL (172 g/L), serum K+ 4.9 mEq/L (4.8
mmol/L), and serum Na+ 135 mEq/L (135 mmol/L). Which action will
the nurse anticipate taking now?
a. Monitor urine output every 4 hours.
b. Continue to monitor the laboratory results.
c. Increase the rate of the ordered IV solution.
d. Type and crossmatch for a blood transfusion. ANS: C
The patient's laboratory data show hemoconcentration, which may lead
to a decrease in blood flow to the microcirculation unless fluid intake is
increased. Because the hematocrit and hemoglobin are elevated, a
transfusion is inappropriate, although transfusions may be needed after
the emergent phase once the patient's fluid balance has been restored. On
admission to a burn unit, the urine output would be monitored more
often than every 4 hours; likely every1 hour.
◉ 3. A patient is admitted to the burn unit with burns to the head, face,
and hands. Initially, wheezes are heard, but an hour later, the lung
sounds are decreased and no wheezes are audible. What is the best
action for the nurse to take?
,a. Encourage the patient to cough and auscultate the lungs again.
b. Notify the health care provider and prepare for endotracheal
intubation.
c. Document the results and continue to monitor the patient's respiratory
rate.
d. Reposition the patient in high-Fowler's position and reassess breath
sounds. ANS: B
The patient's history and clinical manifestations suggest airway edema
and the health care provider should be notified immediately, so that
intubation can be done rapidly. Placing the patient in a more upright
position or having the patient cough will not address the problem of
airway edema. Continuing to monitor is inappropriate because
immediate action should occur.
◉ 4. A patient with severe burns has crystalloid fluid replacement
ordered using the Parkland formula. The initial volume of fluid to be
administered in the first 24 hours is 30,000 mL. The initial rate of
administration is 1875 mL/hr. After the first 8 hours, what rate should
the nurse infuse the IV fluids?
a. 350 mL/hour
b. 523 mL/hour
c. 938 mL/hour
d. 1250 mL/hour. ANS: C
Half of the fluid replacement using the Parkland formula is administered
in the first 8 hours and the other half over the next 16 hours. In this case,
the patient should receive half of the initial rate, or 938 mL/hr.
, ◉ 5. During the emergent phase of burn care, which assessment will be
most useful in determining whether the patient is receiving adequate
fluid infusion?
a. Check skin turgor.
b. Monitor daily weight.
c. Assess mucous membranes.
d. Measure hourly urine output. ANS: D
When fluid intake is adequate, the urine output will be at least 0.5 to 1
mL/kg/hour. The patient's weight is not useful in this situation because
of the effects of third spacing and evaporative fluid loss. Mucous
membrane assessment and skin turgor also may be used, but they are not
as adequate in determining that fluid infusions are maintaining adequate
perfusion.
◉ 6. A patient has just been admitted with a 40% total body surface area
(TBSA) burn injury. To maintain adequate nutrition, the nurse should
plan to take which action?
a. Insert a feeding tube and initiate enteral feedings.
b. Infuse total parenteral nutrition via a central catheter.
c. Encourage an oral intake of at least 5000 kcal per day.
d. Administer multiple vitamins and minerals in the IV solution. ANS: A
Enteral feedings can usually be initiated during the emergent phase at
low rates and increased over 24 to 48 hours to the goal rate. During the
emergent phase, the patient will be unable to eat enough calories to meet
