NURSING 232 EXAM 3 QUESTIONS AND
ANSWERS GRADED A+ 2026
Causes of burns - ANS Hot water
House fires
Campfires
Fireworks
Candles
Abuse
MVA
Fire play
Electrical burns - ANS Can result in cardiac arrest, metabolic acidosis
Chemical burns - ANS Household cleaners, fertilizers, drain cleaners
Inhalation burns - ANS Smoke, etc
Thermal burns - ANS -Most common
-Flame, grease, contact, scalds, frostbite
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 1
,-Splash burns to lower extremity- sign of child abuse
Skin - ANS Largest organ
Epidermis - ANS Acts as barrier to hold in moisture and protect against infection
Dermis - ANS Cushions the body from stress and strain; contains nails, hair follicles,
sebaceous glands. 30-45 X thicker than epidermis
Hypodermis - ANS Also called subcutaneous tissue; acts as insulation and protects the
internal organs from variations in temperature
Classification of burn injury - ANS Extent (Rule of nines)
Depth
Location
Patient Risk Factors
Rule of nines - ANS To approximate the percentage of burned surface area; divides the body
into sections.
1st degree burn - ANS Superficial, pain, redness, swelling
2nd degree burn - ANS Partial thickness, pink to cherry red, wet and shiny, serous exudate,
painful, blisters, nerve injury, regeneration
3rd degree burn - ANS Full thickness, dry and waxy, white to dark brown/black, nerve
endings destroyed, eschar
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 2
,Burn location/special considerations - ANS -Face, eyes, hands, arms, ears, and perineum
require vigilant nursing care
-For some, unable to open eyes bc of swelling
-Ears and nose susceptible to infection (poor blood supply)
-Ears free of pressure (no pillows, rolled towel under shoulders)
-Hands and arms extended and elevated on pillows (decrease edema)
-Splints (decrease contracture)
-Buttocks and perineum- increased infection
Phases of burn management - ANS Prehospital, emergent, acute, rehabilitation
Prehospitalization burn phase - ANS -Small thermal wounds ( < 10% TBSA) cover w a clean,
cool, tap water towel
-Large burns: focus on ABC's; cool no more than 10 min, remove as much burned clothing as
possible
-Chemical burn: brush dry chemical from skin before irrigation, flush area with copious amounts
of NS or water
-Never cover with ice: causes more damage
Emergent burn phase - ANS -Concern is hypovolemic shock and edema formation
-Lasts up to 72 hours (ends when fluid mobilization begins)
-Water, sodium, and protein (esp. albumin) move into interstitial space (second spacing)
-Third spacing
-Decreased BP, increased HR, decreased UO
-Increased HCT, electrolyte imbalances
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 3
, Airway- burns - ANS -Soot around nares, on tongue
-Singed nasal hairs
-Darkened nasal or oral membranes
-Singed eyelashes
-Redness of throat or mouth
-Obstructions from edema
Circulation- burns - ANS -Monitor BP, pulse
-Hemolysis of RBC
-Thrombosis of capillaries
-Carboxyhemoglobinemia (carbon monoxide poisoning): skin cherry red when severe, treated
with 100% O2
Urinary system- burns - ANS -Acute Tubular Necrosis (ATN): myoglobin (from muscle cell
breakdown) and hemoglobin (from RBC breakdown) are released into bloodstream and occlude
renal tubules; occurs with full thickness and major electrical burns
-Hypovolemic: renal ischemia
Fluid resuscitation- burns - ANS -Lactated ringers for first 24 hrs (Parkland formula: LR 4
mL/kg/% TBSA burn- for total fluid req. first 24 hrs)
-Any burn > 10% in children and > 15% in adults requires resuscitation
-Colloids (albumin): given 12-24 hrs post burn when capillary permeability is normal or near
normal
Pain management- burns - ANS -Must pre medicate 1/2 hour w oral meds
-Burn pt require multiple doses or more than recommended dosing
-Be an advocate for your pt; burns are extremely painful
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 4
ANSWERS GRADED A+ 2026
Causes of burns - ANS Hot water
House fires
Campfires
Fireworks
Candles
Abuse
MVA
Fire play
Electrical burns - ANS Can result in cardiac arrest, metabolic acidosis
Chemical burns - ANS Household cleaners, fertilizers, drain cleaners
Inhalation burns - ANS Smoke, etc
Thermal burns - ANS -Most common
-Flame, grease, contact, scalds, frostbite
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 1
,-Splash burns to lower extremity- sign of child abuse
Skin - ANS Largest organ
Epidermis - ANS Acts as barrier to hold in moisture and protect against infection
Dermis - ANS Cushions the body from stress and strain; contains nails, hair follicles,
sebaceous glands. 30-45 X thicker than epidermis
Hypodermis - ANS Also called subcutaneous tissue; acts as insulation and protects the
internal organs from variations in temperature
Classification of burn injury - ANS Extent (Rule of nines)
Depth
Location
Patient Risk Factors
Rule of nines - ANS To approximate the percentage of burned surface area; divides the body
into sections.
1st degree burn - ANS Superficial, pain, redness, swelling
2nd degree burn - ANS Partial thickness, pink to cherry red, wet and shiny, serous exudate,
painful, blisters, nerve injury, regeneration
3rd degree burn - ANS Full thickness, dry and waxy, white to dark brown/black, nerve
endings destroyed, eschar
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 2
,Burn location/special considerations - ANS -Face, eyes, hands, arms, ears, and perineum
require vigilant nursing care
-For some, unable to open eyes bc of swelling
-Ears and nose susceptible to infection (poor blood supply)
-Ears free of pressure (no pillows, rolled towel under shoulders)
-Hands and arms extended and elevated on pillows (decrease edema)
-Splints (decrease contracture)
-Buttocks and perineum- increased infection
Phases of burn management - ANS Prehospital, emergent, acute, rehabilitation
Prehospitalization burn phase - ANS -Small thermal wounds ( < 10% TBSA) cover w a clean,
cool, tap water towel
-Large burns: focus on ABC's; cool no more than 10 min, remove as much burned clothing as
possible
-Chemical burn: brush dry chemical from skin before irrigation, flush area with copious amounts
of NS or water
-Never cover with ice: causes more damage
Emergent burn phase - ANS -Concern is hypovolemic shock and edema formation
-Lasts up to 72 hours (ends when fluid mobilization begins)
-Water, sodium, and protein (esp. albumin) move into interstitial space (second spacing)
-Third spacing
-Decreased BP, increased HR, decreased UO
-Increased HCT, electrolyte imbalances
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 3
, Airway- burns - ANS -Soot around nares, on tongue
-Singed nasal hairs
-Darkened nasal or oral membranes
-Singed eyelashes
-Redness of throat or mouth
-Obstructions from edema
Circulation- burns - ANS -Monitor BP, pulse
-Hemolysis of RBC
-Thrombosis of capillaries
-Carboxyhemoglobinemia (carbon monoxide poisoning): skin cherry red when severe, treated
with 100% O2
Urinary system- burns - ANS -Acute Tubular Necrosis (ATN): myoglobin (from muscle cell
breakdown) and hemoglobin (from RBC breakdown) are released into bloodstream and occlude
renal tubules; occurs with full thickness and major electrical burns
-Hypovolemic: renal ischemia
Fluid resuscitation- burns - ANS -Lactated ringers for first 24 hrs (Parkland formula: LR 4
mL/kg/% TBSA burn- for total fluid req. first 24 hrs)
-Any burn > 10% in children and > 15% in adults requires resuscitation
-Colloids (albumin): given 12-24 hrs post burn when capillary permeability is normal or near
normal
Pain management- burns - ANS -Must pre medicate 1/2 hour w oral meds
-Burn pt require multiple doses or more than recommended dosing
-Be an advocate for your pt; burns are extremely painful
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 4
