NUR 265 Week 5: Advanced Burn Management and Emergency
Nursing 2026 |Galen College
1. A patient arrives in the ED with partial-thickness burns to the entire left arm
and the anterior trunk. Using the Rule of Nines, what is the estimated Total
Body Surface Area (TBSA) affected?
A. 27%
B. 18%
C. 36%
D. 45%
Answer: A
Rationale: The anterior trunk is 18% and the entire arm (front and back) is 9%. 18 + 9 =
27%.
2. During the emergent phase of burn care, which electrolyte imbalance is most
commonly expected due to cellular destruction?
A. Hypokalemia
B. Hypercalcemia
C. Hyponatremia
D. Hyperkalemia
Answer: D
Rationale: Cellular injury and destruction release intracellular potassium into the
extracellular space, leading to hyperkalemia during the first 24-48 hours.
,3. A client weighing 70 kg has sustained burns to 40% of their TBSA. Using the
Parkland Formula (4mL/kg/%TBSA), what is the total fluid volume required in
the first 24 hours?
A. 5,600 mL
B. 2,800 mL
C. 8,400 mL
D. 11,200 mL
Answer: D
Rationale: 4mL x 70kg x 40 = 11,200 mL.
4. In the scenario described above (70kg, 40% TBSA), how many mL of fluid
should be administered in the first 8 hours from the time of injury?
A. 2,800 mL
B. 5,600 mL
C. 4,200 mL
D. 11,200 mL
Answer: B
Rationale: The Parkland formula dictates that half of the total 24-hour volume (11,
= 5,600 mL) should be given in the first 8 hours.
5. A patient was rescued from a burning building and presents with singed nasal
hairs and soot-tinged sputum. Which intervention is the highest priority?
A. Start two large-bore IV lines
B. Administer pain medication
C. Prepare for immediate endotracheal intubation
D. Apply silver sulfadiazine to the wounds
Answer: C
Rationale: Singed nasal hairs and soot-tinged sputum are signs of inhalation injury, which
can lead to rapid airway edema. Maintaining airway patency is the top priority.
, 6. Which assessment finding indicates that fluid resuscitation is successful in a
patient with 50% TBSA burns?
A. Heart rate of 120 bpm
B. Urine output of 0.5 to 1 mL/kg/hr
C. Blood pressure of 90/60 mmHg
D. Decreasing peripheral edema
Answer: B
Rationale: Urine output is the most reliable indicator of adequate organ perfusion and
successful fluid resuscitation in the emergent phase.
7. A patient presents with a burn that is red, moist, has blisters, and is
extremely painful to the touch. How would the nurse classify this burn?
A. Superficial (first-degree)
B. Deep full-thickness (fourth-degree)
C. Full-thickness (third-degree)
D.
E. Partial-thickness (second-degree)
Answer: E
Rationale: Partial-thickness burns involve the epidermis and parts of the dermis, typically
presenting with blisters, moisture, and intense pain.
Nursing 2026 |Galen College
1. A patient arrives in the ED with partial-thickness burns to the entire left arm
and the anterior trunk. Using the Rule of Nines, what is the estimated Total
Body Surface Area (TBSA) affected?
A. 27%
B. 18%
C. 36%
D. 45%
Answer: A
Rationale: The anterior trunk is 18% and the entire arm (front and back) is 9%. 18 + 9 =
27%.
2. During the emergent phase of burn care, which electrolyte imbalance is most
commonly expected due to cellular destruction?
A. Hypokalemia
B. Hypercalcemia
C. Hyponatremia
D. Hyperkalemia
Answer: D
Rationale: Cellular injury and destruction release intracellular potassium into the
extracellular space, leading to hyperkalemia during the first 24-48 hours.
,3. A client weighing 70 kg has sustained burns to 40% of their TBSA. Using the
Parkland Formula (4mL/kg/%TBSA), what is the total fluid volume required in
the first 24 hours?
A. 5,600 mL
B. 2,800 mL
C. 8,400 mL
D. 11,200 mL
Answer: D
Rationale: 4mL x 70kg x 40 = 11,200 mL.
4. In the scenario described above (70kg, 40% TBSA), how many mL of fluid
should be administered in the first 8 hours from the time of injury?
A. 2,800 mL
B. 5,600 mL
C. 4,200 mL
D. 11,200 mL
Answer: B
Rationale: The Parkland formula dictates that half of the total 24-hour volume (11,
= 5,600 mL) should be given in the first 8 hours.
5. A patient was rescued from a burning building and presents with singed nasal
hairs and soot-tinged sputum. Which intervention is the highest priority?
A. Start two large-bore IV lines
B. Administer pain medication
C. Prepare for immediate endotracheal intubation
D. Apply silver sulfadiazine to the wounds
Answer: C
Rationale: Singed nasal hairs and soot-tinged sputum are signs of inhalation injury, which
can lead to rapid airway edema. Maintaining airway patency is the top priority.
, 6. Which assessment finding indicates that fluid resuscitation is successful in a
patient with 50% TBSA burns?
A. Heart rate of 120 bpm
B. Urine output of 0.5 to 1 mL/kg/hr
C. Blood pressure of 90/60 mmHg
D. Decreasing peripheral edema
Answer: B
Rationale: Urine output is the most reliable indicator of adequate organ perfusion and
successful fluid resuscitation in the emergent phase.
7. A patient presents with a burn that is red, moist, has blisters, and is
extremely painful to the touch. How would the nurse classify this burn?
A. Superficial (first-degree)
B. Deep full-thickness (fourth-degree)
C. Full-thickness (third-degree)
D.
E. Partial-thickness (second-degree)
Answer: E
Rationale: Partial-thickness burns involve the epidermis and parts of the dermis, typically
presenting with blisters, moisture, and intense pain.
