med surg EXAM A+ GRADE ASSURED COMPLETE SOLUTIONS AND VERIFIED ANSWERS

EXAM

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NCLEX Style Burns Med Surg Burns NCLEX Review Que
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stions Med Surg Exam 3 Burns Questions Med Surg : Ch
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apter 25 Burns 2026 A+ GRADE ASSURED COMPLETE S
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OLUTIONS AND VERIFIED ANSWERS (47318) ms ms ms ms




QUESTION 1 ms




When assessing a patient who spilled hot oil on the right leg and foot, the nurse notes
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that the skin is dry, pale, hard skin. The patient states that the burn is not painful. W
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hat term would the nurse use to document the burn depth?
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a. First-degree skin destruction
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b. Full-thickness skin destruction
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c. Deep partial-thickness skin destruction
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d. Superficial partial-thickness skin destruction
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ANSWER

ANS: B With full-
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thickness skin destruction, the appearance is pale and dry or leathery and the area is painless becau
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se of the associated nerve destruction. Erythema, swelling, and blisters point to a deep partial-
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thickness burn. With superficial partial-
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thickness burns, the area is red, but no blisters are present. First-
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degree burns exhibit erythema, blanching, and pain
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QUESTION 2 ms




A patient with severe burns has crystalloid fluid replacement ordered using the Parkl
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and formula. The initial volume of fluid to be administered in the first 24 hours is 30,
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000 mL. The initial rate of administration is 1875 mL/hr. After the first 8 hours, what
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rate should the nurse infuse the IV fluids?
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a. 350 mL/hour
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b. 523 mL/hour
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c. 938 mL/hour
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d. 1250 mL/hour
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ANSWER

,ANS: C Half of the fluid replacement using the Parkland formula is administered in the first 8 hours
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and the other half over the next 16 hours. In this case, the patient should receive half of the initial
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rate, or 938 mL/hr.
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QUESTION 3 ms




During the emergent phase of burn care, which assessment will be most useful in dete
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rmining whether the patient is receiving adequate fluid infusion?
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a. Check skin turgor.
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b. Monitor daily weight.
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c. Assess mucous membranes.
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d. Measure hourly urine output.
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ANSWER

ANS: D When fluid intake is adequate, the urine output will be at least 0.5 to 1 mL/kg/hour. The pa
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tient's weight is not useful in this situation because of the effects of third spacing and evaporative fl
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uid loss. Mucous membrane assessment and skin turgor also may be used, but they are not as adeq
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uate in determining that fluid infusions are maintaining adequate perfusion.
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QUESTION 4 ms




A patient with circumferential burns of both legs develops a decrease in dorsalis pedi
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s pulse strength and numbness in the toes. Which action should the nurse take?
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a. Notify the health care provider.
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b. Monitor the pulses every 2 hours.
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c. Elevate both legs above heart level with pillows.
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d. Encourage the patient to flex and extend the toes on both feet.
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ANSWER

ANS: A The decrease in pulse in a patient with circumferential burns indicates decreased circulation
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to the legs and the need for an escharotomy. Monitoring the pulses is not an adequate response to t
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he decrease in circulation. Elevating the legs or increasing toe movement will not improve the patie
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nt's circulation
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QUESTION 5 ms




Esomeprazole (Nexium) is prescribed for a patient who incurred extensive burn injuri
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es 5 days ago. Which nursing assessment would best evaluate the effectiveness of the
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medication?
a. Bowel sounds
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b. Stool frequency
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c. Abdominal distention
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d. Stools for occult blood
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ANSWER

, ANS: D H2 blockers and proton pump inhibitors are given to prevent Curling's ulcer in the patient
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who has suffered burn injuries. Proton pump inhibitors usually do not affect bowel sounds, stool fre
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quency, or appetite ms ms




QUESTION 6 ms




The nurse is reviewing the medication administration record (MAR) on a patient with
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partial-
thickness burns. Which medication is best for the nurse to administer before schedule
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d wound debridement?
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a. Ketorolac (Toradol)
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b. Lorazepam (Ativan)
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c. Gabapentin (Neurontin)
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d. Hydromorphone (Dilaudid)
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ANSWER

ANS: D Opioid pain medications are the best choice for pain control. The other medications are used
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as adjuvants to enhance the effects of opioids.
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QUESTION 7 ms




A patient with burns covering 40% total body surface area (TBSA) is in the acute pha
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se of burn treatment. Which snack would be best for the nurse to offer to this patient
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?
a. Bananasms



b. Orange gelatin
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c. Vanilla milkshake
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d. Whole grain bagel
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ANSWER

ANS: C A patient with a burn injury needs high protein and calorie food intake, and the milkshake i
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s the highest in these nutrients. The other choices are not as nutrient-
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dense as the milkshake. Gelatin is likely high in sugar. The bagel is a good carbohydrate choice, but
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low in protein. Bananas are a good source of potassium, but are not high in protein and calories.
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QUESTION 8 ms




A patient has just arrived in the emergency department after an electrical burn from
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exposure to a high-voltage current. What is the priority nursing assessment?
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a. Oral temperature
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b. Peripheral pulses
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c. Extremity movement
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d. Pupil reaction to light
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ANSWER