NCLEX Style Med Surg - Burns NCLEX Med Surg Exam 3 -
Chapter 25 Burns EXAM LATEST 2026-2027 100 QUESTIONS
AND 100% Verified ANSWERS
A patient with a burn inhalation injury is receiving albuterol (Ventolin) for bronchospasm. What is the most
important adverse effect of this medication for the nurse to manage?
A. GI distress
B. Tachycardia
C. Restlessness
D. Hypokalemia - answer>>B. Tachycardia
Albuterol (Ventolin) stimulates β-adrenergic receptors in the lungs to cause bronchodilation. However, it is a non-
cardioselective agent so it also stimulates the β-receptors in the heart to increase the heart rate. Restlessness and
GI upset may occur but will decrease with use. Hypokalemia does not occur with albuterol.
A patient receiving treatment for severe burns over more than half of his body has an indwelling urinary catheter.
When evaluating the patient's intake and output, which of the following should be taken into consideration?
1. The amount of urine will be reduced in the first 24-48 hours, and will then increase.
2. The amount of urine output will be greatest in the first 24 hours after the burn injury.
3. The amount of urine will be reduced during the first eight hours of the burn injury and will then increase as the
diuresis begins.
4. The amount of urine will be elevated due to the amount of intravenous fluids administered during the initial
phases of treatment.
5. The amount of urine is expected to be decreased for three to five days. - answer>>Correct Answer: 1
Rationale: The patient will have an initial reduction in urinary output. Fluid is reduced in the initial phases as the
body manages the insult caused by the injury and fluids are drawn into the interstitial spaces. After the shock
period passes, the patient will enter a period of diuresis. The diuresis begins between 24 and 36 hours after the
burn injury.
The nurse is reviewing the results of laboratory tests to assess the renal status of a patient who experienced a
major burn event on 45% of the body 24 hours ago. Which of the following results would the nurse expect to see?
,(Select all that apply)
1. glomerular filtration rate (GFR) reduced
2. specific gravity elevated
3. creatinine clearance reduced
4. BUN reduced
5. uric acid decreased - answer>>Correct Answer: 1,2
Rationale: During the initial phases of a burn injury, blood flow to the renal system is reduced, resulting in
reduction in GFR and an increase in specific gravity. During this period, BUN levels, creatinine, and uric acid are
increased
The patient in the emergent phase of a burn injury is being treated for pain. What medication should the nurse
anticipate using for this patient?
A. SQ tetanus toxoid
B. IV morphine sulfate
C. IM hydromorphone (Dilaudid)
D. PO oxycodone and acetaminophen (Percocet) - answer>>B. IV morphine sulfate
IV medications are used for burn injuries in the emergent phase to rapidly deliver relief and prevent unpredictable
absorption as would occur with the IM route. The PO route is not used because GI function is slowed or impaired
due to shock or paralytic ileus, although oxycodone and acetaminophen may be used later in the patient's
recovery. Tetanus toxoid may be administered but not for pain.
When evaluating the laboratory values of the burn-injured patient, which of the following can be anticipated?
1. decreased hemoglobin and elevated hematocrit levels
2. elevated hemoglobin and elevated hematocrit levels
3. elevated hemoglobin and decreased hematocrit levels
4. decreased hemoglobin and decreased hematocrit levels
5. hemoglobin and hematocrit levels within normal ranges - answer>>Correct Answer: 1
Rationale: Hemoglobin levels are reduced in response to the hemolysis of red blood cells. Hematocrit levels are
elevated secondary to hemoconcentration, and fluid shifts from the intravascular compartment.
,The patient received a cultured epithelial autograft (CEA) to the entire left leg. What should the nurse include in
the discharge teaching for this patient?
A. Sit or lay in the position of comfort.
B. Wear a pressure garment for 8 hours each day.
C. Refer the patient to a counselor for psychosocial support.
D. Use the sun to increase the skin color on the healed areas. - answer>>C. Refer the patient to a counselor for
psychosocial support.
In the rehabilitation phase, the patient will work toward resuming a functional role in society, but frequently there
are body image concerns and grieving for the loss of the way they looked and functioned before the burn, so
continued counseling helps the patient in this phase as well. Putting the leg in the position of comfort is more
likely to lead to contractures than to help the patient. If a pressure garment is prescribed, it is used for 24 hours
per day for as long as 12 to 18 months. Sunlight should be avoided to prevent injury, and sunscreen should always
be worn when the patient is outside.
When caring for a patient with an electrical burn injury, which order from the health care provider should the
nurse question?
a. mannitol 75 gm IV
b. urine for myoglobulin
c. LR at 25 mL/h
d. sodium bicarbonate 24 mEq q.4h - answer>>c.
An infusion rate of 25 mL/hr is not sufficient to maintain adequate urine output in prevention and treatment of
ATN.
Electrical injury puts the patient at risk for myoglobinuria, which can lead to acute renal tubular necrosis (ATN).
Treatment consists of infusing lactated Ringer's at 2-4 mL/kg/%TBSA, a rate sufficient to maintain urinary output
at 75 to 100 mL/hr. Mannitol can also be used to maintain urine output. Sodium bicarbonate may be given to
alkalinize the urine. The urine would also be monitored for the presence of myoglobin.
, When monitoring the vital signs of the patient who has experienced a major burn injury, the nurse assesses a
heart rate of 112 and a temperature of 99.9° F. Which of the following best describes the findings?
1. These values are normal for the patient's post-burn injury condition.
2. The patient is demonstrating manifestations consistent with the onset of an infection.
3. The patient is demonstrating manifestations consistent with an electrolyte imbalance.
4. The patient is demonstrating manifestations consistent with renal failure.
5. The patient is demonstrating manifestations of fluid volume overload. - answer>>Correct Answer: 1
Rationale: The burn-injured patient is not considered tachycardic until the heart rate reaches 120 beats per
minute. In the absence of other symptoms, the temperature does not signal the presence of an infection. It could
be a response to a hypermetabolic response.
A patient is admitted with second- and third-degree burns covering the face, entire right upper extremity, and the
right anterior trunk area. Using the rule of nines, what should the nurse calculate the extent of these burns as
being?
a. 18%
b. 22.5%
c. 27%
d. 36% - answer>>b.
Using the rule of nines, for these second- and third-degree burns, the face encompasses 4.5% of the body area,
the entire right arm encompasses 9% of the body area, and the entire anterior trunk encompasses 18% of the
body area. Since the patient has burns on only the right side of the anterior trunk, the nurse would assess that
burn as encompassing half of the 18%, or 9%. Therefore adding the three areas together (4.5 + 9 + 9), the nurse
would correctly calculate the extent of this patient's burns to cover approximately 22.5% of the total body surface
area.
A patient has experienced a burn injury. Which of the following interventions by the nurse is of the highest priority
at this time?
1. determination of the type of burn injury
2. determination of the types of home remedies attempted prior to the patient's coming to the hospital
3. assessment of past medical history
Chapter 25 Burns EXAM LATEST 2026-2027 100 QUESTIONS
AND 100% Verified ANSWERS
A patient with a burn inhalation injury is receiving albuterol (Ventolin) for bronchospasm. What is the most
important adverse effect of this medication for the nurse to manage?
A. GI distress
B. Tachycardia
C. Restlessness
D. Hypokalemia - answer>>B. Tachycardia
Albuterol (Ventolin) stimulates β-adrenergic receptors in the lungs to cause bronchodilation. However, it is a non-
cardioselective agent so it also stimulates the β-receptors in the heart to increase the heart rate. Restlessness and
GI upset may occur but will decrease with use. Hypokalemia does not occur with albuterol.
A patient receiving treatment for severe burns over more than half of his body has an indwelling urinary catheter.
When evaluating the patient's intake and output, which of the following should be taken into consideration?
1. The amount of urine will be reduced in the first 24-48 hours, and will then increase.
2. The amount of urine output will be greatest in the first 24 hours after the burn injury.
3. The amount of urine will be reduced during the first eight hours of the burn injury and will then increase as the
diuresis begins.
4. The amount of urine will be elevated due to the amount of intravenous fluids administered during the initial
phases of treatment.
5. The amount of urine is expected to be decreased for three to five days. - answer>>Correct Answer: 1
Rationale: The patient will have an initial reduction in urinary output. Fluid is reduced in the initial phases as the
body manages the insult caused by the injury and fluids are drawn into the interstitial spaces. After the shock
period passes, the patient will enter a period of diuresis. The diuresis begins between 24 and 36 hours after the
burn injury.
The nurse is reviewing the results of laboratory tests to assess the renal status of a patient who experienced a
major burn event on 45% of the body 24 hours ago. Which of the following results would the nurse expect to see?
,(Select all that apply)
1. glomerular filtration rate (GFR) reduced
2. specific gravity elevated
3. creatinine clearance reduced
4. BUN reduced
5. uric acid decreased - answer>>Correct Answer: 1,2
Rationale: During the initial phases of a burn injury, blood flow to the renal system is reduced, resulting in
reduction in GFR and an increase in specific gravity. During this period, BUN levels, creatinine, and uric acid are
increased
The patient in the emergent phase of a burn injury is being treated for pain. What medication should the nurse
anticipate using for this patient?
A. SQ tetanus toxoid
B. IV morphine sulfate
C. IM hydromorphone (Dilaudid)
D. PO oxycodone and acetaminophen (Percocet) - answer>>B. IV morphine sulfate
IV medications are used for burn injuries in the emergent phase to rapidly deliver relief and prevent unpredictable
absorption as would occur with the IM route. The PO route is not used because GI function is slowed or impaired
due to shock or paralytic ileus, although oxycodone and acetaminophen may be used later in the patient's
recovery. Tetanus toxoid may be administered but not for pain.
When evaluating the laboratory values of the burn-injured patient, which of the following can be anticipated?
1. decreased hemoglobin and elevated hematocrit levels
2. elevated hemoglobin and elevated hematocrit levels
3. elevated hemoglobin and decreased hematocrit levels
4. decreased hemoglobin and decreased hematocrit levels
5. hemoglobin and hematocrit levels within normal ranges - answer>>Correct Answer: 1
Rationale: Hemoglobin levels are reduced in response to the hemolysis of red blood cells. Hematocrit levels are
elevated secondary to hemoconcentration, and fluid shifts from the intravascular compartment.
,The patient received a cultured epithelial autograft (CEA) to the entire left leg. What should the nurse include in
the discharge teaching for this patient?
A. Sit or lay in the position of comfort.
B. Wear a pressure garment for 8 hours each day.
C. Refer the patient to a counselor for psychosocial support.
D. Use the sun to increase the skin color on the healed areas. - answer>>C. Refer the patient to a counselor for
psychosocial support.
In the rehabilitation phase, the patient will work toward resuming a functional role in society, but frequently there
are body image concerns and grieving for the loss of the way they looked and functioned before the burn, so
continued counseling helps the patient in this phase as well. Putting the leg in the position of comfort is more
likely to lead to contractures than to help the patient. If a pressure garment is prescribed, it is used for 24 hours
per day for as long as 12 to 18 months. Sunlight should be avoided to prevent injury, and sunscreen should always
be worn when the patient is outside.
When caring for a patient with an electrical burn injury, which order from the health care provider should the
nurse question?
a. mannitol 75 gm IV
b. urine for myoglobulin
c. LR at 25 mL/h
d. sodium bicarbonate 24 mEq q.4h - answer>>c.
An infusion rate of 25 mL/hr is not sufficient to maintain adequate urine output in prevention and treatment of
ATN.
Electrical injury puts the patient at risk for myoglobinuria, which can lead to acute renal tubular necrosis (ATN).
Treatment consists of infusing lactated Ringer's at 2-4 mL/kg/%TBSA, a rate sufficient to maintain urinary output
at 75 to 100 mL/hr. Mannitol can also be used to maintain urine output. Sodium bicarbonate may be given to
alkalinize the urine. The urine would also be monitored for the presence of myoglobin.
, When monitoring the vital signs of the patient who has experienced a major burn injury, the nurse assesses a
heart rate of 112 and a temperature of 99.9° F. Which of the following best describes the findings?
1. These values are normal for the patient's post-burn injury condition.
2. The patient is demonstrating manifestations consistent with the onset of an infection.
3. The patient is demonstrating manifestations consistent with an electrolyte imbalance.
4. The patient is demonstrating manifestations consistent with renal failure.
5. The patient is demonstrating manifestations of fluid volume overload. - answer>>Correct Answer: 1
Rationale: The burn-injured patient is not considered tachycardic until the heart rate reaches 120 beats per
minute. In the absence of other symptoms, the temperature does not signal the presence of an infection. It could
be a response to a hypermetabolic response.
A patient is admitted with second- and third-degree burns covering the face, entire right upper extremity, and the
right anterior trunk area. Using the rule of nines, what should the nurse calculate the extent of these burns as
being?
a. 18%
b. 22.5%
c. 27%
d. 36% - answer>>b.
Using the rule of nines, for these second- and third-degree burns, the face encompasses 4.5% of the body area,
the entire right arm encompasses 9% of the body area, and the entire anterior trunk encompasses 18% of the
body area. Since the patient has burns on only the right side of the anterior trunk, the nurse would assess that
burn as encompassing half of the 18%, or 9%. Therefore adding the three areas together (4.5 + 9 + 9), the nurse
would correctly calculate the extent of this patient's burns to cover approximately 22.5% of the total body surface
area.
A patient has experienced a burn injury. Which of the following interventions by the nurse is of the highest priority
at this time?
1. determination of the type of burn injury
2. determination of the types of home remedies attempted prior to the patient's coming to the hospital
3. assessment of past medical history
