# Burns, et al. NCLEX-RN Exam Questions and Answers
Latest 2024/2025 Edition: Ace Your Exam with 80
Questions and Detailed Rationales for First Attempt
Success
---
**01.** A nurse is caring for a client who has sustained partial‑thickness (second‑degree) burns over
30% of total body surface area (TBSA). During the emergent (resuscitative) phase, which finding requires
immediate intervention?
A) Urine output of 25 mL over 2 hours
B) Pain rated 7 on a 0‑10 scale
C) Serum sodium of 135 mEq/L
D) Heart rate of 110 bpm
🔍 RATIONALE💡-- In the emergent phase of burn injury, adequate fluid resuscitation is critical. Urine
output <30 mL/hr indicates hypovolemia and inadequate renal perfusion. The goal is 0.5‑1 mL/kg/hr
(roughly 30‑50 mL/hr). Pain and tachycardia are expected, and sodium may be low or normal initially.
ANSWER💫✔️-- A) Urine output of 25 mL over 2 hours
---
**02.** A nurse is assessing a client with a full‑thickness (third‑degree) burn on the anterior chest.
Which finding is characteristic of this type of burn?
A) Painful, blistered, and moist
B) Red, dry, and painful
C) Waxy, white, or charred and painless
D) Painful, with eschar and edema
,🔍 RATIONALE💡-- Full‑thickness burns destroy all layers of skin, including nerve endings, resulting in a
painless, waxy, white, or charred appearance. Superficial partial‑thickness burns are painful and
blistered. First‑degree burns are red and painful.
ANSWER💫✔️-- C) Waxy, white, or charred and painless
---
**03.** A nurse is planning care for a client during the acute phase of burn injury. Which complication is
the client at greatest risk for?
A) Hypovolemic shock
B) Infection and sepsis
C) Hypernatremia
D) Hypothermia
🔍 RATIONALE💡-- During the acute phase (after the first 48‑72 hours), the primary risk is infection due
to loss of skin barrier and immunosuppression. Hypovolemic shock is the main concern during the
emergent phase. Sepsis is a leading cause of death in burn patients.
ANSWER💫✔️-- B) Infection and sepsis
---
**04.** A nurse is calculating the fluid resuscitation for a client who weighs 80 kg and has burns over
40% TBSA using the Parkland formula (4 mL × kg × % TBSA). How much fluid should be administered in
the first 8 hours after injury?
A) 3,200 mL
B) 6,400 mL
C) 12,800 mL
D) 1,600 mL
,🔍 RATIONALE💡-- Parkland formula: 4 mL × kg × % TBSA = 4 × 80 × 40 = 12,800 mL over 24 hours. Half
(6,400 mL) is given in the first 8 hours. The other half over the next 16 hours. So in first 8 hours = 6,400
mL.
ANSWER💫✔️-- B) 6,400 mL
---
**05.** A nurse is caring for a client with electrical burns who is now in the rehabilitation phase. Which
assessment finding is most important to address?
A) Pruritus of the healing burn area
B) Contractures of the wrist and elbow
C) Hypertrophic scarring
D) Difficulty with activities of daily living (ADLs)
🔍 RATIONALE💡-- Contractures are a major complication of burn healing, leading to loss of function and
range of motion. While all options are relevant, prevention and treatment of contractures are priority to
maintain mobility and independence. Early physical therapy and positioning are critical.
ANSWER💫✔️-- B) Contractures of the wrist and elbow
---
**06.** A nurse is assessing a client who sustained chemical burns to the right hand and forearm from a
cleaning agent. Which action should the nurse take first?
A) Apply a topical antibiotic ointment
B) Irrigate the area with copious amounts of water
C) Cover the burn with a dry sterile dressing
D) Notify the provider immediately
, 🔍 RATIONALE💡-- For chemical burns, the priority is to remove the chemical by irrigating with copious
amounts of water (except for dry lime or certain metals). Irrigation should continue for at least 15‑20
minutes before any dressing or medication.
ANSWER💫✔️-- B) Irrigate the area with copious amounts of water
---
**07.** A nurse is evaluating laboratory results for a client 24 hours after a major burn injury. Which
finding is expected during the emergent phase?
A) Hypernatremia
B) Hypokalemia
C) Hyperkalemia
D) Hypoglycemia
🔍 RATIONALE💡-- In the emergent phase (first 24‑48 hours), massive cell destruction releases
intracellular potassium, leading to hyperkalemia. Hyponatremia (from fluid shifts) and hyperglycemia
(stress response) are also common. Hypokalemia occurs later during diuresis.
ANSWER💫✔️-- C) Hyperkalemia
---
**08.** A nurse is caring for a client with full‑thickness burns on both lower extremities. The nurse
notes that the client’s toes are becoming dusky and cool. What is the priority action?
A) Elevate the lower extremities
B) Notify the provider of possible compartment syndrome
C) Apply warm blankets to the feet
D) Document the finding and continue monitoring
Latest 2024/2025 Edition: Ace Your Exam with 80
Questions and Detailed Rationales for First Attempt
Success
---
**01.** A nurse is caring for a client who has sustained partial‑thickness (second‑degree) burns over
30% of total body surface area (TBSA). During the emergent (resuscitative) phase, which finding requires
immediate intervention?
A) Urine output of 25 mL over 2 hours
B) Pain rated 7 on a 0‑10 scale
C) Serum sodium of 135 mEq/L
D) Heart rate of 110 bpm
🔍 RATIONALE💡-- In the emergent phase of burn injury, adequate fluid resuscitation is critical. Urine
output <30 mL/hr indicates hypovolemia and inadequate renal perfusion. The goal is 0.5‑1 mL/kg/hr
(roughly 30‑50 mL/hr). Pain and tachycardia are expected, and sodium may be low or normal initially.
ANSWER💫✔️-- A) Urine output of 25 mL over 2 hours
---
**02.** A nurse is assessing a client with a full‑thickness (third‑degree) burn on the anterior chest.
Which finding is characteristic of this type of burn?
A) Painful, blistered, and moist
B) Red, dry, and painful
C) Waxy, white, or charred and painless
D) Painful, with eschar and edema
,🔍 RATIONALE💡-- Full‑thickness burns destroy all layers of skin, including nerve endings, resulting in a
painless, waxy, white, or charred appearance. Superficial partial‑thickness burns are painful and
blistered. First‑degree burns are red and painful.
ANSWER💫✔️-- C) Waxy, white, or charred and painless
---
**03.** A nurse is planning care for a client during the acute phase of burn injury. Which complication is
the client at greatest risk for?
A) Hypovolemic shock
B) Infection and sepsis
C) Hypernatremia
D) Hypothermia
🔍 RATIONALE💡-- During the acute phase (after the first 48‑72 hours), the primary risk is infection due
to loss of skin barrier and immunosuppression. Hypovolemic shock is the main concern during the
emergent phase. Sepsis is a leading cause of death in burn patients.
ANSWER💫✔️-- B) Infection and sepsis
---
**04.** A nurse is calculating the fluid resuscitation for a client who weighs 80 kg and has burns over
40% TBSA using the Parkland formula (4 mL × kg × % TBSA). How much fluid should be administered in
the first 8 hours after injury?
A) 3,200 mL
B) 6,400 mL
C) 12,800 mL
D) 1,600 mL
,🔍 RATIONALE💡-- Parkland formula: 4 mL × kg × % TBSA = 4 × 80 × 40 = 12,800 mL over 24 hours. Half
(6,400 mL) is given in the first 8 hours. The other half over the next 16 hours. So in first 8 hours = 6,400
mL.
ANSWER💫✔️-- B) 6,400 mL
---
**05.** A nurse is caring for a client with electrical burns who is now in the rehabilitation phase. Which
assessment finding is most important to address?
A) Pruritus of the healing burn area
B) Contractures of the wrist and elbow
C) Hypertrophic scarring
D) Difficulty with activities of daily living (ADLs)
🔍 RATIONALE💡-- Contractures are a major complication of burn healing, leading to loss of function and
range of motion. While all options are relevant, prevention and treatment of contractures are priority to
maintain mobility and independence. Early physical therapy and positioning are critical.
ANSWER💫✔️-- B) Contractures of the wrist and elbow
---
**06.** A nurse is assessing a client who sustained chemical burns to the right hand and forearm from a
cleaning agent. Which action should the nurse take first?
A) Apply a topical antibiotic ointment
B) Irrigate the area with copious amounts of water
C) Cover the burn with a dry sterile dressing
D) Notify the provider immediately
, 🔍 RATIONALE💡-- For chemical burns, the priority is to remove the chemical by irrigating with copious
amounts of water (except for dry lime or certain metals). Irrigation should continue for at least 15‑20
minutes before any dressing or medication.
ANSWER💫✔️-- B) Irrigate the area with copious amounts of water
---
**07.** A nurse is evaluating laboratory results for a client 24 hours after a major burn injury. Which
finding is expected during the emergent phase?
A) Hypernatremia
B) Hypokalemia
C) Hyperkalemia
D) Hypoglycemia
🔍 RATIONALE💡-- In the emergent phase (first 24‑48 hours), massive cell destruction releases
intracellular potassium, leading to hyperkalemia. Hyponatremia (from fluid shifts) and hyperglycemia
(stress response) are also common. Hypokalemia occurs later during diuresis.
ANSWER💫✔️-- C) Hyperkalemia
---
**08.** A nurse is caring for a client with full‑thickness burns on both lower extremities. The nurse
notes that the client’s toes are becoming dusky and cool. What is the priority action?
A) Elevate the lower extremities
B) Notify the provider of possible compartment syndrome
C) Apply warm blankets to the feet
D) Document the finding and continue monitoring
