Final Exam - NUR2755 / NUR 2755
(Latest ): Multidimensional
Care IV / MDC 4 - Rasmussen
1. A patient with 40% TBSA full-thickness burns is 6 hours post-injury.
Which IV fluid regimen is most appropriate in the first 24 hours?
A. 2 mL/kg/%TBSA burn of lactated Ringer’s
B. 4 mL/kg/%TBSA burn of lactated Ringer’s
C. 0.9% normal saline at 250 mL/hr
D. 5% dextrose in water at 150 mL/hr
Correct ,,,answer,,,,: B
Rationale: Parkland formula is 4 mL/kg/%TBSA lactated Ringer’s in first 24
hours for major burns. Half given in first 8 hours. A is for minor burns; C
and D do not provide enough volume or electrolyte balance.
2. Which finding in a burn patient indicates adequate fluid resuscitation?
A. Heart rate 140 bpm
B. Urine output 0.8 mL/kg/hr
C. Systolic BP 85 mm Hg
D. Central venous pressure 2 mm Hg
Correct ,,,answer,,,,: B
Rationale: Target urine output in adults is 0.5–1 mL/kg/hr. Tachycardia,
hypotension, low CVP suggest hypovolemia.
3. A patient with electrical burns has dark, tea-colored urine. What priority
intervention is needed?
,A. Increase IV fluids and monitor creatine kinase
B. Administer packed red blood cells
C. Restrict fluids to prevent overload
D. Apply silver sulfadiazine to all burns
Correct ,,,answer,,,,: A
Rationale: Dark urine suggests myoglobinuria from muscle necrosis.
Aggressive fluids and monitoring for acute kidney injury are key. Blood
transfusion not indicated without anemia. Fluid restriction is dangerous.
4. Which topical agent is contraindicated in a patient with sulfa allergy?
A. Mafenide acetate
B. Silver sulfadiazine
C. Bacitracin
D. Petrolatum gauze
Correct ,,,answer,,,,: B
Rationale: Silver sulfadiazine contains sulfa. Mafenide acetate is a
different class but can cause metabolic acidosis; still, sulfa allergy
contraindicates silver sulfadiazine.
5. During escharotomy of a circumferential chest burn, the nurse expects
immediate improvement in:
A. Urine output
B. Peripheral pulses
C. Chest expansion and SpO₂
D. Mental status
Correct ,,,answer,,,,: C
Rationale: Escharotomy relieves constriction from non-elastic eschar,
improving ventilation and oxygenation. Pulses improve if limbs are
involved, but chest escharotomy specifically targets respiratory
mechanics.
,6. A burn patient develops new-onset confusion, BP 80/50, and
temperature 39.5°C on day 5. What is the most likely cause?
A. Burn shock
B. Sepsis
C. Adrenal insufficiency
D. Pulmonary embolism
Correct ,,,answer,,,,: B
Rationale: Post-burn days 3–7, sepsis is common due to wound
colonization. Burn shock occurs early (<48 hours). Fever + hypotension +
altered mental status = septic shock until proven otherwise.
7. Which nutritional intervention is most important for a patient with 30%
TBSA burns?
A. Low-protein, high-fat diet
B. High-calorie, high-protein enteral feeding
C. Total parenteral nutrition as primary source
D. Clear liquids until edema resolves
Correct ,,,answer,,,,: B
Rationale: Hypermetabolism requires early enteral feeding with high
protein and calories to support healing and immune function. TPN is
reserved if enteral not possible.
8. During wound care for a partial-thickness burn, blisters rupture. The
nurse should:
A. Remove all remaining blister roof
B. Leave intact blister roof in place
C. Apply betadine directly to raw surface
D. Cover with dry gauze only
Correct ,,,answer,,,,: B
Rationale: Intact blister roof protects underlying tissue and reduces pain
, and infection risk. Debridement of loose tissue may be done later by
provider.
9. Which finding in a burn patient requires immediate notification of the
provider?
A. Pain 7/10
B. Circumferential extremity burn with absent Doppler pulses
C. Itching around healing burn
D. Serum sodium 133 mEq/L
Correct ,,,answer,,,,: B
Rationale: Absent pulses in circumferential burn indicates compartment
syndrome requiring escharotomy or fasciotomy. Pain is expected; mild
hyponatremia common; itching normal in healing.
10. A patient with inhalation injury has stridor and hoarseness. Priority
action:
A. Administer racemic epinephrine
B. Prepare for intubation
C. Apply face mask oxygen
D. Obtain chest x-ray
Correct ,,,answer,,,,: B
Rationale: Stridor after inhalation injury indicates upper airway edema
that can rapidly progress to obstruction. Immediate intubation is life-
saving. Epinephrine may buy time but not definitive.
Shock (11–20)
(Latest ): Multidimensional
Care IV / MDC 4 - Rasmussen
1. A patient with 40% TBSA full-thickness burns is 6 hours post-injury.
Which IV fluid regimen is most appropriate in the first 24 hours?
A. 2 mL/kg/%TBSA burn of lactated Ringer’s
B. 4 mL/kg/%TBSA burn of lactated Ringer’s
C. 0.9% normal saline at 250 mL/hr
D. 5% dextrose in water at 150 mL/hr
Correct ,,,answer,,,,: B
Rationale: Parkland formula is 4 mL/kg/%TBSA lactated Ringer’s in first 24
hours for major burns. Half given in first 8 hours. A is for minor burns; C
and D do not provide enough volume or electrolyte balance.
2. Which finding in a burn patient indicates adequate fluid resuscitation?
A. Heart rate 140 bpm
B. Urine output 0.8 mL/kg/hr
C. Systolic BP 85 mm Hg
D. Central venous pressure 2 mm Hg
Correct ,,,answer,,,,: B
Rationale: Target urine output in adults is 0.5–1 mL/kg/hr. Tachycardia,
hypotension, low CVP suggest hypovolemia.
3. A patient with electrical burns has dark, tea-colored urine. What priority
intervention is needed?
,A. Increase IV fluids and monitor creatine kinase
B. Administer packed red blood cells
C. Restrict fluids to prevent overload
D. Apply silver sulfadiazine to all burns
Correct ,,,answer,,,,: A
Rationale: Dark urine suggests myoglobinuria from muscle necrosis.
Aggressive fluids and monitoring for acute kidney injury are key. Blood
transfusion not indicated without anemia. Fluid restriction is dangerous.
4. Which topical agent is contraindicated in a patient with sulfa allergy?
A. Mafenide acetate
B. Silver sulfadiazine
C. Bacitracin
D. Petrolatum gauze
Correct ,,,answer,,,,: B
Rationale: Silver sulfadiazine contains sulfa. Mafenide acetate is a
different class but can cause metabolic acidosis; still, sulfa allergy
contraindicates silver sulfadiazine.
5. During escharotomy of a circumferential chest burn, the nurse expects
immediate improvement in:
A. Urine output
B. Peripheral pulses
C. Chest expansion and SpO₂
D. Mental status
Correct ,,,answer,,,,: C
Rationale: Escharotomy relieves constriction from non-elastic eschar,
improving ventilation and oxygenation. Pulses improve if limbs are
involved, but chest escharotomy specifically targets respiratory
mechanics.
,6. A burn patient develops new-onset confusion, BP 80/50, and
temperature 39.5°C on day 5. What is the most likely cause?
A. Burn shock
B. Sepsis
C. Adrenal insufficiency
D. Pulmonary embolism
Correct ,,,answer,,,,: B
Rationale: Post-burn days 3–7, sepsis is common due to wound
colonization. Burn shock occurs early (<48 hours). Fever + hypotension +
altered mental status = septic shock until proven otherwise.
7. Which nutritional intervention is most important for a patient with 30%
TBSA burns?
A. Low-protein, high-fat diet
B. High-calorie, high-protein enteral feeding
C. Total parenteral nutrition as primary source
D. Clear liquids until edema resolves
Correct ,,,answer,,,,: B
Rationale: Hypermetabolism requires early enteral feeding with high
protein and calories to support healing and immune function. TPN is
reserved if enteral not possible.
8. During wound care for a partial-thickness burn, blisters rupture. The
nurse should:
A. Remove all remaining blister roof
B. Leave intact blister roof in place
C. Apply betadine directly to raw surface
D. Cover with dry gauze only
Correct ,,,answer,,,,: B
Rationale: Intact blister roof protects underlying tissue and reduces pain
, and infection risk. Debridement of loose tissue may be done later by
provider.
9. Which finding in a burn patient requires immediate notification of the
provider?
A. Pain 7/10
B. Circumferential extremity burn with absent Doppler pulses
C. Itching around healing burn
D. Serum sodium 133 mEq/L
Correct ,,,answer,,,,: B
Rationale: Absent pulses in circumferential burn indicates compartment
syndrome requiring escharotomy or fasciotomy. Pain is expected; mild
hyponatremia common; itching normal in healing.
10. A patient with inhalation injury has stridor and hoarseness. Priority
action:
A. Administer racemic epinephrine
B. Prepare for intubation
C. Apply face mask oxygen
D. Obtain chest x-ray
Correct ,,,answer,,,,: B
Rationale: Stridor after inhalation injury indicates upper airway edema
that can rapidly progress to obstruction. Immediate intubation is life-
saving. Epinephrine may buy time but not definitive.
Shock (11–20)
