WALDEN COAST UNIVERSITY NURS 120 EXAM Questions And
Answers Best Rated A+ Guaranteed Success Latest Update
2022
Advanced Medsurg Final for lucky students
A patient is admitted to the burn unit with burns to the head, face, and hands.
Initially, wheezes are heard, but an hour later, the lung sounds are decreased and no
wheezes are audible. What is the best action for the nurse to take?
a. Encourage the patient to cough and auscultate the lung
again.
b. Notify the health care provider and prepare for
endotracheal intubation.
c. Document the results and continue to monitor the
patient's respiratory rate.
d. Reposition the patient in high-Fowler’s position and
reassess breath sounds.
The patient’s history and clinical manifestations suggest airway edema and the
health care provider should be notified immediately, so that intubation can be done
rapidly. Placing the patient in a more upright position or having the patient cough
will not address the problem of airway edema. Continuing to monitor is
inappropriate because immediate action should occur.
A patient with severe burns has crystalloid fluid replacement ordered using the
Parkland formula. The initial volume of fluid to be administered in the first 24 hours is
30,000 mL. The initial rate of administration is 1875 mL/hr. After the first 8 hours,
what rate should the nurse infuse the IV fluids?
WALDEN COAST UNIVERSITY NURS 120 EXAM Questions And
Answers Best Rated A+ Guaranteed Success Latest Update
2022
,WALDEN COAST UNIVERSITY NURS 120 EXAM Questions And
Answers Best Rated A+ Guaranteed Success Latest Update
2022
a. 350 mL/hour
b. 523 mL/hour
c. 938 mL/hour
d. 1250 mL/hour
Half of the fluid replacement using the Parkland formula is administered in the
first 8 hours and the other half over the next 16 hours. In this case, the patient
should receive half of the initial rate, or 938 mL/hr.
During the emergent phase of burn care, which assessment will be most useful in
determining whether the patient is receiving adequate fluid infusion?
a. Check skin turgor.
b. Monitor daily weight.
c. Assess mucous membranes.
d. Measure hourly urine output.
When fluid intake is adequate, the urine output will be at least 0.5 to 1
mL/kg/hour. The patient’s weight is not useful in this situation because of the
effects of third spacing and evaporative fluid loss. Mucous membrane
assessment and skin turgor also may be used, but they are not as adequate in
determining that fluid infusions are maintaining adequate perfusion.
WALDEN COAST UNIVERSITY NURS 120 EXAM Questions And
Answers Best Rated A+ Guaranteed Success Latest Update
2022
,WALDEN COAST UNIVERSITY NURS 120 EXAM Questions And
Answers Best Rated A+ Guaranteed Success Latest Update
2022
A patient has just been admitted with a 40% total body surface area (TBSA) burn
injury. To maintain adequate nutrition, the nurse should plan to take which action?
a. Insert a feeding tube and initiate enteral feedings.
b. Infuse total parenteral nutrition via a central catheter.
c. Encourage an oral intake of at least 5000 kcal per day.
d. Administer multiple vitamins and minerals in the IV
solution.
Enteral feedings can usually be initiated during the emergent phase at low rates
and increased over 24 to 48 hours to the goal rate. During the emergent phase, the
patient will be unable to eat enough calories to meet nutritional needs and may
have a paralytic ileus that prevents adequate nutrient absorption. Vitamins and
minerals may be administered during the emergent phase, but these will not assist
in meeting the patient’s caloric needs. Parenteral nutrition increases the infection
risk, does not help preserve gastrointestinal function, and is not routinely used in
burn patients.
While the patient’s full–thickness burn wounds to the face are exposed, what is the
best nursing action to prevent cross contamination?
WALDEN COAST UNIVERSITY NURS 120 EXAM Questions And
Answers Best Rated A+ Guaranteed Success Latest Update
2022
, WALDEN COAST UNIVERSITY NURS 120 EXAM Questions And
Answers Best Rated A+ Guaranteed Success Latest Update
2022
a. Use sterile gloves when removing old dressings.
b. Wear gowns, caps, masks, and gloves during all care of the
patient.
c. Administer IV antibiotics to prevent bacterial colonization of
wounds.
d. Turn the room temperature up to at least 70° F (20° C) during
dressing changes.
Use of gowns, caps, masks, and gloves during all patient care will decrease the
possibility of wound contamination for a patient whose burns are not covered.
When removing contaminated dressings and washing the dirty wound, use
nonsterile, disposable gloves. The room temperature should be kept at
approximately 85° F for patients with open burn wounds to prevent shivering.
Systemic antibiotics are not well absorbed into deep burns because of the lack of
circulation.
A nurse is caring for a patient who has burns of the ears, head, neck, and right arm and
hand. The nurse should place the patient in which position?
a. Place the right arm and hand flexed in a position of
comfort.
b. Elevate the right arm and hand on pillows and extend
the fingers.
c. Assist the patient to a supine position with a small
WALDEN COAST UNIVERSITY NURS 120 EXAM Questions And
Answers Best Rated A+ Guaranteed Success Latest Update
2022
Answers Best Rated A+ Guaranteed Success Latest Update
2022
Advanced Medsurg Final for lucky students
A patient is admitted to the burn unit with burns to the head, face, and hands.
Initially, wheezes are heard, but an hour later, the lung sounds are decreased and no
wheezes are audible. What is the best action for the nurse to take?
a. Encourage the patient to cough and auscultate the lung
again.
b. Notify the health care provider and prepare for
endotracheal intubation.
c. Document the results and continue to monitor the
patient's respiratory rate.
d. Reposition the patient in high-Fowler’s position and
reassess breath sounds.
The patient’s history and clinical manifestations suggest airway edema and the
health care provider should be notified immediately, so that intubation can be done
rapidly. Placing the patient in a more upright position or having the patient cough
will not address the problem of airway edema. Continuing to monitor is
inappropriate because immediate action should occur.
A patient with severe burns has crystalloid fluid replacement ordered using the
Parkland formula. The initial volume of fluid to be administered in the first 24 hours is
30,000 mL. The initial rate of administration is 1875 mL/hr. After the first 8 hours,
what rate should the nurse infuse the IV fluids?
WALDEN COAST UNIVERSITY NURS 120 EXAM Questions And
Answers Best Rated A+ Guaranteed Success Latest Update
2022
,WALDEN COAST UNIVERSITY NURS 120 EXAM Questions And
Answers Best Rated A+ Guaranteed Success Latest Update
2022
a. 350 mL/hour
b. 523 mL/hour
c. 938 mL/hour
d. 1250 mL/hour
Half of the fluid replacement using the Parkland formula is administered in the
first 8 hours and the other half over the next 16 hours. In this case, the patient
should receive half of the initial rate, or 938 mL/hr.
During the emergent phase of burn care, which assessment will be most useful in
determining whether the patient is receiving adequate fluid infusion?
a. Check skin turgor.
b. Monitor daily weight.
c. Assess mucous membranes.
d. Measure hourly urine output.
When fluid intake is adequate, the urine output will be at least 0.5 to 1
mL/kg/hour. The patient’s weight is not useful in this situation because of the
effects of third spacing and evaporative fluid loss. Mucous membrane
assessment and skin turgor also may be used, but they are not as adequate in
determining that fluid infusions are maintaining adequate perfusion.
WALDEN COAST UNIVERSITY NURS 120 EXAM Questions And
Answers Best Rated A+ Guaranteed Success Latest Update
2022
,WALDEN COAST UNIVERSITY NURS 120 EXAM Questions And
Answers Best Rated A+ Guaranteed Success Latest Update
2022
A patient has just been admitted with a 40% total body surface area (TBSA) burn
injury. To maintain adequate nutrition, the nurse should plan to take which action?
a. Insert a feeding tube and initiate enteral feedings.
b. Infuse total parenteral nutrition via a central catheter.
c. Encourage an oral intake of at least 5000 kcal per day.
d. Administer multiple vitamins and minerals in the IV
solution.
Enteral feedings can usually be initiated during the emergent phase at low rates
and increased over 24 to 48 hours to the goal rate. During the emergent phase, the
patient will be unable to eat enough calories to meet nutritional needs and may
have a paralytic ileus that prevents adequate nutrient absorption. Vitamins and
minerals may be administered during the emergent phase, but these will not assist
in meeting the patient’s caloric needs. Parenteral nutrition increases the infection
risk, does not help preserve gastrointestinal function, and is not routinely used in
burn patients.
While the patient’s full–thickness burn wounds to the face are exposed, what is the
best nursing action to prevent cross contamination?
WALDEN COAST UNIVERSITY NURS 120 EXAM Questions And
Answers Best Rated A+ Guaranteed Success Latest Update
2022
, WALDEN COAST UNIVERSITY NURS 120 EXAM Questions And
Answers Best Rated A+ Guaranteed Success Latest Update
2022
a. Use sterile gloves when removing old dressings.
b. Wear gowns, caps, masks, and gloves during all care of the
patient.
c. Administer IV antibiotics to prevent bacterial colonization of
wounds.
d. Turn the room temperature up to at least 70° F (20° C) during
dressing changes.
Use of gowns, caps, masks, and gloves during all patient care will decrease the
possibility of wound contamination for a patient whose burns are not covered.
When removing contaminated dressings and washing the dirty wound, use
nonsterile, disposable gloves. The room temperature should be kept at
approximately 85° F for patients with open burn wounds to prevent shivering.
Systemic antibiotics are not well absorbed into deep burns because of the lack of
circulation.
A nurse is caring for a patient who has burns of the ears, head, neck, and right arm and
hand. The nurse should place the patient in which position?
a. Place the right arm and hand flexed in a position of
comfort.
b. Elevate the right arm and hand on pillows and extend
the fingers.
c. Assist the patient to a supine position with a small
WALDEN COAST UNIVERSITY NURS 120 EXAM Questions And
Answers Best Rated A+ Guaranteed Success Latest Update
2022
