Burns Questions And Answers 2022
1.The newly admitted client has burns on both legs. The burned areas appear white and
leather-like. No blisters or bleeding are present, and the client states that he or she has
little pain. How should this injury be categorized?
A.Superficial
B.Partial-thickness superficial
C.Partial-thickness deep
D.Full thickness - Answer - D
The characteristics of the wound meet the criteria for a full-thickness injury(color that is
black, brown, yellow, white or red; no blisters; pain minimal;outer layer firm and
inelastic)
The newly admitted client has a large burned area on the right arm. The burned area
appears red, has blisters, and is very painful. How should this injury be categorized?
A.Superficial
B.Partial-thickness superficial
C.Partial-thickness deep
D.Full thickness - Answer - B
The characteristics of the wound meet the criteria for a superficial partial-thickness
injury (color that is pink or red; blisters; pain present and high).
The burned client newly arrived from an accident scene is prescribed toreceive 4 mg of
morphine sulfate by IV push. What is the most important reason toadminister the opioid
analgesic to this client by the intravenous route?
A.The medication will be effective more quickly than if given intramuscularly.
B.It is less likely to interfere with the client's breathing and oxygenation.
C.The danger of an overdose during fluid remobilization is reduced.
D.The client delayed gastric emptying - Answer - C
Although providing some pain relief has a high priority, and giving the drug bythe IV
route instead of IM, SC, or orally does increase the rate of effect, themost important
reason is to prevent an overdose from accumulation of drug in theinterstitial space
during the fluid shift of the emergent phase. When edema ispresent, cumulative doses
are rapidly absorbed when the fluid shift is resolving.This delayed absorption can result
in lethal blood levels of analgesics
Which vitamin deficiency is most likely to be a long-term consequenceof a full-thickness
burn injury?
A.Vitamin A
B.Vitamin B
C.Vitamin C
D.Vitamin D - Answer - D
Skin exposed to sunlight activates vitamin D. Partial-thickness burns reduce
theactivation of vitamin D. Activation of vitamin D is lost completely in full-thickness
burns.
,Which client factors should alert the nurse to potential increasedcomplications with a
burn injury?
A.The client is a 26-year-old male.
B.The client has had a burn injury in the past.
C.The burned areas include the hands and perineum.
D.The burn took place in an open field and ignited the client's clothing - Answer - C
Burns of the perineum increase the risk for sepsis. Burns of the hands requirespecial
attention to ensure the best functional outcome
The burned client is ordered to receive intravenous cimetidine, an H2histamine blocking
agent, during the emergent phase. When the client's family askswhy this drug is being
given, what is the nurse's best response?
A."To increase the urine output and prevent kidney damage."
B."To stimulate intestinal movement and prevent abdominal bloating."
C."To decrease hydrochloric acid production in the stomach and preventulcers."
D."To inhibit loss of fluid from the circulatory system and preventhypovolemic shock." -
Answer - CUlcerative gastrointestinal disease may develop within 24 hours after a
severeburn as a result of increased hydrochloric acid production and decreased
mucosalbarrier. Cimetidine inhibits the production and release of hydrochloric acid.
At what point after a burn injury should the nurse be most alert forthe complication of
hypokalemia?
A.Immediately following the injury
B.During the fluid shift
C.During fluid remobilization
D.During the late acute phase - Answer - C
Hypokalemia is most likely to occur during the fluid remobilization period as aresult of
dilution, potassium movement back into the cells, and increasedpotassium excreted into
the urine with the greatly increased urine output
What clinical manifestation should alert the nurse to possible carbonmonoxide
poisoning in a client who experienced a burn injury during a house fire?
A.Pulse oximetry reading of 80%
B.Expiratory stridor and nasal flaring
C.Cherry red color to the mucous membranes
D.Presence of carbonaceous particles in the sputum - Answer - C
The saturation of hemoglobin molecules with carbon monoxide and the
subsequentvasodilation induces a "cherry red" color of the mucous membranes in
theseclients. The other manifestations are associated with inhalation injury, but
notspecifically carbon monoxide poisoning
What clinical manifestation indicates that an escharotomy is needed ona circumferential
extremity burn?
A.The burn is full thickness rather than partial thickness.
, B.The client is unable to fully pronate and supinate the extremity.
C.Capillary refill is slow in the digits and the distal pulse is absent.
D.The client cannot distinguish the sensation of sharp versus dull in theextremity. -
Answer - C
Circumferential eschar can act as a tourniquet when edema forms from the fluidshift,
increasing tissue pressure and preventing blood flow to the distalextremities and
increasing the risk for tissue necrosis. This problem is anemergency and, without
intervention, can lead to loss of the distal limb. Thisproblem can be reduced or
corrected with an escharotomy.
What additional laboratory test should be performed on any AfricanAmerican client who
sustains a serious burn injury?
A.Total protein
B.Tissue type antigens
C.Prostate specific antigen
D.Hemoglobin S electrophoresis - Answer - D
Sickle cell disease and sickle cell trait are more common among African Americans.
Although clients with sickle cell disease usually know their status, the clientwith sickle
cell trait may not. The fluid, circulatory, and respiratoryalterations that occur in the
emergent phase of a burn injury could result indecreased tissue perfusion that is
sufficient to cause sickling of cells, even ina person who only has the trait. Determining
the client's sickle cell status bychecking the percentage of hemoglobin S is essential for
any African Americanclient who has a burn injury
Which type of fluid should the nurse expect to prepare and administeras fluid
resuscitation during the emergent phase of burn recovery?
A.Colloids
B.Crystalloids
C.Fresh-frozen plasma
D.Packed red blood cells - Answer - B
Although not universally true, most fluid resuscitation for burn injuries startswith
crystalloid solutions, such as normal saline and Ringer's lactate. The burnclient rarely
requires blood during the emergent phase unless the burn iscomplicated by another
injury that involved hemorrhage. Colloids and plasma arenot generally used during the
fluid shift phase because these large particles passthrough the leaky capillaries into the
interstitial fluid, where they increase theosmotic pressure. Increased osmotic pressure
in the interstitial fluid can worsenthe capillary leak syndrome and make maintaining the
circulating fluid volume evenmore difficult.
The client with a dressing covering the neck is experiencing some respiratory difficulty.
What is the nurse's best first action?
A.Administer oxygen.
B.Loosen the dressing.
C.Notify the emergency team.
D.Document the observation as the only action - Answer - B
1.The newly admitted client has burns on both legs. The burned areas appear white and
leather-like. No blisters or bleeding are present, and the client states that he or she has
little pain. How should this injury be categorized?
A.Superficial
B.Partial-thickness superficial
C.Partial-thickness deep
D.Full thickness - Answer - D
The characteristics of the wound meet the criteria for a full-thickness injury(color that is
black, brown, yellow, white or red; no blisters; pain minimal;outer layer firm and
inelastic)
The newly admitted client has a large burned area on the right arm. The burned area
appears red, has blisters, and is very painful. How should this injury be categorized?
A.Superficial
B.Partial-thickness superficial
C.Partial-thickness deep
D.Full thickness - Answer - B
The characteristics of the wound meet the criteria for a superficial partial-thickness
injury (color that is pink or red; blisters; pain present and high).
The burned client newly arrived from an accident scene is prescribed toreceive 4 mg of
morphine sulfate by IV push. What is the most important reason toadminister the opioid
analgesic to this client by the intravenous route?
A.The medication will be effective more quickly than if given intramuscularly.
B.It is less likely to interfere with the client's breathing and oxygenation.
C.The danger of an overdose during fluid remobilization is reduced.
D.The client delayed gastric emptying - Answer - C
Although providing some pain relief has a high priority, and giving the drug bythe IV
route instead of IM, SC, or orally does increase the rate of effect, themost important
reason is to prevent an overdose from accumulation of drug in theinterstitial space
during the fluid shift of the emergent phase. When edema ispresent, cumulative doses
are rapidly absorbed when the fluid shift is resolving.This delayed absorption can result
in lethal blood levels of analgesics
Which vitamin deficiency is most likely to be a long-term consequenceof a full-thickness
burn injury?
A.Vitamin A
B.Vitamin B
C.Vitamin C
D.Vitamin D - Answer - D
Skin exposed to sunlight activates vitamin D. Partial-thickness burns reduce
theactivation of vitamin D. Activation of vitamin D is lost completely in full-thickness
burns.
,Which client factors should alert the nurse to potential increasedcomplications with a
burn injury?
A.The client is a 26-year-old male.
B.The client has had a burn injury in the past.
C.The burned areas include the hands and perineum.
D.The burn took place in an open field and ignited the client's clothing - Answer - C
Burns of the perineum increase the risk for sepsis. Burns of the hands requirespecial
attention to ensure the best functional outcome
The burned client is ordered to receive intravenous cimetidine, an H2histamine blocking
agent, during the emergent phase. When the client's family askswhy this drug is being
given, what is the nurse's best response?
A."To increase the urine output and prevent kidney damage."
B."To stimulate intestinal movement and prevent abdominal bloating."
C."To decrease hydrochloric acid production in the stomach and preventulcers."
D."To inhibit loss of fluid from the circulatory system and preventhypovolemic shock." -
Answer - CUlcerative gastrointestinal disease may develop within 24 hours after a
severeburn as a result of increased hydrochloric acid production and decreased
mucosalbarrier. Cimetidine inhibits the production and release of hydrochloric acid.
At what point after a burn injury should the nurse be most alert forthe complication of
hypokalemia?
A.Immediately following the injury
B.During the fluid shift
C.During fluid remobilization
D.During the late acute phase - Answer - C
Hypokalemia is most likely to occur during the fluid remobilization period as aresult of
dilution, potassium movement back into the cells, and increasedpotassium excreted into
the urine with the greatly increased urine output
What clinical manifestation should alert the nurse to possible carbonmonoxide
poisoning in a client who experienced a burn injury during a house fire?
A.Pulse oximetry reading of 80%
B.Expiratory stridor and nasal flaring
C.Cherry red color to the mucous membranes
D.Presence of carbonaceous particles in the sputum - Answer - C
The saturation of hemoglobin molecules with carbon monoxide and the
subsequentvasodilation induces a "cherry red" color of the mucous membranes in
theseclients. The other manifestations are associated with inhalation injury, but
notspecifically carbon monoxide poisoning
What clinical manifestation indicates that an escharotomy is needed ona circumferential
extremity burn?
A.The burn is full thickness rather than partial thickness.
, B.The client is unable to fully pronate and supinate the extremity.
C.Capillary refill is slow in the digits and the distal pulse is absent.
D.The client cannot distinguish the sensation of sharp versus dull in theextremity. -
Answer - C
Circumferential eschar can act as a tourniquet when edema forms from the fluidshift,
increasing tissue pressure and preventing blood flow to the distalextremities and
increasing the risk for tissue necrosis. This problem is anemergency and, without
intervention, can lead to loss of the distal limb. Thisproblem can be reduced or
corrected with an escharotomy.
What additional laboratory test should be performed on any AfricanAmerican client who
sustains a serious burn injury?
A.Total protein
B.Tissue type antigens
C.Prostate specific antigen
D.Hemoglobin S electrophoresis - Answer - D
Sickle cell disease and sickle cell trait are more common among African Americans.
Although clients with sickle cell disease usually know their status, the clientwith sickle
cell trait may not. The fluid, circulatory, and respiratoryalterations that occur in the
emergent phase of a burn injury could result indecreased tissue perfusion that is
sufficient to cause sickling of cells, even ina person who only has the trait. Determining
the client's sickle cell status bychecking the percentage of hemoglobin S is essential for
any African Americanclient who has a burn injury
Which type of fluid should the nurse expect to prepare and administeras fluid
resuscitation during the emergent phase of burn recovery?
A.Colloids
B.Crystalloids
C.Fresh-frozen plasma
D.Packed red blood cells - Answer - B
Although not universally true, most fluid resuscitation for burn injuries startswith
crystalloid solutions, such as normal saline and Ringer's lactate. The burnclient rarely
requires blood during the emergent phase unless the burn iscomplicated by another
injury that involved hemorrhage. Colloids and plasma arenot generally used during the
fluid shift phase because these large particles passthrough the leaky capillaries into the
interstitial fluid, where they increase theosmotic pressure. Increased osmotic pressure
in the interstitial fluid can worsenthe capillary leak syndrome and make maintaining the
circulating fluid volume evenmore difficult.
The client with a dressing covering the neck is experiencing some respiratory difficulty.
What is the nurse's best first action?
A.Administer oxygen.
B.Loosen the dressing.
C.Notify the emergency team.
D.Document the observation as the only action - Answer - B
