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11TH EDITION BY HARDING
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Questions & Answers s m m m
atisfaction guaranteed success ( CHAPTERS 21-
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29)latest update
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11TH EDITION BYHARDING Questions & Answers sat
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isfaction guaranteed success ( CHAPTERS 21- m m m m m
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Chapter 21: Burns m m
Test Bankm m
MULTIPLE m
CHOICE
1. When assessing a patient who spilled hot oil on the right leg and foot, t
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he nurse notes that the skin is dry, pale, hard skin. The patient states that
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the burn is not painful. What term would the nurse use to document the
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burn depth? m
a. First-degree skin destruction m m
b. Full-thickness skin destruction m m
c. Deep partial-thickness skin destruction
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d. Superficial partial- m
thickness skin destructionANS: B
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With full- m
thickness skin destruction, the appearance is pale and dry or leathery and t
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he area is painless becauseof the associated nerve destruction. Erythema, sw
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elling, and blisters point to a deep partial-thickness burn.
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With superficial partial-thickness burns, the area is red, but no blisters are
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TESTBANK FOR LEWIS MEDICAL SURGICAL NURSING m m m m m
11TH EDITION BYHARDING Questions & Answers sat
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isfaction guaranteed success ( CHAPTERS 21- m m m m m
29)latest update m m
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present. First-degree burns exhibiterythema, blanching, and pain.
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DIF: Cognitive Level: Understand (comprehension)
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TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
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2. On admission to the burn unit, a patient with an approximate 25% tot
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al body surface area (TBSA) burn hasthe following initial laboratory resu
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lts: Hct 58%, Hgb 18.2 mg/dL (172 g/L), serum K+ 4.9 mEq/L (4.8 mmol
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/L), and serum Na+ 135 mEq/L (135 mmol/L). Which action will the nur
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se anticipate taking now?
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a. Monitor urine output every 4 hours.
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b. Continue to monitor the laboratory results.
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c. Increase the rate of the ordered IV solution.
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d. Type and crossmatch for a blood transfusion.
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ANS: C m
The patients laboratory data show hemoconcentration, which may lead to a
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TESTBANK FOR LEWIS MEDICAL SURGICAL NURSING m m m m m
11TH EDITION BYHARDING Questions & Answers sat
m m m m m m
isfaction guaranteed success ( CHAPTERS 21- m m m m m
29)latest update m m
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11TH EDITION BYHARDING Questions & Answers sat
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isfaction guaranteed success ( CHAPTERS 21-
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29)latest update m m
decrease in blood flow to the microcirculation unless fluid intake is increas
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ed. Because the hematocrit and hemoglobin are elevated, a transfusion is in
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appropriate, although transfusions may be needed after the emergent phase
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once the patients fluid balance has been restored. On admission to a burn
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unit, the urine output would be monitored more often than every 4 hours; li
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kely every1 hour.
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DIF: Cognitive Level: Apply (application)
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TESTBANK FOR LEWIS MEDICAL SURGICAL NURSING
m m m m m
11TH EDITION BYHARDING Questions & Answers sat
m m m m m m
isfaction guaranteed success ( CHAPTERS 21-
m m m m m
29)latest update m m