BURNS & INJURIES (AH2 EXAM 4 FINAL MATERIAL) Q&A | NEWEST UPDATE 2025/2026 | 100% CORRECT BURNS ATI MED/SURG (CH.75)

BURNS & INJURIES (AH2 EXAM 4 FINAL MATERIAL) Q&A | NEWEST UPDATE 2025/2026 | 100% CORRECT BURNS ATI MED/SURG (CH.75) A nurse in a provider's oce is assessing a client who has a severe sunburn. Which of the following classicaons should the nurse use to document this burn? A. Supercial thickness B. Supercial paral thickness C. Deep paral thicknessD. Full thickness Ans: A sunburn is a supercial thickness burn. Supercial burns damage the top layer of the skin. B. A supercial paral thickness burn results from fames or scalds. This damages the enre epidermis layer of the skin.‐ C. A deep paral thickness burn can result from contact with hot grease. This afects the deep layers of the skin.‐ D. A full thickness burn can result from contact with hot tar. This afects the dermis and somemes the subcutaneous fat layer. A nurse is caring for a client who has sustained burns over 35% of his total body surface area. The client's voice has become hoarse. He has a brassy cough and is drooling. The nurse should idenfy these ndings as indicaons that the client has which of the following? A. Pulmonary edema B. Bacterial pneumonia C. Inhalaon injury D. Carbon monoxide poisoning A. Diculty breathing and producon of pink frothy sputum indicate pulmonary edema. B. Producve cough and a fever are indicave of a bacterial infecon. C. CORRECT: Wheezing and hoarseness indicate inhalaon injury with impending loss of the airway. These require immediate reporng to the provider. D. Confusion and headaches indicate carbon monoxide poisoning. A nurse is assessing a client who sustained deep paral thickness and full thickness burns over 40% of his body 24 hr ‐ ago. Which of the following are ndings should the nurse expect? (Select all that apply.) A. Temperature 36.1 C (97 F) B. Bradycardia C. Hyperkalemia D. Hyponatremia E. Decreased hematocrit A. CORRECT: Dyspnea can occur during the inial phase following a burn due to airway injury and uid shi?s. B. Tachycardia occurs during the inial phase following a burn due to sympathec nervous system compensaon.C. CORRECT: Hyperkalemia occurs during the inial phase following a burn as a result of leakage of uid from the intracellular space. D. CORRECT: Hyponatremia occurs during the inial phase of a burn as a result in sodium retenon in the intersal space. E. Hct increases during the inial phase of a burn due to hemoconcentraon. The injury that is least likely to result in a full-thickness burn is: a. sunburn b. scald injury c. chemical burn d. electrical injury Raonale: Full-thickness burns may be caused by contact with fames, scalding liquids, chemicals, tar, or electrical current. A nurse is preparing to administer fentanyl to a client who sustained deep paral thickness and full thickness burns over ‐ 60% of his body 24 hr ago. The nurse should plan to use which of the following routes to administer the medicaon? A. Subcutaneous B. Oral C. Intravenous D. Transdermal Ans: The nurse should use the IV route to administer pain medicaon for rapid absorpon and fast pain relief during the resuscitaon phase. A. The nurse should not give subcutaneous injecons due to the diculty of absorpon from ssue during the resuscitaon phase. B. The nurse should not give oral (including buccal, sublingual) medicaons due to decreased molity in the gastrointesnal tract during the resuscitaon phase. D. The nurse should not use the transdermal route of administraon due to delays in absorpon during the resuscitaon phase. A nurse is planning care for an adult client who sustained severe burn injuries. Which of the following intervenons should the nurse include in the plan of care? (Select all that apply.) A. Limit visitors in the client's room. B. Encourage fresh vegetables in the diet. C. Increase protein intake. D. Instruct the client to consume 2,000 calories/day. E. Restrict fresh fowers in the room. A. CORRECT: The nurse should limit the number of visitors and limit the amount of me they can visit to decrease the risk of infecon. C. CORRECT: The client should increase protein consumpon, which promotes wound healing and prevents ssue breakdown. E. CORRECT: Flowers should not be in the client's room due to the bacteria they carry, which increase the risk for infecon. B. The client should restrict consumpon of fresh vegetables due to the presence of bacteria on the surface and the increased risk for infecon. D. The client should consume up to 5,000 calories/day because caloric needs double or triple beginning 4 to 12 days following the burn. Knowing the most common causes of household res, which prevenon strategy would the nurse focus on when teaching about re safety? a. Set hot water temperature at 140 degrees F b. Use only hardwired smoke detectors c. Encourage regular home re exit drills d. Never permit older adults to cook unaHended Raonale: A risk-reducon strategy for household res is to encourage regular home re exit drills. Hot water heaters set at 140° F (60° C) or higher are a burn hazard in the home; the temperature should be set at less than 120° F (40° C). Installaon of smoke and carbon monoxide detectors can prevent inhalaon injuries. Hard-wired smoke detectors do not require baHery replacement; baHery-operated smoke detectors may be used. Supervision of older adults who are cooking is necessary only if cognive alteraons are observed. When assessing a paent with a paral-thickness burn, the nurse would expect to nd (SATA): a. blisters