AWLS Final Exam with All Correct & 100% Verified
Answers| Actual Complete Exam| Already Graded A+
The optimal measurement of intravascular fluid status during the immediate fluid resuscitation
phase of burn treatment is:
a.
blood urea nitrogen.
b.
daily weight.
c.
hourly intake and urine output.
d.
serum potassium. ✔Correct answer-ANS: C
During initial fluid resuscitation, urine output helps guide fluid resuscitation needs. Measuring hourly
intake and output is most effective in determining the needs for additional fluid infusion than is urine
output alone. Blood urea nitrogen may be used to monitor volume status, but it is affected by the
hypermetabolic state seen after burns, so it is not the optimal measure of intravascular fluid status.
Daily weight measures overall volume status, not just intravascular volume. Serum potassium is
released with tissue damage and thus is not the optimum measure of intravascular fluid status.
In patients with extensive burns, edema occurs in both burned and unburned areas because of:
a.
catecholamine-induced vasoconstriction.
b.
decreased glomerular filtration.
c.
increased capillary permeability.
d.
loss of integument barrier. ✔Correct answer-ANS: C
Capillary permeability is altered in burns beyond the area of tissue damage, resulting in significant
shift of proteins, fluid, and electrolytes resulting in edema (third spacing). Catecholamine-induced
vasoconstriction does not produce edema. Decreased glomerular filtration may cause fluid retention,
but it is not responsible for the extensive edema seen after burn injury. Loss of integument barrier
does not cause edema.
Tissue damage from burn injury activates an inflammatory response that increases the patients risk
for:
a.
acute kidney injury.
b.
acute respiratory distress syndrome.
c.
infection.
d.
stress ulcers. ✔Correct answer-ANS: C
The loss of skin as the primary barrier against microorganisms and activation of the inflammatory
response cascades results in immunosuppression, placing the patient at an increased risk of
infection. A systemic inflammatory response (SIRS) also increases the risk of acute kidney injury in
the presence of poor tissue perfusion. Acute respiratory distress syndrome is also a potential
,complication, but the risk of infection is greater because of the loss of the skin barrier.
Catecholamine release and gastrointestinal ischemia are the causes of stress ulcers.
The nurse is caring for a burn-injured patient who weighs 154 pounds, and the burn injury covers
50% of his body surface area. The nurse calculates the fluid needs for the first 24 hours after a burn
injury using a standard fluid resuscitation formula of 4 mL/kg/% burn of intravenous (IV) fluid for the
first 24 hours. The nurse plans to administer what amount of fluid in the first 24 hours?
a.
2800 mL
b.
7000 mL
c.
14 L
d.
28 L ✔Correct answer-ANS: C
154 pounds/2.2 = 70 kg
4 70 kg 50 = 14,000 mL, or 14 liters.
The nurse is caring for a patient who has circumferential full-thickness burns of his forearm? A
priority in the plan of care is :
a.
Keeping the extremity in a dependent position
b.
Active and passive range of motion every hour.
c.
Preparing for an escharotomy as a prophylactic measure
d.
Splinting the forearm ✔Correct answer-ANS: B
Special attention is given to circumferential (completely surrounding a body part) full thickness
burns of the extremities. Pressure from bands of eschar or from edema that develops as
resuscitation proceeds may impair blood flow to underlying and distal tissue. Therefore, extremities
are elevated to reduce edema. Active or passive range-of-motion (ROM) exercises are performed
every hour for 5 minutes to increase venous return and to minimize edema. Peripheral pulses are
assessed every hour, especially in circumferential burns of the extremities, to confirm adequate
circulation. If signs and symptoms of compartment syndrome are present on serial examination,
preparation is made for an escharotomy to relieve pressure and to restore circulation.
The patient asks the nurse if the placement of the autograft over his full-thickness burn will be the
only surgical intervention needed to close his wound. The nurses best response would be:
a.
Unfortunately, an autograft skin is a temporary graft and a second surgery will be needed to close the
wound.
b.
An autograft is a biological dressing that will eventually be replaced by your body generating new
tissue.
c.
Yes, an autograft will transfer your own skin from one area of your body to cover the burn wound.
d.
Unfortunately, autografts frequently do not adhere well to burn wounds and a xenograft will be
necessary to close the wound. ✔Correct answer-ANS: C
, The autograft is the only permanent method of grafting and it uses the patients own tissue to cover
the burn wound. Autografting is permanent and does not require a second surgery unless the graft
fails. A biological or biosynthetic graft or dressing is a temporary wound covering. A xenograft is from
an animal, usually pig skin and is a temporary graft.
A patient admitted with severe burns to his face and hands is showing signs of extreme agitation. The
nurse should explore the mechanism of burn injury possibly related to:
a.
excessive alcohol use.
b.
methamphetamine use.
c.
posttraumatic stress disorder.
d.
subacute delirium. ✔Correct answer-ANS: B
A vague or inconsistent injury history, burns to the face and hands, and signs of agitation or
substance withdrawal should alert the nurse to a potential methamphetamine-related injury.
The nurse is caring for patient who has been struck by lightning. Because of the nature of the injury,
the nurse assesses the patient for which of the following?
a.
Central nervous system deficits
b.
Contractures
c.
Infection
d.
Stress ulcers ✔Correct answer-ANS: A
Lightning injury frequently causes cardiopulmonary arrest. However, of those patients who survive,
70% will have transient central nervous system deficits. Contractures, infection, and stress ulcer risks
are no greater than with other causes of burn injury.
The nurse is providing care to manage the pain of a patient with burns. The physician has ordered
opiates to be given intramuscularly. The nurse contacts the physician to change the order to
intravenous administration because:
a.
intramuscular injections cause additional skin disruption.
b.
burn pain is so severe it requires relief by the fastest route available.
c.
hypermetabolism limits effectiveness of medications administered intramuscularly.
d.
tissue edema may interfere with drug absorption of injectable routes. ✔Correct answer-ANS: D
Edema and impaired circulation of the soft tissue interfere with absorption of medications
administered subcutaneously or intramuscularly. Even though it is true intramuscular injections
disrupt tissue, medication absorption is not effective. Burn pain is severe and intravenous
administration is desired to relieve pain, but this is not the physiological basis for giving medications
intravenously. Hypermetabolism affects medication effectiveness but is not the rationale for
administering opioids intravenously.
Answers| Actual Complete Exam| Already Graded A+
The optimal measurement of intravascular fluid status during the immediate fluid resuscitation
phase of burn treatment is:
a.
blood urea nitrogen.
b.
daily weight.
c.
hourly intake and urine output.
d.
serum potassium. ✔Correct answer-ANS: C
During initial fluid resuscitation, urine output helps guide fluid resuscitation needs. Measuring hourly
intake and output is most effective in determining the needs for additional fluid infusion than is urine
output alone. Blood urea nitrogen may be used to monitor volume status, but it is affected by the
hypermetabolic state seen after burns, so it is not the optimal measure of intravascular fluid status.
Daily weight measures overall volume status, not just intravascular volume. Serum potassium is
released with tissue damage and thus is not the optimum measure of intravascular fluid status.
In patients with extensive burns, edema occurs in both burned and unburned areas because of:
a.
catecholamine-induced vasoconstriction.
b.
decreased glomerular filtration.
c.
increased capillary permeability.
d.
loss of integument barrier. ✔Correct answer-ANS: C
Capillary permeability is altered in burns beyond the area of tissue damage, resulting in significant
shift of proteins, fluid, and electrolytes resulting in edema (third spacing). Catecholamine-induced
vasoconstriction does not produce edema. Decreased glomerular filtration may cause fluid retention,
but it is not responsible for the extensive edema seen after burn injury. Loss of integument barrier
does not cause edema.
Tissue damage from burn injury activates an inflammatory response that increases the patients risk
for:
a.
acute kidney injury.
b.
acute respiratory distress syndrome.
c.
infection.
d.
stress ulcers. ✔Correct answer-ANS: C
The loss of skin as the primary barrier against microorganisms and activation of the inflammatory
response cascades results in immunosuppression, placing the patient at an increased risk of
infection. A systemic inflammatory response (SIRS) also increases the risk of acute kidney injury in
the presence of poor tissue perfusion. Acute respiratory distress syndrome is also a potential
,complication, but the risk of infection is greater because of the loss of the skin barrier.
Catecholamine release and gastrointestinal ischemia are the causes of stress ulcers.
The nurse is caring for a burn-injured patient who weighs 154 pounds, and the burn injury covers
50% of his body surface area. The nurse calculates the fluid needs for the first 24 hours after a burn
injury using a standard fluid resuscitation formula of 4 mL/kg/% burn of intravenous (IV) fluid for the
first 24 hours. The nurse plans to administer what amount of fluid in the first 24 hours?
a.
2800 mL
b.
7000 mL
c.
14 L
d.
28 L ✔Correct answer-ANS: C
154 pounds/2.2 = 70 kg
4 70 kg 50 = 14,000 mL, or 14 liters.
The nurse is caring for a patient who has circumferential full-thickness burns of his forearm? A
priority in the plan of care is :
a.
Keeping the extremity in a dependent position
b.
Active and passive range of motion every hour.
c.
Preparing for an escharotomy as a prophylactic measure
d.
Splinting the forearm ✔Correct answer-ANS: B
Special attention is given to circumferential (completely surrounding a body part) full thickness
burns of the extremities. Pressure from bands of eschar or from edema that develops as
resuscitation proceeds may impair blood flow to underlying and distal tissue. Therefore, extremities
are elevated to reduce edema. Active or passive range-of-motion (ROM) exercises are performed
every hour for 5 minutes to increase venous return and to minimize edema. Peripheral pulses are
assessed every hour, especially in circumferential burns of the extremities, to confirm adequate
circulation. If signs and symptoms of compartment syndrome are present on serial examination,
preparation is made for an escharotomy to relieve pressure and to restore circulation.
The patient asks the nurse if the placement of the autograft over his full-thickness burn will be the
only surgical intervention needed to close his wound. The nurses best response would be:
a.
Unfortunately, an autograft skin is a temporary graft and a second surgery will be needed to close the
wound.
b.
An autograft is a biological dressing that will eventually be replaced by your body generating new
tissue.
c.
Yes, an autograft will transfer your own skin from one area of your body to cover the burn wound.
d.
Unfortunately, autografts frequently do not adhere well to burn wounds and a xenograft will be
necessary to close the wound. ✔Correct answer-ANS: C
, The autograft is the only permanent method of grafting and it uses the patients own tissue to cover
the burn wound. Autografting is permanent and does not require a second surgery unless the graft
fails. A biological or biosynthetic graft or dressing is a temporary wound covering. A xenograft is from
an animal, usually pig skin and is a temporary graft.
A patient admitted with severe burns to his face and hands is showing signs of extreme agitation. The
nurse should explore the mechanism of burn injury possibly related to:
a.
excessive alcohol use.
b.
methamphetamine use.
c.
posttraumatic stress disorder.
d.
subacute delirium. ✔Correct answer-ANS: B
A vague or inconsistent injury history, burns to the face and hands, and signs of agitation or
substance withdrawal should alert the nurse to a potential methamphetamine-related injury.
The nurse is caring for patient who has been struck by lightning. Because of the nature of the injury,
the nurse assesses the patient for which of the following?
a.
Central nervous system deficits
b.
Contractures
c.
Infection
d.
Stress ulcers ✔Correct answer-ANS: A
Lightning injury frequently causes cardiopulmonary arrest. However, of those patients who survive,
70% will have transient central nervous system deficits. Contractures, infection, and stress ulcer risks
are no greater than with other causes of burn injury.
The nurse is providing care to manage the pain of a patient with burns. The physician has ordered
opiates to be given intramuscularly. The nurse contacts the physician to change the order to
intravenous administration because:
a.
intramuscular injections cause additional skin disruption.
b.
burn pain is so severe it requires relief by the fastest route available.
c.
hypermetabolism limits effectiveness of medications administered intramuscularly.
d.
tissue edema may interfere with drug absorption of injectable routes. ✔Correct answer-ANS: D
Edema and impaired circulation of the soft tissue interfere with absorption of medications
administered subcutaneously or intramuscularly. Even though it is true intramuscular injections
disrupt tissue, medication absorption is not effective. Burn pain is severe and intravenous
administration is desired to relieve pain, but this is not the physiological basis for giving medications
intravenously. Hypermetabolism affects medication effectiveness but is not the rationale for
administering opioids intravenously.
