DEIFIREV • 4 MAXE
★ ★
Nursing Program — NSG 233
RN Medical-Surgical Nursing III
E X C E L L E N C E I N C L I N I C A L J U D G M E N T & P AT I E N T C A R E
EST. 2026
Exam 4 — Medical-Surgical Nursing III
BURNS | HIV/AIDS | ANTIRETROVIRAL THERAPY (ART)
COURSE NSG 233 — Medical-Surgical Nursing III EXAM Exam 4 (Comprehensive)
ACADEMIC YEAR TOTAL QUESTIONS 24 Questions + Clinical Pearls
FORMAT Q&A with Verified Rationales STATUS 100% Correct — Grade A Verified
EXAMINATION INSTRUCTIONS
▸ This document contains verified Q&A for NSG 233 Exam 4 — all answers are 100% correct for the latest curriculum.
▸ Topics: Burn Injuries (epidemiology, depth classification, TBSA: Rule of Nines/Lund & Browder/Palmer, zones of
coagulation/stasis/hyperemia, electrical burns, geriatric considerations, fluid resuscitation, inhalation injury, CO/cyanide
poisoning, hypermetabolism, complications); HIV/AIDS (transmission, PrEP/PEP, stages of HIV infection, ART goals, IRIS,
opportunistic infections: PCP, KS, TB; neuro complications); Antiretrovirals (NRTIs: Zidovudine — MOA, AEs, RN considerations;
NNRTIs: Efavirenz — MOA, AEs, patient education).
▸ Each question includes the correct answer followed by a clinical rationale and additional nursing points.
▸ Use this guide for final exam preparation — content reflects NCLEX-style prioritization and current HIV treatment guidelines.
SECTION I — BURNS, HIV/AIDS & ANTIRETROVIRAL THERAPY Questions 1 – 24
1. What are the most common types of burn injuries?
CORRECT ANSWER 1) Flame-related (41%), 2) Scalding (25%), 3) Direct source contact (10%), 4) Electrical (3%), 5)
Chemical contact (3%), 6) Inhalation only (3%).
RATIONALE Men are affected 2x more than women; most common age group is 20-30 years. Most burns occur at home (73%),
followed by industry-related (8%) and recreational (5%). Understanding burn epidemiology helps guide prevention
strategies and resource allocation.
2. What factors predispose geriatric patients to burn injuries?
CORRECT ANSWER Decreased: mobility, strength, sensation, memory, postural stability, coordination, visual acuity.
Fire/flame sources (56%). Increased mortality in geriatrics compared to similar severity in young
patients.
RATIONALE Geriatric burn complications include pneumonia (#1), UTIs (#2), respiratory failure, septicemia, cellulitis, wound
infection, kidney injury, arrhythmias, and HAIs. Thinner, less elastic skin affects depth of injury and healing
capacity.
, 3. What are the characteristics of a 1st degree (superficial) burn?
CORRECT ANSWER Epidermis ONLY. Wound: Red (erythematous), blanches with pressure, dry, minimal edema. Recovery
within a few days. Topical antimicrobials NOT indicated.
RATIONALE Causes: sunburn, low-intensity flash, superficial scald. Pain is soothed by cooling; may have peeling and itching.
Negative Nikolsky's sign (burn doesn't separate from underlying dermis when rubbed).
4. What are the characteristics of a 2nd degree (partial-thickness) burn?
CORRECT ANSWER Epidermis & part of dermis. Wound: Blistered, mottled red base, disrupted epidermis, WET surface,
edema. Recovery 2-3 weeks; may require grafting.
RATIONALE Fluid is third-spacing, causing edema and a very wet wound. Hair follicles and skin appendages remain intact,
allowing re-epithelialization. Causes: scalds, flash flame, contact burns.
5. What are the characteristics of a 3rd degree (full-thickness) burn?
CORRECT ANSWER Epidermis + dermis + SQ tissue. NO PAIN (nerve fibers damaged). Wound: DRY, pale/white/red/brown,
leathery or charred. Grafting necessary.
RATIONALE The wound is DRY because microcirculation is destroyed (like Bovie cautery). Third-degree burns are often
deceiving to patients because there's no pain. Causes: flame, prolonged hot liquids, electric current, chemical.
6. What is a 4th degree (deep burn necrosis) burn?
CORRECT ANSWER Full-thickness burn that includes fat, fascia, muscle and/or bone. Wound: CHARRED. Amputations
likely. Grafting has NO benefit given depth.
RATIONALE If you don't have underlying tissue to attach the skin graft to, grafting is pointless. Associated with myoglobinuria
and hemolysis. Causes: prolonged exposure, high-voltage electrical injury.
7. What is the Rule of Nines for determining TBSA?
CORRECT ANSWER Head/neck: 9%; each UE: 9%; each LE: 18%; anterior trunk: 18%; posterior trunk: 18%; perineum: 1%.
RATIONALE Most common method for adults. Lund & Browder method is more precise for age-related changes. Palmer
method: size of patient's hand (including fingers) = 1% TBSA.
8. What are the three zones of a burn wound?
CORRECT ANSWER Zone of Coagulation (center, necrosis), Zone of Stasis (may undergo necrosis if persistent ischemia),
Zone of Hyperemia (minimal injury, may recover).
RATIONALE Burn wounds are NOT homogeneous. Initial injury evolves and worsens over time. Resuscitation and wound care
aim to salvage the zone of stasis to prevent conversion to full-thickness necrosis.
9. What is the difference between flash injury and conductive injury in electrical burns?
CORRECT ANSWER Flash: generates light/heat → thermal burns, fewer complications, shorter LOS. Conductive: current
travels through body → deep muscle injury, compartment syndrome COMMON.
RATIONALE AC (alternating current) can hold a victim to it (paralyzed in place), increasing contact time. Visual examination of
electrical burns is NOT predictive of burn size/severity; internal damage may be extensive.
★ ★
Nursing Program — NSG 233
RN Medical-Surgical Nursing III
E X C E L L E N C E I N C L I N I C A L J U D G M E N T & P AT I E N T C A R E
EST. 2026
Exam 4 — Medical-Surgical Nursing III
BURNS | HIV/AIDS | ANTIRETROVIRAL THERAPY (ART)
COURSE NSG 233 — Medical-Surgical Nursing III EXAM Exam 4 (Comprehensive)
ACADEMIC YEAR TOTAL QUESTIONS 24 Questions + Clinical Pearls
FORMAT Q&A with Verified Rationales STATUS 100% Correct — Grade A Verified
EXAMINATION INSTRUCTIONS
▸ This document contains verified Q&A for NSG 233 Exam 4 — all answers are 100% correct for the latest curriculum.
▸ Topics: Burn Injuries (epidemiology, depth classification, TBSA: Rule of Nines/Lund & Browder/Palmer, zones of
coagulation/stasis/hyperemia, electrical burns, geriatric considerations, fluid resuscitation, inhalation injury, CO/cyanide
poisoning, hypermetabolism, complications); HIV/AIDS (transmission, PrEP/PEP, stages of HIV infection, ART goals, IRIS,
opportunistic infections: PCP, KS, TB; neuro complications); Antiretrovirals (NRTIs: Zidovudine — MOA, AEs, RN considerations;
NNRTIs: Efavirenz — MOA, AEs, patient education).
▸ Each question includes the correct answer followed by a clinical rationale and additional nursing points.
▸ Use this guide for final exam preparation — content reflects NCLEX-style prioritization and current HIV treatment guidelines.
SECTION I — BURNS, HIV/AIDS & ANTIRETROVIRAL THERAPY Questions 1 – 24
1. What are the most common types of burn injuries?
CORRECT ANSWER 1) Flame-related (41%), 2) Scalding (25%), 3) Direct source contact (10%), 4) Electrical (3%), 5)
Chemical contact (3%), 6) Inhalation only (3%).
RATIONALE Men are affected 2x more than women; most common age group is 20-30 years. Most burns occur at home (73%),
followed by industry-related (8%) and recreational (5%). Understanding burn epidemiology helps guide prevention
strategies and resource allocation.
2. What factors predispose geriatric patients to burn injuries?
CORRECT ANSWER Decreased: mobility, strength, sensation, memory, postural stability, coordination, visual acuity.
Fire/flame sources (56%). Increased mortality in geriatrics compared to similar severity in young
patients.
RATIONALE Geriatric burn complications include pneumonia (#1), UTIs (#2), respiratory failure, septicemia, cellulitis, wound
infection, kidney injury, arrhythmias, and HAIs. Thinner, less elastic skin affects depth of injury and healing
capacity.
, 3. What are the characteristics of a 1st degree (superficial) burn?
CORRECT ANSWER Epidermis ONLY. Wound: Red (erythematous), blanches with pressure, dry, minimal edema. Recovery
within a few days. Topical antimicrobials NOT indicated.
RATIONALE Causes: sunburn, low-intensity flash, superficial scald. Pain is soothed by cooling; may have peeling and itching.
Negative Nikolsky's sign (burn doesn't separate from underlying dermis when rubbed).
4. What are the characteristics of a 2nd degree (partial-thickness) burn?
CORRECT ANSWER Epidermis & part of dermis. Wound: Blistered, mottled red base, disrupted epidermis, WET surface,
edema. Recovery 2-3 weeks; may require grafting.
RATIONALE Fluid is third-spacing, causing edema and a very wet wound. Hair follicles and skin appendages remain intact,
allowing re-epithelialization. Causes: scalds, flash flame, contact burns.
5. What are the characteristics of a 3rd degree (full-thickness) burn?
CORRECT ANSWER Epidermis + dermis + SQ tissue. NO PAIN (nerve fibers damaged). Wound: DRY, pale/white/red/brown,
leathery or charred. Grafting necessary.
RATIONALE The wound is DRY because microcirculation is destroyed (like Bovie cautery). Third-degree burns are often
deceiving to patients because there's no pain. Causes: flame, prolonged hot liquids, electric current, chemical.
6. What is a 4th degree (deep burn necrosis) burn?
CORRECT ANSWER Full-thickness burn that includes fat, fascia, muscle and/or bone. Wound: CHARRED. Amputations
likely. Grafting has NO benefit given depth.
RATIONALE If you don't have underlying tissue to attach the skin graft to, grafting is pointless. Associated with myoglobinuria
and hemolysis. Causes: prolonged exposure, high-voltage electrical injury.
7. What is the Rule of Nines for determining TBSA?
CORRECT ANSWER Head/neck: 9%; each UE: 9%; each LE: 18%; anterior trunk: 18%; posterior trunk: 18%; perineum: 1%.
RATIONALE Most common method for adults. Lund & Browder method is more precise for age-related changes. Palmer
method: size of patient's hand (including fingers) = 1% TBSA.
8. What are the three zones of a burn wound?
CORRECT ANSWER Zone of Coagulation (center, necrosis), Zone of Stasis (may undergo necrosis if persistent ischemia),
Zone of Hyperemia (minimal injury, may recover).
RATIONALE Burn wounds are NOT homogeneous. Initial injury evolves and worsens over time. Resuscitation and wound care
aim to salvage the zone of stasis to prevent conversion to full-thickness necrosis.
9. What is the difference between flash injury and conductive injury in electrical burns?
CORRECT ANSWER Flash: generates light/heat → thermal burns, fewer complications, shorter LOS. Conductive: current
travels through body → deep muscle injury, compartment syndrome COMMON.
RATIONALE AC (alternating current) can hold a victim to it (paralyzed in place), increasing contact time. Visual examination of
electrical burns is NOT predictive of burn size/severity; internal damage may be extensive.
