Herzing University
4 MAXE • 332 GSN
★ ★
H College of Nursing
E D U C AT I O N F O R T H E R E A L W O R L D
EST. 1965
NSG 233 — Examination 4 (Comprehensive)
M E D I C A L-S U R G I C A L N U R S I N G I I I : B U R N S , H I V/A I D S & A N T I R E T R O V I R A LS
INSTITUTION Herzing University COURSE CODE NSG 233
PROGRAM Bachelor of Science in Nursing (BSN) ACADEMIC YEAR
EXAM TITLE Examination 4 — Comprehensive Final TOTAL QUESTIONS 24 Questions
COURSE TITLE Medical-Surgical Nursing III FORMAT Multiple Choice — Select the Single Best
Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless otherwise instructed.
▸ Burn depth classification, TBSA calculation methods, and fluid resuscitation formulas are testable content.
▸ HIV pathophysiology, staging, ART goals, and opportunistic infections are emphasized throughout.
▸ Antiretroviral mechanisms of action, adverse effects, and nursing considerations are core competencies.
▸ Correct answers and clinical rationales appear below each question for board review purposes.
▸ All pharmacological and clinical data reflects current evidence-based guidelines.
SECTION I — BURN INJURIES: CLASSIFICATION, PATHOPHYSIOLOGY & Questions 1 –
MANAGEMENT 14
1. What are the most common types of burn injuries by etiology, and which demographic is at highest risk?
A. Chemical contact (41%), women ages 40-50 most common
B. Flame-related (41%) and scalding (25%); men 2x more than women, ages 20-30 most common
C. Electrical (41%) and radiation (25%); children under 10 most common
D. Inhalation only (41%) and friction (25%); adults over 65 most common
CORRECT ANSWER B — Flame-related (41%) and scalding (25%); men 2x more than women, ages 20-30 most common
RATIONALE The most common burn etiologies are flame-related (41%), scalding (25%), direct source contact (10%),
electrical (3%), chemical contact (3%), and inhalation only (3%). Men are affected 2x more than women, with
the highest incidence in ages 20-30. Most burns occur at home (73%), followed by industry-related (8%) and
recreationally-related (5%) settings.
, 2. Which factors predispose geriatric patients to burn injuries, and what are the most common complications in this
population?
A. Increased mobility and strength; #1 complication is wound infection
B. Decreased mobility, strength, sensation, memory, postural stability, coordination, and visual acuity; #1 complication
is pneumonia, #2 is UTIs
C. Hyperactive reflexes and increased skin elasticity; #1 complication is arrhythmia
D. Enhanced coordination but decreased visual acuity; #1 complication is cellulitis
CORRECT ANSWER B — Decreased mobility, strength, sensation, memory, postural stability, coordination, and visual
acuity; #1 complication is pneumonia, #2 is UTIs
RATIONALE Geriatric patients have decreased mobility, strength, sensation, memory, postural stability, coordination, and
visual acuity, all predisposing to burn injuries. Fire/flame sources account for 56% of geriatric burns. Mortality
is increased compared to similar severity in young patients. Complications ranked: #1 pneumonia, #2 UTIs,
followed by respiratory failure, septicemia, cellulitis, wound infection, kidney injury, arrhythmias, and HAIs.
Thinner, less elastic skin affects both injury depth and healing capacity.
3. What are the characteristics of a 1st degree (superficial) burn?
A. Involves epidermis and dermis; blistered, weeping surface; requires grafting
B. Involves epidermis, dermis, and SQ tissue; dry, leathery appearance; no pain
C. Epidermis ONLY; red (erythematous), blanches with pressure, dry, minimal to no edema; recovery within days;
topical antimicrobials NOT indicated
D. Involves fat, fascia, muscle, and bone; charred appearance; amputation likely
CORRECT ANSWER C — Epidermis ONLY; red (erythematous), blanches with pressure, dry, minimal to no edema; recovery
within days; topical antimicrobials NOT indicated
RATIONALE 1st degree (superficial) burns involve the epidermis only. Common causes: sunburn, low-intensity flash,
superficial scald. The wound appears red (erythematous), blanches with pressure, dry, with minimal to no
edema. Recovery is complete within a few days. Pain is soothed by cooling; peeling and itching may occur.
Nikolsky's sign is negative (burn doesn't separate from underlying dermis when rubbed). Topical
antimicrobial agents are NOT indicated.
4. What are the characteristics of a 2nd degree (partial-thickness) burn?
A. Epidermis only; dry, blanches with pressure; heals in 24 hours
B. Full-thickness with nerve destruction; no pain, no sensation, leathery appearance
C. Epidermis and part of dermis; blistered, mottled red base, disrupted epidermis, weeping (WET) surface, edema;
recovery in 2-3 weeks; may require grafting
D. Includes bone and muscle; charred appearance; grafting has no benefit
CORRECT ANSWER C — Epidermis and part of dermis; blistered, mottled red base, disrupted epidermis, weeping (WET)
surface, edema; recovery in 2-3 weeks; may require grafting
RATIONALE 2nd degree (partial-thickness) burns involve the epidermis and part of the dermis. Causes include scalds,
flash flame, and contact. The wound appears blistered, with a mottled red base, disrupted epidermis, and a
weeping (WET) surface due to fluid third-spacing and edema. Hair follicles and skin appendages remain
intact, allowing re-epithelialization. Recovery takes 2-3 weeks; grafting may be required depending on depth.
4 MAXE • 332 GSN
★ ★
H College of Nursing
E D U C AT I O N F O R T H E R E A L W O R L D
EST. 1965
NSG 233 — Examination 4 (Comprehensive)
M E D I C A L-S U R G I C A L N U R S I N G I I I : B U R N S , H I V/A I D S & A N T I R E T R O V I R A LS
INSTITUTION Herzing University COURSE CODE NSG 233
PROGRAM Bachelor of Science in Nursing (BSN) ACADEMIC YEAR
EXAM TITLE Examination 4 — Comprehensive Final TOTAL QUESTIONS 24 Questions
COURSE TITLE Medical-Surgical Nursing III FORMAT Multiple Choice — Select the Single Best
Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless otherwise instructed.
▸ Burn depth classification, TBSA calculation methods, and fluid resuscitation formulas are testable content.
▸ HIV pathophysiology, staging, ART goals, and opportunistic infections are emphasized throughout.
▸ Antiretroviral mechanisms of action, adverse effects, and nursing considerations are core competencies.
▸ Correct answers and clinical rationales appear below each question for board review purposes.
▸ All pharmacological and clinical data reflects current evidence-based guidelines.
SECTION I — BURN INJURIES: CLASSIFICATION, PATHOPHYSIOLOGY & Questions 1 –
MANAGEMENT 14
1. What are the most common types of burn injuries by etiology, and which demographic is at highest risk?
A. Chemical contact (41%), women ages 40-50 most common
B. Flame-related (41%) and scalding (25%); men 2x more than women, ages 20-30 most common
C. Electrical (41%) and radiation (25%); children under 10 most common
D. Inhalation only (41%) and friction (25%); adults over 65 most common
CORRECT ANSWER B — Flame-related (41%) and scalding (25%); men 2x more than women, ages 20-30 most common
RATIONALE The most common burn etiologies are flame-related (41%), scalding (25%), direct source contact (10%),
electrical (3%), chemical contact (3%), and inhalation only (3%). Men are affected 2x more than women, with
the highest incidence in ages 20-30. Most burns occur at home (73%), followed by industry-related (8%) and
recreationally-related (5%) settings.
, 2. Which factors predispose geriatric patients to burn injuries, and what are the most common complications in this
population?
A. Increased mobility and strength; #1 complication is wound infection
B. Decreased mobility, strength, sensation, memory, postural stability, coordination, and visual acuity; #1 complication
is pneumonia, #2 is UTIs
C. Hyperactive reflexes and increased skin elasticity; #1 complication is arrhythmia
D. Enhanced coordination but decreased visual acuity; #1 complication is cellulitis
CORRECT ANSWER B — Decreased mobility, strength, sensation, memory, postural stability, coordination, and visual
acuity; #1 complication is pneumonia, #2 is UTIs
RATIONALE Geriatric patients have decreased mobility, strength, sensation, memory, postural stability, coordination, and
visual acuity, all predisposing to burn injuries. Fire/flame sources account for 56% of geriatric burns. Mortality
is increased compared to similar severity in young patients. Complications ranked: #1 pneumonia, #2 UTIs,
followed by respiratory failure, septicemia, cellulitis, wound infection, kidney injury, arrhythmias, and HAIs.
Thinner, less elastic skin affects both injury depth and healing capacity.
3. What are the characteristics of a 1st degree (superficial) burn?
A. Involves epidermis and dermis; blistered, weeping surface; requires grafting
B. Involves epidermis, dermis, and SQ tissue; dry, leathery appearance; no pain
C. Epidermis ONLY; red (erythematous), blanches with pressure, dry, minimal to no edema; recovery within days;
topical antimicrobials NOT indicated
D. Involves fat, fascia, muscle, and bone; charred appearance; amputation likely
CORRECT ANSWER C — Epidermis ONLY; red (erythematous), blanches with pressure, dry, minimal to no edema; recovery
within days; topical antimicrobials NOT indicated
RATIONALE 1st degree (superficial) burns involve the epidermis only. Common causes: sunburn, low-intensity flash,
superficial scald. The wound appears red (erythematous), blanches with pressure, dry, with minimal to no
edema. Recovery is complete within a few days. Pain is soothed by cooling; peeling and itching may occur.
Nikolsky's sign is negative (burn doesn't separate from underlying dermis when rubbed). Topical
antimicrobial agents are NOT indicated.
4. What are the characteristics of a 2nd degree (partial-thickness) burn?
A. Epidermis only; dry, blanches with pressure; heals in 24 hours
B. Full-thickness with nerve destruction; no pain, no sensation, leathery appearance
C. Epidermis and part of dermis; blistered, mottled red base, disrupted epidermis, weeping (WET) surface, edema;
recovery in 2-3 weeks; may require grafting
D. Includes bone and muscle; charred appearance; grafting has no benefit
CORRECT ANSWER C — Epidermis and part of dermis; blistered, mottled red base, disrupted epidermis, weeping (WET)
surface, edema; recovery in 2-3 weeks; may require grafting
RATIONALE 2nd degree (partial-thickness) burns involve the epidermis and part of the dermis. Causes include scalds,
flash flame, and contact. The wound appears blistered, with a mottled red base, disrupted epidermis, and a
weeping (WET) surface due to fluid third-spacing and edema. Hair follicles and skin appendages remain
intact, allowing re-epithelialization. Recovery takes 2-3 weeks; grafting may be required depending on depth.
