BURNS MED SURG 2026 COMPLETE
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Updated 2026 Questions and Answers | 100% Verified
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,A patient is admitted to the burn unit with burns to the ANS: B
head, face, and hands. Initially, wheezes are heard, but an The patient's history and clinical manifestations suggest airway edema and the
hour later, the lung sounds are decreased and no health care provider should be notified immediately, so that intubation can be
wheezes are audible. What is the best action for the nurse done rapidly. Placing the patient in a more upright position or having the patient
to take? cough will not address the problem of airway edema. Continuing to monitor is
a. Encourage the patient to cough and auscultate the inappropriate because immediate action should occur
lungs again.
b. Notify the health care provider and prepare for
endotracheal intubation.
c. Document the results and continue to monitor the
patient's respiratory rate.
d. Reposition the patient in high-Fowler's position and
reassess breath sounds.
A patient with severe burns has crystalloid fluid ANS: C
replacement ordered using the Parkland formula. The Half of the fluid replacement using the Parkland formula is administered in the first
initial volume of fluid to be administered in the first 24 8 hours and the other half over the next 16 hours. In this case, the patient should
hours is 30,000 mL. The initial rate of administration is 1875 receive half of the initial rate, or 938 mL/hr.
mL/hr. After the first 8 hours, what rate should the nurse
infuse the IV fluids?
a. 350 mL/hour
b. 523 mL/hour
c. 938 mL/hour
d. 1250 mL/hour
During the emergent phase of burn care, which ANS: D
assessment will be most useful in determining whether When fluid intake is adequate, the urine output will be at least 0.5 to 1 mL/kg/hour.
the patient is receiving adequate fluid infusion? The patient's weight is not useful in this situation because of the effects of third
a. Check skin turgor. spacing and evaporative fluid loss. Mucous membrane assessment and skin turgor
b. Monitor daily weight. also may be used, but they are not as adequate in determining that fluid infusions
c. Assess mucous membranes. are maintaining adequate perfusion.
d. Measure hourly urine output.
A patient has just been admitted with a 40% total body ANS: A
surface area (TBSA) burn injury. To maintain adequate Enteral feedings can usually be initiated during the emergent phase at low rates
nutrition, the nurse should plan to take which action? and increased over 24 to 48 hours to the goal rate. During the emergent phase,
a. Insert a feeding tube and initiate enteral feedings. the patient will be unable to eat enough calories to meet nutritional needs and
b. Infuse total parenteral nutrition via a central catheter. may have a paralytic ileus that prevents adequate nutrient absorption. Vitamins
c. Encourage an oral intake of at least 5000 kcal per day. and minerals may be administered during the emergent phase, but these will not
d. Administer multiple vitamins and minerals in the IV assist in meeting the patient's caloric needs. Parenteral nutrition increases the
solution. infection risk, does not help preserve gastrointestinal function, and is not routinely
used in burn patients.
While the patient's full-thickness burn wounds to the face ANS: B
are exposed, what is the best nursing action to prevent Use of gowns, caps, masks, and gloves during all patient care will decrease the
cross contamination? possibility of wound contamination for a patient whose burns are not covered.
a. Use sterile gloves when removing old dressings. When removing contaminated dressings and washing the dirty wound, use
b. Wear gowns, caps, masks, and gloves during all care of nonsterile, disposable gloves. The room temperature should be kept at
the patient. approximately 85° F for patients with open burn wounds to prevent shivering.
c. Administer IV antibiotics to prevent bacterial Systemic antibiotics are not well absorbed into deep burns because of the lack of
colonization of wounds. circulation.
d. Turn the room temperature up to at least 70° F (20° C)
during dressing changes.
, A nurse is caring for a patient who has burns of the ears, ANS: B
head, neck, and right arm and hand. The nurse should The right hand and arm should be elevated to reduce swelling and the fingers
place the patient in which position? extended to avoid flexion contractures (even though this position may not be
a. Place the right arm and hand flexed in a position of comfortable for the patient). The patient with burns of the ears should not use a
comfort. pillow for the head because this will put pressure on the ears, and the pillow may
b. Elevate the right arm and hand on pillows and extend stick to the ears. Patients with neck burns should not use a pillow because the
the fingers. head should be maintained in an extended position in order to avoid
c. Assist the patient to a supine position with a small contractures.
pillow under the head.
d. Position the patient in a side-lying position with rolled
towel under the neck.
A patient with circumferential burns of both legs ANS: A
develops a decrease in dorsalis pedis pulse strength and The decrease in pulse in a patient with circumferential burns indicates decreased
numbness in the toes. Which action should the nurse circulation to the legs and the need for an escharotomy. Monitoring the pulses is
take? not an adequate response to the decrease in circulation. Elevating the legs or
a. Notify the health care provider. increasing toe movement will not improve the patient's circulation
b. Monitor the pulses every 2 hours.
c. Elevate both legs above heart level with pillows.
d. Encourage the patient to flex and extend the toes on
both feet.
Esomeprazole (Nexium) is prescribed for a patient who ANS: D
incurred extensive burn injuries 5 days ago. Which H2 blockers and proton pump inhibitors are given to prevent Curling's ulcer in the
nursing assessment would best evaluate the effectiveness patient who has suffered burn injuries. Proton pump inhibitors usually do not
of the medication? affect bowel sounds, stool frequency, or appetite
a. Bowel sounds
b. Stool frequency
c. Abdominal distention
d. Stools for occult blood
The nurse is reviewing the medication administration ANS: D
record (MAR) on a patient with partial-thickness burns. Opioid pain medications are the best choice for pain control. The other
Which medication is best for the nurse to administer medications are used as adjuvants to enhance the effects of opioids.
before scheduled wound debridement?
a. Ketorolac (Toradol)
b. Lorazepam (Ativan)
c. Gabapentin (Neurontin)
d. Hydromorphone (Dilaudid)
A young adult patient who is in the rehabilitation phase ANS: D
after having deep partial-thickness face and neck burns The willingness to use strategies to enhance appearance is an indication that the
has a nursing diagnosis of disturbed body image. Which disturbed body image is resolving. Expressing feelings about the scars indicates a
statement by the patient indicates that the problem is willingness to discuss appearance, but not resolution of the problem. Because
resolving? deep partial-thickness burns leave permanent scars, a statement that the scars are
a. "I'm glad the scars are only temporary." temporary indicates denial rather than resolution of the problem. Avoiding using a
b. "I will avoid using a pillow, so my neck will be OK." pillow will help prevent contractures, but it does not address the problem of
c. "I bet my boyfriend won't even want to look at me disturbed body image
anymore."
d. "Do you think dark beige makeup foundation would
cover this scar on my cheek?"