1.

When assessing a patient with a partial-thickness burn, the nurse would expect to
find (SATA):

a. blisters
b. exposed fascia
c. exposed muscles
d. intact nerve endings
e. red, shiny, wet appearance

2. A patient is admitted to the burn center with burns of his head and neck, chest,
and back after an explosion in his garage. On assessment, the nurse auscultates
wheezes throughout the lung fields. On reassessment, the wheezes are gone and
the breath sounds are greatly diminished. Which action is the most appropriate for
the nurse to take next?

a. obtain vital signs and a STAT ABG

b. encourage the patient to cough and auscultate the lungs again
c. document the findings and continue to monitor the patient's breathing
d. anticipate the need for endotracheal intubation and notify the physician

3. Fluid and electrolyte shifts that occur during the early emergent phase of a burn
injury include:

a. adherence of albumin to vascular walls

b. movement of potassium into vascular space
c. sequestering of sodium and water in interstitial fluid
d. hemolysis of red blood cells from large volumes of rapidly administered fluid

4. To maintain a positive nitrogen balance in a major burn, the patient must:

a. eat a high-protein, low-fat, high-carbohydrate diet

b. increase normal caloric intake by about three times
c. eat at least 1500 calories/day in small, frequent meals
d. eat rice and whole wheat for the chemical effect on nitrogen balance.

5. A patient has 25% TBSA burned from a car fire. His wounds have been debrided
and covered with a silver-impregnated dressing. The nurse's priority intervention for
wound care would be to:

a. reapply a new dressing without disturbing the wound bed

b. observe the wound for signs of infection during dressing changes
c. apply cool compresses for pain relief in between dressing changes
d. wash the wound aggressively with soap and water three times a day.

6. Pain management for the burn patient is most effective when (SATA):
a. a pain rating tool is used to monitor the patient's level of pain
b. painful dressing changes are delayed until the patient's pain is completely relieved
c. the patient is informed about and has some control over the management of the
pain
d. a multi-modal approach is used (e.g., sustained-release and short-acting opioids,
NSAIDS, adjuvant analgesics).
e. non-pharmacological therapies (e.g., music therapy, distraction) replace opioids in
the rehabilitation phase of a burn injury

7. A therapeutic measure used to prevent hypertrophic scarring during rehabilitation

phase of burn recover is:

a. applying pressure garments

b. repositioning the patient every 2 hours
c. performing active ROM at least every 4 hours
d. massaging the new tissue with water-based moisturizers

8. A patient is recovering from second- and third-degree burns over 30% of his body
and is now ready for discharge. The first action the nurse should take when meeting
with the patient would be to:

a. arrange a return-to-clinic appointment and prescription for pain medications

b. teach the patient and caregiver proper wound care to be performed at home
c. review the patient's current health care status and readiness for discharge to
home
d. give the patient written discharge information and websites for additional
information for burn survivors.

9. A patient is brought to the Emergency Department from the site of a chemical fire.
The paramedics report that the patient has a burn that involves the epidermis,
dermis, and the muscle and bone of the right arm. When you assess the patient he
verbalizes no pain in the right arm and the skin appears charred. Based upon these
assessment findings, what is the depth of the burn on the patient's right arm?

A) Superficial partial-thickness
B) Deep partial-thickness
C) Full partial-thickness
D) Full-thickness

10. The nursing instructor is going over burn injuries. The instructor tells the students
that the nursing care priorities for a patient with a burn injury include wound care,
nutritional support, and prevention of complications such as infection. Based upon
these care priorities, the instructor is most likely discussing a patient in what phase
of burn care?

A) Emergent
B) Immediate resuscitative
C) Acute
D) Rehabilitation

11. A patient in the emergent/resuscitative phase of a burn injury has had her lab
work drawn. Upon analysis of the patient's laboratory studies, the nurse will expect
the results to indicate what?

A) Hyperkalemia, hyponatremia, elevated hematocrit, and metabolic acidosis

B) Hypokalemia, hypernatremia, decreased hematocrit, and metabolic acidosis
C) Hyperkalemia, hypernatremia, decreased hematocrit, and metabolic alkalosis
D) Hypokalemia, hyponatremia, elevated hematrocrit, and metabolic alkalosis

12. The patient you are caring for has an electrical burn and has developed thick
eschar over the burn wound. Which of the following topical antibacterial agents will
the nurse expect the physician to order for the wound?

A) Silver sulfadiazine 1% (Silvadene) water-soluble cream

B) Mafenide acetate 10% (Sulfamylon) hydrophilic-based cream
C) Silver nitrate 0.5% aqueous solution
D) Acticoat

13. The occupational health nurse is called to the floor of the factory where a patient
has sustained a flash burn to the right arm. The nurse arrives and the flames have
been extinguished. The next step is to "cool the burn." How will the nurse cool the
burn?

A) Apply ice to the site of the burn for 5 to 10 minutes.

B) Wrap the patient's affected extremity in ice until help arrives.
C) Apply an oil-based substance or butter to the burned area until help arrives.
D) Wrap cool towels around the affected extremity intermittently.

14. The emergency department nurse has just admitted a patient with a burn. The
nurse recognizes that the patient is likely to experience a local and systemic
response to the burn when the burn exceeds a total body surface area (TBSA) of
what?
A) 10%
B) 15%
C) 20%
D) 25%
15. The nurse on a burn unit is caring for a
patient in the acute phase of burn care. While performing an assessment during this
phase of burn care, the nurse recognizes that airway obstruction related to upper
airway edema may occur up to how long after the burn injury?
A) 2 days
B) 3 days
C) 5 days
D) A week

16. A patient has sustained a severe burn injury and is thought to have an impaired
intestinal mucosal barrier. Since this patient is considered at an increased risk for
infection, what intervention will assist in avoiding increased intestinal permeability
and prevent early endotoxin translocation?
A) Early enteral feeding
B) Administration of prophylactic antibiotics
C) Bowel cleansing procedures
D) Administration of stool softeners

17. During the emergency phase of burn care, which assessment will be most useful
in determining whether a patient is fully hydrated or not?

a. Assess mucous membranes

b. Monitor daily weight
c. Measure hourly urinary output
d. Check skin turgor

18. Which of the following meal trays are beneficial for Mr. Thomas’ recovery?
(Select All That Apply)

a. Scrambled eggs, 8 oz milk, toast with butter

b. Pizza, chips, coke
c. Hamburger, fries, milkshake
d. Veggie lasagna, salad, coke
e. Baked chicken, beans, veggies with butter, milk

19. A patient, being treated for burns over 40% of the total body surface area, is
experiencing a hypermetabolic state. The nurse anticipates the addition of which
type of medication to help reduce muscle wasting and accelerate healing time?

a. Antibiotics
b. Cardiac glycosides
c. Insulin
d. Calcium channel blockers
20. The nurse is caring for a patient admitted with thermal burns. The nurse will plan
to monitor the patient closely over the next 2 to 3 days for development of which
most serious complication?

a. Pain
b. Burn shock
c. Continuation of the burn process below the level of obvious injury
d. Hypervolemia

21. The nurse is planning the care of a patient who has burns to the face, neck,
upper chest, and both upper arms. To prevent contracture development, the nurse
should include which interventions in the patient's plan of care? Select all that apply.

a. Use a bed cradle over the burned areas.

b. Have patient assume the position of comfort while sleeping.
c. Administer analgesics prior to physical therapy.
d. Instruct the patient to avoid using pillows under the head.
e. Get the patient out of bed as soon as medically feasible.

22. A patient with several burn scars tells the nurse that the scars are prone to injury
and don’t seem as tough as the rest of his skin. Which nursing response is
indicated?

a. “Even when healed, the scar will only regain about 80% of the strength of normal
skin.”
b. “Your body is still making new blood vessels for the wound.”
c. “Your body is trying to remove additional bacteria from the wound area.”
d. “Your healing process hasn't been completed.”

23. A patient is rehabilitating after a severe burn 6 months ago that left her with scars
across her chest and abdomen. She says, “I don’t care what people think, I am going
to the beach in a bikini next week.” What most important information should the
nurse provide?

a. “This may be difficult since you are still supposed to be wearing your compression
garment.”
b. “You need to avoid sun exposure to your scars for at least one year.”
c. “You should prepare yourself for how others will react to your scars.”
d. “Remember that you are prone to getting too hot easily.”
24. For the first 24 hours after a burn injury, a standard fluid resuscitation formula is
4 mL/kg/% burn of intravenous (IV) fluid for the first 24 hours. What is the total
amount of fluid that will be administered to a 70-kg man with a burn injury that covers
50% of his body surface area?
A. 2800
B. 700 mL
C. 14 L
D. 28 L

25. Permanent measures for covering a full-thickness burn include:

A. autograft skin graft.

B. biological dressings.
C. cadaver skin graft.
D. pigskin graft