Saunders Burn Questions

A 60-kg client has sustained third-degree burns over 40% of the body. Using the Parkland (Baxter) formula, the minimum fluid requirements are which during the first 24 hours after the burn?

1. 1200 mL of 5% dextrose in water solution 2. 2400 mL of 0.45% normal saline solution 3. 4800 mL of 0.9% normal saline solution 4. 9600 mL of lactated Ringer's solution

An adult client was burned in an explosion. The burn initially affected the client's entire face (anterior half of the head) and the upper half of the anterior torso, and there were circumferential burns to the lower half of both arms. The client's clothes caught on fire, and the client ran, causing subsequent burn injuries to the posterior surface of the head and the upper half of the posterior torso. Using the rule of nines, what would be the extent of the burn injury?

1. 18% 2. 24% 3. 36% 4. 48%

Answer Key

1. 2 2. 1 3. 3 4. 4 5. 2 6. 4 7. 22.5% 8. (2, 3, and 6) 9. 3 10. 3 11. 3 12. 1 13. 2 14. 2 15. 3 16. 1 17. 2 18. 2 19. 2 20. 3 21. 1 22. 3 23. 4 24. 1 25. 54% 26. 1 27. 4 28. 2 29. 4 30. 2

Collagenase is prescribed for a client with a severe burn to the hand. The nurse is providing instructions to the client and spouse regarding wound treatment. Which should the nurse include in the instructions?

1. Apply once a day and leave it open to the air. 2. Apply twice a day and leave it open to the air. 3. Apply twice a day and cover it with a sterile dressing. 4. Apply once a day and cover it with a sterile dressing.

The nurse is performing an assessment on a client who sustained circumferential burns of both legs. Which assessment would be the initial priority in caring for this client?

1. Assessing heart rate 2. Assessing respiratory rate 3. Assessing peripheral pulses 4. Assessing blood pressure (BP)

A client is diagnosed with a full-thickness burn. What should the nurse anticipate will be used for final coverage of the client's burn wound?

1. Biobrane 2. Autograft 3. Homograft 4. Xenograft

The nurse is caring for a client who sustained superficial partial-thickness burns on the anterior lower legs and anterior thorax. Which finding does the nurse expect to note during the resuscitation/emergent phase of the burn injury?

1. Decreased heart rate 2. Increased urinary output 3. Increased blood pressure 4. Elevated hematocrit levels

Which finding indicates a burn client is adequately fluid resuscitated?

1. Disorientation to time only 2. Heart rate of 95 beats/minute 3. +1 palpable peripheral pulses 4. Urine output of 30 mL over the last 2 hours

A client is diagnosed with a full-thickness burn. The nurse plans care, knowing that which structural areas of the skin are involved?

1. Epidermis only 2. Epidermis and deeper dermis 3. Epidermis and upper layer of dermis 4. Epidermis, entire dermis, and epithelial portion of subcutaneous fat

A client sustained a burn from cutaneous exposure to lye. At the site of injury, copious irrigation to the site was performed for 1 hour. On admission to the hospital emergency department, the nurse assesses the burn site. Which findings would indicate that the chemical burn process is continuing?

1. Eschar 2. Intact blisters 3. Liquefaction necrosis 4. Cherry-red, firm tissue

The emergency department nurse is caring for a client who has sustained chemical burns to the esophagus after ingestion of lye. The nurse reviews the health care provider's prescriptions and should plan to question which prescription?

1. Gastric lavage 2. Intravenous (IV) fluid therapy 3. Nothing by mouth (NPO) status 4. Preparation for laboratory studies

A burn client is receiving treatments of topical mafenide acetate to the site of injury. The nurse monitors the client, knowing that which finding indicates that a systemic effect has occurred?

1. Hyperventilation 2. Elevated blood pressure 3. Local rash at the burn site 4. Local pain at the burn site

The nurse is performing an assessment on a client admitted to the nursing unit who has sustained an extensive burn injury involving 45% of total body surface area. When planning for fluid resuscitation, the nurse should consider that fluid shifting to the interstitial spaces is greatest during which time period?

1. Immediately after the injury 2. Within 12 hours after the injury 3. Between 18 and 24 hours after the injury 4. Between 42 and 72 hours after the injury

A client who is being evaluated for thermal burn injuries to the arms and legs complains of thirst and asks the nurse for a drink. Which action by the nurse is most appropriate?

1. Keep the client on NPO status. 2. Allow the client to have full liquids. 3. Give the client small glasses of clear liquids. 4. Order the client a full meal tray with extra liquids.

The nurse is planning care for a client returning from the operating room after having an autograft applied to the right lower extremity. Which nursing intervention is focused on promoting graft "take"?

1. Monitor temperature every 4 hours. 2. Leave the dressing intact for 3 to 5 days. 3. Maintain the right lower extremity in a dependent position. 4. Apply an ice pack to the site to decrease edema formation.

The nurse is developing a nursing care plan for a client with a circumferential burn injury of the right arm. What is the nurse's priority action?

1. Monitor the radial pulse every hour. 2. Keep the extremity in a dependent position. 3. Document any changes that occur in the pulse. 4. Place pressure dressings and wraps around the burn sites.

The nurse has developed a nursing care plan for a client with a burn injury to implement during the emergent phase. Which priority intervention should the nurse include in the plan of care?

1. Monitor vital signs every 4 hours. 2. Monitor mental status every hour. 3. Monitor intake and output every shift. 4. Obtain and record weight every other day.

The nurse is planning care for a client who suffered a burn injury and has a negative self-image related to keloid formation at the burn site. The keloid formation is indicative of which condition?

1. Nerve damage 2. Hypertrophy of collagen fibers 3. Compromised circulation at the burn site 4. Increase in subcutaneous tissue at the burn site

A client who previously suffered a burn injury now exhibits a keloid at the burn site. The nurse plans care, knowing that this lesion is caused by hypertrophy of which part of the dermis?

1. Nerves 2. Collagen 3. Vasculature 4. Subcutaneous tissue

The nurse is caring for a client following an autograft and grafting to a burn wound on the right knee. What would the nurse anticipate to be prescribed for the client?

1. Out-of-bed activities 2. Bathroom privileges 3. Immobilization of the affected leg 4. Placing the affected leg in a dependent position

The industrial nurse is providing instructions to a group of employees regarding care to a client in the event of a chemical burn injury. The nurse instructs the employees that which is the first consideration in immediate care?

1. Removing all clothing, including gloves, shoes, and any undergarments 2. Determining the antidote for the chemical and placing the antidote on the burn site 3. Leaving all clothing in place until the client is brought to the emergency department 4. Lavaging the skin with water and avoiding brushing powdered chemicals off the clothing

The nurse is preparing to care for a burn client scheduled for an escharotomy procedure being performed for a third-degree circumferential arm burn. The nurse understands that which finding is the anticipated therapeutic outcome of the escharotomy?

1. Return of distal pulses 2. Brisk bleeding from the site 3. Decreasing edema formation 4. Formation of granulation tissue

The nurse caring for a child who sustained a burn injury plans care based on which pediatric considerations associated with this injury? Select all that apply. 1. Scarring is less severe in a child than in an adult. 2. A delay in growth may occur after a burn injury. 3. An immature immune system presents an increased risk of infection for infants and young children. 4. Fluid resuscitation is unnecessary unless the burned area is more than 25% of the total body surface area. 5. The lower proportion of body fluid to body mass in a child increases the risk of cardiovascular problems. 6. Infants and young children are at increased risk for protein and calorie deficiency because they have smaller muscle mass and less body fat than adults.

1. Scarring is less severe in a child than in an adult. 2. A delay in growth may occur after a burn injury. 3. An immature immune system presents an increased risk of infection for infants and young children. 4. Fluid resuscitation is unnecessary unless the burned area is more than 25% of the total body surface area. 5. The lower proportion of body fluid to body mass in a child increases the risk of cardiovascular problems. 6. Infants and young children are at increased risk for protein and calorie deficiency because they have smaller muscle mass and less body fat than adults.

A burn client has been having 1% silver sulfadiazine applied to burns twice a day for the past 3 days. Which laboratory abnormality indicates that the client is experiencing a side or adverse effect of this medication?

1. Serum sodium of 120 mEq/L (120 mmol/L) 2. Serum potassium of 3.0 mEq/L (3.0 mmol/L) 3. White blood cell count of 3000 mm3 (3 × 109/L) 4. pH 7.30, PaCO2 of 32 mm Hg (32 mmHg), HCO3- of 19 mEq/L (19 mmol/L)

The nurse is caring for a client who was admitted to the burn unit after sustaining a burn injury covering 30% of the body. What is the most appropriate time frame for the emergent phase?

1. The entire period of time during which rehabilitation occurs 2. The period from the time the client is stable until all burns are covered with skin 3. The period from the time the burn was incurred to the time when the client is admitted to the hospital 4. The period from the time the burn was incurred to the time when the client is considered physiologically stable

A client is undergoing fluid replacement after being burned on 20% of her body 12 hours ago. The nursing assessment reveals a blood pressure of 90/50 mm Hg, a pulse rate of 110 beats/minute, and a urine output of 20 mL over the past hour. The nurse reports the findings to the health care provider (HCP) and anticipates which prescription?

1. Transfusing 1 unit of packed red blood cells 2. Administering a diuretic to increase urine output 3. Increasing the amount of intravenous (IV) lactated Ringer's solution administered per hour 4. Changing the IV lactated Ringer's solution to one that contains dextrose in water

The nurse is administering fluids intravenously as prescribed to a client who sustained superficial partial-thickness burn injuries of the back and legs. In evaluating the adequacy of fluid resuscitation, the nurse understands that which assessment would provide the most reliable indicator for determining the adequacy?

1. Vital signs 2. Urine output 3. Mental status 4. Peripheral pulses

A client is seen in the ambulatory care clinic for a superficial burn to the arm. On assessing the skin at the burn injury, what will the nurse observe?

1. White color 2. Pink or red color 3. Weeping blisters 4. Insensitivity to pain and cold