BURNS
How do pressure garments improve immature scars? A. By thinning hypertrophic epithelium B. By remodeling irregular collagen C. By reducing skin friction D. By increasing arterial blood flow
B.
To detect compartmental syndrome in those with critical burns, what would the nurse assess for? A. Pain in extremity with exercise B. Pain in extremity with passive movement C. Contractures D. Pallor in extremity
B.
A severely burned patient is now in the acute rehabilitative phase of burn care. How can the nurse help to minimize psychological and emotional problems in this patient? 1. Involve the patient in self-care activities as soon as medically feasible. 2. Keep the patient sedated as long as possible while healing continues. 3. Shelter the patient from any negative interactions about the future. 4. Do not allow mirrors on the burn rehabilitation unit.
1
The nurse teaches a patient to apply an emollient to healing burn wounds several times a day. Which rationale should the nurse offer for this instruction? (Select all that apply.) 1. "This will help keep your skin moist." 2. "You do not have as many sebaceous glands as you did before the injury." 3. "If you use this lotion, you will not need soap, which can be drying." 4. "Emollients will protect your skin from shearing pressures while you are in bed." 5. "This lotion will protect your skin from the sun."
1,2.
A nurse is developing educational materials on burn prevention. The nurse would discuss which reasons that older adults are prone to burn injury? (Select all that apply.) 1. Older adults often have impaired senses. 2. Older adults spend the majority of their time alone. 3. As people age, their reaction times slow. 4. Aging increases people's tendency toward risk-taking behaviors. 5. Risk assessment skills decline with aging.
1,3,5,
A patient had an immediate hypermetabolic response to a severe burn and is now experiencing a hypermetabolic hyperdynamic state. Which assessment findings would the nurse anticipate? (Select all that apply.) 1. Increased heart rate 2. Decreased cardiac output 3. Decreased temperature 4. Increased respiratory rate 5. Decreased serum glucose
1,4.
A patient's burned arm is erythematous and blistered. Capillary refill is brisk and the patient complains of severe pain. How should the nurse document this burn? 1. Full-thickness 2. Superficial partial-thickness 3. Deep partial-thickness 4. First-degree
2
The nurse is working with a physical therapist and an occupational therapist to promote antideformity positioning in a burned patient. What criterion should the positions meet? 1. The position should be comfortable for the patient. 2. The position should maintain joint extension. 3. The position should allow for maximum joint flexion. 4. The position should be easily altered by the patient.
2
A patient has an inhalation injury. The nurse would prepare to assist with which tests specific to this injury? 1. Electrocardiogram, thallium scan 2. Arterial blood gases, bronchoscopy 3. Serum potassium, serum sodium levels 4. Pulmonary angiograms, hemoglobin level
2,
The surgeon has planned tangential excision of eschar on a severely burned patient. How would the nurse explain this procedure to the patient's family? (Select all that apply.) 1. "Your loved one is too unstable for the other option, which is fascial excision." 2. "This procedure can result in blood loss, so we may need to transfuse." 3. "The cosmetic results of this procedure are better than those of the alternatives." 4. "This procedure will be done under anesthesia in the operating room." 5. "This is a form of biological debridement."
2,3,4.
An emergency department uses the American Burn Association's criteria for transfer to a burn center. The nurse would anticipate that which patient would require transfer? 1. A patient with superficial partial-thickness burns on 10% of TBSA 2. A patient with superficial burns on 50% of TBSA 3. A patient with deep partial-thickness burns over the entire face 4. A patient with deep partial-thickness burns on less than 5% of TBSA
3.
Which assessment finding is most important for the nurse to monitor during initial fluid resuscitation of a seriously burned patient? 1. Hemoglobin 2. Pain level 3. Thirst 4. Urine output
4.
What is the effect of alkalizing the urine? A. Promotes renal clearance of myoglobin B. Promotes hepatic clearance of myoglobin C. Increases urine output D. Concentrates myoglobin so it can be removed more easily
A.
Interventions during the rehabilitation phase are focused on which factor? (Select all that apply.) A. Physical conditioning B. Care of healing skin C. Support of psychosocial adjustment D. Transfer to rehabilitation centers
A,B,C
Which treatment goals are related to physical mobility during the acute rehabilitative phase? (Select all that apply.) A. Return to preinjury functioning B. Promotion of wound healing C. Scar management D. Walking 150 feet without assistance
A,B,C.
Burned patients have increased levels of anxiety related to which factors? (Select all that apply.) A. Treatment B. Outcomes C. Injury type D. Pain E. Dressing changes
A,B,D,E.
How is joint function preserved? (Select all that apply.) A. Active range-of-motion exercises B. Passive range-of-motion exercises C. Restrictive training D. Aerobic exercise
A,B.
Which statements are correct regarding mobility after a burn injury? (Select all that apply.) A. During the acute resuscitative phase, patients have decreased mobility due to treatments to maintain life. B. During the resuscitative phase, edema is no longer an issue. C. Patients are allowed limited mobility to protect healing grafts from shearing. D. As wounds heal, mobility is restricted by scar formation.
A,C,D
Critically burned patients are at high risk for which complication during the resuscitative phase? A. Burn shock B. Neurogenic shock C. Contractures D. Myocardial infarction
A.
Electrical contact injuries can be caused by low-voltage lines in which form? A. Alternating current B. Direct current C. Current source D. Reflex arc
A.
In general, how are full-thickness burns best described? A. Not painful B. Mildly painful C. Moderately painful D. Extremely painful
A.
Mr. C. has a 55% TBSA burn and weighs 75 kilograms. Using the Parkland formula, calculate his fluid resuscitation requirements for the first 8 hours. A. 8,250 mL B. 16,500 mL C. 4,125 mL D. 12,375 mL
A.
Nursing care related to temporary wound coverings includes inspection for which factor? A. Dislodgement B. Permanent adherence C. Autograft integrity D. Scar formation
A.
Rehabilitative interventions begin during which phase of burn care? A. Resuscitative B. Acute rehabilitative C. Long-term rehabilitative D. Transitional
A.
The nurse is caring for a patient with 60% TBSA burns in the emergency department. The patient is to be transferred to a regional burn center within 20 minutes. What is the appropriate initial wound care management while awaiting transfer? A. Cleanse the wounds and cover the patient with a dry sheet. B. Place Neosporin ointment on all open burn wounds. C. Put antibiotic cream on all wounds. D. Cleanse the wounds and leave them open to the air to dry out.
A.
Using the rule of nines, calculate the extent of burn for a patient with burns to the posterior head and posterior trunk. A. 22.5% B. 18% C. 20% D. 13%
A.
What is a component of treatment for carbon monoxide poisoning? A. 100% O2 B. Hypertonic saline C. Keeping peak inspiratory pressure less than 40 cm H2O D. Pulmonary hygiene
A.
White, charred, leathery wounds are the result of which type of burn? A. Full-thickness B. Superficial C. Deep partial-thickness D. Superficial partial-thickness
A.
Which burn injury is associated with pain that is exceptionally sensitive and painful even to an air current passing over it? A. Full-thickness B. Partial-thickness C. Third-degree D. Electrical
Answer given for Question: D but in the text mentions B. Partial Thickness being the one that is sensitive.
Which groups are at greatest risk for burn injuries? (Select allthat apply.) A. African Americans B. Older adults C. Children D. Diabetics
B,C,D
Psychological and emotional problems can be minimized by involving patients in which activities? (Select all that apply.) A. Music therapy B. Feeding themselves C. Exercise programs D. Taking their own medications E. Wound care
B,C,D,E
Allografts and homografts are used for which purpose? A. To determine if the wound bed is adequate to accept a xenograft B. To prepare for autografting C. To protect the grafted wound D. To maintain a dry environment
B.
Which statement reflects current recommendations for meeting the hypermetabolic needs of a burn patient? A. Total parenteral nutrition should be started within 24 hours after injury. B. Enteral nutrition should be started within 24 hours after injury. C. The patient should not be fed until bowel sounds are present. D. Enteral nutrition should be started after 48 hours of admission.
B.
Which term describes a burn that involves the epidermis and deep layer of the dermis and has sluggish or absent capillary refill? A. Superficial partial-thickness burn B. Deep partial-thickness burn C. Full-thickness burn D. Subdermal burns
B.
Which type of burn is characterized by deep penetration of tissues and necrosis continuing for several hours after injury? A. Acidic burn B. Alkaline burn C. Electrical burn D. Flash burn
B.
Wound contraction in burn wounds produces which conditions? (Select all that apply.) A. Infection B. Inflammation C. Cosmetic deformities D. Functional deformities
C,D.
An adult patient received partial-thickness flash burns to the head and neck. Estimate the extent of the injury according to the Lund and Browder Chart. A. 21% B. 19% C. 9% D. 7%
C.
The resuscitative phase of burn injury lasts how long after the time of injury? A. 24 to 48 hours B. 36 to 60 hours C. 48 to 72 hours D. 60 to 84 hours
C.
When does the initial evaluation of burn wounds take place? A. Immediately on arrival B. At the end of the primary assessment C. At the end of the head-to-toe evaluation during the secondary assessment D. On admission to the burn center
C.
When should antideformity positioning begin? A. After skin grafting B. After the patient can walk again C. At the time of admission D. On discharge from the high-acuity area
C.
Which injury places the burn patient at the highest risk for developing renal failure? A. Full-thickness burn to the perineum B. Full-thickness burn to the flank C. Electrical or crush-type injury D. Traumatic brain injury
C.
Which statement about pain associated with burn injury is true? A. Burn wounds are ischemic, so burn patients do not experience pain. B. Pain generally increases during the acute rehabilitative phase. C. Patients achieve better pain control when they can choose the interventions that work best for them. D. Nonpharmacologic interventions have been tried in burn patients, but without success.
C.
Which thermal burn zone is an area of immediately nonviable tissue? A. Hyperemia B. Ischemia C. Coagulation D. Stasis
C.
Patients exposed to electrical injuries are at risk for developing which condition? A. Nonspecific ST wave changes B. Shortening of QT segment C. Ventricular contractions D. Ventricular fibrillation
D
In terms of psychosocial adjustment, which behavior is MOST likely to occur in the long-term rehabilitative phase? A. Survival anxiety B. Searching for meaning C. Adaptation to severe pain D. Reintegration of identity
D.
Which criterion indicates that a burn center referral should be made? A. Superficial-thickness burn greater than 1% TBSA B. Any superficial burn C. Patients exposed to cigarette smoke D. Partial-thickness burn greater than 10% TBSA
D.
Which method of dead tissue removal harms newly formed tissue? A. Mechanical debridement B. Biodebridement C. Chemical debridement D. Wet-to-dry dressing debridement
D.
Which route is preferred in the administration of nutrition for patients with burn injury? A. IV B. Oral C. Parenteral D. Enteral
D.
The burn patient should be asked to rate pain as either ______ or ______.
procedural or nonprocedural (background)