test 3 103

an adult client was burned as a result of an explosion. the burn initially affected the clients entire face (the anterior half of the head) and the upper half of the upper torso, and there were circumferential burns on the lower half of both arms. the clients clothes caught on fire, and the client ran, which caused subsequent injuries to the posterior surface of the head and the upper half of the posterior torso. according to the rule of nines what is the extent of the clients injuries?

36% according to the rule of nines with the initial burn the anterior half of the head equals 4.5%, the upper half of the anterior torso equals 9%, and the lower half of the arms equal 9%. the subsequent burn included the posterior half of the head, which equals 4.5%, and the upper half of the posterior torso which equals 9%. this totals 36%.

What are some patient priorities during the emergent phase of burn management?* A. Fluid volume B. Respiratory status C. Psychosocial D. Wound closure E. Nutrition

A and B. This phase starts from the onset of the burn and ends with the restoration of capillary permeability. Wound closure, and nutrition would be during the acute phase, and would continue into the rehabilitative phase. Psychosocial would be in the rehab phase.

Based on the depth of the burn in figure 1 (picture is above), you would expect to find:* A. report of sensation to only pressure B. blanching C. anesthetization to feeling D. extreme pain

C. This is a 3rd degree to 4th degree burn (full-thickness) and the nerves that detect pain are destroyed. The patient would have no feeling or experiences an extreme decrease sensation to pain.

beneficence

the duty to do good to others and maintain a balance between benefits and harms. Paternalism is an undesirable outcome, in which the HCP decides which is best for the client and encourages the client to act against his or her own choices

fidelity

the duty to do what one has promised

justice

the equitable distribution of potential benefits and tasks determining the order in which clients should be provided care

nonmaleficence

the obligation to do or cause no harm to another

veracity

the obligation to tell the truth

A 65 year old male patient has experienced full-thickness electrical burns on the legs and arms. As the nurse you know this patient is at risk for the following: Select all that apply:* A. Acute kidney injury B. Dysrhythmia C. Iceberg effect D. Hypernatremia E. Bone fractures F. Fluid volume overload

A, B, C, and E. Electric burns are due to an electrical current passing through the body that leads to damage to the skin but also the muscles and bones that are underneath the skin. The patient is at risk for AKI (acute kidney injury) because when the muscles become affected they release myoglobin and the red blood cells release hemoglobin in the blood, which can collect in the kidneys leading to injury. In addition, the heart's electrical system can become damaged leading to dysrhythmia. The iceberg effect can present as well because the extent of damage is not clearly visible on the skin (there can be severe damage underneath). In addition, if the electrical current is strong enough it can lead to bone fractures (specifically cervical spine injuries) due to the severe contraction of the muscles involved.

You are about to provide care to a patient with severe burns. You will don:* A. gloves B. goggles C. gown D. N-95 mask E. surgical mask F. shoe covers G. hair cover

A, C, E, F, and G. Before providing care to a patient with severe burns the nurse would want to wear protective isolation apparel like: gloves, gown, surgical mask, shoe covers, and hair cover. This protects the patient from potential infection.

A patient has a burn on the back of the torso that is extremely red and painful but no blisters are present. When you pressed on the skin it blanches. You document this as a:* A. 1st degree (superficial) burn B. 2nd degree (partial-thickness) burn C. 3rd degree (full-thickness) burn D. 4th degree (deep full-thickness) burn

A. These are the classic characteristics of a 1st degree, superficial burn.

5 Rights of Delegation to make sure you are delegating properly. Select all the 5 Rights of Delegation:* A. Right Credentials B. Right Direction/Communication C. Right Supervision D. Right Experience E. Right Task F. Right Person G. Right Patient H. Right Circumstance I. Right Time J. Right Order

B, C, E, F, and H. The 5 Rights of Delegation are: Right Task, Right Circumstance, Right Person, Right Direction/Communication, and Right Supervision.

A patient has an emergency escharotomy performed on the right leg. The patient has full-thickness circumferential burns on the leg. Which finding below demonstrates the procedure was successful?* A. The patient can move the extremity. B. The right foot's capillary refill is less than 2 seconds. C. The patient reports a new sensation of extreme pain. D. The patient has a positive babinski reflex.

B. Escharotomy is performed when a full-thickness burn, due to eschar (which is burned tissue that is hard), is compromising blood flow to the distal extremity. The eschar is cut and this relieves pressure and allows blood to flow to the extremity.

A patient is presenting with bright red lips, headache, and nausea. The physician suspects carbon monoxide poisoning. As the nurse, you know the patient needs:* A. Oxygen nasal cannula 5-6 Liters B. 100% oxygen via non-rebreather mask C. Continuous Bipap D. Venturi mask 6 L oxygen

B. This is the treatment for carbon monoxide poisoning.

A patient has experienced full-thickness burns to the face and neck. As the nurse it is priority to:* A. Prevent hypothermia B. Assess the blood pressure C. Assess the airway D. Prevent infection

C. Due to the location of the burns (face and neck), the patient is at major risk for respiratory issues due to damage to the upper airways and the risk of an inhalation injury.

After receiving report on a patient receiving treatment for severe burns, you perform your head-to-toe assessment. On arrival to the patient's room you note the room temperature to be 75'F. You will:* A. Decrease the temperature by 5-10 degrees to prevent hyperthermia. B. Leave the temperature setting. C. Increase the temperature to a minimum of 85'F.

C. Patients with severe burns can NOT regulate their temperature and are at risk for hypothermia. The room temperature should be a minimum of 85'F.

Your patient with severe burns is due to have a dressing change. You will pre-medicate the patient prior to the dressing change. The patient has standing orders for all the medications below. Which medication is best for this patient?* A. IM morphine B. PO morphine C. IV morphine D. Subq morphine

C. The best route that is predictable and easily absorbed is via the IV route in burn victims.

A patient is in the acute phase of burn management. The patient experienced full-thickness burns to the perineum and sacral area of the body. In the patient's plan of care, which nursing diagnosis is priority at this time?* A. Impaired skin integrity B. Risk for fluid volume overload C. Risk for infection D. Ineffective coping

C. The patient is now in the acute phase where fluid resuscitation was successful and ends with wound closure. Therefore, during this stage diuresis occurs (so fluid volume deficient could occur NOT overload) and INFECTION. The location of the burns increases the risk of infection because these areas naturally harbor bacteria. Therefore, this takes priority because during this phase wound healing is promoted.

A patient is receiving IV Lactated Ringers 950 mL/hr post 18 hours after a receiving a severe burn. The patient urinary output is 20 mL/hr. As the nurse your next nursing action is to:* A. Increase the IV fluids B. Continue to monitor the patient C. Decrease the IV fluids D. Notify the physician of this finding

D. The patient's urinary output is too low and needs more fluids. It should be at least 30 mL/hr. Therefore, the nurse must notify the physician for further orders. The nurse can NOT increase or decrease IV fluids without a physician's order.

Which of the following statements is true regarding The Joint Commission's authority relating to health care organizations? a. The Joint Commission standards have the same effect as law, and organizations can be fined by The Joint Commission for noncompliance. b. The Joint Commission regulations have no effect on the legal process in health care. c. The Joint Commission serves as an advisor to the federal government in establishing fines related to noncompliance. d. The Joint Commission regulations may be seen as having the effect of law because they accredit organizations to bill Medicare and the standards are frequently used in malpractice cases.

d The Joint Commission standards do not have the same effect as law; however, they are often utilized as best practice standards in a malpractice case against which negligence is measured. The Joint Commission does not establish fines for noncompliance.

A patient arrives to the ER with full-thickness burns on the front and back of the torso and neck. The patient has no spinal injuries but is disoriented and coughing up black sooty sputum. Vital signs are: oxygen saturation 63%, heart rate 145, blood pressure 80/56, and respiratory rate 39. As the nurse you will:* A. Place the patient in High Fowler's positon. B. Prep the patient for escharotomy. C. Prep the patient for fasciotomy. D. Prep the patient for intubation. E. Place a pillow under the patient's neck. F. Obtain IV access at two sites. G. Restrict fluids.

A, B, D, and F. After reading this scenario the location of the burns and the patient's presentation should be jumping out at you. The patient is at risk for circumferential burns due to the location of the burns and the depth (full-thickness....will have eschar present that will restrict circulation or here in this example the ability of the patient to breathe in and out). Based on the patient's VS, we see that the respiratory effort is compromised majorly AND that there is a risk of inhalation injury since the patient is coughing up black sooty sputum. Therefore, the nurse should place the patient in high Fowler's position to help with respiratory effort (unless contraindicated with spinal injuries), prep the patient for escharotomy (this will cut the eschar and help relieve pressure and allow for breathing) and prep for intubation to help with the respiratory distress. In addition, obtain IV access in at least two sites for fluid replacement....remember the first 24 hours after a burn a patient is at risk for hypovolemic shock.

A 58 year old female patient has superficial partial-thickness burns to the anterior head and neck, front and back of the left arm, front of the right arm, posterior trunk, front and back of the right leg, and back of the left leg. Using the Rule of Nines, calculate the total body surface area percentage that is burned?* A. 63% B. 81% C. 72% D. 54%

A. Anterior head and neck (4.5%), front and back of the left arm (9%), front of the right arm (4.5%), posterior trunk (18%), front and back of the right leg (18%), back of the left leg (9%) which equals 63%.

As the nurse providing care to a patient who experienced a full-thickness electrical burn you know to monitor the patient's urine for:* A. Hemoglobin and myoglobin B. Free iron and white blood cells C. Protein and red blood cells D. Potassium and Urea

A. Patients who've experienced a severe electrical burn or full-thickness burns are at risk for acute kidney injury. This is because the muscles can experience damage from the electrical current leading them to release myoglobin. In addition, the red blood cells will release hemoglobin. These substances will collect in the kidneys leading to acute tubular necrosis (hence leading to AKI). Therefore, the nurse should monitor the patient's urine for these substances.

Which patients below are best assigned to the LPN?* A. A 30-year-old male patient with active GI bleeding that requires multiple blood transfusions. B. A 78-year-old female with osteoporosis who needs assistance performing range of motion exercises and ambulating with a walker. C. A 29-year-old male patient who is post-op day 6 from a colostomy placement that is on a clear liquid diet. D. A 55-year-old male patient who reports chest pain and has ST segment elevation on his EKG.

B and C. LPNs should be assigned STABLE patients with predicable outcomes and cases that don't require critical thinking or complex analysis. The patients in options A and D are unstable and require constant care with decisions being based on how to interpret patient findings.

You're assisting the nursing assistant with repositioning a patient with full-thickness burns on the neck. Which action by the nursing assistant requires you to intervene?* A. The nursing assistant elevates the head of the bed above 30 degrees. B. The nursing assistant places a pillow under the patient's head. C. The nursing assistant places rolled towels under the patient's shoulders. D. The nursing assistant covers the patient with sterile linens.

B. If a patient has severe burns to the neck (head as well) a pillow should NOT be used under the head because this can cause wound contractions. Instead rolled towels should be placed under the shoulders.

You receive a patient who has experienced a burn on the right leg. You note the burn contains small blisters and is extremely pinkish red and shiny/moist. The patient reports severe pain. You document this burn as:* A. 1st Degree (superficial) B. 2nd Degree (partial-thickness) C. 3rd Degree (full-thickness) D. 4th Degree (deep full-thickness)

B. These are the classic characteristics of a 2nd degree (partial-thickness) burn.

A patient experienced a full-thickness burn 72 hours ago. The patient's vital signs are within normal limits and urinary output is 50 mL/hr. This is known as what phase of burn management?* A. Emergent B. Acute C. Rehabilitative

B. This phase starts when capillary permeability has returned to normal and the patient's vitals are within normal limits and ends with wound closure. The phase after this is rehabilitative.

"Nurses advancing our profession to improve health for all" is the mission statement of which professional group? a. American Nurses Association b. Institutes of Medicine c. Joint Commission d. Robert Wood Johnson Foundation

a This is the mission statement of the American Nurses Association (ANA). The Institutes of Medicine and Robert Wood Johnson Foundation have collaborated on health issues and produced The Future of Nursing report. The Joint Commission is an interdisciplinary organization that published the Hospital National Patient Safety Goals.

A 28-year-old married woman received word that she is pregnant. Sadly, the patient is not able to carry the pregnancy because she suffers from long QT syndrome, which causes an abnormality of the heart, meaning any rush of adrenaline could prove fatal. The pregnant patient states, "I want to have this baby." The nurse realizes that this is a conflict that involves the ethical principle of? a. utilitarianism. b. deontology. c. autonomy. d. veracity.

a Utilitarianism is an approach that is rooted in the assumption that an action or practice is right if it leads to the greatest possible balance of good consequences or to the least possible balance of bad consequences. An attempt is made to determine which actions will lead to the greatest ratio of benefit to harm for all persons involved in the dilemma. Veracity is telling the truth in personal communication as a moral and ethical requirement. Deontology is an approach that is rooted in the assumption that an action or practice is right if it leads to the greatest possible balance of good consequences or to the least possible balance of bad consequences. Autonomy is the principle of respect for the individual person. All persons have unconditional intrinsic value. People are self-determining agents who are entitled to decide their own destiny.

a nurse in a providers office is collecting data from a client who has a severe sunburn. which of the following classifications should the nurse expect to use to document this burn? a. superficial thickness burn b. superficial partial thickness burn c. deep partial thickness burn d. full thickness

a a sunburn is a superficial thickness burn, which only damages the top layer of skin. a superficial partial thickness burn results from flames or scalds. a deep partial thickness burn can result from contact with hot grease. a full thickness burn can result from contact with hot tar.

a nurse is assisting with the care of an adolescent who has a major burn and is experiencing sever pain. which of the following prescriptions should the nurse expect for management of the child's pain? a. morphine sulfate IV via continuous infusion b. meperidine IM as needed c. acetaminophen PO every 4 hours d. hydrocodone PO every 6 hours

a opioids given IV are the most appropriate. when someone is burned they do not need anything PO.

The nurse practitioner orders a wet-to-dry normal saline solution (NSS) dressing for a patient who has a stage III pressure ulcer on the sacral area. The patient's daughter will be dressing the wound at home. Which of the following steps should the nurse include in the teaching plan? Select all that apply. a. Cleansing the wound b. Managing pain c. Applying a dry sterile dressing d. Using cold water in the bath

a, b Administering pain medications will ensure that the patient is comfortable prior to a dressing change. The nurse should cleanse the wound and then apply the sterile dressing. The order calls for a wet-to-dry normal saline dressing. A cold water bath would be contraindicated for pressure ulcer treatment.

Which of the following concepts would a nurse consider to have the strongest links to technology and informatics? Select all that apply. a. Clinical judgment b. Ethics c. Leadership d. Professionalism e. Safety

a, b, c, e Professionalism refers to the attributes and behaviors of a nurse as a representative of the nursing profession and as a health care professional. There are many interrelated concepts that bear some relationship to health information technology and health informatics, including data, information, knowledge, wisdom, trust, health, health care, meaningful use, bandwidth, and interoperability. Others found in this book include clinical judgment, leadership, communication, collaboration, safety, evidence, care coordination, health care quality, ethics, health policy, and health care law.

a nurse is assisting with the data collection from a preschooler who has major burns and suspected septic shock. which of the following findings should the nurse expect? select all that apply a. increased temp b. altered sensorium c. decreased capillary refill d. decreased urine output e. increased bowel sounds

a, b, d increased temp, altered sensorium, and decreased urine output are all manifestations of septic shock. prolonged cap refill and decreased bowel sounds are signs of septic shock.

a nurse is collecting data from a client who sustained deep partial thickness and full thickness burns over 40% of his body 24 hours ago. which of the following findings should the nurse expect? select all that apply a. dyspnea b. bradycardia c. hyperkalemia d. hyponatremia e. decreased hematocrit

a, c, d dyspnea, hyperkalemia, and hyponatremis occurs during the initial phase following fluid shifting. tachycardia occurs during the initial phase of the burn due to sympathetic nervous system compensation. hematocrit increases due to hemoconcentration.

A nurse protecting a patient's right to consent to a procedure is represented in which of the following answers? a. Finding that the informed consent document is not with the chart, the nurse gives the patient another consent document to sign before the procedure. b. When the nurse finds that the informed consent document is not yet complete, she holds the patient's pre-procedure narcotics until the physician can obtain patient consent. c. The nurse finds that the consent form is unsigned in the chart and waits until after the procedure to get the document signed. d. Knowing the patient is not competent to sign a consent form, the nurse asks the friend who came with the patient to sign it.

b To be valid, information for consent must be given prior to the procedure by the provider who will be performing the procedure and the information given must include a description of the procedure, a description of the risks and benefits of the procedure, and a discussion of any alternatives to the proposed procedure. Consent by the patient must be voluntarily given, and the person who consents must have the capacity to consent. Capacity can be determined by the health care provider and may be affected by drugs or the current or underlying medical condition. If the patient is unable to give consent directly, he or she may designate a person who can give consent on his or her behalf. If such a person is not designated by the patient, most states provide a statutory solution or a law that lists "statutory surrogates."

the nurse is assisting with caring for a client who is receiving IV fluids and who has sustained full thickness burns to the back and legs. the nurse understands that which would provide the most reliable indicator for determining the adequacy of the fluid resuscitation? a. vital signs b. urine output c. mental status d. peripheral pulses

b successful or adequate fluid resuscitation in the adult is signaled by stable vital signs, adequate urine output, palpable peripheral pulses, and a clear sensorium. the most reliable indicator for determining the adequacy of fluid resuscitation is the urine output. for an adult the hourly urine volume should be 30-50 mL

a nurse is caring for a client who has just been admitted to the nursing unit after receiving flame burns to the face and chest. the nurse notes a hoarse cough, and the client is expectorating sputum with black flecks. the client suddenly becomes restless, and his color is becoming dusky. the nurse should interpret this data as indicating which? a. the client is hypotensive b. pain is present from the burn injury c. the burn has probably caused laryngeal edema, which has occluded the airway d. the client is having a panic attack as a result of the unfamiliar surroundings

c the client exhibits several warning signs of an inhalation injury: a history of a flame burn to the face, hoarseness, cough, carbonaceous sputum, singed facial hair, facial edema, and color change. additionally one of the cardinal signs of hypoxia is restlessness

why is pain relief important for the burn patient? a. it prevents discomfort b. the child must be kept from crying c. parents become upset d. pain contributes to shock

d Acute pain can lead to shock, and the nurse must follow the six Cs of burn care: clothing, cooling, cleaning, chemoprophylaxis, covering, and comforting (or pain relief). Cleaning a burn wound can be painful, and measures for pain relief should be taken.

autonomy

respect for an individual's right to self-determination

A patient has full-thickness burns on the front and back of both arm and hands. It is nursing priority to:* A. Elevate and extend the extremities B. Elevate and flex the extremities C. Keep extremities below heart level and extended D. Keep extremities level with the heart level and flexed

A. This position will decrease edema, which will help prevent compartment syndrome.

The nurse notes a patient has full-thickness circumferential burns on the right leg. The nurse would: select all that apply* A. Place cold compressions on the burn and elevate the right leg below the heart level B. Assess the distal pulses in the right extremity C. Elevate the right leg above the heart level D. Place gauze securely around the leg to prevent infection

B and C. The patient has burns that completely surround the front and back of the right leg. This can lead to compartment syndrome where the edema from the burn compromises circulation to the distal extremity. The nurse should elevate the extremity ABOVE heart level to decrease swelling and assess distal pulses in the extremity to confirm circulation is present.

A patient who is being treated for partial thickness burns on 60% of the body is now in the acute phase of burn management. The nurse assesses the patient for a possible Curling's Ulcer. What signs and symptoms can present with this condition?* A. Swelling and pain on the area distal to the burn B. Burning, gnawing sensation pain in the stomach and vomiting C. Dark red or gray sores on the soles of the feet D. Difficulty swallowing and gagging

B. This is a type of ulcer that occurs in the stomach, duodenum, due to a high amount of stress on the body from a burn. The blood supply to the factors that help protect the stomach lining from gastric erosion decreases and this allows for ulcers to form.

During the acute phase of burn management, what is the best diet for a patient who has experienced severe burns?* A. High fiber, low calories, and low protein B. High calorie, high protein and carbohydrate C. High potassium, high carbohydrate, and low protein D. Low sodium, high protein, and restrict fluids to 1 liter per day

B. This type of diet promotes wound healing and meets the caloric demands of the body.

A patient arrives to the ER due to experiencing burns while in an enclosed warehouse. Which assessment findings below demonstrate the patient may have experienced an inhalation injury?* A. Carbonaceous sputum B. Hair singeing on the head and nose C. Lhermitte's Sign D. Bright red lips E. Hoarse voice F. Tachycardia

A, B, D, E, and F. These are all signs of a possible inhalation injury. Bright red lips and tachycardia are present in carbon monoxide poisoning as well.

A 30 year old female patient has deep partial thickness burns on the front and back of the right and left leg, front of right arm, and anterior trunk. The patient weighs 63 kg. Use the Parkland Burn Formula: What is the flow rate during the FIRST 8 hours (mL/hr) based on the total you calculated?* A. 921 mL/hr B. 938 mL/hr C. 158 mL/hr D. 789 mL/hr

A: 921 mL/hr.... First calculate the total amount of fluid needed with the formula: Total Amount of LR = 4 mL x BSA % x pt's weight in kg. The pt's weight 63 kg. BSA percentage: 58.5%...Front and back of right and left leg (36%), front of right arm (4.5%), anterior trunk (18%) which equals 58.5%. ......4 x 58.5 x 63 = 14,742 mL......Remember during the FIRST 8 hours 1/2 of the solution is infused, which will be 14,742 divided by 2 = 7371 mL......Hourly Rate: 7371 divide by 8 equals 921 mL/hr

While collecting a medical history on a patient who experienced a severe burn, which statement by the patient's family member requires nursing intervention?* A. "He takes medication for glaucoma". B. "I think it has been 10 years or more since he had a tetanus shot." C. "He was told he had COPD last year." D. "He smokes 2 packs of cigarettes a day."

B. Patients who have had burns need a tetanus shot if they have not had a vaccine within the past 5 to 10 years.

You're providing education to a group of local firefighters about carbon monoxide poisoning. Which statement is correct about the pathophysiology regarding this condition?* A. "Patients are most likely to present with cyanosis around the lips and face." B. "In this condition, carbon monoxide binds to the hemoglobin of the red blood cell leading to a decrease in the ability of the hemoglobin to carry oxygen to the body." C. "Carbon monoxide poisoning leads to a hyperoxygenated state, which causes hypercapnia." D. "Carbon monoxide binds to the hemoglobin of the red blood cell and prevents the transport of carbon dioxide out of the blood, which leads to poisoning."

B. This is the only correct statement about carbon monoxide poisoning.

Select the patient below who is at MOST risk for complications following a burn:* A. A 42 year old male with partial-thickness burns on the front of the right and left arms and legs. B. A 25 year old female with partial-thickness burns on the front of the head and neck and front and back of the torso. C. A 36 year old male with full-thickness burns on the front of the left arm. D. A 10 year old with superficial burns on the right leg.

B. When thinking about which patient will have the MOST complications following a burn think about: percentage of the total body surface area that is burned (use the rule of nine to calculate), depth of the burn, age, location of the burn, and patient's medical history. The patient in option B has 40.5% TSBA burned (option A 27%, C: 4.5%, D: 9%). Remember that the higher the total of the body surface area that is burned the higher the risk of complications due to an increase in capillary permeability (swelling, hypovolemic shock etc.). In addition, the location of the burn is a major issue with the patient in option B. The burns are on the head and neck and front and back of the torso. Therefore, with head and neck burns always think about respiratory issues because the airway can become compromised due to swelling or an inhalation injury. And with torso burns that are on the front and back, the patient is at risk for circumferential burns that can lead to further respiratory compromise. The other options have burns that are isolated.

True or False: A patient who experiences an alkali chemical burn is easier to treat because the skin will neutralize the chemical rather than with an acidic chemical burn.* True False

False: Alkali burns are harder to treat than acidic chemical burns because the skin will neutralize the acidic burn.

The _____________ layer of the skin helps regulate our body temperature.* A. Epidermis B. Dermis C. Hypodermis D. Fascia

C. This layer contains fatty tissue, veins, arteries, nerves and helps insulate the muscles, bones, organs and helps REGULATE our body temperature.

During the emergent phase of burn management, you would expect the following lab values:* A. Low sodium, low potassium, high glucose, low hematocrit B. High sodium, low potassium, low glucose, high hematocrit C. High sodium, high potassium, high glucose, low hematocrit D. Low sodium, high potassium, high glucose, high hematocrit

D. Think about the increase in the capillary permeability that happens with severe burns, which causes the plasma to leave the intravascular system and enter the interstitial tissue: Low sodium..why: sodium leaves with the plasma to the interstitial tissue and drops the levels in the blood; High potassium...why? damaged cells lysis and leak potassium which increases the leave in the blood; high glucose...why? stress response leads the liver to release glycogen and this increases levels; low hematocrit...why? when the plasma leaves the intravascular system (the fluid) it causes the blood to become more concentrated so hematocrit increases (this will decrease when the patient's fluid is replaced).

which should be the anticipated therapeutic outcome of an escharotomy procedure performed for a circumferential burn? a. the return of the distal pulses b. decreasing edema formation c. brisk bleeding from the injury site d. the formation of granulation tissue

a escharotomies are performed to alleviate the compartment syndrome that can occur when edema forms under nondistensible eschar in a circumferential burn. escharotomies are performed through avascular eschar subcutaneous fat. although bleeding may occur from the site, it is considered a complication rather than an anticipated therapeutic outcome. the formation of granulation tissue is not the intent of an escharotomy, and escharotomy will not affect the formation of edema

A 16-year old patient with cystic fibrosis is admitted with increased shortness of breath and possible pneumonia. Which nursing activity is most important to include in the patient's care? A Perform postural drainage and chest physiotherapy every 4 hours B Allow the patient to decide whether she needs aerosolized medications C Place the patient in a private room to decrease the risk of further infection D Plan activities to allow at least 8 hours of uninterrupted sleep

a Airway clearance techniques are critical for patients with cystic fibrosis and should take priority over the other activities. Although allowing more independent decision making is important for adolescents, the physiologic need for improved respiratory function takes precedence at this time. A private room may be desirable for the patient but is not necessary. With increased shortness of breath, it will be more important that the patient have frequent respiratory treatments than 8 hours of sleep.

A patient with chronic obstructive pulmonary disease (COPD). Which intervention for airway management should you delegate to a nursing assistant (PCT)? A Assisting the patient to sit up on the side of the bed B Instructing the patient to cough effectively C Teaching the patient to use incentive spirometry D Auscultation of breath sounds every 4 hours

a Assisting patients with positioning and activities of daily living is within the educational preparation and scope of practice of a nursing assistant. Teaching, instructing, and assessing patients all require additional education and skills and are more appropriate for a licensed nurse.

A nursing instructor assigns their clinical group the task of writing a journal depicting the student's clinical day. What is the most likely rationale for this assignment? a. Journaling allows reflection, an important critical thinking skill. b. Journaling gives you time to review what happened in your clinical. c. Journaling is a way to organize your thoughts about your experiences. d. Journaling teaches open-mindedness, a critical thinking disposition.

a Critical thinking requires reflection on what occurred, how data were processed, and how decisions were made. Journaling is one method of developing critical thinking skills. Journaling does give nurses time to review what happened in their clinical, but this statement does not go far enough in explaining the importance of the journal-writing process. Journaling may be a way to organize thoughts about one's experiences, but this statement is too narrow an explanation and does not account for the critical aspect of reflection. Open-mindedness is a critical thinking disposition that allows one to be tolerant of divergent views. Journaling can assist with developing this disposition, but only if what is written reflects that specific topic.

When discussing the purposes of nursing health care informatics with a nurse during orientation, a nurse educator would be concerned if the nurse orientee stated that which is a primary purpose of informatics? a. Develop a data management system. b. Improve disease tracking. c. Improve a health provider's work flow. d. Increase administrative efficiencies.

a Data management is an exemplar of health informatics, but it would not be a primary purpose for a bedside nurse. The nurse educator would use this incorrect response to plan additional teaching about the primary purposes of health care informatics for the staff nurse. Purposes of information health technology include improving health provider work flow, improving health care quality, preventing medical errors, reducing health care costs, increasing administrative efficiencies, decreasing paper work, and improving disease tracking.

What group is primarily protected under the laws that regulate nursing practice? a. The public b. Practicing nurses c. The employing agency d. People with health problems

a Each state protects the health of the public by regulating nursing practice. Standards of nursing practice provide the framework for nurses. An employing agency (e.g., hospital, clinic, or home care agency) is responsible for ensuring that employees are qualified. More people than just those with health problems are protected by the laws.(Adapted from Nugent PM, Green JS, Hellmer Saul MA, Pelikan PM. Mosby's comprehensive review of nursing for the NCLEX-RN examination, 20th ed. St Louis, 2012, Mosby.)

Professionalism exemplars related to leadership include which attribute? a. Influential b. Licensed c. Respectful d. Therapeutic

a Exemplars related to leadership include influential, inspired, and proficient. Exemplars related to comportment include licensed, professionally certified, lifelong learner, and self-aware. Exemplars related to communication include therapeutic, accurate, skilled, and focused. Exemplars related to ethics include moral, beneficent, respectful, truthful, and honorable.

Which are consequences for a staff nurse related to the use of health informatics? a. Clinical decision support tools b. Confidentiality of health data c. Decreased cost of health care d. Personal health record

a The availability of clinical decision support tools at the point of care would be a consequence for a staff nurse. Confidentiality of health data affects patients; a nurse might be involved in ensuring the security and privacy of health information and exchange. A decreased cost of health care would affect a patient; a nurse's ability to reduce duplication of services will influence costs. Adopting a personal health record would be a consequence for a patient.

A new nurse needs further teaching when stating a valid consent involves which action? a. It must be presented to the patient by a nurse. b. The consent includes information about the risks and benefits of the procedure. c. The patient must have the capacity to give consent. d. The patient must voluntarily give consent.

a The person presenting the informed consent document must be the provider performing the procedure. To be valid, information for consent must be given by the provider who will be performing the procedure and includes information about the risks and benefits of the procedure. The patient must voluntarily give consent

when caring for a newly admitted child with a major burn injury, the priority nursing responsibilities include which of the following interventions? select all that apply a. prevent infection b. maintain accurate intake and output c. provide daily baths for cleanliness d. provide a high calorie diet

a, b Nursing priorities include preventing and reporting signs of infection: elevations of temperature, pulse, and respiration; restlessness and confusion; pain; purulent drainage; and an odor emanating from the wound dressing. The nurse remains alert for signs of fluid overload, in particular, behavioral changes and altered sensorium. Although initially restricted to prevent nausea and vomiting, oral fluids are necessary during the convalescent stages to prevent kidney damage and to maintain body fluid requirements. The nurse must use ingenuity to persuade the child to take sufficient amounts of fluids. An accurate record of intake and output of fluids is kept. Frequent feedings of foods high in calories, protein, and iron are necessary.

The nurse would explain to a patient that effective treatments for atopic pruritus include which treatments? Select all that apply. a. Oral steroids b. Topical steroids c. Oral antihistamines d. Topical antihistamines e. Topical petroleum ointment

a, b Oral and topical steroids may be given for acute cases of atopic pruritus. Oral and topical antihistamines are not usually given, because they are ineffective and may cause further irritation. Petroleum is also ineffective.

An experienced LPN, under the supervision of the team leader RN, is providing nursing care for a patient with a respiratory problem. Which actions are appropriate to the scope of practice of an experienced LPN? Select all that apply. A Auscultate breath sounds B Administer medications via metered-dose inhaler (MDI) C Complete in-depth admission assessment D Initiate the nursing care plan E Evaluate the patient's technique for using MDI's

a, b The experienced LPN is capable of gathering data and making observations, including noting breath sounds and performing pulse oximetry. Administering medications, such as those delivered via MDIs, is within the scope of practice of the LPN. Independently completing the admission assessment, initiating the nursing care plan, and evaluating a patient's abilities require additional education and skills. These actions are within the scope of practice of the professional RN.

a child is admitted with a burn injury that involves the forehead, ears, cheeks, and chest. which of the following are essential nursing responsibilities?select all that apply a. weigh the child b. provide oxygen and assess respirations c. apply dry sterile dressings to burned areas d. remove eschar from burned areas

a, b Weighing the child is an essential nursing option in order to determine the safe dose of a medication that may ordered, and providing oxygen and assessing respirations are essential because the burn injury may have damaged the mucosa of the airway. Sterile dressings may or may not be applied to a burn area. Removing eschar is a late burn intervention.

The nurse believes that a patient who states he is in pain is "faking it" and is hoping to get "high." The nurse decides to give the patient a placebo instead of the pain medication that was ordered for the patient. The nurse is violating which principle(s) of ethics? Select all that apply. a. Autonomy b. Utilitarianism c. Beneficence d. Dilemmas e. Veracity

a, b, c Autonomy is the principle of respect for the individual person; the nurse does not respect someone upon whom the nurse is inflicting harm. Beneficence is providing benefit to others by promoting their welfare. In general terms, to be beneficent is to promote goodness, kindness, and charity. By taking the patient's pain medication and substituting saline, the nurse did harm, not good, for the patient. Veracity is truth-telling. The nurse misled the patient to believe he/she was receiving a dose of pain medication. Utilitarianism is the principle that assumes that an action is right if it leads to the greatest possible balance of good consequences or to the least possible balance of bad consequences. Because the patient's pain medication was taken away, the consequences were all bad. Dilemmas are not included as a principle of ethics.

the nurse makes a home health visit 1 year after a patient was burned over 30% of his body. what problem may the patient be experiencing at this time? select all that apply a. concern with body image due to extensive scarring b. chronic pain due to contractures and nerve compartmentalization c. continued risk for infection due to reconstruction wounds d. increased risk for falls due to joint contractures

a, b, c, d All of the answers are correct. Recovery from extensive burns may require up to 5 years.

The nurse in the skilled nursing facility is very busy and unable to answer the call bell lights. Which tasks related to skin care can the nurse delegate to the nursing assistant? Select all that apply. a. Applying over-the-counter lotions to skin that is not broken b. Assisting the client with frequent turning to prevent pressure ulcers c. Covering the client who complains of being cold with more blankets d. Placing a sterile gauze pad over broken skin to contain drainage e. Assessing a patient complaining of an itching rash

a, b, c, d All the above options can be delegated to an unlicensed assistive personnel employee except assessing a patient complaining of an itching rash. Assessment of a rash should be done by the nurse so the appropriate referrals can be made if necessary. The nurse needs to investigate a new rash for the possibility of an allergic reaction.

a nurse is assisting with the plan of care for an adult who sustained severe burn injuries. which of the following interventions should the nurse include in the plan of care? select all that apply a. limit visitors in the clients room b. encourage fresh vegetables in the diet c. increase protein intake d. instruct the client to consume 2,000 calories/day e. restrict fresh flowers in the room

a, c, e the nurse should limit visitors to reduce the risk of getting an infection. the client should increase protein intake to help healing. flowers should not be in the clients room due to the risk of infection. clients should limit the intake of vegetables because of the risk of infection. clients should consume up to 5000 calories a day to promote healing.

An interpretivist nurse is caring for a patient in the hospital setting. Which of the following factors will the interpretivist consider when caring for this patient? Select all that apply. a. Context of care b. The information from the chart c. What the nurse personally brings to the caring encounter d. Information from significant others and friends e. The nurse's previous experiences, values, and emotions

a, d, e Interpretivist approaches situate the nurse squarely in the context of care and account for what the nurse personally brings to the caring encounter, including previous experiences, values, and emotions. The information from the chart and from others is gathered in the steps of the nursing process.

To help decrease the threat of melanoma in a blonde-haired, fair-skinned patient at risk, which recommendations should the nurse provide? Select all that apply. a. Wear sunglasses. b. Drink plenty of water. c. Eat plenty of foods high in vitamin K. d. Apply sunscreen 30 minutes prior to exposure. e. Consume fish oil and vitamin E.

a, d, e Wearing sunglasses and using sunscreen are recommended by the National Cancer Institute. Drinking water will help with heat exhaustion but will not prevent melanoma. Green tea, fish oil, soy products, and vitamin E are thought to be helpful in minimizing the risk of developing melanoma; however, vitamin K can cause the blood to clot and has not been indicated.

a nurse is caring for a school aged child who has a minor burn. which of the following actions should the nurse take? a. keep the wound open to air b. apply cool, wet compresses to the affected area c. clean the affected area using a soft bristled brush d. apply lotion twice a day to the affected area

b the nurse should apply a cool compress to help with the burning process. the nurse should cover the wound to prevent contamination. the nurse should use gentle cleansing with tepid water and a mild soap and avoid the use of friction. the nurse should avoid the use of lotions on burned areas

Which statement is included in the clinical reasoning communication category? a. The mathematical calculation process by which a nurse verifies a medication dosage b. Relying heavily on analytical reasoning that requires systematically breaking a situation down into parts, examining alternatives, and weighing options c. Using experiential knowledge, the nurse begins to put everything together to make sense of it. d. Clinical judgment is inherently complex and influenced by many factors related to the particular patient and caregiving situation.

b Clinical reasoning is a thinking process that assists in making clinical decisions. The rules-based approach is included in this category and involves systematically breaking down the situation into more manageable parts. Process orientation utilizes experimental knowledge. The holistic view is influenced by complex factors surrounding the patient's circumstance. A dosage calculation is a knowledge-based skill.

A patient and her husband used in vitro fertilization to become pregnant. The unused sperm were frozen so the couple could have more children later. They bore a little girl who was diagnosed with leukemia when she was 5 years old. The child now needs a bone marrow transplant (BMT). The best chance of a match for the BMT is a sibling. The couple would like to use the sperm to have another child so that they can increase the likelihood of a match. The nurse realizes that the unborn child poses an ethical dilemma involving which principle? a. Beneficence b. Human dignity c. Justice d. Veracity

b Human dignity is the inherent worth and uniqueness of a person. Human rights are the basic rights of each individual. Beneficence is defined as promoting goodness, kindness, and charity. In ethical terms, beneficence means to provide benefit to others by promoting their welfare. Justice involves upholding moral and legal principles. Veracity is truth-telling.

A homeless man presents to the emergency room with hypothermia. He tells the nurse that he is positive for human immunodeficiency virus (HIV) and sought revenge by deliberately having sex with his mate, who does not know of his HIV status. This patient is violating which ethical principle? a. Veracity b. Beneficence c. Nonmaleficence d. Autonomy

b Nonmaleficence means to abstain from injuring others and to help others further their own well-being by removing harm and eliminating threats. The patient is definitely violating this principle through his actions. Veracity is telling the truth in personal communication. Beneficence is promoting goodness, kindness, and charity. Autonomy is the principle of respect for the individual person. This concept maintains that all persons have unconditional intrinsic value.

What is the goal of the professional nurse in the team leader role? a. Compliance with physicians b. Positive outcomes and patient satisfaction c. Satisfied physical therapists and occupational therapists d. Social service referrals for home care

b Positive outcomes and patient satisfaction are goals of the professional nurse in the team leader role. Strong nursing leaders are in the best position to influence patient care and policy. A professional nurse would collaborate effectively with all team members; compliance connotes the inappropriate "handmaiden" role of a nurse. Satisfied health team members could improve outcomes, but that would not be the primary goal. Home care is not necessarily needed by all patients.

while the nurse is performing the initial assessment a patient with extensive burn injuries suddenly develops hoarseness and stridor. pulse oximetry is 86%. what is the priority nursing action? a. encourage the patient to take deep breaths b. provide humidified oxygen c. administer respiratory treatments d. suction respiratory secretions

b Stridor is an ominous sign that indicates a potential obstruction of the airway and respiratory distress. Giving oxygen is the priority action. The patient may need to be intubated. Encouraging patient is not incorrect, but it will not resolve the problem. Respiratory treatments are unlikely to help if the patient has progressed to stridor. (Suctioning is not helpful and may worsen the situation.

a nurse is contributing the the plan of care for an adolescent who has a major burn. which of the following interventions should the nurse recommend? select all that apply a. advise visitors to bring cut flowers instead of live plants b. implement reverse isolation precautions c. administer tetanus toxoid vaccine if more then 5 years since last immunization d. encourage visits from adolescent peers e. use client designated equipment

b, c, e the nurse should recommend reverse isolation, tetanus shot, and client designated equipment to reduce the risk of infection. the nurse should restrict any plants to be in the room because of the risk of infection. limiting visitors may help with preventing infection

a nurse is assisting with the care of a client who sustained deep partial thickness and full thickness burns over 60% of his body 24 hours ago and is requesting pain medication. the nurse should ensure the medication is adminstered using which of the following routes to administer the medication? a. subcutaneous b. oral c. IV d. transdermal

c the nurse needs to administer meds through IV for rapid absorption rate and pain relief. the nurse should not give meds PO, sub q, or transdermal because the difficulty of absorption during the resuscitation phase.

You are a new graduate nurse working with a nurse who has been out of school for 10 years. The seasoned nurse states, "I don't see the difference between this clinical reasoning and the nursing process." Which of the following statements would be an appropriate response? Select all that apply. a. Clinical reasoning is limited to assessing, evaluating, and treating the nursing diagnosis. b. Clinical reasoning involves reflecting on interventions and reevaluating the plan of care based on the results of reflection. c. Clinical reasoning involves assessing, diagnosing, and planning and using interventions based on assessments. d. Clinical reasoning is the thinking process by which a nurse reaches a clinical judgment. e. Clinical reasoning is an iterative process of noticing, interpreting, and responding—reasoning in transition with a fine attunement to the patient and how the patient responds to the nurse's actions.

b, d, e Clinical reasoning is an iterative process of noticing, interpreting, and responding—reasoning in transition with a fine attunement to the patient and how the patient responds to the nurse's actions. The nursing process is limited to assessment, diagnosis, planning, and developing interventions based on assessments.

Which ethical term matches this statement: "A problem for which in order to do something right you have to do something wrong"? a. Justice b. Veracity c. Ethical dilemma d. Fidelity

c An ethical dilemma involves a problem for which in order to do something right you have to do something wrong. Justice involves upholding moral and legal principles. Veracity means telling the truth as a moral and ethical requirement. Fidelity is the principle that requires a person to act in ways that are loyal. In the role of a nurse, such action includes keeping promises, doing what is expected of you, performing your duties, and being trustworthy.

A nurse wishes to obtain data about a new patient's self-esteem. To gain the clearest picture, the nurse uses which assessment technique? a. Completing an entire head-to-toe assessment first b. Conducting a structured interview with direct questions c. Interviewing the patient in an unstructured format d. Disregard any nonverbal clues from the patient

c An unstructured interview format allows the nurse to establish rapport and get insight into the patient's perspective. Combined with observation, this would yield the best information. Observation often results in gathering a depth of data that is difficult to gain by other methods. Combined with an unstructured interview to gain the patient's trust, this technique would be very valuable. A head-to-toe assessment would not yield information about self-esteem. A structured interview is often used to gather specific information, but since this nurse has not yet had time to develop rapport, focusing questions on a sensitive issue such as self-esteem would probably not elicit accurate information. Also, structured interviews are most often used in emergency situations, and this does not qualify as an emergency.

To address a goal of improving the health of populations, a nurse is most likely to use informatics in which domain? a. Certified clinical information systems b. Clinical health care informatics c. Public health/population informatics d. Translocational bioinformatics

c Public health/population informatics is the domain that relates information, computer science, and technology to public health science to improve the health of populations; this domain would provide data for a nurse working with communities. Certified clinical information systems (CISs) refers to the tools used for achieving quality outcomes, including electronic health records, clinical data repositories, decision support programs, and handheld devices, not to the data. Clinical health care informatics and the subset nursing informatics provide for the development of direct approaches to patients and their families that can be used by a staff nurse to promote quality patient care. Translational bioinformatics refers to the research science domain where biomedical and genomic data are combined; it is a new term that describes the domain where bioinformatics meets clinical medicine and generally applies to health care research rather than direct patient care.

A patient with sleep apnea has a nursing diagnosis of Sleep Deprivation related to disrupted sleep cycle. Which action should you delegate to the nursing assistant (PCT)? A Discuss weight-loss strategies such as diet and exercise with the patient B Teach the patient how to set up the BiPAP machine before sleeping C Remind the patient to sleep on his side instead of his back D Administer modafinil (Provigil) to promote daytime wakefulness

c The nursing assistant can remind patients about actions that have already been taught by the nurse and are part of the patient's plan of care. Discussing and teaching require additional education and training. These actions are within the scope of practice of the RN. The RN can delegate administration of medication to an LPN/LVN.

To enter the nursing profession, an individual must successfully complete which criterion? a. Clinical checklist b. A graduate degree c. Licensure examination d. Ongoing education

c To enter the nursing profession, an individual must have successfully completed a state board-credentialed education program (a minimum educational requirement) and passed a common licensure examination. Clinical checklists may be helpful but are not a required component of an educational program. There are a variety of educational programs that prepare individuals for the role of professional nurse, ranging from associate to doctoral degrees. A graduate degree is not a requirement. Ongoing education and clinical competence are expectations for continued practice but are not required for entry into the profession.

a nurse is assisting with the care of a school age child who has a major burn. which of the following actions should the nurse take? a. maintain immobilization of the affected area b. position the child in supine position without pillows c. initiate high calorie and high protein diet d. limit the child's intake of zinc

c the patient needs high calories and protein to help with the healing process. the metabolic rate increases and the client needs to keep up with the demands that are needed fro healing. the client needs ROM to prevent contractures. the nurse needs to move the client every 2 hours to prevent sores. the nurse should encourage the intake of vitamin a and c and zinc to help with the healing process

a nurse is caring for a client who has sustained burns over 35% of his total body surface area. most of the burns are full thickness burns on the arms, face, neck and shoulders. the clients voice has become hoarse. he has a brassy cough and is drooling. these findings are indications of which of the following? a. pulmonary edema b. bacterial pneumonia c. inhalation injury d. carbon monoxide poisoning

c wheezing and hoarseness indicate an inhalation injury. difficulty breathing and pink frothy sputum indicate pulmonary edema. productive cough and fever are indicative of a bacterial infection. confusion and headaches indicate carbon monoxide poisoning

A nurse is instructing a nursing assistant in how to prevent pressure ulcers in a frail elderly client. The nursing assistant indicates that she understands the instruction when she agrees to perform which actions? Select all that apply. a. Bathe and dry the skin vigorously to stimulate circulation. b. Keep the head of the bed elevated 30 degrees. c. Offer nutritional supplements and frequent snacks. d. Turn the patient at least every 2 hours. e. Maintain a cooler environment when bathing.

c, d The patient should be turned at least every 2 hours because permanent damage can occur in 2 hours or less. If skin assessment reveals a stage I ulcer while the patient is on a 2-hour turning schedule, the patient must be turned more frequently. Protein-calorie malnutrition is another major risk factor for developing pressure ulcers. Additional supplements boost nutritional status, which is essential to healthy skin. Use of donut pads, elevation of the head of the bed, and overstimulation of the skin may all stimulate, if not actually encourage, dermal decline. Older adults are more prone to hypothermia if bathed in a cooler environment.

when instructing parents who plan to take their 5 month old infant sunbathing at the beach, it is most important to emphasize which of the following? a. use a sunscreen greater than 30 over exposed areas of the infants skin b. reapply sunscreen after the child has been playing in the water c. use sunglasses to protect the child d. use light clothes and a hat to protect against sun exposure

d Sunscreens are not recommended for infants under 6 months of age. Small infants should be physically protected from excessive sun exposure.

After change of shift, you are assigned to care for the following patients. Which patient should you assess first? A A 60-year old patient on a ventilator for whom a sterile sputum specimen must be sent to the lab B A 55-year old with COPD and a pulse oximetry reading from the previous shift of 90% saturation C A 70-year old with pneumonia who needs to be started on intravenous (IV) antibiotics D A 50-year old with asthma who complains of shortness of breath after using a bronchodilator

d The patient with asthma did not achieve relief from shortness of breath after using the bronchodilator and is at risk for respiratory complications. This patient's needs are urgent. The other patients need to be assessed as soon as possible, but none of their situations are urgent. in COPD patients pulse oximetry oxygen saturations of more than 90% are acceptable.

The specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice is known as which specialty? a. Computer science b. Health informatics c. Health information technology d. Nursing informatics

d The specialty is nursing informatics. Computer science is a branch of engineering that studies computation and computer technology, hardware, software, and the theoretical foundations of information and computation techniques. Health informatics is a discipline in which health data are stored, analyzed, and disseminated through the application of information and communication technology. Health information technology is an application of information processing that deals with the storage, retrieval sharing, and use of health care data, information, and knowledge for communication and decision making.

the nurse is caring for a patient with circumferential burns to both legs. which leg position is appropriate for this burn? a. a dependent position b. elevation of the knees c. flat, without elevation d. elevation above the level of the heart

d circumferential burns of the extremities may compromise circulation. elevating injured extremities above the level of the heart and performing active exercise help to reduce dependent edema formation

a client is admitted with second degree burns on face, neck, hands, and anterior chest. the nurses priority action would be to: a. cover the burned area with sterile dressings b. initiate IV fluid administration c. administer pain medication as ordered d. assess for dyspnea and stridor

d due to the location of the burns, the client is at risk for developing upper airway edema and subsequent respiratory distress

a client arrives to the ED after a burn injury that occurred in the basement at home, and inhalation injury is suspected. which should the nurse expect as being prescribed for this patient? a. oxygen via NC at 10 L b. oxygen via NC at 15 L c. 100% oxygen via an aerosol mask d. 100% oxygen vie a tight fitting nonrebreather face mask

d if inhalation injuries are suspected the administration of oxygen 100% via a tight fitting nonrebreather mask is prescribed until the carboxyhemoglobin level falls below 15%. with inhalation injuries the oropharynx is inspected for evidence of erythema, blisters or ulcerations. the need for endotracheal intubation is also determined.