Burns

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Sample questions from Burns

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.In the emergency department, a 34-year-old client with burns to the face and upper chest has singed nasal hairs, a hoarse voice, HR 118/min, RR 28/min, BP 144/86 mm Hg, and SpO2 95% on room air. Which action is the priority?

   • A.Prepare for early endotracheal intubation
   • B.Obtain a detailed history of the burn mechanism
   • C.Apply topical antimicrobial cream to the burns
   • D.Administer oral fluids for hydration

   Rationale: Hoarseness and facial burns suggest evolving airway edema, which can make later intubation difficult. Airway protection takes priority over wound care, history-taking, and oral hydration. A seemingly adequate SpO2 does not exclude impending airway obstruction.

2. 2.Refer to the client's chart. Which action should the nurse take first?

   • A.Offer oral fluids and recheck urine output in 4 hours
   • B.Administer a prescribed opioid before completing reassessment
   • C.Apply a cool compress to the burned arm
   • D.Increase the prescribed isotonic fluid rate and reassess perfusion

   Rationale: Urine output has fallen to 15 mL/hr while tachycardia and hypotension worsen, indicating inadequate resuscitation perfusion. The prescribed fluid rate should be adjusted according to the burn protocol and the client reassessed promptly. A compress or oral fluids will not correct shock, and analgesia must not delay circulation management.

3. 3.A 29-year-old client arrives at a burn center after a flash fire, with burns to the face and soot around the mouth. Which actions should the nurse anticipate during initial stabilization? Select all that apply.

   • A.Obtain carboxyhemoglobin level
   • B.Use pulse oximetry alone to rule out carbon monoxide exposure
   • C.Apply ice directly to facial burns
   • D.Prepare for early airway management
   • E.Administer 100% humidified oxygen

   Rationale: High-concentration oxygen, early airway planning, and a carboxyhemoglobin measurement are appropriate after smoke exposure with facial findings. Ice can worsen tissue injury and is not appropriate for burn cooling. Standard pulse oximetry may appear reassuring despite carbon monoxide poisoning, so it cannot rule it out.

4. 4.At change of shift, a charge nurse assigns four clients. Which assignment is appropriate for a practical nurse?

   • A.Titrate resuscitation fluids for a client whose urine output is declining
   • B.Reinforce teaching for a stable client with a healing partial-thickness burn
   • C.Evaluate a client's response to a first dose of IV opioid
   • D.Perform the initial assessment of a newly admitted client with a 25% TBSA burn

   Answer and rationale are in the full material.

5. 5.A provider prescribes IV morphine before dressing care for a 52-year-old client with extensive burns. The client is drowsy, with RR 9/min and SpO2 91% on room air. What should the nurse do?

   • A.Ask the client to take deep breaths, then administer the dose
   • B.Give the morphine as prescribed to prevent procedural pain
   • C.Hold the morphine and assess respiratory status
   • D.Give half the dose and document the client's response

   Answer and rationale are in the full material.