Managements of Patients with Burn Injury

Managements of Patients with 1. A patient is brought to the emergency department from the site of a chemical fire, whe burnthatinvolvestheepidermis,dermis,andthemuscleandboneoftherightarm.O skin appears charred. Based on these assessment findings, what is the depth of the burn arm? A) Superficial partial-thickness B) Deep partial-thickness C) Full partial-thickness D) Full-thickness Ans: D 2. Burn Injury The current phase of a patients treatment for a burn injury prioritizes wound care, nutriti and prevention of complications such as infection. Based on these care priorities, the pat phase of burn care? A) Emergent B) Immediate resuscitative C) Acute D) Rehabilitation Ans: C 3. A patient in the emergent/resuscitative phase of a burn injury has had blood work and a gases drawn. Upon analysis of the patients laboratory studies, the nurse will expect the 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 hematocrit, and metabolic alkalosis Ans: A 4. A patient has experienced an electrical burn and has developed thick eschar over the bur the following topical antibacterial agents will the nurse expect the physician to order for 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 Ans: B 5. An occupational health nurse is called to the floor of a factory where a worker has sus to the right arm. The nurse arrives and the flames have been extinguished. The next st burn. How should the nurse cool the burn? A) Apply ice to the site of the burn for 5 to 10 minutes. B) Wrap the patients 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. Ans: D 6. An emergency department nurse has just admitted a patient with a burn. What characteris will primarily determine whether the patient experiences a systemic response to this injur A) The length of time since the burn B) The location of burned skin surfaces C) The source of the burn D) The total body surface area (TBSA) affected by the burn Ans: D 7. A nurse on a burn unit is caring for a patient in the acute phase of burn care. While assessment during this phase of burn care, the nurse recognizes that airway obstruction r airway edema may occur up to how long after the burn injury? A) 2 days B) 3 days C) 5 days D) 1 week Ans: A 8. A patient has sustained a severe burn injury and is thought to have an impaired intestin barrier. Since this patient is considered at an increased risk for infection, what interventi 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 Ans: A 9. A patient has been admitted to a burn intensive care unit with extensive full-thickness bu the body. After ensuring cardiopulmonary stability, what would be the nurses immediate, concern when planning this patients care? A) Fluid status B) Risk of infection C) Nutritional status D) Psychosocial coping Ans: A 10. The nurse is preparing the patient for mechanical dbridement and informs the patient that involve which of the following procedures? A) A spontaneous separation of dead tissue from the viable tissue B) Removal of eschar until the point of pain and bleeding occurs C) Shaving of burned skin layers until bleeding, viable tissue is revealed D) Early closure of the wound Ans: B 11. A patient with a partial-thickness burn injury had Biobrane applied 2 weeks ago. The nu the Biobrane is separating from the burn wound. What is the nurses most appropriate in A) Reinforce the Biobrane dressing with another piece of Biobrane. B) Remove the Biobrane dressing and apply a new dressing. C) Trim away the separated Biobrane. D) Notify the physician for further emergency-related orders. Ans: C 12. An emergency department nurse learns from the paramedics that they are transporting a p suffered injury from a scald from a hot kettle. What variables will the nurse consider w the depth of burn? A) The causative agent B) The patients preinjury health status C) The patients prognosis for recovery D) The circumstances of the accident Ans: A 13. A nurse is caring for a patient who has sustained a deep partial-thickness burn injury. I nursing diagnoses for the plan of care, the nurse will give the highest priority to what A) Activity Intolerance B) Anxiety C) Ineffective Coping D) Ans: Acute Pain D 14. A triage nurse in the emergency department (ED) receives a phone call from a frantic f 4-year-old child tip a pot of boiling water onto her chest. The father has called an am would the nurse in the ED receiving the call instruct the father to do? A) Cover the burn with ice and secure with a towel. B) Apply butter to the area that is burned. C) Immerse the child in a co ol bath. D) Avoid touching the burned area under any circumstances. Ans: C 15. A nurse is teaching a patient with a partial-thickness wound how to wear his elastic pre How would the nurse instruct the patient to wear this garment?n A) 4 to 6 hours a day for 6 months B) During waking hours for 2 to 3 months after the injury C) Continuously D) At night while sleeping for a year after the injury Ans: C 16. A patient is brought to the ED by paramedics, who report that the patient has partial-th  patient who has been burned and suffered smoke inhalation? A) Pain B) Fluid balance C) Anxiety and fear D) Airway management Ans: D 17. A patient arrives in the emergency department after being burned in a house fire. The p  A) 13% B) 25% C) 9% D) 18% Ans: D 18. A nurse is caring for a patient in the emergent/resuscitative phase of burn injury. During nurse should monitor for evidence of what alteration in laboratory values? A) Sodium deficit B) Decreased prothrombin time (PT) C) Potassium deficit D) Decreased hematocrit Ans: A 19. A nurse is developing a care plan for a patient with a partial-thickness burn, and determ appropriate goal is to maintain position of joints in alignment. What is the best rational intervention? A) To prevent neuropathies B) To prevent wound breakdow n C) To prevent contractures D) To prevent heterotopic ossification Ans: C 20. A patients burns have required a homograft. During the nurses most recent assessment, th observes that the graft is newly covered with purulent exudate. What is the nurses most response? A) Perform mechanical dbridement to remove the exudate and prevent further infection. B) Inform the primary care provider promptly because the graft may need to be remove C) Perform range of motion exercises to increase perfusion to the graft site and facilita D) Document this finding as an expected phase of graft healing. Ans: B 21. A nurse who is taking care of a patient with burns is asked by a family member why so much weight. The patient is currently in the intermediate phase of recovery. What w nurses most appropriate response to the family member? A) Hes on a calorie-restricted diet in order to divert energy to wound healing. B) His body has consumed his fat deposits for fuel because his calorie intake is lower C) He actually hasnt lost weight. Instead, theres been a change in the distribution of h D) He lost many fluids while he was being treated in the emergency phase of burn c Ans: aB 22. A nurse has reported for a shift at a busy burns and plastics unit in a large university patient is most likely to have life-threatening complications? A) A 4-year-old scald victim burned over 24% of the body B) A 27-year-old male burned over 36% of his body in a car accident C) A 39-year-old female patient burned over 18% of her body D) A 60-year-old male burned over 16% of his body in a brush fire Ans: A  systemic event after a major burn injury is what? A) Hemodynamic instability B) Gastrointestinal hypermotility C) Respiratory arrest D) Hypokalemia Ans: A 24. A patient with severe burns is admitted to the intensive care unit to stabilize and begin before transport to the burn center. The nurse should monitor the patient closely for wh onset of burn shock? A) Confusion B) High fever C) Decreased blood pressure D) Sudden agitation Ans: C  The paramedics have started a largebore IV and covered the burn in cool towels. The as covering 24% of the patients body. How should the nurse best address the pathophy s resulting from major burns during the initial burn-shock period? A) Administer IV fluids B) Administer broad-spectrum antibiotics C) Administer IV potassium chloride D) Administer packed red blood cells Ans: A  the emergency department. After establishing intravenous access, the nurse should anticipat e administration of what fluid? A) 0.45% NaCl with 20 mEq/L KCl B) 0.45% NaCl with 40 mEq/L KCl C) Normal saline D) Lactated Ringers Ans: D 27. A patient is admitted to the burn unit after being transported from a fac ility 1000 miles patient has burns to the groin area and circumferential burns to both upper thighs. Whe patients legs distal to the wound site, the nurse should be cognizant of the risk of wh A) Ischemia B) Referred pain C) Cellulitis D) Venous thromboembolism (VTE) Ans: A 28. A patient experienced a 33% TBSA burn 72 hours ago. The nurse observes that the pat output has been steadily increasing over the past 24 hours. How should the nurse best finding? A) Obtain an order to reduce the rate of the patients IV fluid infusion. B) Report the patients early signs of acute kidney injury (AKI). C) Recognize that the patient is experiencing an expected onset of diuresis. D) Administer sodium chloride as ordered to compensate for this fluid loss. Ans: C 29. A public health nurse has reviewed local data about the incidence and prevalence of bur community. These data are likely to support what health promotion effort? A) Education about home safety B) Education about safe storage of chemicals C) Education about workplace health threats D) Education about safe driving Ans: A 30. A nurse is performing a home visit to a patient who is recovering following a long co treatment for burn injuries. When performing this home visit, the nurse should do which following? A) Assess the patient for signs of electrolyte imbalances. B) Administer fluids as ordered. C) Assess the risk for injury recurrence. D) Assess the patients psychosocial state. Ans: D 31. A patient has experienced burns to his upper thighs and knees. Following the application dressings, the nurse should perform what nursing action? A) Instruct the patient to keep the wound site in a dependent position. B) Administer PRN analgesia as ordered. C) Assess the patients peripheral pulses distal to the dressing. D) Assist with passive range of motion exercises to set the new dressing. Ans: C 32. A nurse is caring for a patient with burns who is in the later stages of the acute pha plan of nursing care should include which of the following nursing actions? A) Maintenance of bed rest to aid healing B) Choosing appropriate splints and functional devices C) Administration of beta adrenergic blockers D) Prevention of venous thromboembolism Ans: D  Ineffective Coping Related to Trauma of Burn Injury. What interventions appropriately ad d diagnosis? Select all that apply. A) Promote truthful communication. B) Avoid asking the patient to make decisions . C) Teach the patient coping strategies. D) Administer benzodiazepines as ordered. E) Provide positive reinforcement. Ans: A, C, E 34. A patient who was burned in a workplace accident has completed the acute phase of tre plan of care has been altered to prioritize rehabilitation. What nursing action should be this phase of treatment? A) Monitoring fluid and electrolyte imbalances B) Providing education to the patient and family C) Treating infection D) Promoting thermoregulation Ans: B 35. A burn patient is transitioning from the acute phase of the injury to the rehabilitation p tells the nurse, I cant wait to have surgery to reconstruct my face so I look normal a the nurses best response? A) Thats something that you and your doctor will likely talk about after your scars ma B) That is something for you to talk to your doctor about because its not a nursing C) I know this is really important to you, but you have to realize that no one can m you used to. D) Unfortunately, its likely that you will have most of these scars for the rest of your Ans: A 36. A patient who is in the acute phase of recovery from a burn injury has yet to experie control. What pain management strategy is most likely to meet this patients needs? A) A patient-controlled analgesia (PCA) system B) Oral opioids supplemented by NSAIDs C) Distraction and relaxation techniques supplemented by NSAIDs D) A combination of benzodiazepines and topical anesthetics Ans: A 37. The nurse caring for a patient who is recovering from full-thickness burns is aware of t for contracture and hypertrophic scarring. How can the nurse best mitigate this risk? A) Apply skin emollients as ordered after granulation has occurred. B) Keep injured areas immobilized whenever possible to promote healing. C) Administer oral or IV corticosteroids as ordered. D) Encourage physical activity and range of motion exercises. Ans: D  series of sarcastic remarks to the nurse and criticized her technique. How should the nu this patients behavior? A) The patient may be experiencing an adverse drug reaction that is affecting his cogni behavior. B) The patient may be experiencing neurologic or psychiatric complications of his injurie C) The patient may be experiencing inconsistencies in the care that he is being provide D) The patient may be experiencing anger about his circumstances that he is deflecting nurse. Ans: D 39. A home care nurse is performing a visit to a patients home to perform wound care fol hospital treatment for severe burns. While interacting with the patient, the nurse should a evidence of what complication? A) Psychosis B) Post-traumatic stress disorder C) Delirium D) Vascular dementia Ans: B 40. A nurse who provides care on a burn unit is preparing to apply a patients ordered topi ointment. What action should the nurse perform when administering this medication? A) Apply the new ointment without disturbing the existing layer of ointment. B) Apply the ointment using a sterile tongue depressor. C) Apply a layer of ointment approximately 1/16 inch thick. D) Gently irrigate the wound bed after applying the antibiotic ointment. Ans: C