Deck 50: Management of Clients with Burn Injury

Question 1

The nurse is caring for a client with burns covering the entire surface of both arms and the anterior trunk. Using the rule of nines, the nurse would estimate the percentage of burn surface area to be

A) 18%.
B) 27%.
C) 36%.
D) 45%.

Answer 1

36%.

Question 2

The nurse would assess that the client with a "major burn" is

A) 60 years old with a 20% burn.
B) 32 years old with a 14 % burn.
C) 18 years old with an 18% burn.
D) 10 years old with a 15% burn.

Answer 2

60 years old with a 20% burn.

Question 3

The nurse caring for a client with burns over 40% of the body notes a hematocrit of 55% at 12 hours after the injury. The nurse would explain that this finding is related to

A) cellular debris from burned tissue.
B) decreased intravascular fluid.
C) increased red blood cell (RBC) production.
D) presence of carboxyhemoglobin (COHb).

Answer 3

decreased intravascular fluid.

Question 4

A client admitted to the emergency department (ED) with burns of the chest and neck exhibits a wet, shiny, weeping surface with some blistering. The nurse would document these burn injuries as

A) full thickness, fourth degree.
B) full thickness, third degree.
C) partial thickness, second degree.
D) superficial, first degree.

Question 5

A client suffered what seems to be a moderate electrical burn from contact with household electricity. However, the physician wants to admit the client for monitoring. When questioned about this decision, the best answer by the nurse is

A) "I am not sure but I can find out for you."
B) "It is our protocol that all electrical burns get admitted."
C) "With household current, there is great risk of cardiac rhythm problems."
D) "You need to be watched for fractures that can occur under normal use."

Question 6

The nurse would assure a family member that for the first 24 hours after a burn injury, pain is kept to a minimum by administering

A) intravenous narcotic agents.
B) liquid narcotics via a nasogastric tube.
C) narcotics via an intramuscular route into nonburned tissue.
D) tepid soaks and oral morphine.

Question 7

A client has a circumferential third-degree burn on the upper left arm. The nursing assessments specific for this client would include

A) assessing capillary refill in the left hand.
B) evaluating left hand strength.
C) measuring left forearm circumference.
D) monitoring blood pressure in the left arm.

Question 8

The nurse would stress to the ancillary staff that the most important means of preventing the spread of infection in the burn unit is

A) prophylactic antibiotics.
B) restricting visitors with respiratory tract infections.
C) strict hand-washing.
D) using clean gowns, gloves, and masks.

Question 9

The nurse would explain to a client that when a major burn occurs, the body's initial systemic responses include

A) elevated pulse rate, decreased cardiac output, and polyuria.
B) increased capillary permeability, decreased cardiac output, and oliguria.
C) plasma leakage into surrounding tissue, decreased hematocrit, and oliguria.
D) production of epinephrine, vasodilation, and increased cardiac output.

Question 10

A client's burn wound is being treated with enzymatic debridement. At this time the nurse would assess the client for

A) allergic reactions.
B) bleeding from the burn wound.
C) increased fluid loss.
D) serum electrolyte imbalances.

Question 11

The nurse teaching a home safety course would emphasize that because of growth and development factors, toddlers are most at risk for burn injuries caused by

A) cigarettes.
B) electricity.
C) flame.
D) scald.

Question 12

When admitting a client who has sustained a burn injury, the nurse would inoculate against tetanus if the client has

A) been inoculated in the last 6 years.
B) open wounds with copious debris embedded.
C) second-degree burns with broken blisters.
D) third-degree burns.

Question 13

A 200-pound client is receiving fluid replacement in the emergency department after 35% of the client's body was burned. The nurse would anticipate fluid resuscitation of at least

A) 140 ml/hour.
B) 14,000 ml in 24 hours.
C) 63 ml/hour.
D) 6364 ml in 24 hours.

Question 14

The nurse teaching a class on burn injury prevention would stress that the leading cause of fire deaths is

A) children playing with matches.
B) cigarettes igniting furniture.
C) kitchen fires igniting other combustibles.
D) space heaters igniting clothing.

Question 15

The nurse caring for a burn client would monitor the client's stools for occult blood as assessment for development of

A) bleeding caused by bowel distention.
B) gastric irritation related to smoke.
C) intestinal ileus.
D) stress ulcers.

Question 16

The nurse doing a home safety assessment would conclude that the client at highest risk for burns sustained from clothing ignition during meal preparation is

A) an 18-month-old toddler.
B) a 5-year-old child.
C) a 15-year-old teenager.
D) a 75-year-old adult.

Question 17

The nurse would perform close respiratory assessment for a client with inhalation injuries because lung tissue injury resulting from inhalation of smoke is caused by

A) anoxia from lowered blood oxygen content.
B) carbon monoxide poisoning.
C) chemical action on lung tissues.
D) heat damage from superheated air.

Question 18

The physician orders 1% silver sulfadiazine cream applied to a client's burn wound two times daily. The nurse would be aware that this medication can affect

A) blood pH.
B) hemoglobin level.
C) serum electrolyte levels.
D) white blood cell count.

Question 19

To reduce contractures of the knee in a client with extensive burns of the knee and mid-leg, the nurse would position the client with the knee

A) extended.
B) flexed.
C) adducted.
D) abducted.

Question 20

When caring for a severely burned client, the nurse notes that the client's urine is dark brown. The priority action by the nurse would be to

A) check the urinary catheter for patency and irrigate it if needed.
B) monitor vital signs more frequently to detect hypovolemia.
C) notify the physician immediately and request an order for urinalysis.
D) titrate intravenous (IV) fluids to maintain urine output of 75-100 ml/hour.

Question 21

The nurse would know that goals for the diagnosis Disabled Family Coping have been met when the family of a burn-injured client

A) asks frequent questions of all the staff.
B) begins to interact with the local burn support group.
C) insists on participating in the client's care.
D) only comes to visit when the client requests.

Question 22

The nurse dismissing a burn-injured client would evaluate that teaching goals have been met when the client says "I

A) have to avoid any moisturizers on the burns so they 'toughen up'."
B) can't wait to go home and throw out these pressure garments!"
C) should use only alcohol-free skin moisturizers."
D) will need to wear sunscreen for at least a year."

Question 23

Using the Curreri formula to compute daily caloric needs of a 200-pound client with a 20% burn, the nurse-practitioner would compute the client's daily caloric needs to be

A)2272.
B)2580.
C)2872.
D)3072.

Question 24

To best meet the psychological needs of a burned client in the acute phase of burn care, the nurse would (Select all that apply)

A) administer tranquilizers when the client is out of control.
B) assist the client to control destructive behaviors.
C) involve the family as much as they and the client desire and are able.
D) offer factual information about the appearance of burns.
E) provide an atmosphere that accepts emotional lability.

Question 25

A client has received a meshed split-thickness skin graft for coverage of a burn wound. The nurse would explain that the graft is meshed in order to

A) allow fluid to escape from the wound.
B) avoid the need for sutures to hold the graft in place.
C) facilitate debridement of the wound.
D) observe the wound more carefully.

Question 26

A client was found unconscious in a burning wooden shed and is admitted to the intensive care unit. The client is tachypneic and restless, with a respiratory rate of 32 breaths/min. The client's oxygen saturation is 99%. The most appropriate action by the nurse is to

A) administer morphine for both pain and anxiety control.
B) apply oxygen at 2 L by nasal cannula.
C) check the oximeter to see if it is working.
D) request the physician order a carboxyhemoglobin level.

Question 27

The older client is at greater risk of death following a burn because the older client (Select all that apply)

A) does not have immunity to infections seen in burned clients.
B) has a combination of age-related functional impairments.
C) has thinner skin than a younger person does.
D) may live alone without any social support.

Question 28

The ambulatory pediatric nurse teaching parents about prevention of burn injury would emphasize that the leading cause of burn injury for toddlers is

A) contact with scalding liquids.
B) open flames, including space heaters.
C) playing with matches.
D) touching hot radiators.

Question 29

To minimize hypertrophic scarring of a client's burn wound, the nurse would anticipate providing which intervention?

A) Applying continuous pressure with elastic wraps
B) Applying topical antimicrobial agents
C) Debridement with enzymatic products
D) Vigorous removal of all dead tissue

Question 30

A severely burn-injured client is being discharged at the end of the week. Important interventions the nurse can provide to assist the client with re-integration into society include (Select all that apply)

A) down-playing the appearance of the burned areas to prevent discouragement.
B) encouraging the client to interact with people outside the hospital setting.
C) making the client totally responsible for all physical care to improve confidence.
D) role-playing potentially difficult social interactions with the client.