BRN

Question 1

A patient is brought to the emergency department from the site of a chemical fire, where he suffered a burn that involves the epidermis, dermis, and the muscle and bone of the right arm. On inspection, the skin appears charred. Based on these assessment findings, what is the depth of the burn on the patients arm?
A) Superficial partial-thickness
B) Deep partial-thickness
C) Full partial-thickness
D) Full-thickness

Answer 1

D) Full-thickness

Question 2

The current phase of a patients treatment for a burn injury prioritizes wound care, nutritional support, and prevention of complications such as infection. Based on these care priorities, the patient is in what phase of burn care?
A) Emergent
B) Immediate resuscitative
C) Acute
D) Rehabilitation

Answer 2

C) Acute

Question 3

A patient in the emergent/resuscitative phase of a burn injury has had blood work and arterial blood gases drawn. Upon analysis of the patients laboratory studies, the nurse will expect the results to indicate 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

Answer 3

A) Hyperkalemia, hyponatremia, elevated hematocrit, and metabolic acidosis

Question 4

A patient has experienced an electrical burn and has developed thick eschar over the burn site. Which of the following topical antibacterial agents will the nurse expect the physician to order for the wound?
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

Answer 4

B) Mafenide acetate 10% (Sulfamylon) hydrophilic-based cream

Question 5

An occupational health nurse is called to the floor of a factory where a worker has sustained a flash burn to the right arm. The nurse arrives and the flames have been extinguished. The next step is to cool the 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.

Answer 5

D) Wrap cool towels around the affected extremity intermittently.

Question 5

An emergency department nurse has just admitted a patient with a burn. What characteristic of the burn will primarily determine whether the patient experiences a systemic response to this injury?
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

Answer 5

D) The total body surface area (TBSA) affected by the burn

Question 6

A nurse on a burn unit is caring for a patient in the acute phase of burn care. While performing an assessment during this phase of burn care, the nurse recognizes that airway obstruction related to upper airway edema may occur up to how long after the burn injury?
A) 2 days
B) 3 days
C) 5 days
D) 1 week

Answer 6

A) 2 days

Question 7

A patient has sustained a severe burn injury and is thought to have an impaired intestinal mucosal barrier. Since this patient is considered at an increased risk for infection, what intervention will best 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

Answer 7

A) Early enteral feeding

Question 8

A patient has been admitted to a burn intensive care unit with extensive full-thickness burns over 25% of the body. After ensuring cardiopulmonary stability, what would be the nurses immediate, priority concern when planning this patients care?
A) Fluid status
B) Risk of infection
C) Nutritional status
D) Psychosocial coping

Answer 8

A) Fluid status

Question 9

The nurse is preparing the patient for mechanical dbridement and informs the patient that this will involve which of the following procedures?

A spontaneous separation of dead tissue from the viable tissue
Removal of eschar until the point of pain and bleeding occurs
Shaving of burned skin layers until bleeding, viable tissue is revealed
Early closure of the wound

Answer 9

Removal of eschar until the point of pain and bleeding occurs

Question 10

A patient with a partial-thickness burn injury had Biobrane applied 2 weeks ago. The nurse notices that the Biobrane is separating from the burn wound. What is the nurses most appropriate intervention?

Reinforce the Biobrane dressing with another piece of
Biobrane. Remove the Biobrane dressing and apply a new dressing.
Trim away the separated Biobrane.
Notify the physician for further emergency-related orders.

Answer 10

Trim away the separated Biobrane.

Question 11

An emergency department nurse learns from the paramedics that they are transporting a patient who has suffered injury from a scald from a hot kettle. What variables will the nurse consider when determining 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

Answer 11

A) The causative agent

Question 12

A nurse is caring for a patient who has sustained a deep partial-thickness burn injury. In prioritizing the nursing diagnoses for the plan of care, the nurse will give the highest priority to what nursing diagnosis?

A) Activity Intolerance
B) Activity Intolerance
C) Anxiety Ineffective Coping
D) Acute Pain

Answer 12

D) Acute Pain

Question 13

A triage nurse in the emergency department (ED) receives a phone call from a frantic father who saw his 4-year-old child tip a pot of boiling water onto her chest. The father has called an ambulance. What 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 cool bath.
D) Avoid touching the burned area under any circumstances.

Answer 13

C) Immerse the child in a cool bath.

Question 14

A nurse is teaching a patient with a partial-thickness wound how to wear his elastic pressure garment. How would the nurse instruct the patient to wear this garment?

4 to 6 hours a day for 6 months
During waking hours for 2 to 3 months after the injury
Continuously
At night while sleeping for a year after the injury

Answer 14

Continuously

Question 15

A patient is brought to the ED by paramedics, who report that the patient has partial-thickness burns on the chest and legs. The patient has also suffered smoke inhalation. What is the priority in the care of a patient who has been burned and suffered smoke inhalation?
A) Pain
B) Fluid balance
C) Anxiety and fear
D) Airway management

Answer 15

D) Airway management

Question 16

A patient arrives in the emergency department after being burned in a house fire. The patients burns cover the face and the left forearm. What extent of burns does the patient most likely have?
A) 13%
B) 25%
C) 9%
D) 18%

Answer 16

D) 18%

Question 17

A nurse is caring for a patient in the emergent/resuscitative phase of burn injury. During this phase, the 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

Answer 17

A) Sodium deficit

Question 18

A nurse is developing a care plan for a patient with a partial-thickness burn, and determines that an appropriate goal is to maintain position of joints in alignment. What is the best rationale for this intervention?
A) To prevent neuropathies
B) To prevent wound breakdown
C) To prevent contractures
D) To prevent heterotopic ossification

Answer 18

C) To prevent contractures

Question 19

A patients burns have required a homograft. During the nurses most recent assessment, the nurse observes that the graft is newly covered with purulent exudate. What is the nurses most appropriate 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 removed.
C) Perform range of motion exercises to increase perfusion to the graft site and facilitate healing.
D) Document this finding as an expected phase of graft healing.

Answer 19

B) Inform the primary care provider promptly because the graft may need to be removed.

Question 20

A nurse who is taking care of a patient with burns is asked by a family member why the patient is losing so much weight. The patient is currently in the intermediate phase of recovery. What would be the 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 than normal.
C) He actually hasnt lost weight. Instead, theres been a change in the distribution of his body fat.
D) He lost many fluids while he was being treated in the emergency phase of burn care.

Answer 20

B) His body has consumed his fat deposits for fuel because his calorie intake is lower than normal.

Question 21

A nurse has reported for a shift at a busy burns and plastics unit in a large university hospital. Which 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

Answer 21

A) A 4-year-old scald victim burned over 24% of the body