Burn Lecture Flashcards
A client with extensive burns is at risk for hypovolemic shock. Which of the following assessment findings would indicate that the client is experiencing hypovolemic shock?
A. Blood pressure of 138/82 mmHg and heart rate of 76 bpm
B. Urine output of 20 mL/hour and heart rate of 130 bpm
C. Respiratory rate of 12 breaths per minute and warm, dry skin
D. Capillary refill of less than 2 seconds and normal mental status
Correct Answer: B. Urine output of 20 mL/hour and heart rate of 130 bpm
Rationale: Hypovolemic shock occurs due to fluid loss from the vascular system, leading to decreased perfusion. A heart rate of 130 bpm is a compensatory mechanism to maintain cardiac output, and a urine output of 20 mL/hour is a sign of inadequate kidney perfusion. Normal urine output should be at least 30 mL/hour.
Incorrect Answers:
A. Blood pressure of 138/82 mmHg and heart rate of 76 bpm – This is a normal blood pressure and heart rate, which would not indicate hypovolemic shock.
C. Respiratory rate of 12 breaths per minute and warm, dry skin – Hypovolemic shock typically presents with increased respiratory rate (tachypnea) due to compensatory mechanisms, not decreased respiratory rate.
D. Capillary refill of less than 2 seconds and normal mental status – In hypovolemic shock, delayed capillary refill and altered mental status (due to poor perfusion) are expected.
A client with carbon monoxide poisoning is brought to the emergency department. The nurse expects which classic clinical finding?
A. Cyanosis and cold extremities
B. Cherry-red skin color
C. Peripheral edema and ascites
D. Jaundice and scleral icterus
Correct Answer: B. Cherry-red skin color
Rationale: Carbon monoxide binds to hemoglobin, forming carboxyhemoglobin, which prevents oxygen transport. This leads to hypoxia despite a cherry-red skin appearance due to the altered hemoglobin.
Incorrect Answers:
A. Cyanosis and cold extremities – Cyanosis occurs when there is deoxygenated hemoglobin, but in CO poisoning, the blood appears bright red due to carboxyhemoglobin.
C. Peripheral edema and ascites – These findings are more common in conditions like heart failure or liver disease, not CO poisoning.
D. Jaundice and scleral icterus – Jaundice results from liver dysfunction and bilirubin buildup, which is unrelated to CO poisoning.
A client with an electrical burn injury is at greatest risk for which complication?
A. Hyperglycemia
B. Cardiac arrhythmias
C. Respiratory acidosis
D. Increased urine output
Correct Answer: B. Cardiac arrhythmias
Rationale: Electrical burns can cause deep tissue damage, leading to cardiac arrhythmias due to disruption of electrical conduction pathways in the heart. The client may develop ventricular fibrillation or asystole.
Incorrect Answers:
A. Hyperglycemia – While stress can increase glucose levels, hyperglycemia is not the primary concern in electrical burns.
C. Respiratory acidosis – While electrical burns can cause respiratory issues, acidosis is more commonly seen in conditions affecting ventilation, such as COPD.
D. Increased urine output – Electrical burns often cause myoglobin release, which can lead to acute kidney injury (AKI) and decreased urine output rather than increased urine output.
The nurse is caring for a client with a circumferential burn to the lower extremity. What is the priority nursing assessment?
A. Assessing bowel sounds
B. Monitoring for compartment syndrome
C. Checking for facial edema
D. Measuring urine output
Correct Answer: B. Monitoring for compartment syndrome
Rationale: Circumferential burns can cause severe edema and tissue compression, leading to compartment syndrome. This condition can impair circulation, resulting in ischemia and potential limb loss if not treated promptly.
Incorrect Answers:
A. Assessing bowel sounds – While important, bowel function is not the immediate priority for a circumferential burn.
C. Checking for facial edema – Facial edema is more relevant in airway burns, not circumferential burns of the extremity.
D. Measuring urine output – While urine output is an important measure for fluid resuscitation, the priority concern in this case is circulatory compromise.
A client with a major burn injury requires fluid resuscitation. Which formula is most commonly used to calculate the amount of fluid replacement?
A. Parkland (Baxter) formula
B. Glasgow Coma Scale
C. Ringer’s formula
D. Rule of Nines
Correct Answer: A. Parkland (Baxter) formula
Rationale: The Parkland formula is used to determine fluid resuscitation needs for burn patients. It calculates the total volume of Lactated Ringer’s solution to be administered over 24 hours based on weight and total body surface area (TBSA) burned.
Incorrect Answers:
B. Glasgow Coma Scale – This assesses neurological function but is not used for fluid resuscitation.
C. Ringer’s formula – This is not a recognized method for burn fluid calculation. Ringer’s lactate is the preferred fluid, but the amount is determined using the Parkland formula.
D. Rule of Nines – This is used to estimate TBSA affected by burns but does not determine fluid resuscitation volume.
6. A client with severe burns is receiving an allograft. The nurse explains that an allograft is:
A. A skin graft from another person
B. A skin graft from an animal
C. A skin graft from the client’s own body
D. A synthetic skin substitute
Correct Answer: A. A skin graft from another person
Rationale: An allograft (homograft) is a temporary skin graft taken from a cadaver or another human donor. It is used to protect the wound while the client’s own skin heals.
Incorrect Answers:
B. A skin graft from an animal – This is called a xenograft, not an allograft.
C. A skin graft from the client’s own body – This is an autograft, which is the most ideal graft but requires healthy donor sites.
D. A synthetic skin substitute – This is not an allograft but rather a biosynthetic option like Integra or Biobrane.
A nurse is caring for a client with an inhalation injury above the glottis. Which of the following assessment findings is the most concerning?
A. Hoarseness and difficulty swallowing
B. Pink, moist mucous membranes
C. Decreased pain sensation at the burn site
D. Peripheral edema in the lower extremities
Correct Answer: A. Hoarseness and difficulty swallowing
Rationale: Hoarseness and difficulty swallowing indicate airway edema and possible impending airway obstruction, which requires immediate intervention such as early intubation.
Incorrect Answers:
B. Pink, moist mucous membranes – This finding is normal and does not indicate airway compromise.
C. Decreased pain sensation at the burn site – This is expected in full-thickness burns but does not indicate airway involvement.
D. Peripheral edema in the lower extremities – This can occur with fluid shifts but is not an immediate airway concern.
A client with electrical burns is at risk for acute kidney injury. Which laboratory value should the nurse monitor most closely?
A. Blood urea nitrogen (BUN) and creatinine
B. Hemoglobin and hematocrit
C. Troponin and CK-MB
D. White blood cell (WBC) count
Correct Answer: A. Blood urea nitrogen (BUN) and creatinine
Rationale: Electrical burns cause muscle breakdown, releasing myoglobin, which can clog renal tubules and lead to acute kidney injury. BUN and creatinine are the best indicators of renal function.
Incorrect Answers:
B. Hemoglobin and hematocrit – These values assess blood loss and anemia but are not primary indicators of kidney injury.
C. Troponin and CK-MB – These values assess cardiac damage but are not specific to kidney function.
D. White blood cell (WBC) count – WBC count assesses infection but is not directly related to kidney injury.
A client with a major burn is receiving fluid resuscitation. Which of the following assessment findings indicates effective fluid resuscitation?
A. Heart rate of 140 bpm
B. Urine output of 35 mL/hour
C. Blood pressure of 80/50 mmHg
D. Serum sodium level of 120 mEq/L
Correct Answer: B. Urine output of 35 mL/hour
Rationale: Adequate urine output (30-50 mL/hour) indicates that the kidneys are being perfused, which is a key marker of effective fluid resuscitation.
Incorrect Answers:
A. Heart rate of 140 bpm – Tachycardia suggests ongoing hypovolemia and inadequate resuscitation.
C. Blood pressure of 80/50 mmHg – Hypotension indicates poor perfusion and inadequate fluid replacement.
D. Serum sodium level of 120 mEq/L – This indicates hyponatremia, which can result from fluid shifts and dilutional effects of IV fluids.
A nurse is caring for a client in the emergent phase of a major burn injury. What is the primary focus of nursing care during this phase?
A. Infection prevention and wound healing
B. Airway management and fluid resuscitation
C. Physical rehabilitation and contracture prevention
D. Psychosocial support and pain management
Correct Answer: B. Airway management and fluid resuscitation
Rationale: The emergent phase (first 72 hours) focuses on stabilizing the client by ensuring airway patency and restoring circulating blood volume through aggressive fluid resuscitation.
Incorrect Answers:
A. Infection prevention and wound healing – This becomes a priority in the acute phase.
C. Physical rehabilitation and contracture prevention – This is a focus during the rehabilitation phase.
D. Psychosocial support and pain management – These are important but secondary to airway and fluid stabilization in the emergent phase.
A nurse is caring for a client with full-thickness burns to the arms and legs. What finding is most concerning?
A. Increased thirst and dry mucous membranes
B. Painless, leathery, white skin on the burned areas
C. Capillary refill of greater than 5 seconds in the affected limbs
D. Hyperactive bowel sounds and soft abdomen
Correct Answer: C. Capillary refill of greater than 5 seconds in the affected limbs
Rationale: Delayed capillary refill suggests impaired circulation and possible compartment syndrome, which requires immediate intervention.
Incorrect Answers:
A. Increased thirst and dry mucous membranes – Expected due to fluid loss but not the most urgent issue.
B. Painless, leathery, white skin on the burned areas – Full-thickness burns destroy nerve endings, making the burn painless, but this is an expected finding.
D. Hyperactive bowel sounds and soft abdomen – These findings are not concerning in a burn patient.
A client with deep partial-thickness burns asks how long it will take for their burns to heal. The nurse responds that healing typically occurs within:
A. 1 to 2 weeks
B. 3 to 4 weeks
C. 6 to 8 weeks
D. 10 to 12 weeks
Correct Answer: B. 3 to 4 weeks
Rationale: Deep partial-thickness burns typically heal within 3-4 weeks with proper wound care and possible grafting.
Incorrect Answers:
A. 1 to 2 weeks – This timeframe is more typical for superficial partial-thickness burns.
C. 6 to 8 weeks – Healing may take this long for deep burns requiring extensive grafting.
D. 10 to 12 weeks – This is a longer healing timeframe for full-thickness burns.
The nurse is reviewing the Parkland formula for a burn client weighing 70 kg with a total body surface area (TBSA) of 40%. How much fluid should be administered in the first 8 hours?
A. 2,800 mL
B. 5,600 mL
C. 8,400 mL
D. 11,200 mL
Correct Answer: B. 5,600 mL
Rationale: The Parkland formula is 4 mL × kg × TBSA burned.
4
×
70
×
40
=
11
,
200
4×70×40=11,200 mL total.
50% of fluids (5,600 mL) are given in the first 8 hours.
Incorrect Answers:
A. 2,800 mL – Incorrect calculation; this is 25% of the total, not 50%.
C. 8,400 mL – Incorrect; 75% of the total is given in 16 hours, not 8 hours.
D. 11,200 mL – This is the total 24-hour volume, not the first 8-hour dose.
A nurse is assessing a client with an inhalation injury below the glottis. Which of the following findings is most concerning?
A. Singed nasal hairs and facial burns
B. Hoarseness and painful swallowing
C. Pink, frothy sputum and dyspnea
D. Cherry-red skin and confusion
Correct Answer: C. Pink, frothy sputum and dyspnea
Rationale: Inhalation injury below the glottis can lead to pulmonary edema, which may not appear until 12-24 hours after the injury. Pink, frothy sputum and dyspnea indicate fluid buildup in the lungs, requiring immediate intervention.
Incorrect Answers:
A. Singed nasal hairs and facial burns – These are concerning for an upper airway injury, but lower airway injury involves more severe respiratory distress.
B. Hoarseness and painful swallowing – These are indicative of an upper airway injury above the glottis.
D. Cherry-red skin and confusion – These findings suggest carbon monoxide poisoning rather than lower airway injury.
A client with a burn injury has a serum potassium level of 6.2 mEq/L. Which of the following interventions should the nurse anticipate?
A. Administering IV potassium chloride
B. Monitoring for muscle weakness and decreased reflexes
C. Preparing the client for continuous cardiac monitoring
D. Restricting sodium intake to prevent further imbalances
Correct Answer: C. Preparing the client for continuous cardiac monitoring
Rationale: Hyperkalemia (K+ >5.0 mEq/L) can lead to life-threatening cardiac dysrhythmias. Continuous cardiac monitoring is necessary to detect and manage ECG changes such as peaked T waves and widened QRS complexes.
Incorrect Answers:
A. Administering IV potassium chloride – This would worsen hyperkalemia and is contraindicated.
B. Monitoring for muscle weakness and decreased reflexes – These signs are more common in hypokalemia, whereas hyperkalemia may cause muscle cramps or paralysis.
D. Restricting sodium intake – Sodium intake does not directly affect potassium levels in burns.
A client with a 40% TBSA burn is receiving aggressive fluid resuscitation. Which of the following findings indicates the client is receiving adequate fluids?
A. Urine output of 50 mL/hour
B. Heart rate of 140 bpm
C. Blood pressure of 82/50 mmHg
D. Serum sodium level of 125 mEq/L
Correct Answer: A. Urine output of 50 mL/hour
Rationale: An adequate urine output (30-50 mL/hour) indicates sufficient kidney perfusion and effective fluid resuscitation.
Incorrect Answers:
B. Heart rate of 140 bpm – Tachycardia suggests ongoing hypovolemia.
C. Blood pressure of 82/50 mmHg – Hypotension indicates inadequate perfusion.
D. Serum sodium level of 125 mEq/L – This indicates hyponatremia, possibly due to excessive fluid administration.
A client with a circumferential full-thickness burn to the arm is at risk for which complication?
A. Pulmonary embolism
B. Compartment syndrome
C. Curling’s ulcer
D. Hyperkalemia
Correct Answer: B. Compartment syndrome
Rationale: Circumferential burns can cause edema and tight eschar formation, leading to increased pressure within a limb, impairing circulation, and resulting in compartment syndrome.
Incorrect Answers:
A. Pulmonary embolism – This is a risk for immobile clients but not directly caused by circumferential burns.
C. Curling’s ulcer – This is a stress-related gastrointestinal complication in burn clients but not specific to circumferential burns.
D. Hyperkalemia – This is a common complication of severe burns due to cell lysis but is not directly related to circumferential burns.
The nurse is caring for a client in the rehabilitative phase of a burn injury. What is the primary goal during this phase?
A. Preventing infection and sepsis
B. Restoring the client’s functional abilities
C. Preventing fluid volume deficit
D. Managing airway edema and obstruction
Correct Answer: B. Restoring the client’s functional abilities
Rationale: The rehabilitative phase focuses on improving mobility, minimizing contractures, and helping the client return to normal activities.
Incorrect Answers:
A. Preventing infection and sepsis – This is a priority in the acute phase.
C. Preventing fluid volume deficit – This is a priority in the emergent phase.
D. Managing airway edema and obstruction – This is most critical in the emergent phase.
A nurse is caring for a client with partial-thickness burns to the chest. Which positioning strategy is best to prevent contractures?
A. Keeping the client in a flexed position
B. Elevating the head of the bed to 90 degrees
C. Using splints and encouraging range-of-motion exercises
D. Immobilizing the client until wounds fully heal
Correct Answer: C. Using splints and encouraging range-of-motion exercises
Rationale: Proper positioning and ROM exercises help prevent contractures and maintain joint mobility.
Incorrect Answers:
A. Keeping the client in a flexed position – This increases the risk of contractures.
B. Elevating the head of the bed to 90 degrees – While airway protection is important, this does not prevent contractures.
D. Immobilizing the client until wounds fully heal – This promotes stiffness and contractures.
A client with major burns is at risk for a Curling’s ulcer. Which intervention helps prevent this complication?
A. Administering proton pump inhibitors (PPIs)
B. Restricting oral fluids
C. Placing the client in a Trendelenburg position
D. Providing a high-protein diet
Correct Answer: A. Administering proton pump inhibitors (PPIs)
Rationale: Curling’s ulcers are stress-related gastric ulcers that develop after severe burns. PPIs reduce gastric acid production and lower the risk of ulcer formation.
Incorrect Answers:
B. Restricting oral fluids – Hydration is essential in burn clients.
C. Placing the client in a Trendelenburg position – This is not a standard intervention for preventing gastric ulcers.
D. Providing a high-protein diet – Protein is important for healing but does not directly prevent ulcers.
The nurse is reviewing discharge teaching for a client recovering from burns. Which statement indicates the need for further teaching?
A. “I should use sunscreen and protective clothing when outdoors.”
B. “I will perform range-of-motion exercises daily.”
C. “I can stop wearing compression garments once my skin feels normal.”
D. “I should keep my skin moisturized to prevent dryness and itching.”
Correct Answer: C. “I can stop wearing compression garments once my skin feels normal.”
Rationale: Compression garments should be worn as prescribed (often for up to a year) to prevent hypertrophic scarring and promote optimal healing.
Incorrect Answers:
A. “I should use sunscreen and protective clothing when outdoors.” – Burned skin is highly sensitive to sunlight.
B. “I will perform range-of-motion exercises daily.” – This helps prevent contractures.
D. “I should keep my skin moisturized to prevent dryness and itching.” – This is important for skin healing.
A client with full-thickness burns is receiving IV pain medication. Why is this the preferred route for analgesia in burn clients?
A. Oral medications are absorbed too quickly.
B. The client has an increased pain threshold.
C. IV administration provides rapid and effective pain relief.
D. Topical analgesics are more effective.
Correct Answer: C. IV administration provides rapid and effective pain relief.
Rationale: IV pain medications provide immediate pain relief and are preferred because absorption from muscle and subcutaneous tissues is unpredictable due to fluid shifts.
Incorrect Answers:
A. Oral medications are absorbed too quickly. – Oral medications actually have delayed absorption due to slowed gastric motility in burn clients.
B. The client has an increased pain threshold. – Burn clients often experience severe pain, requiring effective pain management.
D. Topical analgesics are more effective. – Topical medications may help with localized pain but are not sufficient for severe burn pain.
A client has sustained burns over 45% of their total body surface area (TBSA). Which nutritional intervention is most appropriate?
A. A low-calorie, high-fiber diet
B. High-protein, high-calorie enteral feeding
C. A low-protein, low-fat diet
D. NPO status for the first 72 hours
Correct Answer: B. High-protein, high-calorie enteral feeding
Rationale: Burn clients have a hypermetabolic state, requiring increased protein for wound healing and high calories to meet energy demands. Enteral nutrition is preferred to maintain gut integrity.
Incorrect Answers:
A. A low-calorie, high-fiber diet – Burn clients require high-calorie intake, not low-calorie.
C. A low-protein, low-fat diet – Protein is essential for tissue repair.
D. NPO status for the first 72 hours – Enteral feeding should begin early to prevent catabolism.
A nurse is monitoring a client with electrical burns. Which of the following laboratory values is most concerning?
A. Serum calcium of 9.2 mg/dL
B. Serum potassium of 6.8 mEq/L
C. Hemoglobin of 13 g/dL
D. WBC count of 8,000/mm³
Correct Answer: B. Serum potassium of 6.8 mEq/L
Rationale: Electrical burns cause muscle breakdown (rhabdomyolysis), leading to the release of potassium, which can result in life-threatening cardiac dysrhythmias.
Incorrect Answers:
A. Serum calcium of 9.2 mg/dL – This is within normal range.
C. Hemoglobin of 13 g/dL – This is within normal range.
D. WBC count of 8,000/mm³ – This is a normal finding.
A nurse is caring for a client in the acute phase of a burn injury. Which intervention is most important to prevent infection?
A. Administering broad-spectrum antibiotics to all burn clients
B. Maintaining strict hand hygiene and aseptic wound care
C. Keeping the client NPO to prevent gastrointestinal infections
D. Administering IV fluids to maintain hydration
Correct Answer: B. Maintaining strict hand hygiene and aseptic wound care
Rationale: Burn clients are at high risk for infection due to loss of the skin barrier. Proper hand hygiene and wound care reduce the risk of wound contamination.
Incorrect Answers:
A. Administering broad-spectrum antibiotics to all burn clients – Antibiotics are used only when there is an infection, not prophylactically.
C. Keeping the client NPO to prevent gastrointestinal infections – Burn clients need aggressive nutritional support.
D. Administering IV fluids to maintain hydration – While important, this does not directly prevent infection.
A nurse is caring for a client with facial burns. What is the priority nursing intervention?
A. Applying antibiotic ointment to the face
B. Elevating the head of the bed
C. Keeping the client’s face uncovered to promote healing
D. Assessing for signs of airway compromise
Correct Answer: D. Assessing for signs of airway compromise
Rationale: Burns to the face increase the risk of airway edema and obstruction. Early assessment and intervention (e.g., intubation) may be needed.
Incorrect Answers:
A. Applying antibiotic ointment to the face – Important, but airway management takes priority.
B. Elevating the head of the bed – Helpful for swelling but not the priority over airway assessment.
C. Keeping the client’s face uncovered to promote healing – This does not address airway concerns.
A nurse is caring for a client with full-thickness burns. Which assessment finding suggests sepsis?
A. Increased urine output and decreased thirst
B. Hypothermia and hypotension
C. Dry skin and decreased respiratory rate
D. Mild erythema around the wound edges
Correct Answer: B. Hypothermia and hypotension
Rationale: Hypothermia, hypotension, and tachycardia are signs of burn wound sepsis, which is life-threatening and requires immediate intervention.
Incorrect Answers:
A. Increased urine output and decreased thirst – This is not characteristic of sepsis.
C. Dry skin and decreased respiratory rate – Burn clients often have fluid loss and tachypnea, not decreased respiratory rate.
D. Mild erythema around the wound edges – Some redness is expected, but severe redness, swelling, or drainage would be concerning.
A client with severe burns is prescribed silver sulfadiazine (Silvadene). What is an important nursing consideration?
A. Monitor for signs of neutropenia and leukopenia
B. Apply thick layers of the medication to promote absorption
C. Avoid dressing changes to reduce pain
D. Keep the wound completely dry to enhance medication efficacy
Correct Answer: A. Monitor for signs of neutropenia and leukopenia
Rationale: Silver sulfadiazine can cause bone marrow suppression, leading to decreased WBC count and increased infection risk.
Incorrect Answers:
B. Apply thick layers of the medication to promote absorption – A thin layer is sufficient.
C. Avoid dressing changes to reduce pain – Regular dressing changes are necessary for wound healing.
D. Keep the wound completely dry to enhance medication efficacy – Some moisture is needed for optimal healing.
A nurse is assessing a client with burns over 35% of their TBSA. Which of the following findings suggests a positive response to fluid resuscitation?
A. Blood pressure of 88/60 mmHg
B. Heart rate of 135 bpm
C. Urine output of 45 mL/hour
D. Serum sodium level of 120 mEq/L
Correct Answer: C. Urine output of 45 mL/hour
Rationale: A urine output of 30-50 mL/hour indicates adequate renal perfusion and successful fluid resuscitation.
Incorrect Answers:
A. Blood pressure of 88/60 mmHg – Suggests inadequate resuscitation.
B. Heart rate of 135 bpm – Tachycardia suggests hypovolemia.
D. Serum sodium level of 120 mEq/L – Indicates hyponatremia, a possible complication of excessive fluid administration.
A client in the rehabilitation phase of a burn injury is concerned about hypertrophic scarring. What intervention should the nurse recommend?
A. Applying pressure garments as prescribed
B. Keeping the scar exposed to sunlight
C. Avoiding range-of-motion exercises
D. Using ice packs on the scarred areas
Correct Answer: A. Applying pressure garments as prescribed
Rationale: Pressure garments help reduce hypertrophic scarring and should be worn consistently for months to aid in healing.
Incorrect Answers:
B. Keeping the scar exposed to sunlight – Burned skin is sensitive and should be protected from the sun.
C. Avoiding range-of-motion exercises – ROM exercises prevent contractures.
D. Using ice packs on the scarred areas – This does not prevent hypertrophic scarring.
A nurse is caring for a client with major burns who is at risk for developing acute respiratory distress syndrome (ARDS). Which early sign would indicate the onset of ARDS?
A. Decreased urine output and bradycardia
B. Crackles and increasing oxygen requirements
C. Peripheral cyanosis and slow respiratory rate
D. Hypotension and decreased deep tendon reflexes
Correct Answer: B. Crackles and increasing oxygen requirements
Rationale: ARDS is a potential complication of severe burns, particularly those involving inhalation injuries. Early signs include crackles (indicating pulmonary edema) and increasing oxygen needs due to impaired gas exchange.
Incorrect Answers:
A. Decreased urine output and bradycardia – Decreased urine output may indicate hypovolemia, but it is not an early sign of ARDS.
C. Peripheral cyanosis and slow respiratory rate – ARDS typically presents with tachypnea and hypoxemia rather than a slow respiratory rate.
D. Hypotension and decreased deep tendon reflexes – Hypotension may occur in burn shock, but it is not an early indicator of ARDS.
A nurse is assessing a 5-year-old child who has sustained burns to the front of both legs, the right arm, and the head. Using the Lund-Browder chart, how much of the child’s body surface area (BSA) is affected by the burns?
A) 27%
B) 35%
C) 40%
D) 50%
Answer: B) 35%
(For a 5-year-old: head = 18%, both legs = 14%, right arm = 9%)
Rationale: According to the Lund-Browder chart for a 5-year-old child, the head is 18%, the front of each leg is 7% (total of 14% for both legs), and the right arm is 9%. So, the total BSA burned is 18% (head) + 14% (both legs) + 9% (right arm) = 35%.
A 25-year-old adult patient is admitted to the emergency department with burns involving the chest, the front of both legs, and the head. Using the Rule of Nines, what is the total percentage of BSA burned?
A) 36%
B) 45%
C) 54%
D) 63%
Answer: A) 36%
(For an adult: head = 9%, chest = 18%, front of both legs = 18%)
Rationale: The Rule of Nines for an adult:
Head = 9%
Chest = 18%
Front of both legs = 18% The total BSA burned is 9% (head) + 18% (chest) + 18% (front of both legs) = 36%.
Which of the following statements is true when using the Rule of Nines to estimate the BSA burned in a patient?
A) The percentage for the head is the same in both adults and children.
B) The legs account for 18% of the BSA in an adult, but 14% in a child.
C) The Rule of Nines is only applicable to pediatric patients.
D) The front of the body is always considered 50% of BSA for any patient
Answer: B) The legs account for 18% of the BSA in an adult, but 14% in a child.
Rationale: The Rule of Nines assigns 18% of BSA to each leg in an adult, but in a child, the legs account for 14% of BSA. This is because children have a larger head in proportion to their body, so the percentages are adjusted in the Rule of Nines for pediatric patients.
The Rule of Nines estimates that the head and neck account for ______% of an adult’s total body surface area.
Answer: 9%
Rationale: The head and neck account for 9% of the total body surface area in an adult when using the Rule of Nines
In the Lund-Browder chart, for a 2-year-old child, the head accounts for ______% of the total body surface area.
Answer: 18%
Rationale: In the Lund-Browder chart, for a 2-year-old child, the head is assigned 18% of the body surface area, which is significantly higher than in adults due to the proportionally larger head size in children.
A nurse assesses a 10-year-old child with burns involving the front of both legs, the left arm, and the torso. Based on the Lund-Browder chart, the total BSA burned is ______%.
Answer: 36%
(For a 10-year-old: front of both legs = 14%, left arm = 9%, torso = 18%)
Rationale: According to the Lund-Browder chart for a 10-year-old:
Front of both legs = 14% (7% for each leg)
Left arm = 9%
Torso = 18% So, the total BSA burned is 14% (both legs) + 9% (left arm) + 18% (torso) = 36%.
A 30-year-old adult patient has burns on the back of both legs, the front of the torso, and the right arm. Using the Rule of Nines, what is the total percentage of body surface area (BSA) burned?
A) 45%
B) 54%
C) 63%
D) 72%
Answer: A) 45%
(Back of both legs = 18%, front of torso = 18%, right arm = 9%, total = 18% + 18% + 9% = 45%)
A 3-year-old child has burns involving the front of both legs, the left arm, and the head. According to the Lund-Browder chart, what is the total percentage of body surface area (BSA) burned?
A) 35%
B) 42%
C) 50%
D) 57%
Answer: B) 42%
(Head = 18%, both legs = 14%, left arm = 9%, total = 18% + 14% + 9% = 42%)
A 12-year-old child has burns on the front of the torso, both arms, and the head. Using the Lund-Browder chart, what is the total BSA burned?
A) 45%
B) 50%
C) 60%
D) 70%
Answer: A) 45%
(Head = 9%, front of torso = 18%, both arms = 18%, total = 9% + 18% + 18% = 45%)
For an adult male with burns on the chest, abdomen, back, and both legs, what is the total body surface area (BSA) burned using the Rule of Nines?
A) 54%
B) 63%
C) 72%
D) 82%
Answer: B) 63%
(Chest = 18%, abdomen = 18%, back = 18%, both legs = 36%, total = 18% + 18% + 18% + 36% = 63%)
A 10-year-old child has burns involving the head, both arms, and the back. Using the Lund-Browder chart, how much of the child’s body surface area (BSA) is burned?
A) 38%
B) 40%
C) 50%
D) 60%
Answer: A) 38%
(Head = 12%, both arms = 18%, back = 18%, total = 12% + 18% + 18% = 38%)
For an adult, the back of each leg accounts for ______% of the total body surface area using the Rule of Nines.
Answer: 9%
(Each leg’s back is 9% in the Rule of Nines for an adult.)
In a 4-year-old child, the head accounts for ______% of the total body surface area.
Answer: 16%
(The head accounts for 16% in a 4-year-old child on the Lund-Browder chart.)
A 50-year-old adult has burns on the face, both arms, and both legs. Using the Rule of Nines, the total BSA burned is ______%.
Answer: 54%
(Face = 4.5%, both arms = 18%, both legs = 36%, total = 4.5% + 18% + 36% = 54%)
A 15-year-old child has burns involving the head, the front of both legs, and the right arm. Using the Lund-Browder chart, the total BSA burned is ______%.
Answer: 36%
(Head = 9%, front of both legs = 14%, right arm = 9%, total = 9% + 14% + 9% = 36%)
A 6-year-old child has burns on the front of both arms, the head, and the back. Using the Lund-Browder chart, the total BSA burned is ______%.
Answer: 41%
(Head = 18%, front of both arms = 14%, back = 18%, total = 18% + 14% + 18% = 41%)
