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100

  1. According to the American Burn Association classification, which of the following are characteristics of major burns in adults? Select all that apply.

    1. Partial-thickness burn 15%–25% TBSA

    2. Full-thickness burn <2% of TBSA

    3. Burns affecting eyes, ears, genitalia

    4. Full-thickness burn >10% TBSA

    5. Partial-thickness burn >25% TBSA

  • Burns affecting eyes, ears, genitalia

  • Full-thickness burn >10% TBSA

  • Partial-thickness burn >25% TBSA

100

  1. Which of the following is a component of the acute phase of burns? Select all that apply.

    1. Begins immediately at the time of injury

    2. Diuresis present

    3. Burns left exposed to heal on their own

    4. Reduced sepsis risk

    5. Daily wound cleansing

  • Diuresis present

  • Daily wound cleansing

100

  1. A patient has suffered a major burn injury. Which of the following is likely to occur? Select all that apply.

    1. Increased GI motility and absorption

    2. Fluid loss

    3. Increased renal perfusion

    4. Elevated basal metabolic rate

    5. Impairment of immune system

  • Elevated basal metabolic rate

100

  1. Which level of the skin is damaged by a superficial burn?

    1. Epidermis only

    2. Epidermis and papillary

    3. Epidermis, papillary, and reticular

    4. Through epidermis and dermis

  • Epidermis only

100

  1. In the rule of nines, what is divided into areas of 9%?

    1. Body organs

    2. Blood flow to organs

    3. Total body surface area

    4. Extremity mass

  • Total body surface area

200

  1. Which selection indicates the proper sequence of phases for burn injuries?

    1. Rehabilitation, emergent, acute

    2. Acute, emergent, rehabilitation

    3. Acute, rehabilitation, emergent

    4. Emergent, acute, rehabilitation

Emergent, acute, rehabilitation

200

  1. Which type of burn is a scald burn?

    1. Radiation

    2. Chemical

    3. Thermal

    4. Electrical

Thermal

200

  1. In burn injury, which area is the most damaged?

    1. Zone of hyperemia

    2. Zone of coagulation

    3. Zone of stasis

    4. Zone of perfusion

  • Zone of coagulation

200

  1. A nurse is asked to record the size of the zone of coagulation for a burn victim. Which of the following is appropriate?

    1. The nurse measures the outer, reddened area of the burn.

    2. The nurse employs the “Rule of Nines.”

    3. The nurse measures the diameters of the most severely burned area.

    4. The nurse records the size of the skin graft.

  • The nurse measures the diameters of the most severely burned area.

200

  1. A patient suffered an electrical burn. Which tissues are most likely to be damaged?

    1. Nerves and muscle

    2. Fat

    3. Bone

    4. Tendons

  • Nerves and muscle

300

  1. A patient has suffered a severe scalding burn around the knee area. Upon healing, the wound edges appear to be pulling inward, decreasing joint mobility. Which of the following is the most likely explanation for what is happening?

    1. Keloid formation

    2. Contracture

    3. Compartment syndrome

    4. Opportunistic infection

Contracture

300

  1. A patient has suffered a superficial partial-thickness burn on his leg. Which tissue layers have been burned? Select all that apply.

    1. Epidermis

    2. Papillary

    3. Reticular

    4. Hypodermis

    5. Muscle

  • Epidermis

  • Papillary

300

  1. A nursing student is learning about types of burns. Which type should he remember is the most common burn type?

    1. Electrical

    2. Thermal 
    3. Chemical 

    4. Radiation

Thermal

300

  1. Which of the following systemic changes may a clinician encounter in a burn patient?

    1. Increased basal metabolic rate (BMR)

    2. Decreased risk for opportunistic infection

    3. Hypervolemia

    4. Increased renal perfusion

  • Increased basal metabolic rate (BMR)

300

  1. A nurse is treating a patient with a radiation injury. What does the “rems” for the injury refer to?

    1. Temperature effect of the radiation

    2. Radiation dose of energy absorbed by the tissue

    3. Biological risk of the exposure

    4. Depth of tissue damage

  • Biological risk of the exposure

400

  1. A nurse is caring for a patient who has suffered a thermal burn and is now receiving hospitalized care. Which of the following post-burn complications may the nurse expect? Select all that apply.

    1. Inhalation injury

    2. Decreased metabolic rate

    3. Increased gastrointestinal (GI) motility and absorption

    4. Respiratory distress

    5. Decreased kidney perfusion

  • Inhalation injury

  • Respiratory distress

  • Decreased kidney perfusion

400

  1. A nurse is treating a burn wound on a patient. She notes that the outer area of the burn is red in color. Which of the following is true about this area of the wound?

    1. The reddened area is the zone of coagulation.

    2. This zone demonstrates the severest level of injury.

    3. The area is referred to as the zone of hyperemia.

    4. This zone indicates where irreversible damage has happened.

  • The area is referred to as the zone of hyperemia.

400

  1. Severe burns can alter normal physiologic organ function if the thermal injury is greater than what percentage of the total body surface area (TBSA)?

    1. 5%

    2. 10%

    3. 25%

    4. 30%

30%

400

  1. When may a clinician be most concerned about carbon monoxide (CO) poisoning in a burn victim?

    1. Patient suffering electrical burn and metabolic acidosis

    2. Patient experiencing burning within an enclosed space

    3. Patient with a scald wound near the thoracic area

    4. Patient experiencing a chemical burn in an industrial building

  • Patient experiencing burning within an enclosed space

400

  1. A patient is in the acute stage of burn recovery. What time frame does the nurse expect?

    1. First stage beginning with onset of injury lasting up to 4 hours post-burn

    2. Time beginning 48 to 72 hours post-burn

    3. First 1 hour following per injury

    4. 4 weeks up to several years following burn injury

  • Time beginning 48 to 72 hours post-burn

500

  1. A paramedic arrives on an accident scene and quickly assesses that the total body surface area damaged by burn is 27% for the patient. Which criteria did the paramedic most likely use to arrive at this conclusion?

    1. Rule of Nines

    2. Kirby-Bauer method

    3. Burn-depth model

    4. Burn-typing method

  • Rule of Nines

500

  1. In considering burn patient nutritional needs, which of the following combinations occurs in burn patients?

    1. Increased gastrointestinal (GI) motility and increased absorption

    2. Increased basal metabolic rate (BMR) and decreased GI absorption

    3. Increased BMR and increased GI absorption

    4. Decreased BMR and decreased Gi absorption

  • Increased basal metabolic rate (BMR) and decreased GI absorption

500

  1. A nurse is speaking to a patient about debridement of a burn wound. Which of the following is correct to state to the patient?

    1. Debridement is needed only during the very late stages of burn-wound healing.

    2. Because of nerve damage, debridement is seldom painful.

    3. Debridement improves blood flow to the area of injury.

    4. Debridement increases the risk for infection.

  • Debridement improves blood flow to the area of injury.

500

Chapter 43 Question

  1. Which of the following terms indicate infection of the eye? Select all that apply.

    1. Amblyopia

    2. Exophthalmos

    3. Keratitis

    4. Conjunctivitis

    5. Stye

  • Keratitis

  • Conjunctivitis

500

  1. In primary open-angle glaucoma, onset of signs and symptoms involve which of the following? Select all that apply.

    • Eye pain

    • Halo around light

    • Eye redness

    • Clouding of lens

    • Hyperopia


  • Halo around light