Nokea
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%
Correct Answer: D
Rationale: Using the Rule of Nines, the face accounts for 9% and the left forearm 9%, totaling 18% TBSA.
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A nurse is performing a home visit to a patient who is recovering following a long course of inpatient treatment for burn injuries. When performing this home visit, the nurse should do which of the 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.
Correct Answer: D
Rationale: Psychosocial assessment is critical during rehabilitation, as burn recovery poses psychological challenges like PTSD or depression. Electrolyte imbalances are rare in this phase, fluids are not typically administered, and burn recurrence is unlikely.
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
Correct Answer: A
Rationale: Upper airway edema from burns can develop up to 48 hours post-injury due to inflammation and fluid shifts, requiring vigilant monitoring. Later onset is less likely.
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
Correct Answer: D
Rationale: A full-thickness burn extends through the epidermis, dermis, and into underlying tissues like muscle or bone, appearing charred and painless due to nerve destruction. Superficial partial-thickness affects the epidermis, deep partial-thickness involves the deeper dermis, and full partial-thickness is not a recognized term.
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
Correct Answer: B
Rationale: Mafenide acetate penetrates thick eschar, making it ideal for electrical burns with deep tissue involvement. Silver sulfadiazine and silver nitrate do not penetrate eschar effectively, and Acticoat is a dressing, not a topical agent.
The nurse caring for a patient who is recovering from full-thickness burns is aware of the patients risk 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.
Correct Answer: D
Rationale: Physical activity and range of motion exercises prevent contractures and hypertrophic scarring by maintaining joint mobility and reducing tissue shortening. Emollients and immobilization are not standard, and corticosteroids slow healing.