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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
Correct Answer: D
Rationale: Airway management is the priority due to the risk of obstruction from smoke inhalation-induced edema, following the ABCs of trauma care. Pain, fluid balance, and anxiety are secondary.
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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.
While performing a patients ordered wound care for the treatment of a burn, the patient has made a series of sarcastic remarks to the nurse and criticized her technique. How should the nurse best interpret this patients behavior?
- A. The patient may be experiencing an adverse drug reaction that is affecting his cognition and behavior.
- B. The patient may be experiencing neurologic or psychiatric complications of his injuries.
- C. The patient may be experiencing inconsistencies in the care that he is being provided.
- D. The patient may be experiencing anger about his circumstances that he is deflecting toward the nurse.
Correct Answer: D
Rationale: Anger is common in burn patients and may be deflected toward caregivers. Drug reactions, complications, or care inconsistencies are less likely without specific evidence.
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
Correct Answer: C
Rationale: The acute phase, starting 48-72 hours post-burn, focuses on wound care, infection prevention, and nutritional support. The emergent phase prioritizes fluid resuscitation and airway management, immediate resuscitative is not a distinct phase, and rehabilitation focuses on scar prevention and psychosocial support.
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
Correct Answer: A
Rationale: Early enteral feeding supports the intestinal mucosal barrier, reducing permeability and preventing endotoxin translocation. Prophylactic antibiotics risk resistant bacteria, and bowel cleansing or stool softeners do not address this issue.
A patient with severe burns is admitted to the intensive care unit to stabilize and begin fluid resuscitation before transport to the burn center. The nurse should monitor the patient closely for what signs of the onset of burn shock?
- A. Confusion
- B. High fever
- C. Decreased blood pressure
- D. Sudden agitation
Correct Answer: C
Rationale: Decreased blood pressure signals burn shock onset due to reduced vascular volume from fluid loss. Confusion, fever, or agitation are not primary indicators.