Welcome to your burns NCLEX questions and reviewer. In this nursing test bank, we’ll test your knowledge on the concepts of burn injury nursing management. The goal of this NCLEX quiz is to help student nurses prepare and review the nursing care of patients with burn injuries.
This section includes the NCLEX practice questions for burns. This nursing test bank set includes 100 practice questions for burns and is divided into five (5) parts.
TIP: Remember to read the reviewer for burns management below to give you a quick refresh of its concepts.
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A 23-year-old male client who has had a full-thickness burn is being discharged from the hospital. Which information is most important for the nurse to provide prior to discharge?
A client who is admitted after a thermal burn injury has the following vital signs: blood pressure, 70/40; heart rate, 140 beats/min; respiratory rate, 25/min. He is pale in color and it is difficult to find pedal pulses. Which action will the nurse take first?
A 40-year-old male client who was burned was admitted under your care. Assessment reveals he has crackles, respiratory rate of 40/min, and is coughing up blood-tinged sputum. What action will the nurse take first?
How will the nurse position a client with a burn wound to the posterior neck to prevent contractures?
On assessment, the nurse notes that the client has burns inside the mouth and is wheezing. Several hours later, the wheezing is no longer heard. What is the nurse’s next action?
Ten hours after the client with 50% burns is admitted, her blood glucose level is 140 mg/dL. What is the nurse’s best action?
The client has a large burned area on the right arm. The burned area appears pink, has blisters, and is very painful. How will the nurse categorize this injury?
The client has burns on both legs. These areas appear white and leather-like. No blisters or bleeding are present, and there is just a “small amount of pain.” How will the nurse categorize this injury?
The client has experienced an electrical injury of the lower extremities. Which are the priority assessment data to obtain from this client?
A 33-year-old male client was admitted due to severe burns around his right hip. Which position is most important to use to maintain the maximum function of this joint?
The client who is burned is drooling and having difficulty swallowing. Which action will the nurse take first?
A 22-year-old female client with a full-thickness burn is being discharged to home after a month in the hospital. Her wounds are minimally opened and she will be receiving home care. Which nursing diagnosis has the highest priority?
The client with a new burn injury asks the nurse why he is receiving intravenous cimetidine (Tagamet). What is the nurse’s best response?
A 12-year-old male with facial burns asks the nurse if he will ever look the same. Which response is best for the nurse to provide?
The client with open burn wounds begins to have diarrhea. The client is found to have a below-normal temperature, with a white blood cell count of 4000/mm3. Which is the nurse’s best action?
The family of a client who has been burned asks at what point the client will no longer be at greater risk for infection. What is the nurse’s best response?
The nurse is conducting a home safety class. It is most important for the nurse to include which information in the teaching plan?
The nurse provides wound care for a client 48 hours after a burn injury. To achieve the desired outcome of the procedure, which nursing action will be carried out first?
The nurse should teach the community that a minor burn injury could be caused by what common occurrence?
The nurse uses topical gentamicin sulfate (Garamycin) on a client’s burn injury. Which laboratory value will the nurse monitor?
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Burns. A burn is an injury that results from direct exposure to any thermal, electrical, chemical, or radiation source. It occurs when energy from a heat source is transferred into body tissues beyond what the body could hold leading to tissue injury. It is characterized by severe skin damage that causes the affected skin cells to die.
There are many other causes of burns aside from open flames. They include:
The three zones of a burn were described by Jackson in 1947. These three zones of a burn are three dimensional, and loss of tissue in the zone of stasis will lead to the wound deepening as well as widening. (National Center for Biotechnology Information, U.S. National Library of Medicine)
The release of cytokines and other inflammatory mediators at the site of injury has a systemic effect once the burn reaches 30% of total body surface area.
Management of burn injury is categorized into three phases of care: emergent phase, acute phase, and rehabilitation.
The emergent phase starts from the time of burn injury and ends when the patient is hemodynamically stable, capillary permeability has been restored, and when fluid resuscitation has been completed. Usually 48-72 hours from the time of injury. Emergent phase is also known as the resuscitative phase and the goals of this phase include prevention of hypovolemic shock and preservation of vital organ functioning.
Asses for the burn depth.
Burn depth is assessed at 24 hours after injury as blisters and other injuries may evolve.
First Degree Burn (Superficial Partial Thickness Burn). In first-degree burn injuries, the skin function remains intact, and transfer to a burn center is not required. They do NOT count towards total body surface area (TBSA) burned. This classification of burn depth affects the epidermis leading to the following signs and symptoms:
Second Degree Burn (Deep Partial Thickness Burn). In second-degree burn injuries, the skin function is lost. Deep partial-thickness injuries can easily convert to or require the same management as full-thickness. The goal in an MCI (mass casualty incident) is to treat as many 2nd degree injuries as possible in an outpatient setting. This classification of burn depth affects the dermis and epidermis leading to the following signs and symptoms:
Third-Degree Burn (Full Thickness Burn). In third-degree burn injuries, skin function is lost and grafting is required for functional healing. Third-degree burns will almost always require hospital admission. This classification of burn depth affects the subcutaneous tissues, epidermis, and dermis leading to:
Fourth-Degree Burn (Deep Fullness Thickness Burn). In fourth-degree burn injuries, the affected areas go through both layers of the skin and underlying tissue as well as deeper tissue. This classification of burn depth involves the muscle and bone.
Assess the burn size and extent.
The size of the burn is expressed through percentage according to the total body surface area (TBSA), Rule of Nines.
Assess for the burn location.
The area of a burn injury usually directs treatment. Burns on the face, hands, feet, and genitalia as well as large burns in other areas of the body and those associated with inhalation injury are often referred to burn centers for specialized expertise.
Airway Management is vital to maintain the airway and provide supplemental oxygen in patients with major burns. Airway management is especially important for types of burns related to inhalation injury.
Fluid Resuscitation refers to the replacement of fluids in burn patients to prevent hypovolemia and hypoperfusion that can result from the body’s systemic response to burn injury.
The larger the burn size, the more nutrients are needed for healing.
Pain due to burns can range from mild to severe to excruciating. Pain management, which includes pharmacologic and nonpharmacologic approaches, is a central component of the complex issues involved in treating patients with burns.
Prescribed topical agents are administered before the wound is covered with layers of dry dressings.
The acute phase of burn management starts 48-72 hours from the time of burn injury when the patient is hemodynamically stable with completed fluid resuscitation and with restored capillary permeability and ends upon wound closure.
Prevent infection. Patients with burns are at the highest risk for healthcare-associated infections (HAIs). The loss of the barrier function of the skin, combined with necrotic tissue produces an environment conducive to bacterial growth. Nursing interventions to prevent infection includes:
Provide nutritional support. Nutritional support through total parenteral nutrition or enteral tube feeding for patients with burn is aggressive. There should be an increase in calories, proteins, and fats.
Provide proper wound care. Wound cleansing should be done through hydrotherapy and may be emerged in Hubbard tank.
Debridement is the removal of necrotic tissues to prevent bacterial growth promoting wound healing.
Antimicrobial Agents or Ointments
Autografting. Autografting is the surgical removal of a superficial layer of the patient’s own unburned skin (donor site) which is subsequently grafted to the patient’s excised open wound.
Post Op Considerations:
Rehabilitation phase occurs immediately after the burn has occurred and can extend for years after the initial injury.
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