Leonora C
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Quiz on cc Burns, created by Leonora C on 07/12/2018.

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Leonora C
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cc Burns

Question 1 of 20

1

The optimal measurement of intravascular fluid status during the immediate fluid resuscitation phase of burn treatment is

Select one of the following:

  • hourly intake and urine output.

  • serum potassium.

  • daily weight.

  • blood urea nitrogen

Explanation

Question 2 of 20

1

A patient admitted with severe burns to his face and hands is showing signs of extreme agitation. The nurse should explore the mechanism of burn injury possibly related to

Select one of the following:

  • subacute delirium.

  • methamphetamine use.

  • excessive alcohol use.

  • posttraumatic stress disorder.

Explanation

Question 3 of 20

1

The nurse is assisting the patient to select foods from the menu that will promote wound healing. Which statement indicates the nurse’s knowledge of nutritional goals?

Select one of the following:

  • Choose foods that are high in protein, such as meat, eggs, and beans. These help the burns to heal.”

  • “Avoid foods that have saturated fats. Fats interfere with the ability of the burn wound to heal.”

  • It is important to choose foods such as bread and pasta that are high in carbohydrates. These foods will give you energy and help you to heal faster.”

  • Select foods that have lots of fiber, such as whole grains and fruits. These will promote removal of toxins from the body that interfere with healing.”

Explanation

Question 4 of 20

1

The nurse is caring for a patient who has undergone skin grafting of the face and arms for burn wound treatment. A primary nursing diagnosis is

Select one of the following:

  • fluid volume deficit.

  • body image disturbance.

  • altered nutrition, less than body requirements

  • decreased cardiac output

Explanation

Question 5 of 20

1

The nurse is caring for a patient with an electrical injury. The nurse understands that patients with electrical injury are at a high risk for acute kidney injury secondary to

Select one of the following:

  • release of myoglobin from injured tissues.

  • increased incidence of ureteral stones.

  • hypervolemia from burn resuscitation.

  • nephrotoxic antibiotics for prevention of infection

Explanation

Question 6 of 20

1

A(An) ____________________ often produces a superficial cutaneous injury but may cause cardiopulmonary arrest and transient but severe central nervous system deficits.

Select one of the following:

  • electrical burn

  • chemical burn

  • infection

  • heat burn

Explanation

Question 7 of 20

1

Silver is used as an ingredient in many burn dressings because it

Select one of the following:

  • stimulates tissue granulation.

  • provides topical pain relief.

  • is effective against a wide spectrum of wound pathogens.

  • stimulates wound healing.

Explanation

Question 8 of 20

1

A 63-year-old patient is admitted with new-onset fever; flulike symptoms; blisters over the arms, chest, and neck; and red, painful oral mucous membranes. The patient should be further evaluated for which possible non–burn-injured skin disorder?

Select one of the following:

  • Toxic epidermal necrolysis

  • Graft-versus-host disease

  • Necrotizing soft tissue infection

  • Staphylococcal scalded skin syndrome

Explanation

Question 9 of 20

1

A patient with a 60% burn in the acute phase of treatment develops a tense abdomen, decreasing urine output, hypercapnia, and hypoxemia. Based on this assessment, the nurse anticipates interventions to evaluate and treat the patient for

Select one of the following:

  • disseminated intravascular coagulation disorder.

  • intra-abdominal hypertension.

  • acute respiratory distress syndrome.

  • acute kidney injury.

Explanation

Question 10 of 20

1

Tissue damage from burn injury activates an inflammatory response that increases the patient’s risk for

Select one of the following:

  • acute kidney injury.

  • stress ulcers.

  • acute respiratory distress syndrome

  • infection.

Explanation

Question 11 of 20

1

A burn patient in the rehabilitation phase of injury is increasingly anxious and unable to sleep. The nurse should consult with the provider to further assess the patient for

Select one of the following:

  • posttraumatic stress disorder

  • .
    bipolar disorder

  • acute delirium.

  • suicidal intentions.

Explanation

Question 12 of 20

1

The nurse is managing the pain of a patient with burns. The provider has prescribed opiates to be given intramuscularly. The nurse contacts the provider to change the prescription to intravenous administration because

Select one of the following:

  • burn pain is so severe it requires relief by the fastest route available.

  • hypermetabolism limits effectiveness of medications administered intramuscularly.

  • tissue edema may interfere with drug absorption of injectable routes.

  • intramuscular injections cause additional skin disruption.

Explanation

Question 13 of 20

1

The nurse is caring for a burn-injured patient who weighs 154 pounds, and the burn injury covers 50% of his body surface area. The nurse calculates the fluid needs for the first 24 hours after a burn injury using a standard fluid resuscitation formula of 4 mL/kg/% burn of intravenous (IV) fluid for the first 24 hours. The nurse plans to administer what amount of fluid in the first 24 hours?

Select one of the following:

  • .
    14 L

  • 7000 mL

  • 28 L

  • 2800 mL

Explanation

Question 14 of 20

1

In patients with extensive burns, edema occurs in both burned and unburned areas because of

Select one of the following:

  • increased capillary permeability.

  • catecholamine-induced vasoconstriction

  • decreased glomerular filtration.

  • loss of integument barrier

Explanation

Question 15 of 20

1

Patients with burns may have mesh grafts or sheet grafts. Which of the following sites is most likely to have a sheet graft applied?

Select one of the following:

  • Face

  • Chest

  • Arm

  • Leg

Explanation

Question 16 of 20

1

When paramedics notice singed hairs in the nose of a burn patient, it is recommended that the patient be intubated. What is the reasoning for the immediate intubation?

Select one of the following:

  • Inhalation injury above the glottis may cause significant edema that obstructs the airway.

  • The singed hairs and soot in the nostrils will cause dysfunction of cilia in the airways

  • Carbon monoxide poisoning always occurs when soot is visible.

  • The patient will have a copious amount of mucus that will need to be suctioned.

Explanation

Question 17 of 20

1

The nurse is conducting an admission assessment of an 82-year-old patient who sustained a 12% burn from spilling hot coffee on the hand and arm. Which statement is of priority to assist in planning treatment?

Select one of the following:

  • “Do you live alone?”

  • Have you had any surgeries?”

  • “Do you have a heart condition or heart failure?”

  • “Do you have any drug or food allergies?”

Explanation

Question 18 of 20

1

The nurse is caring for a patient with a chemical burn injury. The priority nursing intervention is to

Select one of the following:

  • apply saline compresses.

  • remove the patient’s clothes and flush the area with water.

  • remove all jewelry.

  • contact a poison control center for directions on neutralizing agents.

Explanation

Question 19 of 20

1

The patient asks the nurse if the placement of the autograft over his full-thickness burn will be the only surgical intervention needed to close his wound. The nurse’s best response would be:

Select one of the following:

  • “Yes, an autograft will transfer your own skin from one area of your body to cover the burn wound.”

  • Unfortunately, an autograft skin is a temporary graft and a second surgery will be needed to close the wound.”

  • “An autograft is a biological dressing that will eventually be replaced by your body generating new tissue.”

  • “Unfortunately, autografts frequently do not adhere well to burn wounds and a xenograft will be necessary to close the wound.”

Explanation

Question 20 of 20

1

An elderly individual from an assisted-living facility (ALF) presents with severe scald burns to the buttocks and back of the thighs. The caregiver from the ALF accompanies the patient to the emergency department and states that the bath water was “too hot” and that the “patient sat in the water too long.” What should the nurse do?

Select one of the following:

  • .
    Ask the caregiver to step out while examining the patient’s burn injury.

  • Immediately contact the police to report the suspected elder abuse.

  • Ask the caregiver to describe exactly how the injury occurred.

  • Ask the caregiver at what temperature the water heater is set in the home.

Explanation

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