1.

The newly admitted client has burns on

both legs. The burned areas appear white
and leather-like. No blisters or bleeding are
present, and the client states that he or she
has little pain. How should this injury be
categorized?
A. Superficial
B. Partial-thickness superficial
C. Partial-thickness deep
D. Full thickness
2. The newly admitted client has a large
burned area on the right arm. The burned
area appears red, has blisters, and is very
painful. How should this injury be
categorized?
A. Superficial
B. Partial-thickness superficial
C. Partial-thickness deep
D. Full thickness
3. The burned client newly arrived from an
accident scene is prescribed to receive 4 mg
of morphine sulfate by IV push. What is the
most important reason to administer the
opioid analgesic to this client by the
intravenous route?
A. The medication will be effective more
quickly than if given intramuscularly.
B. It is less likely to interfere with the clients
breathing and oxygenation.
C. The danger of an overdose during fluid
remobilization is reduced.
D. The client delayed gastric emptying.
4. Which vitamin deficiency is most likely to
be a long-term consequence of a fullthickness burn injury?
A. Vitamin A
B. Vitamin B
C. Vitamin C
D. Vitamin D
5. Which client factors should alert the nurse
to potential increased complications with a
burn injury?
A. The client is a 26-year-old male.
B. The client has had a burn injury in the
past.
C. The burned areas include the hands and
perineum.

D. The burn took place in an open field and

ignited the clients clothing.
6. The burned client is ordered to receive
intravenous cimetidine, an H2 histamine
blocking agent, during the emergent phase.
When the clients family asks why this drug
is being given, what is the nurses best
response?
A. To increase the urine output and prevent
kidney damage.
B. To stimulate intestinal movement and
prevent abdominal bloating.
C. To decrease hydrochloric acid production
in the stomach and prevent ulcers.
D. To inhibit loss of fluid from the circulatory
system and prevent hypovolemic shock.
7. At what point after a burn injury should
the nurse be most alert for the complication
of hypokalemia?
A. Immediately following the injury
B. During the fluid shift
C. During fluid remobilization
D. During the late acute phase
8. What clinical manifestation should alert
the nurse to possible carbon monoxide
poisoning in a client who experienced a burn
injury during a house fire?
A. Pulse oximetry reading of 80%
B. Expiratory stridor and nasal flaring
C. Cherry red color to the mucous
membranes
D. Presence of carbonaceous particles in the
sputum
9. What clinical manifestation indicates that
an escharotomy is needed on a
circumferential extremity burn?
A. The burn is full thickness rather than
partial thickness.
B. The client is unable to fully pronate and
supinate the extremity.
C. Capillary refill is slow in the digits and the
distal pulse is absent.
D. The client cannot distinguish the
sensation of sharp versus dull in the
extremity.

10. What additional laboratory test should be

performed on any African American client
who sustains a serious burn injury?
A. Total protein
B. Tissue type antigens
C. Prostate specific antigen
D. Hemoglobin S electrophoresis
11. Which type of fluid should the nurse
expect to prepare and administer as fluid
resuscitation during the emergent phase of
burn recovery?
A. Colloids
B. Crystalloids
C. Fresh-frozen plasma
D. Packed red blood cells
12. The client with a dressing covering the
neck is experiencing some respiratory
difficulty. What is the nurses best first
action?
A. Administer oxygen.
B. Loosen the dressing.
C. Notify the emergency team.
D. Document the observation as the only
action.
13. The client who experienced an inhalation
injury 6 hours ago has been wheezing. When
the client is assessed, wheezes are no longer
heard. What is the nurses best action?
A. Raise the head of the bed.
B. Notify the emergency team.
C. Loosen the dressings on the chest.
D. Document the findings as the only action.
14. Ten hours after the client with 50% burns
is admitted, her blood glucose level is 90
mg/dL. What is the nurses best action?
A. Notify the emergency team.
B. Document the finding as the only action.
C. Ask the client if anyone in her family has
diabetes mellitus.
D. Slow the intravenous infusion of dextrose
5% in Ringers lactate.
15. On admission to the emergency
department the burned clients blood
pressure is 90/60, with an apical pulse rate of
122. These findings are an expected result of
what thermal injuryrelated response?

A. Fluid shift
B. Intense pain
C. Hemorrhage
D. Carbon monoxide poisoning
16. Twelve hours after the client was initially
burned, bowel sounds are absent in all four
abdominal quadrants. What is the nurses
best action?
A. Reposition the client onto the right side.
B. Document the finding as the only action.
C. Notify the emergency team.
D. Increase the IV flow rate.
17. Which clinical manifestation indicates
that the burned client is moving into the fluid
remobilization phase of recovery?
A. Increased urine output, decreased urine
specific gravity
B. Increased peripheral edema, decreased
blood pressure
C. Decreased peripheral pulses, slow
capillary refill
D. Decreased serum sodium level, increased
hematocrit
18. What is the priority nursing diagnosis
during the first 24 hours for a client with fullthickness chemical burns on the anterior
neck, chest, and all surfaces of the left arm?
A. Risk for Ineffective Breathing Pattern
B. Decreased Tissue Perfusion
C. Risk for Disuse Syndrome
D. Disturbed Body Image
19. All of the following laboratory test results
on a burned clients blood are present during
the emergent phase. Which result should the
nurse report to the physician immediately?
A. Serum sodium elevated to 131 mmol/L
(mEq/L)
B. Serum potassium 7.5 mmol/L (mEq/L)
C. Arterial pH is 7.32
D. Hematocrit is 52%
20. The client has experienced an electrical
injury, with the entrance site on the left hand
and the exit site on the left foot. What are
the priority assessment data to obtain from
this client on admission?

A. Airway patency
B. Heart rate and rhythm
C. Orientation to time, place, and person
D. Current range of motion in all extremities
21. In assessing the clients potential for an
inhalation injury as a result of a flame burn,
what is the most important question to ask
the client on admission?
A. Are you a smoker?
B. When was your last chest x-ray?
C. Have you ever had asthma or any other
lung problem?
D. In what exact place or space were you
when you were burned?
22. Which information obtained by
assessment ensures that the clients
respiratory efforts are currently adequate?
A. The client is able to talk.
B. The client is alert and oriented.
C. The clients oxygen saturation is 97%.
D. The clients chest movements are
uninhibited
23. Which information obtained by
assessment ensures that the clients
respiratory efforts are currently adequate?
A. The client is able to talk.
B. The client is alert and oriented.
C. The clients oxygen saturation is 97%.
D. The clients chest movements are
uninhibited
24. The burned clients family ask at what
point the client will no longer be at increased
risk for infection. What is the nurses best
response?
A. When fluid remobilization has started.
B. When the burn wounds are closed.
C. When IV fluids are discontinued.
D. When body weight is normal.
25. The burned client relates the following
history of previous health problems. Which
one should alert the nurse to the need for
alteration of the fluid resuscitation plan?
A. Seasonal asthma
B. Hepatitis B 10 years ago
C. Myocardial infarction 1 year ago
D. Kidney stones within the last 6 month

26. The burned client on admission is

drooling and having difficulty swallowing.
What is the nurses best first action?
A. Assess level of consciousness and
pupillary reactions.
B. Ask the client at what time food or liquid
was last consumed.
C. Auscultate breath sounds over the trachea
and mainstem bronchi.
D. Measure abdominal girth and auscultate
bowel sounds in all four quadrants.
27. Which intervention is most important for
the nurse to use to prevent infection by
cross-contamination in the client who has
open burn wounds?
A. Handwashing on entering the clients
room
B. Encouraging the client to cough and deep
breathe
C. Administering the prescribed tetanus
toxoid vaccine
D. Changing gloves between cleansing
different burn areas
28. In reviewing the burned clients
laboratory report of white blood cell count
with differential, all the following results are
listed. Which laboratory finding indicates the
possibility of sepsis?
A. The total white blood cell count is
9000/mm3.
B. The lymphocytes outnumber the
basophils.
C. The bands outnumber the segs.
D. The monocyte count is 1,800/mm3.
29. The client has a deep partial-thickness
injury to the posterior neck. Which
intervention is most important to use during
the acute phase to prevent contractures
associated with this injury?
A. Place a towel roll under the clients neck
or shoulder.
B. Keep the client in a supine position
without the use of pillows.
C. Have the client turn the head from side to
side 90 degrees every hour while awake.
D. Keep the client in a semi-Fowlers position
and actively raise the arms above the head
every hour while awake.

30. The client has severe burns around the

right hip. Which position is most important to
be emphasized by the nurse that the client
maintain to retain maximum function of this
joint?
A. Hip maintained in 30-degree flexion, no
knee flexion
B. Hip flexed 90 degrees and knee flexed 90
degrees
C. Hip, knee, and ankle all at maximum
flexion
D. Hip at zero flexion with leg flat
31. During the acute phase, the nurse
applied gentamicin sulfate (topical antibiotic)
to the burn before dressing the wound. The
client has all the following manifestations.
Which manifestation indicates that the client
is having an adverse reaction to this topical
agent?
A. Increased wound pain 30 to 40 minutes
after drug application
B. Presence of small, pale pink bumps in the
wound beds
C. Decreased white blood cell count
D. Increased serum creatinine level
32. The client, who is 2 weeks postburn with
a 40% deep partial-thickness injury, still has
open wounds. On taking the morning vital
signs, the client is found to have a belownormal temperature, is hypotensive, and has
diarrhea. What is the nurses best action?
A. Nothing, because the findings are normal
for clients during the acute phase of
recovery.
B. Increase the temperature in the room and
increase the IV infusion rate.
C. Assess the clients airway and oxygen
saturation.
D. Notify the burn emergency team.
33. Which intervention is most important to
use to prevent infection by
autocontamination in the burned client
during the acute phase of recovery?
A. Changing gloves between wound care on
different parts of the clients body.
B. Avoiding sharing equipment such as blood
pressure cuffs between clients.
C. Using the closed method of burn wound

management.
D. Using proper and consistent handwashing.
34. When should ambulation be initiated in
the client who has sustained a major burn?
A. When all full-thickness areas have been
closed with skin grafts
B. When the clients temperature has
remained normal for 24 hours
C. As soon as possible after wound
debridement is complete
D. As soon as possible after resolution of the
fluid shift
35. What statement by the client indicates
the need for further discussion regarding the
outcome of skin grafting (allografting)
procedures?
A. For the first few days after surgery, the
donor sites will be painful.
B. Because the graft is my own skin, there is
no chance it wont take.
C. I will have some scarring in the area
when the skin is removed for grafting.
D. Once all grafting is completed, my risk
for infection is the same as it was before I
was burned.
36. Which statement by the client indicates
correct understanding of rehabilitation after
burn injury?
A. I will never be fully recovered from the
burn.
B. I am considered fully recovered when all
the wounds are closed.
C. I will be fully recovered when I am able to
perform all the activities I did before my
injury.
D. I will be fully recovered when I achieve
the highest possible level of functioning that
I can.
37. Which statement made by the client with
facial burns who has been prescribed to wear
a facial mask pressure garment indicates
correct understanding of the purpose of this
treatment?
A. After this treatment, my ears will not stick
out.
B. The mask will help protect my skin from
sun damage.
C. Using this mask will prevent scars from

being permanent.
D. My facial scars should be less severe with
the use of this mask.
38. What is the priority nursing diagnosis for
a client in the rehabilitative phase of
recovery from a burn injury?
A. Acute Pain
B. Impaired Adjustment
C. Deficient Diversional Activity
D. Imbalanced Nutrition: Less than Body
Requirements
39. Nurse Faith should recognize that fluid
shift in an client with burn injury results from
increase in the:

a. Total volume of circulating whole blood

b. Total volume of intravascular plasma
c. Permeability of capillary walls
d. Permeability of kidney tubules
40. Louie, with burns over 35% of the body,
complains of chilling. In promoting the
clients comfort, the nurse should:
a. Maintain room humidity below 40%
b. Place top sheet on the client
c. Limit the occurrence of drafts
d. Keep room temperature at 80 degrees