Chapter 62 Management of Patients with
Burn Injury Exam Questions and
Answers Latest Update
A manufacturing plant has exploded, and the nurse is assigned to triage burn victims as
they arrive to the hospital. Which is the most important question for the nurse to ask
prior to the arrival of victims?
"Are the victims suffering from thermal burns?"
"How many victims are anticipated for transport?"
"Are the burns associated with chemicals used in the plant?"
"Are any of the victims expected to have electrical burns?" - Answer-"Are the burns
associated with chemicals used in the plant?"
Explanation:
If the victim has sustained chemical burns, the chemicals must be removed from the
skin to prevent burns to others, including the triage nurse and emergency staff. Thermal
and electrical burn victims do not require special handling considerations. The number
of victims expected is not a significant issue for the triage nurse but rather for the
external disaster team dispatch personnel.
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical
Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 62: Management of
Patients with Burn Injury, On-the-Scene Care, p. 1853.
Several temporary and permanent sources are available for covering a burn wound.
These may be manufactured synthetically, obtained from a biologic source, or a
combination of the two. Which graft is described as a biologic source of skin similar to
that of the client?
allograft
xenograft
autograft
slit graft - Answer-allograft
Explanation:
Allograft or homograft is a biologic source of skin similar to that of the client. A xenograft
or heterograft is obtained from animals, principally pigs or cows. An autograft uses the
client's own skin, transplanted from one part of the body to another. A slit graft is a type
of autograft.
Reference:
,Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical
Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 62: Management of
Patients with Burn Injury, p. 1864.
A nurse helps a health care provider treat a full-thickness burn on a patient's hand. Prior
to treatment, the nurse documents the appearance of the wound as:
Reddened; blanches with pressure.
Blistered with a mottled red base.
Dry and pale white.
Broken epidermis that is weeping. - Answer-Dry and pale white.
Explanation:
The wound appearance for a full-thickness burn would be dry, pale white, leathery, or
charred.
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical
Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 62: Management of
Patients with Burn Injury, Table 62-1, p. 1847.
The nurse cares for a client with extensive burn injuries. Which parameter(s) would the
nurse evaluate to determine if the client is receiving adequate fluid resuscitation? Select
all that apply.
Blood pressure
Heart rate
Urine output
Oxygen saturation - Answer-Heart rate
Urine output
Fluid resuscitation is administered to maintain adequate cardiac output and tissue
perfusion. If adequate fluid is administered, tachycardia, hypotension, and oliguria will
resolve. Expected outcomes of fluid resuscitation specifically include the following: urine
output between 0.5 and 1.0 mL/kg/hr (30-50 mL/hr; 75 to 100 mL/hr if electrical burn
injury), mean arterial pressure (MAP) pressure > 60 mm Hg, voids clear yellow urine
with specific gravity within normal limits, and serum electrolytes are within normal limits.
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical
Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 62: Management of
Patients with Burn Injury, p. 1854.
The nurse recognizes that which of the following provide clues about fluid volume
status? Select all that apply.
Hourly urine output
Daily weights
Percentage of meals eaten
Skin turgor
,Oxygen saturation - Answer-Hourly urine output
Daily weights
Skin turgor
Monitoring of hourly urine output and daily weights provides clues about fluid volume
status. Skin turgor is a sign of fluid loss (dehydration). Percentage of meals eaten, and
oxygen saturation would not be reliable indicators of fluid volume status in the client.
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical
Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 62: Management of
Patients with Burn Injury, Restoring Normal Fluid Balance, p. 1866.
Burn shock is characterized by which of the following?
Capillary leak
Severe hypervolemia
Organ hyperperfusion
Elevated blood pressure (BP) - Answer-Capillary leak
Explanation:
Burn shock is characterized by capillary leak, "third spacing" of fluid, severe
hypovolemia, and decreased cardiac output (CO). Progressive edema develops in
unburned tissue and organs, causing hypoperfusion and hypovolemic shock. As fluid
loss continues and vascular volume decreases, the CO and BP falls. This is the onset of
burn shock.
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical
Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 62: Management of
Patients with Burn Injury, Cardiovascular Alterations, p. 1850.
When the area of burn is irregular in shape and is scattered over multiple areas of the
body, which is the best method for the nurse to obtain a quick assessment of the total
body surface area of the burn?
Rule of nines
Use client's palm size
Parkland formula
Lund and Browder burns assessment - Answer-Use client's palm size
Explanation:
A quick assessment technique to use to evaluate an area of burn that is not restricted to
one portion of the body is by using the client's palm size to approximate the total body
surface. The palm is approximately 1% of a person's TBSA. The Parkland formula
determines fluid resuscitation needs. Lund and Browder burns assessment provides a
more precise estimate for determining TBSA that is burned and is especially more
, specific in children. The rule of nines quantitates burns that involve entire sections of the
body, not scattered burns.
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical
Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 62: Management of
Patients with Burn Injury, Palmer Method, p. 1849.
A client is cared for in a burn unit after suffering partial-thickness burns. The client's
laboratory work reveals a positive wound culture for gram-negative bacteria. The health
care provider orders silver sulfadiazine to be applied to the client's burns. The nurse
provides information to the client about the medication. Which statement made by the
client indicates an understanding about this treatment? Select all that apply.
"This medication is an antibacterial."
"This medication will be applied directly to the wound."
"This medication will stain my skin permanently."
"This medication will help my burn heal." - Answer-"This medication is an antibacterial."
"This medication will be applied directly to the wound."
"This medication will help my burn heal."
This medication is an antibacterial, which has a broad spectrum of activity against gram-
negative bacteria, gram-positive bacteria, and yeast. This medication is directly applied
to the wound. This medication will not stain the client's skin, but it will help heal the
client's burned areas.
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical
Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 62: Management of
Patients with Burn Injury, Table 62-4, p. 1862.
During the late stages of healing, which intervention helps a burn wound to heal with
minimal scarring?
Removing eschar from the skin
Applying continuous-compression wraps
Wearing clothing to protect the burn from the sun
Maintaining wound care irrigation - Answer-Applying continuous-compression wraps
Explanation:
Applying continuous-compression wraps helps skin healing and prevents hypertrophied
tissue from forming. Removing eschar from the skin, wearing clothing to protect the
burn from the sun, and maintaining wound care irrigation are appropriate for the client
with a burn wound, but these interventions don't necessarily help minimize scarring.
Reference:
