NCLEX Burns Review PDF — Management of Care & Safety Practice Exam with Answers &
Rationales @2026
NCLEX A+
NCLEX Management of Care & Safety Practice
Questions | Med Surg Burns Exam 3 Complete
Review UPDATED REVIEW
NCLEX BURNS
MANAGEMENT OF CARE
PRIORITY QUESTIONS with Rationales
A 25-year-old patient is admitted with partial-thickness injuries over 20% of the total body
surface area involving both lower legs. The nurse would classify this injury as being which of
the following?
1. a moderate burn
2. a minor burn
3. a major burn
4. a severe burn
5. an intermediate burn
Correct Answer: 1
Rationale 1: A moderate burn is a partial-thickness injury that is between 15%-25% of total
body surface area in adults.
A 70-year-old patient has experienced a sunburn over much of the body. What self-care
technique is MOST important to emphasize to an older adult in dealing with the effects of the
sunburn?
1. increasing fluid intake
2. applying mild lotions
3. taking mild analgesics
4. maintaining warmth
5. using sunscreen
Correct Answer: 1
Rationale: Older adults are especially prone to dehydration; therefore, increasing fluid intake is
especially important. Other manifestations could include nausea and vomiting. All the
measures help alleviate the manifestations of this minor burn which include pain, skin redness,
chills, and headache. Use of sunscreen is a preventative, not a treatment measure.
,NCLEX Burns Review PDF — Management of Care & Safety Practice Exam with Answers &
Rationales @2026
NCLEX A+
An 80-kg patient with burns over 30% of total body surface area (TBSA) is admitted to the burn
unit. Using the Parkland formula of 4 mL/kg/%TBSA, what is the IV infusion rate (mL/hour) for
lactated Ringer's solution that the nurse will administer during the first 8 hours?
600 mL
The Parkland formula states that patients should receive 4 mL/kg/%TBSA burned during the
first 24 hours. Half of the total volume is given in the first 8 hours and then the last half is given
over 16 hours: 4 80 30 = 9600 mL total volume; 9600/2 = 4800 mL in the first 8 hours; 4800
mL/8 hr = 600 mL/hr.
An 82-year-old patient is moving into an independent living facility. What is the best advice the
nurse can give to the family to help prevent this patient from being accidently burned in her
new home?
A. Cook for her.
B. Stop her from smoking.
C. Install tap water anti-scald devices.
D. Be sure she uses an open space heater.
C. Install tap water anti-scald devices.
Installing tap water anti-scald devices will help prevent accidental scald burns that more easily
occur in older people as their skin becomes drier and the dermis thinner. Cooking for her may
be needed at times of illness or in the future, but she is moving to an independent living
facility, so at this time she should not need this assistance. Stopping her from smoking may be
helpful to prevent burns but may not be possible without the requirement by the facility. Using
an open space heater would increase her risk of being burned and would not be encouraged.
The ambulance reports that they are transporting a patient to the ED who has experienced a
full-thickness thermal burn from a grill. What manifestations should the nurse expect?
A. Severe pain, blisters, and blanching with pressure
B. Pain, minimal edema, and blanching with pressure
C. Redness, evidence of inhalation injury, and charred skin
D. No pain, waxy white skin, and no blanching with pressure
,NCLEX Burns Review PDF — Management of Care & Safety Practice Exam with Answers &
Rationales @2026
NCLEX A+
D. No pain, waxy white skin, and no blanching with pressure
With full-thickness burns, the nerves and vasculature in the dermis are destroyed so there is
no pain, the tissue is dry and waxy-looking or may be charred, and there is no blanching with
pressure. Severe pain, blisters, and blanching occur with partial-thickness (deep, second-
degree) burns. Pain, minimal edema, blanching, and redness occur with partial-thickness
(superficial, first-degree) burns.
The charge nurse observes the following actions being taken by a new nurse on the burn unit.
Which action by the new nurse would require an intervention by the charge nurse?
a. The new nurse uses clean latex gloves when applying antibacterial cream to a burn wound.
b. The new nurse obtains burn cultures when the patient has a temperature of 95.2° F (35.1°
C).
c. The new nurse administers PRN fentanyl (Sublimaze) IV to a patient 5 minutes before a
dressing change.
d. The new nurse calls the health care provider for a possible insulin order when a nondiabetic
patient's serum glucose is elevated.
ANS: A
Sterile gloves should be worn when applying medications or dressings to a burn. Hypothermia
is an indicator of possible sepsis, and cultures are appropriate. Nondiabetic patients may
require insulin because stress and high calorie intake may lead to temporary hyperglycemia.
Fentanyl peaks 5 minutes after IV administration, and should be used just before and during
dressing changes for pain management
During the acute phase of burn treatment, important goals of patient care include which of the
following?
Select all that apply.
1. providing for patient comfort
2. preventing infection
3. providing adequate nutrition for healing to occur
4. splinting, positioning, and exercising affected joints
5. assessing home maintenance management
Correct Answer: 1,2,3,4
Rationale: The goals of treatment for the acute period include wound cleansing and healing;
pain relief; preventing infection; promoting nutrition; and splinting, positioning, and exercising
affected joints. Assessment of home maintenance management is an important goal in the
rehabilitative stage, not the acute stage.
, NCLEX Burns Review PDF — Management of Care & Safety Practice Exam with Answers &
Rationales @2026
NCLEX A+
During the care of the patient with a burn in the acute phase, which new interventions should
the nurse expect to do after the patient progressed from the emergent phase?
A. Begin IV fluid replacement.
B. Monitor for signs of complications.
C. Assess and manage pain and anxiety.
D. Discuss possible reconstructive surgery.
B. Monitor for signs of complications.
Monitoring for complications (e.g., wound infection, pneumonia, contractures) is needed in
the acute phase. Fluid replacement occurs in the emergent phase. Assessing and managing
pain and anxiety occurs in the emergent and the acute phases. Discussing possible
reconstructive surgeries is done in the rehabilitation phase.
During the emergent phase of burn care, which assessment will be most useful in determining
whether the patient is receiving adequate fluid infusion?
a. Check skin turgor.
b. Monitor daily weight.
c. Assess mucous membranes.
d. Measure hourly urine output.
ANS: D
When fluid intake is adequate, the urine output will be at least 0.5 to 1 mL/kg/hour. The
patient's weight is not useful in this situation because of the effects of third spacing and
evaporative fluid loss. Mucous membrane assessment and skin turgor also may be used, but
they are not as adequate in determining that fluid infusions are maintaining adequate
perfusion.
Eight hours after a thermal burn covering 50% of a patient's total body surface area (TBSA) the
nurse assesses the patient. Which information would be a priority to communicate to the
health care provider?
a. Blood pressure is 95/48 per arterial line.
b. Serous exudate is leaking from the burns.
c. Cardiac monitor shows a pulse rate of 108.
d. Urine output is 20 mL per hour for the past 2 hours.
Rationales @2026
NCLEX A+
NCLEX Management of Care & Safety Practice
Questions | Med Surg Burns Exam 3 Complete
Review UPDATED REVIEW
NCLEX BURNS
MANAGEMENT OF CARE
PRIORITY QUESTIONS with Rationales
A 25-year-old patient is admitted with partial-thickness injuries over 20% of the total body
surface area involving both lower legs. The nurse would classify this injury as being which of
the following?
1. a moderate burn
2. a minor burn
3. a major burn
4. a severe burn
5. an intermediate burn
Correct Answer: 1
Rationale 1: A moderate burn is a partial-thickness injury that is between 15%-25% of total
body surface area in adults.
A 70-year-old patient has experienced a sunburn over much of the body. What self-care
technique is MOST important to emphasize to an older adult in dealing with the effects of the
sunburn?
1. increasing fluid intake
2. applying mild lotions
3. taking mild analgesics
4. maintaining warmth
5. using sunscreen
Correct Answer: 1
Rationale: Older adults are especially prone to dehydration; therefore, increasing fluid intake is
especially important. Other manifestations could include nausea and vomiting. All the
measures help alleviate the manifestations of this minor burn which include pain, skin redness,
chills, and headache. Use of sunscreen is a preventative, not a treatment measure.
,NCLEX Burns Review PDF — Management of Care & Safety Practice Exam with Answers &
Rationales @2026
NCLEX A+
An 80-kg patient with burns over 30% of total body surface area (TBSA) is admitted to the burn
unit. Using the Parkland formula of 4 mL/kg/%TBSA, what is the IV infusion rate (mL/hour) for
lactated Ringer's solution that the nurse will administer during the first 8 hours?
600 mL
The Parkland formula states that patients should receive 4 mL/kg/%TBSA burned during the
first 24 hours. Half of the total volume is given in the first 8 hours and then the last half is given
over 16 hours: 4 80 30 = 9600 mL total volume; 9600/2 = 4800 mL in the first 8 hours; 4800
mL/8 hr = 600 mL/hr.
An 82-year-old patient is moving into an independent living facility. What is the best advice the
nurse can give to the family to help prevent this patient from being accidently burned in her
new home?
A. Cook for her.
B. Stop her from smoking.
C. Install tap water anti-scald devices.
D. Be sure she uses an open space heater.
C. Install tap water anti-scald devices.
Installing tap water anti-scald devices will help prevent accidental scald burns that more easily
occur in older people as their skin becomes drier and the dermis thinner. Cooking for her may
be needed at times of illness or in the future, but she is moving to an independent living
facility, so at this time she should not need this assistance. Stopping her from smoking may be
helpful to prevent burns but may not be possible without the requirement by the facility. Using
an open space heater would increase her risk of being burned and would not be encouraged.
The ambulance reports that they are transporting a patient to the ED who has experienced a
full-thickness thermal burn from a grill. What manifestations should the nurse expect?
A. Severe pain, blisters, and blanching with pressure
B. Pain, minimal edema, and blanching with pressure
C. Redness, evidence of inhalation injury, and charred skin
D. No pain, waxy white skin, and no blanching with pressure
,NCLEX Burns Review PDF — Management of Care & Safety Practice Exam with Answers &
Rationales @2026
NCLEX A+
D. No pain, waxy white skin, and no blanching with pressure
With full-thickness burns, the nerves and vasculature in the dermis are destroyed so there is
no pain, the tissue is dry and waxy-looking or may be charred, and there is no blanching with
pressure. Severe pain, blisters, and blanching occur with partial-thickness (deep, second-
degree) burns. Pain, minimal edema, blanching, and redness occur with partial-thickness
(superficial, first-degree) burns.
The charge nurse observes the following actions being taken by a new nurse on the burn unit.
Which action by the new nurse would require an intervention by the charge nurse?
a. The new nurse uses clean latex gloves when applying antibacterial cream to a burn wound.
b. The new nurse obtains burn cultures when the patient has a temperature of 95.2° F (35.1°
C).
c. The new nurse administers PRN fentanyl (Sublimaze) IV to a patient 5 minutes before a
dressing change.
d. The new nurse calls the health care provider for a possible insulin order when a nondiabetic
patient's serum glucose is elevated.
ANS: A
Sterile gloves should be worn when applying medications or dressings to a burn. Hypothermia
is an indicator of possible sepsis, and cultures are appropriate. Nondiabetic patients may
require insulin because stress and high calorie intake may lead to temporary hyperglycemia.
Fentanyl peaks 5 minutes after IV administration, and should be used just before and during
dressing changes for pain management
During the acute phase of burn treatment, important goals of patient care include which of the
following?
Select all that apply.
1. providing for patient comfort
2. preventing infection
3. providing adequate nutrition for healing to occur
4. splinting, positioning, and exercising affected joints
5. assessing home maintenance management
Correct Answer: 1,2,3,4
Rationale: The goals of treatment for the acute period include wound cleansing and healing;
pain relief; preventing infection; promoting nutrition; and splinting, positioning, and exercising
affected joints. Assessment of home maintenance management is an important goal in the
rehabilitative stage, not the acute stage.
, NCLEX Burns Review PDF — Management of Care & Safety Practice Exam with Answers &
Rationales @2026
NCLEX A+
During the care of the patient with a burn in the acute phase, which new interventions should
the nurse expect to do after the patient progressed from the emergent phase?
A. Begin IV fluid replacement.
B. Monitor for signs of complications.
C. Assess and manage pain and anxiety.
D. Discuss possible reconstructive surgery.
B. Monitor for signs of complications.
Monitoring for complications (e.g., wound infection, pneumonia, contractures) is needed in
the acute phase. Fluid replacement occurs in the emergent phase. Assessing and managing
pain and anxiety occurs in the emergent and the acute phases. Discussing possible
reconstructive surgeries is done in the rehabilitation phase.
During the emergent phase of burn care, which assessment will be most useful in determining
whether the patient is receiving adequate fluid infusion?
a. Check skin turgor.
b. Monitor daily weight.
c. Assess mucous membranes.
d. Measure hourly urine output.
ANS: D
When fluid intake is adequate, the urine output will be at least 0.5 to 1 mL/kg/hour. The
patient's weight is not useful in this situation because of the effects of third spacing and
evaporative fluid loss. Mucous membrane assessment and skin turgor also may be used, but
they are not as adequate in determining that fluid infusions are maintaining adequate
perfusion.
Eight hours after a thermal burn covering 50% of a patient's total body surface area (TBSA) the
nurse assesses the patient. Which information would be a priority to communicate to the
health care provider?
a. Blood pressure is 95/48 per arterial line.
b. Serous exudate is leaking from the burns.
c. Cardiac monitor shows a pulse rate of 108.
d. Urine output is 20 mL per hour for the past 2 hours.
