Chapter 24 Burns Lewis UPDATED ACTUAL Questions and
CORRECT Answers
A nurse is providing care to a patient admitted to the A,C,D
burn unit. Which pathophysiologic changes does the In a burn injury, the viscosity of body fluids is increased, the blood volume is
nurse anticipate in this patient? Select all that apply. reduced, and vascular permeability is increased. Hematocrit and peripheral
resistance are increased in burn injuries.
a. Increased viscosity
b. Decreased hematocrit
c. Decreased blood volume
d. Increased vascular permeability
e.Decreased peripheral resistance
Which clinical manifestations are observed in a patient in B,E
the emergent phase of a burn injury? Select all that During the emergent phase of a burn injury, the patient exhibits tachycardia and
apply. hypotension. Other clinical manifestations during this phase include a loss of
a. Increased appetite appetite, a decreased urine output, and tachypnea.
b. Increased heart rate pp. 437-438
c. Increased urine output
d. Decreased respiratory rate
e.Decreased blood pressure
Which complications occur in a patient with metabolic A,D
asphyxiation? Select all that apply. Metabolic asphyxiation is a type of smoke and inhalation injury that occurs due to
a. Hypoxia inhalation of carbon monoxide or hydrogen cyanide. In this condition, the oxygen
b. Cardiac standstill delivery or consumption is impaired, resulting in hypoxia. Hydrogen cyanide
c. Protein hydrolysis poisoning also occurs in metabolic asphyxiation in the absence of burn injury to
d. Hydrogen cyanide poisoning the skin. Cardiac standstill occurs in an electrical injury. Protein hydrolysis occurs
e. Acute respiratory distress syndrome in a chemical injury. Acute respiratory distress syndrome occurs in a lower airway
injury.
p. 430
Which fluid and electrolyte change occurs during the D
early emergent phase of burn injury? After the burn, in the emergent phase, the capillary walls become more
a. Increased excretion of urine permeable, causing the movement of sodium, water, and plasma proteins into
b. Increased colloidal osmotic pressure the interstitial spaces and surrounding tissues. An increased excretion of urine
c. Return of interstitial fluid to the vascular space and the return of interstitial fluid to the vascular spaces occurs toward the end of
d. Movement of sodium and water into interstitial fluids the emergent phase. During the early emergent phase, colloidal osmotic pressure
is decreased with progressive protein loss from the vascular spaces.
pp. 434, 436
A patient who escaped from a burning building, which B
was enclosed with no ventilation, is brought to the A patient who was trapped in an enclosed burning building with no ventilation
emergency department. The patient is confused, has and is exhibiting confusion, dyspnea, and nasal burns is most likely experiencing a
difficulty breathing, and has nasal burns. Which condition lower airway burn injury. Pulmonary edema may occur but not until 12 to 24 hours
does the nurse suspect? after the initial insult. Clinical manifestations of an upper airway injury include
a. Pulmonary edema blisters, edema, difficulty in swallowing, and total airway obstruction. Carbon
b. Lower airway injury monoxide poisoning results in hypoxia, in which oxygen consumption is impaired.
c. Upper airway injury p 431
d. Carbon monoxide poisoning
, A nurse is assessing a patient with a burn injury. Which E
clinical manifestation does the nurse anticipate due to Thrombosis in the capillaries of burned tissue results in a loss of circulating
thrombosis in the capillaries of the burned tissue? erythrocytes (RBCs). An elevated heart rate and decreased blood pressure are
a. Elevated heart rate signs of hypovolemic shock, which is caused by a massive shift of fluids out of the
b. Elevated hematocrit blood vessels. Hematocrit is elevated in burn injuries due to the
c. Decreased blood pressure hemoconcentration that results from fluid loss.
e.Decreased erythrocyte count p. 434
Electrical burns occur from...? ...the intense heat of an electrical current. Electrical burns present with dry and
leathery skin, dysrhythmia, and a loss of consciousness.
Thermal burns occur due to...? ...hot liquids or flames, resulting in skin injuries ranging from superficial to full-
thickness.
What is is the most commonly used parameter to assess Urinary output
the adequacy of fluid resuscitation in emergent phase?
A deep partial-thickness burn involves what layers of The epidermal and dermal layers of the skin.
skin?
How is it characterized? It is characterized by a wet, shiny, weeping surface marked by blisters and is
painful and very sensitive to the touch.
The nurse is assessing a patient admitted to the Singed nasal or facial hair is one of the manifestations of a lower airway injury,
emergency department after the inhalation of toxic involving the trachea, bronchioles, and alveoli. Blisters, total airway obstruction,
chemicals. Which finding indicates a lower airway injury? and substernal retractions can be seen in patients suffering from an upper airway
a. Blisters burn injury.
b. Singed nasal hairs Text Reference: p. 431
c. Total airway obstruction
d. Substernal retractions
A nurse is assessing a patient who was burned after B
contact with gasoline. For which complication does the Gasoline is an organic compound that causes chemical burns. This compound
nurse monitor? produces systemic toxicity in patients. Liquefaction and protein hydrolysis occur
a. Liquefaction due to chemical burns resulting from alkalis. Electrical injury results in severe
b. Systemic toxicity metabolic acidosis.
c. Protein hydrolysis pp. 429-430
d. Severe metabolic acidosis
A patient is admitted to the burn unit with second-degree A,B,C
thermal burns. Which characteristics of a second-degree Second-degree burns show epidermal and dermal involvement to varying depths.
thermal burn should the nurse expect to find during the These burn injuries are characterized by fluid-filled vesicles that are
physical assessment? Select all that apply. erythematous, glossy, and damp. The patient may complain of severe pain caused
a. Severe pain by nerve injury. Mild to moderate edema may be present. Waxy, white, hard skin
b. Mild edema and visible thrombosed vessels are found in third-degree burns.
c.Fluid-filled vesicles
d.Waxy, white, hard skin
e.Visible thrombosed vessels
CORRECT Answers
A nurse is providing care to a patient admitted to the A,C,D
burn unit. Which pathophysiologic changes does the In a burn injury, the viscosity of body fluids is increased, the blood volume is
nurse anticipate in this patient? Select all that apply. reduced, and vascular permeability is increased. Hematocrit and peripheral
resistance are increased in burn injuries.
a. Increased viscosity
b. Decreased hematocrit
c. Decreased blood volume
d. Increased vascular permeability
e.Decreased peripheral resistance
Which clinical manifestations are observed in a patient in B,E
the emergent phase of a burn injury? Select all that During the emergent phase of a burn injury, the patient exhibits tachycardia and
apply. hypotension. Other clinical manifestations during this phase include a loss of
a. Increased appetite appetite, a decreased urine output, and tachypnea.
b. Increased heart rate pp. 437-438
c. Increased urine output
d. Decreased respiratory rate
e.Decreased blood pressure
Which complications occur in a patient with metabolic A,D
asphyxiation? Select all that apply. Metabolic asphyxiation is a type of smoke and inhalation injury that occurs due to
a. Hypoxia inhalation of carbon monoxide or hydrogen cyanide. In this condition, the oxygen
b. Cardiac standstill delivery or consumption is impaired, resulting in hypoxia. Hydrogen cyanide
c. Protein hydrolysis poisoning also occurs in metabolic asphyxiation in the absence of burn injury to
d. Hydrogen cyanide poisoning the skin. Cardiac standstill occurs in an electrical injury. Protein hydrolysis occurs
e. Acute respiratory distress syndrome in a chemical injury. Acute respiratory distress syndrome occurs in a lower airway
injury.
p. 430
Which fluid and electrolyte change occurs during the D
early emergent phase of burn injury? After the burn, in the emergent phase, the capillary walls become more
a. Increased excretion of urine permeable, causing the movement of sodium, water, and plasma proteins into
b. Increased colloidal osmotic pressure the interstitial spaces and surrounding tissues. An increased excretion of urine
c. Return of interstitial fluid to the vascular space and the return of interstitial fluid to the vascular spaces occurs toward the end of
d. Movement of sodium and water into interstitial fluids the emergent phase. During the early emergent phase, colloidal osmotic pressure
is decreased with progressive protein loss from the vascular spaces.
pp. 434, 436
A patient who escaped from a burning building, which B
was enclosed with no ventilation, is brought to the A patient who was trapped in an enclosed burning building with no ventilation
emergency department. The patient is confused, has and is exhibiting confusion, dyspnea, and nasal burns is most likely experiencing a
difficulty breathing, and has nasal burns. Which condition lower airway burn injury. Pulmonary edema may occur but not until 12 to 24 hours
does the nurse suspect? after the initial insult. Clinical manifestations of an upper airway injury include
a. Pulmonary edema blisters, edema, difficulty in swallowing, and total airway obstruction. Carbon
b. Lower airway injury monoxide poisoning results in hypoxia, in which oxygen consumption is impaired.
c. Upper airway injury p 431
d. Carbon monoxide poisoning
, A nurse is assessing a patient with a burn injury. Which E
clinical manifestation does the nurse anticipate due to Thrombosis in the capillaries of burned tissue results in a loss of circulating
thrombosis in the capillaries of the burned tissue? erythrocytes (RBCs). An elevated heart rate and decreased blood pressure are
a. Elevated heart rate signs of hypovolemic shock, which is caused by a massive shift of fluids out of the
b. Elevated hematocrit blood vessels. Hematocrit is elevated in burn injuries due to the
c. Decreased blood pressure hemoconcentration that results from fluid loss.
e.Decreased erythrocyte count p. 434
Electrical burns occur from...? ...the intense heat of an electrical current. Electrical burns present with dry and
leathery skin, dysrhythmia, and a loss of consciousness.
Thermal burns occur due to...? ...hot liquids or flames, resulting in skin injuries ranging from superficial to full-
thickness.
What is is the most commonly used parameter to assess Urinary output
the adequacy of fluid resuscitation in emergent phase?
A deep partial-thickness burn involves what layers of The epidermal and dermal layers of the skin.
skin?
How is it characterized? It is characterized by a wet, shiny, weeping surface marked by blisters and is
painful and very sensitive to the touch.
The nurse is assessing a patient admitted to the Singed nasal or facial hair is one of the manifestations of a lower airway injury,
emergency department after the inhalation of toxic involving the trachea, bronchioles, and alveoli. Blisters, total airway obstruction,
chemicals. Which finding indicates a lower airway injury? and substernal retractions can be seen in patients suffering from an upper airway
a. Blisters burn injury.
b. Singed nasal hairs Text Reference: p. 431
c. Total airway obstruction
d. Substernal retractions
A nurse is assessing a patient who was burned after B
contact with gasoline. For which complication does the Gasoline is an organic compound that causes chemical burns. This compound
nurse monitor? produces systemic toxicity in patients. Liquefaction and protein hydrolysis occur
a. Liquefaction due to chemical burns resulting from alkalis. Electrical injury results in severe
b. Systemic toxicity metabolic acidosis.
c. Protein hydrolysis pp. 429-430
d. Severe metabolic acidosis
A patient is admitted to the burn unit with second-degree A,B,C
thermal burns. Which characteristics of a second-degree Second-degree burns show epidermal and dermal involvement to varying depths.
thermal burn should the nurse expect to find during the These burn injuries are characterized by fluid-filled vesicles that are
physical assessment? Select all that apply. erythematous, glossy, and damp. The patient may complain of severe pain caused
a. Severe pain by nerve injury. Mild to moderate edema may be present. Waxy, white, hard skin
b. Mild edema and visible thrombosed vessels are found in third-degree burns.
c.Fluid-filled vesicles
d.Waxy, white, hard skin
e.Visible thrombosed vessels
