NDEE Exam 5 - Review Questions and
Correct Answers
Question 1
A client is admitted to the hospital with deep partial-thickness burns to both hands
and forearms after an accident. How should the nurse apply the prescribed
antimicrobial medication?
1 Place the medication directly on the dressing in a thick layer using clean gloves.
2 Place the medication directly on the burn wound in a thin layer using sterile gloves.
3 Put the medication in a Hubbard tank and saturate sterile dressings with it before
applying the dressings to the burns.
4 Put the medication in a Hubbard tank and allow the client to soak in the tank for
several minutes every day
Correct Answer
2 Place the medication directly on the burn wound in a thin layer using sterile
gloves.
Sterile aseptic technique is necessary for an open wound, and a thin layer of
ointment is applied directly to the affected area. Surgically aseptic, not medically
aseptic, technique is used. Although some medications may be placed directly in
the tank, antimicrobial medications are placed directly on the affected area using
surgically aseptic technique.
Page 1 of 83
,Question 2
The nurse is evaluating the condition of a client with burns of the upper body. Which
finding will alert the nurse of a potential respiratory obstruction?
1 Deep breathing
2 Hoarse quality to the voice
3 Pink-tinged, frothy sputum
4 Rapid abdominal breathing
Correct Answer
2 Hoarse quality to the voice
Hoarseness is a sign of potential respiratory insufficiency as a result of inhalation
injury, which causes edema in the surrounding tissues, including the vocal cords.
Sputum will be sooty, not frothy; pink-tinged, frothy sputum is associated with
pulmonary edema. Deep breathing and rapid abdominal breathing indicate
metabolic acidosis, not respiratory insufficiency.
Page 2 of 83
,Question 3
Nurse Malcolm is performing a sterile dressing change on a client with a superficial
partial-thickness burn on the shoulder and back. Arrange the steps in the order in
which each should be performed.
- Administer Tramadol (Tramal) 50 mg IV.
- Obtain a sample for wound culture.
- Debride the wound of eschar using gauze sponges.
- Apply silver nitrate ointment.
- Cover the wound using a sterile gauze dressing.
Correct Answer
- Administer Tramadol (Tramal) 50 mg IV.
- Debride the wound of eschar using gauze sponges.
- Obtain a sample for wound culture.
- Apply silver nitrate ointment.
- Cover the wound using a sterile gauze dressing.
Pain medication is administered prior to the dressing change since the type of burn
will be painful during the procedure. Opioids may be required initially to control
pain, but once first aid measures have been effective non-steroidal anti-
inflammatory drugs such as ibuprofen or co-dydramol taken orally will suffice.
Then the wound is debrided before getting the sample for culture to prevent other
bacteria that can contaminate the actual wound. It is important to realize that a new
burn is essentially sterile, and every attempt should be made to keep it so. The burn
wound should be thoroughly cleaned with soap and water or mild antibacterial
wash such as dilute chlorhexidine.
Obtain a sample for wound culture. Burn wound infections are one of the most
important and potentially serious complications that occur in the acute period
following injury
An antibacterial cream such as silver nitrate is applied to the area to attain the
maximum effect of the medication. Flamazine is silver sulfadiazine cream and is
applied topically on the burn wound. It is effective against gram-negative bacteria
including Pseudomonas.
Lastly, cover the wound using a sterile dressing. Depending on how healing is
progressing, dressing changes thereafter should be every three to five days. If the
Jelonet dressing has become adherent, it should be left in place to avoid damage to
the delicate healing epithelium. If Flamazine is used it should be changed on
alternate days.
Page 3 of 83
, Question 4
The client has experienced an electrical injury of the lower extremities. Which are the
priority assessment data to obtain from this client?
A. Current range of motion in all extremities
B. Heart rate and rhythm
C. Respiratory rate and pulse oximetry reading
D. Orientation to time, place, and person
Correct Answer
B. Heart rate and rhythm
Electric current travels through the body from the entrance site to the exit site and
can seriously damage all tissues between the two sites. Early cardiac damage from
electrical injury includes irregular heart rate, rhythm, and ECG changes. It is also
important to obtain the patient’s cardiac history, including any history of prior
arrhythmias.
Option A: Range of motion is also important. However, the priority is to make sure
that the heart rate and rhythm are adequate to support perfusion to the brain and
other vital organs.
Option C: The airway is not at any particular risk with this injury. Therefore,
respiratory rate and pulse oximetry are not priority assessments. Any patient that
was in contact with a high voltage source should have continuous cardiac
monitoring during evaluation.
Option D: These patients are specifically at risk for cardiac damage if the path of
the current traversed the heart. One may also consider CT imaging of the head if
the patient has altered mental status or associated head trauma from a fall or being
thrown in a blast.
Page 4 of 83
Correct Answers
Question 1
A client is admitted to the hospital with deep partial-thickness burns to both hands
and forearms after an accident. How should the nurse apply the prescribed
antimicrobial medication?
1 Place the medication directly on the dressing in a thick layer using clean gloves.
2 Place the medication directly on the burn wound in a thin layer using sterile gloves.
3 Put the medication in a Hubbard tank and saturate sterile dressings with it before
applying the dressings to the burns.
4 Put the medication in a Hubbard tank and allow the client to soak in the tank for
several minutes every day
Correct Answer
2 Place the medication directly on the burn wound in a thin layer using sterile
gloves.
Sterile aseptic technique is necessary for an open wound, and a thin layer of
ointment is applied directly to the affected area. Surgically aseptic, not medically
aseptic, technique is used. Although some medications may be placed directly in
the tank, antimicrobial medications are placed directly on the affected area using
surgically aseptic technique.
Page 1 of 83
,Question 2
The nurse is evaluating the condition of a client with burns of the upper body. Which
finding will alert the nurse of a potential respiratory obstruction?
1 Deep breathing
2 Hoarse quality to the voice
3 Pink-tinged, frothy sputum
4 Rapid abdominal breathing
Correct Answer
2 Hoarse quality to the voice
Hoarseness is a sign of potential respiratory insufficiency as a result of inhalation
injury, which causes edema in the surrounding tissues, including the vocal cords.
Sputum will be sooty, not frothy; pink-tinged, frothy sputum is associated with
pulmonary edema. Deep breathing and rapid abdominal breathing indicate
metabolic acidosis, not respiratory insufficiency.
Page 2 of 83
,Question 3
Nurse Malcolm is performing a sterile dressing change on a client with a superficial
partial-thickness burn on the shoulder and back. Arrange the steps in the order in
which each should be performed.
- Administer Tramadol (Tramal) 50 mg IV.
- Obtain a sample for wound culture.
- Debride the wound of eschar using gauze sponges.
- Apply silver nitrate ointment.
- Cover the wound using a sterile gauze dressing.
Correct Answer
- Administer Tramadol (Tramal) 50 mg IV.
- Debride the wound of eschar using gauze sponges.
- Obtain a sample for wound culture.
- Apply silver nitrate ointment.
- Cover the wound using a sterile gauze dressing.
Pain medication is administered prior to the dressing change since the type of burn
will be painful during the procedure. Opioids may be required initially to control
pain, but once first aid measures have been effective non-steroidal anti-
inflammatory drugs such as ibuprofen or co-dydramol taken orally will suffice.
Then the wound is debrided before getting the sample for culture to prevent other
bacteria that can contaminate the actual wound. It is important to realize that a new
burn is essentially sterile, and every attempt should be made to keep it so. The burn
wound should be thoroughly cleaned with soap and water or mild antibacterial
wash such as dilute chlorhexidine.
Obtain a sample for wound culture. Burn wound infections are one of the most
important and potentially serious complications that occur in the acute period
following injury
An antibacterial cream such as silver nitrate is applied to the area to attain the
maximum effect of the medication. Flamazine is silver sulfadiazine cream and is
applied topically on the burn wound. It is effective against gram-negative bacteria
including Pseudomonas.
Lastly, cover the wound using a sterile dressing. Depending on how healing is
progressing, dressing changes thereafter should be every three to five days. If the
Jelonet dressing has become adherent, it should be left in place to avoid damage to
the delicate healing epithelium. If Flamazine is used it should be changed on
alternate days.
Page 3 of 83
, Question 4
The client has experienced an electrical injury of the lower extremities. Which are the
priority assessment data to obtain from this client?
A. Current range of motion in all extremities
B. Heart rate and rhythm
C. Respiratory rate and pulse oximetry reading
D. Orientation to time, place, and person
Correct Answer
B. Heart rate and rhythm
Electric current travels through the body from the entrance site to the exit site and
can seriously damage all tissues between the two sites. Early cardiac damage from
electrical injury includes irregular heart rate, rhythm, and ECG changes. It is also
important to obtain the patient’s cardiac history, including any history of prior
arrhythmias.
Option A: Range of motion is also important. However, the priority is to make sure
that the heart rate and rhythm are adequate to support perfusion to the brain and
other vital organs.
Option C: The airway is not at any particular risk with this injury. Therefore,
respiratory rate and pulse oximetry are not priority assessments. Any patient that
was in contact with a high voltage source should have continuous cardiac
monitoring during evaluation.
Option D: These patients are specifically at risk for cardiac damage if the path of
the current traversed the heart. One may also consider CT imaging of the head if
the patient has altered mental status or associated head trauma from a fall or being
thrown in a blast.
Page 4 of 83
