NUR 265 Exam 3 Actual Exam 2026/2027 – Complete Med-Surg Questions with
Detailed Rationales | 100% Verified | Pass Guaranteed – A+ Graded
Section A: Burn Injuries – Assessment, Fluid Resuscitation, & Wound
Care (12 Questions)
Q1: A 35-year-old man is brought to the ED after a house fire. He has burns covering his
anterior chest, abdomen, and both anterior legs. Using the adult Rule of Nines, what is
the estimated total body surface area (TBSA) burned?
A. 18%
B. 22.5%
C. 27% [CORRECT]
D. 36%
Correct Answer: C
Rationale: The anterior trunk (chest and abdomen) equals 18% TBSA, and both anterior
legs equal 9% TBSA (4.5% each), for a total of 27%. Option A includes only the trunk; B is
an incorrect intermediate calculation; D incorrectly adds posterior surfaces.
Q2: A 25-year-old woman weighs 70 kg and has sustained burns to 40% TBSA. Using the
Parkland formula, how much Lactated Ringer's solution should she receive in the first 8
hours?
,A. 2,800 mL
B. 4,200 mL
C. 5,600 mL [CORRECT]
D. 11,200 mL
Correct Answer: C
Rationale: The Parkland formula calculates 4 mL × kg × %TBSA = 4 × 70 × 40 = 11,200
mL total for 24 hours; half (5,600 mL) is infused in the first 8 hours. Option A is
one-quarter of the total; B is an incorrect fraction; D is the full 24-hour volume.
Q3: A patient with circumferential full-thickness burns to the chest is exhibiting difficulty
breathing, decreased chest wall excursion, and rising CO₂ levels. Which intervention is
the priority?
A. Increase the IV fluid rate
B. Apply topical antimicrobial ointment
C. Prepare for an escharotomy [CORRECT]
D. Administer nebulized bronchodilators
Correct Answer: C
Rationale: Circumferential full-thickness burns create a rigid eschar that restricts chest
expansion, leading to respiratory compromise; an escharotomy is required to restore
compliance. Options A and D do not address the restrictive chest wall; B is
inappropriate during acute respiratory compromise.
, Q4: A patient rescued from a structure fire has facial burns, singed nasal hairs,
carbonaceous sputum, and a hoarse voice. Which complication is the nurse most
concerned about?
A. Fluid overload
B. Compartment syndrome
C. Inhalation injury and airway edema [CORRECT]
D. Hypertrophic scarring
Correct Answer: C
Rationale: Facial burns, singed hairs, carbonaceous sputum, and hoarseness are classic
indicators of inhalation injury with risk for progressive airway edema and obstruction.
Options A and B are not immediate priorities in this presentation; D is a long-term
concern, not an acute airway threat.
Q5: During the resuscitation phase of a major burn, which parameter is the best
indicator of adequate tissue perfusion?
A. Blood pressure of 90/60 mmHg
B. Heart rate of 110 bpm
C. Urine output of 0.5–1 mL/kg/hr [CORRECT]
D. Central venous pressure of 2 mmHg
Correct Answer: C
Detailed Rationales | 100% Verified | Pass Guaranteed – A+ Graded
Section A: Burn Injuries – Assessment, Fluid Resuscitation, & Wound
Care (12 Questions)
Q1: A 35-year-old man is brought to the ED after a house fire. He has burns covering his
anterior chest, abdomen, and both anterior legs. Using the adult Rule of Nines, what is
the estimated total body surface area (TBSA) burned?
A. 18%
B. 22.5%
C. 27% [CORRECT]
D. 36%
Correct Answer: C
Rationale: The anterior trunk (chest and abdomen) equals 18% TBSA, and both anterior
legs equal 9% TBSA (4.5% each), for a total of 27%. Option A includes only the trunk; B is
an incorrect intermediate calculation; D incorrectly adds posterior surfaces.
Q2: A 25-year-old woman weighs 70 kg and has sustained burns to 40% TBSA. Using the
Parkland formula, how much Lactated Ringer's solution should she receive in the first 8
hours?
,A. 2,800 mL
B. 4,200 mL
C. 5,600 mL [CORRECT]
D. 11,200 mL
Correct Answer: C
Rationale: The Parkland formula calculates 4 mL × kg × %TBSA = 4 × 70 × 40 = 11,200
mL total for 24 hours; half (5,600 mL) is infused in the first 8 hours. Option A is
one-quarter of the total; B is an incorrect fraction; D is the full 24-hour volume.
Q3: A patient with circumferential full-thickness burns to the chest is exhibiting difficulty
breathing, decreased chest wall excursion, and rising CO₂ levels. Which intervention is
the priority?
A. Increase the IV fluid rate
B. Apply topical antimicrobial ointment
C. Prepare for an escharotomy [CORRECT]
D. Administer nebulized bronchodilators
Correct Answer: C
Rationale: Circumferential full-thickness burns create a rigid eschar that restricts chest
expansion, leading to respiratory compromise; an escharotomy is required to restore
compliance. Options A and D do not address the restrictive chest wall; B is
inappropriate during acute respiratory compromise.
, Q4: A patient rescued from a structure fire has facial burns, singed nasal hairs,
carbonaceous sputum, and a hoarse voice. Which complication is the nurse most
concerned about?
A. Fluid overload
B. Compartment syndrome
C. Inhalation injury and airway edema [CORRECT]
D. Hypertrophic scarring
Correct Answer: C
Rationale: Facial burns, singed hairs, carbonaceous sputum, and hoarseness are classic
indicators of inhalation injury with risk for progressive airway edema and obstruction.
Options A and B are not immediate priorities in this presentation; D is a long-term
concern, not an acute airway threat.
Q5: During the resuscitation phase of a major burn, which parameter is the best
indicator of adequate tissue perfusion?
A. Blood pressure of 90/60 mmHg
B. Heart rate of 110 bpm
C. Urine output of 0.5–1 mL/kg/hr [CORRECT]
D. Central venous pressure of 2 mmHg
Correct Answer: C
