NRl 341/l NR341l Finall Exam:l Complexl
Adultl Healthl Guidel (Latestl 2026/l 2027l
Update)l |l Qsl &l As|l Gradel A|l 100%l
Correctl (Verifiedl Answers)-l Chamberlain
QUESTION
Electricall Injuries:
Answer:
-l Severel damagel throughl bodyl byl disruptingl nervel pathways
-l Highl vl lowl voltage:l Highl =l >l 1000l voltsl andl Lowl =l <l 1000l volts
-l Entryl andl exitl burnsl arel possible
-l Respiratory/cardiacl arrestl arel possible;l dysrhythmiasl
-l Bonesl mayl fracturel froml violentl musclel contractions
-l REMEMBER:l ECGl isl mandatory...dysrhythmiasl arel commonl withl thisl typel ofl injuryl
(upl tol 24l hoursl afterl itl occurs)
QUESTION
Burnsl Assessment:
Answer:
-*Cardiovascularl Assessment*:l Hypovolemicl shockl isl al commonl causel ofl deathl inl thel
emergentl phasel inl patientsl withl seriousl injuries;l Monitorl vitall signs,l Monitorl cardiacl
status,l especiallyl inl casesl ofl electricall burnl injuries
-*Renal/Urinaryl Assessment*:l changesl relatedl tol cellularl debrisl &l decreasedl renall bloodl
flowl [Myoglobinl released;l damagel muscles],l Assessl lab;l Creatininel 1.2l tol 1.5l (don'tl
wantl >2),l Examinel urinel forl color/odor/presencel ofl particlesl orl foam.
-*Skinl Assessment*:l Datal collectedl [describel whatl youl see],l determinel sizel andl depthl
ofl injury,l determinel totall bodyl %l affected,l usel rulel ofl 9's.
QUESTION
Burnsl Rulel ofl 9s:
,Answer:
Totall headl -l 9%l Twol Armsl 18%l Trunkl 36%l Perineuml 1%l Twol Legsl 36%l =l 100%
QUESTION
Burnsl Classification:
Answer:
-l 1stl degree-l superficiall layerl ofl thel skinl andl resultl inl reddening
-l 2ndl degreel -l blistersl onl skin;l superficiall isl epidermisl andl somel dermisl whichl healsl
inl 7-10l daysl &l deepl partiall thicknessl =l epidermisl andl mostl ofl dermisl isl lostl andl
healsl inl 2l -l 4l weeks
-l 3rdl degreel -l destroysl skinl downl tol fat.l Skinl appearsl pale,l dryl andl whitel orl charred.l
(lifel threatening)
-l 4thl degreel -l Deepl Full-Thicknessl -l Destructionl ofl alll layersl plusl muscles,l tendons,l
andl bones
QUESTION
4thl Degreel Burn:
Answer:
QUESTION
True/False:l Calculatingl bodyl surfacel areal willl guidel thel healthcarel teaml inl fluidl
resuscitation
Answer:
True
,QUESTION
Fluidl Resuscitation:
Answer:
-l Basedl onl %TBSA
-l IVl fluidl resusl isl institutedl forl patientsl withl greaterl thanl 20%l TBSA
-l Consensusl Formulal (Parkland):l 4l mLl xl kgl perl %TBSAl burned
-l Adminl halfl ofl totall fluidsl duringl firstl 8l hoursl froml timel ofl injury
-l Adminl thel otherl halfl overl thel nextl 16l hoursl froml timel ofl injury
-l Deductl anyl fluidl givenl pre-hospitall froml thel amountl tol bel infusedl inl firstl 8l hours
QUESTION
Physiologicall Responsel tol Burns:
Answer:
-l Acutel inflammation...intravascularl coagulation
-l Cellularl enzymesl andl asoactivl substances
-l Activationl ofl complementsl andl inflammatoryl mediators
-l MONITOR:l Hypovolemicl Shock
-l Alteredl vascularl permeability...shiftl ofl proteinl molecules,l fluid/electrolytel imbalances,l
andl thirdl spacel (akal swelling)
QUESTION
Systemicl Responsel tol Burnsl -l CV:
Answer:
-l Lossl ofl intravascularl volume
-l Decreasedl COl andl O2l delivery//
-l Tachycardial andl vasoconstrictionl duel tol catecholaminel release
-l Myocardiall depressionl withl negativel inotropicl effect
QUESTION
Systemicl Responsel tol Burnsl (cont.):
, Answer:
-l Hostl defensel mechanisms...immunel suppression,l increasedl riskl ofl infection
-l Pulmonary...pulmonaryl HTN,l inhalationl injury,l andl pulmonaryl edema
-l Renal:l sensitivel tol decreasedl CO,l initiall decreasel inl UOPl relatedl tol decreasedl GFR,l
followedl byl diuresisl asl fluidsl shift,l andl ATNl relatedl tol hypovolemial canl resultl inl renall
failurel
-l GI:l Ischemial relatedl tol redistributionl ofl bloodl tol brainl andl heart,l paralyticl ileus,l
Curling'sl ulcerl (stressl ulcer)
-l Metabolic:l Hypermetabolicl state...ratesl arel 100-200%l abovel basall rates,l lastsl upl tol 9-
12l monthsl afterl injury
QUESTION
Phasesl ofl Burnl Care:
Answer:
1.l Resuscitation:l firstl 48l hours,l includesl pre-hospitall time,l ABCs,l andl fluidl managementl
tol preventl shock
2.l Acutel phase:l onsetl ofl diuresisl tol woundl closure,l approx.l 48-72l hoursl postl injuryl
untill woundsl close
3.l Rehabilitativel phase:l restorel tol functionall status
QUESTION
Resuscitativel Phasel ofl Burnl Injury:
Answer:
-l Stopl burningl process;l IDl life-threateningl injuries
-l ABCsl andl cervicall spinel collar
-l O2l @l 100%;l intubationl ifl needed
-l Assessl circulation,l assessl forl additionall trauma,l andl minimizel timel onl thel scene
-l Removel pt.l froml thermall source
-l Coverl andl preventl hypothermia
-l Removel jewelry,l belt,l orl clothingl thatl retainsl heat
-l Scalds,l tar,l asphaltl burns
-l Largel borel IVl cathetersl andl fluids;l IO
-l Painl managementl withl narcotics
-l VSl andl baselinel assessment
Adultl Healthl Guidel (Latestl 2026/l 2027l
Update)l |l Qsl &l As|l Gradel A|l 100%l
Correctl (Verifiedl Answers)-l Chamberlain
QUESTION
Electricall Injuries:
Answer:
-l Severel damagel throughl bodyl byl disruptingl nervel pathways
-l Highl vl lowl voltage:l Highl =l >l 1000l voltsl andl Lowl =l <l 1000l volts
-l Entryl andl exitl burnsl arel possible
-l Respiratory/cardiacl arrestl arel possible;l dysrhythmiasl
-l Bonesl mayl fracturel froml violentl musclel contractions
-l REMEMBER:l ECGl isl mandatory...dysrhythmiasl arel commonl withl thisl typel ofl injuryl
(upl tol 24l hoursl afterl itl occurs)
QUESTION
Burnsl Assessment:
Answer:
-*Cardiovascularl Assessment*:l Hypovolemicl shockl isl al commonl causel ofl deathl inl thel
emergentl phasel inl patientsl withl seriousl injuries;l Monitorl vitall signs,l Monitorl cardiacl
status,l especiallyl inl casesl ofl electricall burnl injuries
-*Renal/Urinaryl Assessment*:l changesl relatedl tol cellularl debrisl &l decreasedl renall bloodl
flowl [Myoglobinl released;l damagel muscles],l Assessl lab;l Creatininel 1.2l tol 1.5l (don'tl
wantl >2),l Examinel urinel forl color/odor/presencel ofl particlesl orl foam.
-*Skinl Assessment*:l Datal collectedl [describel whatl youl see],l determinel sizel andl depthl
ofl injury,l determinel totall bodyl %l affected,l usel rulel ofl 9's.
QUESTION
Burnsl Rulel ofl 9s:
,Answer:
Totall headl -l 9%l Twol Armsl 18%l Trunkl 36%l Perineuml 1%l Twol Legsl 36%l =l 100%
QUESTION
Burnsl Classification:
Answer:
-l 1stl degree-l superficiall layerl ofl thel skinl andl resultl inl reddening
-l 2ndl degreel -l blistersl onl skin;l superficiall isl epidermisl andl somel dermisl whichl healsl
inl 7-10l daysl &l deepl partiall thicknessl =l epidermisl andl mostl ofl dermisl isl lostl andl
healsl inl 2l -l 4l weeks
-l 3rdl degreel -l destroysl skinl downl tol fat.l Skinl appearsl pale,l dryl andl whitel orl charred.l
(lifel threatening)
-l 4thl degreel -l Deepl Full-Thicknessl -l Destructionl ofl alll layersl plusl muscles,l tendons,l
andl bones
QUESTION
4thl Degreel Burn:
Answer:
QUESTION
True/False:l Calculatingl bodyl surfacel areal willl guidel thel healthcarel teaml inl fluidl
resuscitation
Answer:
True
,QUESTION
Fluidl Resuscitation:
Answer:
-l Basedl onl %TBSA
-l IVl fluidl resusl isl institutedl forl patientsl withl greaterl thanl 20%l TBSA
-l Consensusl Formulal (Parkland):l 4l mLl xl kgl perl %TBSAl burned
-l Adminl halfl ofl totall fluidsl duringl firstl 8l hoursl froml timel ofl injury
-l Adminl thel otherl halfl overl thel nextl 16l hoursl froml timel ofl injury
-l Deductl anyl fluidl givenl pre-hospitall froml thel amountl tol bel infusedl inl firstl 8l hours
QUESTION
Physiologicall Responsel tol Burns:
Answer:
-l Acutel inflammation...intravascularl coagulation
-l Cellularl enzymesl andl asoactivl substances
-l Activationl ofl complementsl andl inflammatoryl mediators
-l MONITOR:l Hypovolemicl Shock
-l Alteredl vascularl permeability...shiftl ofl proteinl molecules,l fluid/electrolytel imbalances,l
andl thirdl spacel (akal swelling)
QUESTION
Systemicl Responsel tol Burnsl -l CV:
Answer:
-l Lossl ofl intravascularl volume
-l Decreasedl COl andl O2l delivery//
-l Tachycardial andl vasoconstrictionl duel tol catecholaminel release
-l Myocardiall depressionl withl negativel inotropicl effect
QUESTION
Systemicl Responsel tol Burnsl (cont.):
, Answer:
-l Hostl defensel mechanisms...immunel suppression,l increasedl riskl ofl infection
-l Pulmonary...pulmonaryl HTN,l inhalationl injury,l andl pulmonaryl edema
-l Renal:l sensitivel tol decreasedl CO,l initiall decreasel inl UOPl relatedl tol decreasedl GFR,l
followedl byl diuresisl asl fluidsl shift,l andl ATNl relatedl tol hypovolemial canl resultl inl renall
failurel
-l GI:l Ischemial relatedl tol redistributionl ofl bloodl tol brainl andl heart,l paralyticl ileus,l
Curling'sl ulcerl (stressl ulcer)
-l Metabolic:l Hypermetabolicl state...ratesl arel 100-200%l abovel basall rates,l lastsl upl tol 9-
12l monthsl afterl injury
QUESTION
Phasesl ofl Burnl Care:
Answer:
1.l Resuscitation:l firstl 48l hours,l includesl pre-hospitall time,l ABCs,l andl fluidl managementl
tol preventl shock
2.l Acutel phase:l onsetl ofl diuresisl tol woundl closure,l approx.l 48-72l hoursl postl injuryl
untill woundsl close
3.l Rehabilitativel phase:l restorel tol functionall status
QUESTION
Resuscitativel Phasel ofl Burnl Injury:
Answer:
-l Stopl burningl process;l IDl life-threateningl injuries
-l ABCsl andl cervicall spinel collar
-l O2l @l 100%;l intubationl ifl needed
-l Assessl circulation,l assessl forl additionall trauma,l andl minimizel timel onl thel scene
-l Removel pt.l froml thermall source
-l Coverl andl preventl hypothermia
-l Removel jewelry,l belt,l orl clothingl thatl retainsl heat
-l Scalds,l tar,l asphaltl burns
-l Largel borel IVl cathetersl andl fluids;l IO
-l Painl managementl withl narcotics
-l VSl andl baselinel assessment
