Chapter 66: Caring for Clients With Burns – 2026/2027 Practice Questions and Rationales
1.A nurse is required to monitor the effectiveness of fluid resuscitation in a client who is
being treated for burns. Which of the following assessments would indicate the success of
the fluid resuscitation?
A) The client's heart rate is rapid and regular.
B) The client's urinary output is 0.3 to 0.5 mL/kg/hour.
C) The client's breathing is unlabored, and skin is clammy.
D) The client is alert and conscious.
Ans: B
Feedback:
Successful fluid resuscitation is gauged by a urinary output of 0.3 to 0.5 mL/kg/hour via
an indwelling catheter. Fluid resuscitation does not directly affect the client's heart rate,
breathing, or mental status.
2. Which of the following actions should a nurse perform to help reduce the accumulation
of debris within the burn wound?
A) Use powder-free sterile gloves.
B) Use topical antimicrobial medications.
C) Use cold compresses or sponges.
D) Use sterilized gauze swaps.
Ans: A
Feedback:
The healthcare team should wear powder-free sterile gloves when handling the burn
wound to reduce the accumulation of debris within the wound that may complicate the
healing. After the wound has been cleansed, topical antimicrobial medications are used to
minimize the risk of infection. The particles or fiber from cold compresses, sponges, or
sterilized gauze swaps may add to the accumulation` of debris if used on a burn wound.
3. A nurse is required to care for a client with facial burns who is prescribed the open
method treatment. Which of the following nursing interventions should a nurse perform?
A) Administer a cold sponge bath to the client.
B) Keep the client's room cool and airy.
C) Place a bed cradle or sheets over the client.
D) Place the client on a moist linen sheet.
Ans: C
Feedback:
The skin of the client with burn is sensitive to drafts and temperature changes; therefore,
a bed cradle or sheets should be placed over the client. The room should be kept warm
and humidified, not cool and airy. The client should be placed in isolation in a bed with
sterile, dry linen. Whirlpool baths are prescribed to loosen the crust, or eschar, which
forms over the wound. Sponge baths are not advisable because particles from the sponge
may cause accumulation of debris within the burn wound. Moist linen sheets are not
placed on clients anymore due to their cooling effect, and they can lead the client to work
hard to maintain proper body temperature.
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, Chapter 66: Caring for Clients With Burns – 2026/2027 Practice Questions and Rationales
4. A client with a burn injury is in acute stress. Which of the following complications is
prone to develop in this client?
A) Anemia
B) Gastric ulcers
C) Hyperthyroidism
D) Cardiac arrest
Ans: B
Feedback:
The release of histamine as a consequence of the stress response increases gastric acidity.
The client with a burn is prone to develop gastric ulcers. Anemia develops because of the
heat destroying the erythrocytes. Release of histamine does not cause hyperthyroidism or
cardiac arrest.
5. Skin grafts are necessary for which of the following burns?
A) Superficial
B) Superficial partial thickness
C) Full thickness
D) First degree
Ans: C
Feedback:
Skin grafts are necessary for a full-thickness burn because the skin cells no longer are
alive to regenerate. Superficial (first degree), superficial partial-thickness burns do not
usually need skin grafting.
6. Which zone consists of the area where the injury is most severe and deepest?
A) Coagulation
B) Stasis
C) Hyperemia
D) Necrosis
Ans: A
Feedback:
The zone of coagulation is at the center of the injury and is the area of injury that is most
severe and the deepest. The zone of stasis is the area of intermediate burn injury. The
zone of hyperemia is the area of least injury, where the epidermis and dermis are only
minimally damaged. There is no zone of necrosis.
7. Which type of debridement occurs when nonliving tissues sloughs away from uninjured
tissues?
A) Mechanical
B) Natural
C) Enzymatic
D) Surgical
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1.A nurse is required to monitor the effectiveness of fluid resuscitation in a client who is
being treated for burns. Which of the following assessments would indicate the success of
the fluid resuscitation?
A) The client's heart rate is rapid and regular.
B) The client's urinary output is 0.3 to 0.5 mL/kg/hour.
C) The client's breathing is unlabored, and skin is clammy.
D) The client is alert and conscious.
Ans: B
Feedback:
Successful fluid resuscitation is gauged by a urinary output of 0.3 to 0.5 mL/kg/hour via
an indwelling catheter. Fluid resuscitation does not directly affect the client's heart rate,
breathing, or mental status.
2. Which of the following actions should a nurse perform to help reduce the accumulation
of debris within the burn wound?
A) Use powder-free sterile gloves.
B) Use topical antimicrobial medications.
C) Use cold compresses or sponges.
D) Use sterilized gauze swaps.
Ans: A
Feedback:
The healthcare team should wear powder-free sterile gloves when handling the burn
wound to reduce the accumulation of debris within the wound that may complicate the
healing. After the wound has been cleansed, topical antimicrobial medications are used to
minimize the risk of infection. The particles or fiber from cold compresses, sponges, or
sterilized gauze swaps may add to the accumulation` of debris if used on a burn wound.
3. A nurse is required to care for a client with facial burns who is prescribed the open
method treatment. Which of the following nursing interventions should a nurse perform?
A) Administer a cold sponge bath to the client.
B) Keep the client's room cool and airy.
C) Place a bed cradle or sheets over the client.
D) Place the client on a moist linen sheet.
Ans: C
Feedback:
The skin of the client with burn is sensitive to drafts and temperature changes; therefore,
a bed cradle or sheets should be placed over the client. The room should be kept warm
and humidified, not cool and airy. The client should be placed in isolation in a bed with
sterile, dry linen. Whirlpool baths are prescribed to loosen the crust, or eschar, which
forms over the wound. Sponge baths are not advisable because particles from the sponge
may cause accumulation of debris within the burn wound. Moist linen sheets are not
placed on clients anymore due to their cooling effect, and they can lead the client to work
hard to maintain proper body temperature.
Page 1
, Chapter 66: Caring for Clients With Burns – 2026/2027 Practice Questions and Rationales
4. A client with a burn injury is in acute stress. Which of the following complications is
prone to develop in this client?
A) Anemia
B) Gastric ulcers
C) Hyperthyroidism
D) Cardiac arrest
Ans: B
Feedback:
The release of histamine as a consequence of the stress response increases gastric acidity.
The client with a burn is prone to develop gastric ulcers. Anemia develops because of the
heat destroying the erythrocytes. Release of histamine does not cause hyperthyroidism or
cardiac arrest.
5. Skin grafts are necessary for which of the following burns?
A) Superficial
B) Superficial partial thickness
C) Full thickness
D) First degree
Ans: C
Feedback:
Skin grafts are necessary for a full-thickness burn because the skin cells no longer are
alive to regenerate. Superficial (first degree), superficial partial-thickness burns do not
usually need skin grafting.
6. Which zone consists of the area where the injury is most severe and deepest?
A) Coagulation
B) Stasis
C) Hyperemia
D) Necrosis
Ans: A
Feedback:
The zone of coagulation is at the center of the injury and is the area of injury that is most
severe and the deepest. The zone of stasis is the area of intermediate burn injury. The
zone of hyperemia is the area of least injury, where the epidermis and dermis are only
minimally damaged. There is no zone of necrosis.
7. Which type of debridement occurs when nonliving tissues sloughs away from uninjured
tissues?
A) Mechanical
B) Natural
C) Enzymatic
D) Surgical
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