NEW YORK BURN NURSING EXAM | PRACTICE EXAM |
STUDY GUIDE | TESTBANK | LATEST UPDATE
2026/2027 | QUESTIONS | 100% CORRECT ANSWERS
Table of Contents: Burn Assessment and Classification — Burn Shock and Fluid
Resuscitation — Airway and Inhalation Injury — Electrical and Chemical Burns —
Wound Management and Infection Prevention — Escharotomy and Compartment
Syndromes — Pain, Sedation, and Delirium — Nutrition and Metabolic Support —
Pediatric and Older-Adult Burns — Rehabilitation and Psychosocial Care —
Medication Safety — Ethics, Documentation, and Professional Nursing Practice
Introduction
This advanced New York Burn Nursing practice examination evaluates the clinical
reasoning required to care for patients with complex thermal, chemical, electrical,
and inhalation injuries. Questions emphasize burn-depth assessment, total body
surface area estimation, resuscitation, airway management, wound care, infection
prevention, analgesia, nutrition, pharmacology, complications, rehabilitation, and
multidisciplinary decision-making. The examination is designed for experienced
nurses and learners preparing for advanced professional-level assessments. Expect
challenging clinical scenarios requiring prioritization, interpretation of evolving
assessment findings, calculation of treatment parameters, recognition of life-
threatening complications, and application of evidence-based nursing principles.
Several questions also address documentation, delegation, professional judgment,
and safe practice within a New York nursing-care environment.
Questions 1–30
Question 1
A 42-year-old adult sustains flame burns involving the anterior trunk, entire right
arm, and anterior aspect of the right leg. Using the adult Rule of Nines, which
estimated TBSA should the nurse use initially for fluid-resuscitation planning?
A. 22.5%
B. 27%
C. 31.5%
D. 36%
, Correct Answer: C
Explanation: In an adult, the anterior trunk represents 18%, one entire arm 9%,
and the anterior portion of one leg 4.5%, totaling 31.5% TBSA.
Question 2
A patient with a major thermal burn is receiving crystalloid resuscitation. Four hours
after injury, the patient becomes increasingly restless, has cool extremities, a heart
rate of 132/min, and urine output of 12 mL/hr. Which interpretation is most
appropriate?
A. The patient has achieved adequate resuscitation and requires fluid restriction.
B. The findings suggest inadequate organ perfusion and require reassessment of
resuscitation.
C. The findings are expected during the inflammatory phase and require no
intervention.
D. The low urine output indicates acute renal recovery following fluid therapy.
Correct Answer: B
Explanation: Persistent oliguria, tachycardia, cool skin, and altered mental status
suggest inadequate systemic perfusion. Resuscitation must be reassessed using
the overall clinical picture rather than a single parameter.
Question 3
A patient rescued from a house fire has facial burns, soot around the mouth,
hoarseness, and progressively increasing work of breathing. Pulse oximetry is 99%
after oxygen is applied. What is the priority nursing action?
A. Reassure the patient because oxygen saturation is normal.
B. Encourage oral fluids to loosen airway secretions.
C. Prepare for early advanced airway management.
D. Delay airway intervention until oxygen saturation falls below 90%.
Correct Answer: C
Explanation: Facial burns, soot, hoarseness, and progressive respiratory difficulty
, strongly suggest inhalation injury and evolving airway edema. A normal pulse
oximeter does not exclude significant inhalation injury or impending obstruction.
Question 4
A patient is rescued from an enclosed-space fire and develops headache, confusion,
and nausea. Pulse oximetry remains 100%. Which assessment finding most strongly
supports carbon monoxide poisoning?
A. Elevated carboxyhemoglobin concentration
B. Increased serum sodium concentration
C. Reduced serum albumin concentration
D. Elevated hematocrit caused by dehydration
Correct Answer: A
Explanation: Carbon monoxide binds hemoglobin with high affinity, producing
carboxyhemoglobin and impairing oxygen delivery. Standard pulse oximetry may
appear falsely reassuring.
Question 5
A patient with a circumferential full-thickness burn of the chest develops increasing
airway pressures and diminished chest expansion despite adequate sedation and
mechanical ventilation. What complication should the nurse suspect?
A. Neurogenic pulmonary edema
B. Restrictive thoracic eschar
C. Acute gastric dilation
D. Isolated metabolic alkalosis
Correct Answer: B
Explanation: Circumferential full-thickness chest burns can form a rigid eschar
that restricts thoracic expansion. Escharotomy may be required when the
constriction compromises ventilation.
Question 6
, A patient with a circumferential full-thickness burn of the lower leg develops severe
pain, increasing tissue tension, paresthesia, and diminished distal Doppler signals.
Which intervention should the nurse anticipate?
A. Application of a tighter compression dressing
B. Immediate elevation only and continued observation
C. Evaluation for escharotomy or compartment decompression
D. Delayed assessment until peripheral pulses disappear completely
Correct Answer: C
Explanation: Circumferential burns can impair distal circulation through
constrictive eschar and rising compartment pressure. Progressive neurovascular
compromise requires urgent evaluation and possible decompression.
Question 7
A patient has a chemical burn caused by a dry powdered substance. Which action is
most appropriate initially?
A. Immediately irrigate the substance with water without removing the powder.
B. Brush off the dry chemical while using appropriate protective precautions before
irrigation.
C. Neutralize the chemical with an opposite-pH solution.
D. Cover the chemical with an occlusive dressing before assessment.
Correct Answer: B
Explanation: Dry chemicals should generally be carefully removed from the skin
before irrigation to prevent activation or spread. Staff must use appropriate
personal protective equipment.
Question 8
A worker sustains a hydrofluoric acid burn to the hand. Which laboratory
abnormality is particularly concerning because of systemic fluoride toxicity?
A. Hypercalcemia
B. Hypocalcemia
STUDY GUIDE | TESTBANK | LATEST UPDATE
2026/2027 | QUESTIONS | 100% CORRECT ANSWERS
Table of Contents: Burn Assessment and Classification — Burn Shock and Fluid
Resuscitation — Airway and Inhalation Injury — Electrical and Chemical Burns —
Wound Management and Infection Prevention — Escharotomy and Compartment
Syndromes — Pain, Sedation, and Delirium — Nutrition and Metabolic Support —
Pediatric and Older-Adult Burns — Rehabilitation and Psychosocial Care —
Medication Safety — Ethics, Documentation, and Professional Nursing Practice
Introduction
This advanced New York Burn Nursing practice examination evaluates the clinical
reasoning required to care for patients with complex thermal, chemical, electrical,
and inhalation injuries. Questions emphasize burn-depth assessment, total body
surface area estimation, resuscitation, airway management, wound care, infection
prevention, analgesia, nutrition, pharmacology, complications, rehabilitation, and
multidisciplinary decision-making. The examination is designed for experienced
nurses and learners preparing for advanced professional-level assessments. Expect
challenging clinical scenarios requiring prioritization, interpretation of evolving
assessment findings, calculation of treatment parameters, recognition of life-
threatening complications, and application of evidence-based nursing principles.
Several questions also address documentation, delegation, professional judgment,
and safe practice within a New York nursing-care environment.
Questions 1–30
Question 1
A 42-year-old adult sustains flame burns involving the anterior trunk, entire right
arm, and anterior aspect of the right leg. Using the adult Rule of Nines, which
estimated TBSA should the nurse use initially for fluid-resuscitation planning?
A. 22.5%
B. 27%
C. 31.5%
D. 36%
, Correct Answer: C
Explanation: In an adult, the anterior trunk represents 18%, one entire arm 9%,
and the anterior portion of one leg 4.5%, totaling 31.5% TBSA.
Question 2
A patient with a major thermal burn is receiving crystalloid resuscitation. Four hours
after injury, the patient becomes increasingly restless, has cool extremities, a heart
rate of 132/min, and urine output of 12 mL/hr. Which interpretation is most
appropriate?
A. The patient has achieved adequate resuscitation and requires fluid restriction.
B. The findings suggest inadequate organ perfusion and require reassessment of
resuscitation.
C. The findings are expected during the inflammatory phase and require no
intervention.
D. The low urine output indicates acute renal recovery following fluid therapy.
Correct Answer: B
Explanation: Persistent oliguria, tachycardia, cool skin, and altered mental status
suggest inadequate systemic perfusion. Resuscitation must be reassessed using
the overall clinical picture rather than a single parameter.
Question 3
A patient rescued from a house fire has facial burns, soot around the mouth,
hoarseness, and progressively increasing work of breathing. Pulse oximetry is 99%
after oxygen is applied. What is the priority nursing action?
A. Reassure the patient because oxygen saturation is normal.
B. Encourage oral fluids to loosen airway secretions.
C. Prepare for early advanced airway management.
D. Delay airway intervention until oxygen saturation falls below 90%.
Correct Answer: C
Explanation: Facial burns, soot, hoarseness, and progressive respiratory difficulty
, strongly suggest inhalation injury and evolving airway edema. A normal pulse
oximeter does not exclude significant inhalation injury or impending obstruction.
Question 4
A patient is rescued from an enclosed-space fire and develops headache, confusion,
and nausea. Pulse oximetry remains 100%. Which assessment finding most strongly
supports carbon monoxide poisoning?
A. Elevated carboxyhemoglobin concentration
B. Increased serum sodium concentration
C. Reduced serum albumin concentration
D. Elevated hematocrit caused by dehydration
Correct Answer: A
Explanation: Carbon monoxide binds hemoglobin with high affinity, producing
carboxyhemoglobin and impairing oxygen delivery. Standard pulse oximetry may
appear falsely reassuring.
Question 5
A patient with a circumferential full-thickness burn of the chest develops increasing
airway pressures and diminished chest expansion despite adequate sedation and
mechanical ventilation. What complication should the nurse suspect?
A. Neurogenic pulmonary edema
B. Restrictive thoracic eschar
C. Acute gastric dilation
D. Isolated metabolic alkalosis
Correct Answer: B
Explanation: Circumferential full-thickness chest burns can form a rigid eschar
that restricts thoracic expansion. Escharotomy may be required when the
constriction compromises ventilation.
Question 6
, A patient with a circumferential full-thickness burn of the lower leg develops severe
pain, increasing tissue tension, paresthesia, and diminished distal Doppler signals.
Which intervention should the nurse anticipate?
A. Application of a tighter compression dressing
B. Immediate elevation only and continued observation
C. Evaluation for escharotomy or compartment decompression
D. Delayed assessment until peripheral pulses disappear completely
Correct Answer: C
Explanation: Circumferential burns can impair distal circulation through
constrictive eschar and rising compartment pressure. Progressive neurovascular
compromise requires urgent evaluation and possible decompression.
Question 7
A patient has a chemical burn caused by a dry powdered substance. Which action is
most appropriate initially?
A. Immediately irrigate the substance with water without removing the powder.
B. Brush off the dry chemical while using appropriate protective precautions before
irrigation.
C. Neutralize the chemical with an opposite-pH solution.
D. Cover the chemical with an occlusive dressing before assessment.
Correct Answer: B
Explanation: Dry chemicals should generally be carefully removed from the skin
before irrigation to prevent activation or spread. Staff must use appropriate
personal protective equipment.
Question 8
A worker sustains a hydrofluoric acid burn to the hand. Which laboratory
abnormality is particularly concerning because of systemic fluoride toxicity?
A. Hypercalcemia
B. Hypocalcemia
