,NSG 233 Exam 4 Medical-Surgical Nursing III Questions And
Answers 2026/2027 Herzing University
Q1. A client with a major burn injury is in the emergent phase. Which
laboratory finding should the nurse expect early after a significant thermal
injury?
A) Decreased serum potassium
B) Increased serum potassium
C) Decreased hematocrit from immediate hemodilution
D) Increased serum sodium from fluid shift
Correct Answer: B) Increased serum potassium
Rationale: Extensive tissue destruction releases intracellular potassium into
the bloodstream, producing early hyperkalemia. Fluid shifts can also cause
hemoconcentration.
Q2. Which finding in a client with a major burn injury requires the highest
priority?
A) Severe pain
B) Singed nasal hairs and soot around the mouth
C) Blisters on the arm
D) Anxiety about hospitalization
Correct Answer: B) Singed nasal hairs and soot around the mouth
Rationale: These findings suggest inhalation injury, which can cause rapidly
progressive airway edema and respiratory failure.
Q3. Which assessment should be prioritized when caring for a client with a
facial burn?
A) Airway patency
B) Bowel sounds
C) Appetite
D) Urinary frequency
Correct Answer: A) Airway patency
Rationale: Facial and upper-airway burns can cause edema and airway
obstruction, making airway assessment the immediate priority.
Q4. A client with an inhalation injury develops progressive hoarseness and
stridor. What should the nurse anticipate?
A) Early airway management and possible intubation
B) Oral fluids
C) Delayed respiratory assessment
D) Ambulation
Correct Answer: A) Early airway management and possible intubation
, Rationale: Progressive airway edema can make later intubation difficult or
impossible, so early airway protection is essential.
Q5. Which laboratory value should the nurse monitor closely during the early
phase of a major burn?
A) Potassium
B) Cholesterol
C) Hemoglobin A1c
D) Troponin
Correct Answer: A) Potassium
Rationale: Cellular destruction can cause hyperkalemia initially, while
potassium may later fall during fluid shifts and treatment.
Q6. Which finding suggests progression from the emergent phase toward the
fluid-mobilization phase of burn care?
A) Increasing urine output
B) Persistent severe oliguria
C) Worsening hemoconcentration
D) Increasing tissue ischemia
Correct Answer: A) Increasing urine output
Rationale: As fluid begins moving back into the vascular space and
resuscitation becomes effective, urine output generally improves.
Q7. Which formula is commonly used to estimate initial fluid requirements
for a client with a major burn?
A) Parkland formula
B) Apgar formula
C) Wells score
D) Glasgow formula
Correct Answer: A) Parkland formula
Rationale: The Parkland formula estimates crystalloid requirements during
the initial burn-resuscitation period based on body weight and percentage of
total body surface area burned.
Q8. When using the Parkland formula, when is approximately half of the
calculated fluid volume usually administered?
A) During the first 8 hours after the burn
B) During the second 8 hours
C) During the first 24 minutes
D) During the final 16 hours only
Correct Answer: A) During the first 8 hours after the burn
Rationale: The initial half of the calculated resuscitation volume is generally
Answers 2026/2027 Herzing University
Q1. A client with a major burn injury is in the emergent phase. Which
laboratory finding should the nurse expect early after a significant thermal
injury?
A) Decreased serum potassium
B) Increased serum potassium
C) Decreased hematocrit from immediate hemodilution
D) Increased serum sodium from fluid shift
Correct Answer: B) Increased serum potassium
Rationale: Extensive tissue destruction releases intracellular potassium into
the bloodstream, producing early hyperkalemia. Fluid shifts can also cause
hemoconcentration.
Q2. Which finding in a client with a major burn injury requires the highest
priority?
A) Severe pain
B) Singed nasal hairs and soot around the mouth
C) Blisters on the arm
D) Anxiety about hospitalization
Correct Answer: B) Singed nasal hairs and soot around the mouth
Rationale: These findings suggest inhalation injury, which can cause rapidly
progressive airway edema and respiratory failure.
Q3. Which assessment should be prioritized when caring for a client with a
facial burn?
A) Airway patency
B) Bowel sounds
C) Appetite
D) Urinary frequency
Correct Answer: A) Airway patency
Rationale: Facial and upper-airway burns can cause edema and airway
obstruction, making airway assessment the immediate priority.
Q4. A client with an inhalation injury develops progressive hoarseness and
stridor. What should the nurse anticipate?
A) Early airway management and possible intubation
B) Oral fluids
C) Delayed respiratory assessment
D) Ambulation
Correct Answer: A) Early airway management and possible intubation
, Rationale: Progressive airway edema can make later intubation difficult or
impossible, so early airway protection is essential.
Q5. Which laboratory value should the nurse monitor closely during the early
phase of a major burn?
A) Potassium
B) Cholesterol
C) Hemoglobin A1c
D) Troponin
Correct Answer: A) Potassium
Rationale: Cellular destruction can cause hyperkalemia initially, while
potassium may later fall during fluid shifts and treatment.
Q6. Which finding suggests progression from the emergent phase toward the
fluid-mobilization phase of burn care?
A) Increasing urine output
B) Persistent severe oliguria
C) Worsening hemoconcentration
D) Increasing tissue ischemia
Correct Answer: A) Increasing urine output
Rationale: As fluid begins moving back into the vascular space and
resuscitation becomes effective, urine output generally improves.
Q7. Which formula is commonly used to estimate initial fluid requirements
for a client with a major burn?
A) Parkland formula
B) Apgar formula
C) Wells score
D) Glasgow formula
Correct Answer: A) Parkland formula
Rationale: The Parkland formula estimates crystalloid requirements during
the initial burn-resuscitation period based on body weight and percentage of
total body surface area burned.
Q8. When using the Parkland formula, when is approximately half of the
calculated fluid volume usually administered?
A) During the first 8 hours after the burn
B) During the second 8 hours
C) During the first 24 minutes
D) During the final 16 hours only
Correct Answer: A) During the first 8 hours after the burn
Rationale: The initial half of the calculated resuscitation volume is generally
