Burns Exam 1 –2025-2026 Comprehensive Study Guide with
Detailed Notes, Key Burn Classifications, and Practice Questions
for Nursing Students||Latest Version!!!
A client is admitted with severe second and third degree burns. The
doctor orders IV Ringer's lactate, 3 ml x kg x % TBSAB, for the first
24 hours. In the first 8 hours, the 176‑pound man with a 30 percent
burn should receive:
a. 300 ml/hr
b. 450 ml/hr
c. 720 ml/hr
d. 900 ml/hr - Answer-b. 450 ml/hr
176 lb = 80 kg; 3 x 80 x 30 = 7,200 ml; ½ of the fluid should be
given he first 8 hours and the other ½ given over the remaining 16
hours; 7,200/2 = 3,600 the first 8 hours; 3,600/8 = 450 ml/hr
An adult patient has thermal burns comprising the entire right arm and
the front of his head. The percentage of body surface area burned is
approximately:
a. 6.5%
b. 9%
c. 13.5%
d. 18%
- Answer-c. 13.5% entire right arm = 9%; front of head = 4 1/2%;
The physician prescribes famotidine (Pepcid), 20 mg BID
intravenously. For a burn patient, the primary action of this
medication is to prevent
a. gastrointestinal ulcers
b. infection
c. vomiting
pg. 1
,d. paralytic ileus
- Answer-a. gastrointestinal ulcers
burn patients are prone to gastric ulcers due to stress (causes excess
stomach acid to be produced) and shunting of blood away from the gi
track, making the tissues more vulnerable
The client comes in to the Emergency Department in severe pain and
reports that a pot of boiling water accidentally spilled on his lower
legs. The assessment reveals blistered, painful skin. Which depth of
burn should the nurse document?
a. Partial thickness (2nd degree)
b. Fourth degree
c. Full thickness (3rd degree)
d. First degree
- Answer-a. Partial thickness (2nd degree)
pain plus blisters indicate 2nd degree; 3rd degree is painless in the
burned area as the tissue and nerve endings have been cooked,
coagulated and destroyed; 1st degree is painful but no blistering
What is the primary reason for administering morphine by the
intravenous route following a major burn?
a. there is inadequate absorption of the drug when given IM,
subcutaneously or orally
b. to prevent symptom masking
c. to prevent respiratory depression
d. to promote vasodilation and pooling of blood in the extremities
- Answer-a. there is inadequate absorption of the drug when given
IM, subcutaneously or orally
patients with a major burn are hypovolemic—consider them just as
you would a patient in shock—hypovolemic shock—giving morphine
pg. 2
,IM, subq or po would likely not get the drug in circulation—it will
just sit there because there is no blood to pick it up and carry it
throughout the body to be metabolized—the IV route is the only
reliable way to get the drug into the body
Body fluid and the adequacy of fluid therapy during the first 48 hours
after a major burn is measured by:
a. hourly body weight
b. serum electrolyte level
c. rate of urinary output
d. amount of fluid intake - Answer-c. rate of urinary output
for the first couple of days, the hourly urine output indicates how well
the patient is being perfused—once the interstitial fluids begin to be
reabsorbed back into the vascular space (48-72 hours) urine output
won't be as accurate—get the foley out as soon as possible so the
patient won't get septic
A patient with massive thermal burns is in danger of which type of
shock?
a. cardiogenic
b. hypovolemic
c. neurogenic
d. vasogenic - Answer-b. hypovolemic
plasma moves to the interstitial space and the patient will go into
hypovolemic shock unless there is adequate fluid resusiation
Treatment and/or assessment for an electrical burn would include:
a. applying ice
b. flushing with water
c. continuous ECG monitoring
pg. 3
, d. calling the poison control center - Answer-c. continuous ECG
monitoring
electrical burns often do not look that bad on the surface but the
electric current runs along blood vessels, muscle, bone...—blood
vessels will clot—including coronary vessels—always be on the
lookout for cardiac injury with electrical burns
You recall that patients with severe burns will have massive edema
the first few days after injury. What type of fluid shift is occurring?
a. intracellular to extracellular
b. extracellular to intracellular
c. interstitial to intravascular
d. intravascular to interstitial - Answer-d. intravascular to interstitial
the capillaries get leaking and plasma moves out of the vessels into
the interstitial space
Initial treatment for a chemical burn would generally include:
a. applying ice
b. applying an ointment such as vaseline
c. flushing the skin with water
d. calling the poison control center
- Answer-c. flushing the skin with water
as a rule, always flush, flush, flush, flush with water and then flush
some more—20 minutes
Visual inspection of a full-thickness burn would reveal:
a. a swollen, reddened area that blanches when pressure is applied
b. blisters of varying sizes with a cherry-red base
c. moist skin surface with a mottled, reddened area
pg. 4
Detailed Notes, Key Burn Classifications, and Practice Questions
for Nursing Students||Latest Version!!!
A client is admitted with severe second and third degree burns. The
doctor orders IV Ringer's lactate, 3 ml x kg x % TBSAB, for the first
24 hours. In the first 8 hours, the 176‑pound man with a 30 percent
burn should receive:
a. 300 ml/hr
b. 450 ml/hr
c. 720 ml/hr
d. 900 ml/hr - Answer-b. 450 ml/hr
176 lb = 80 kg; 3 x 80 x 30 = 7,200 ml; ½ of the fluid should be
given he first 8 hours and the other ½ given over the remaining 16
hours; 7,200/2 = 3,600 the first 8 hours; 3,600/8 = 450 ml/hr
An adult patient has thermal burns comprising the entire right arm and
the front of his head. The percentage of body surface area burned is
approximately:
a. 6.5%
b. 9%
c. 13.5%
d. 18%
- Answer-c. 13.5% entire right arm = 9%; front of head = 4 1/2%;
The physician prescribes famotidine (Pepcid), 20 mg BID
intravenously. For a burn patient, the primary action of this
medication is to prevent
a. gastrointestinal ulcers
b. infection
c. vomiting
pg. 1
,d. paralytic ileus
- Answer-a. gastrointestinal ulcers
burn patients are prone to gastric ulcers due to stress (causes excess
stomach acid to be produced) and shunting of blood away from the gi
track, making the tissues more vulnerable
The client comes in to the Emergency Department in severe pain and
reports that a pot of boiling water accidentally spilled on his lower
legs. The assessment reveals blistered, painful skin. Which depth of
burn should the nurse document?
a. Partial thickness (2nd degree)
b. Fourth degree
c. Full thickness (3rd degree)
d. First degree
- Answer-a. Partial thickness (2nd degree)
pain plus blisters indicate 2nd degree; 3rd degree is painless in the
burned area as the tissue and nerve endings have been cooked,
coagulated and destroyed; 1st degree is painful but no blistering
What is the primary reason for administering morphine by the
intravenous route following a major burn?
a. there is inadequate absorption of the drug when given IM,
subcutaneously or orally
b. to prevent symptom masking
c. to prevent respiratory depression
d. to promote vasodilation and pooling of blood in the extremities
- Answer-a. there is inadequate absorption of the drug when given
IM, subcutaneously or orally
patients with a major burn are hypovolemic—consider them just as
you would a patient in shock—hypovolemic shock—giving morphine
pg. 2
,IM, subq or po would likely not get the drug in circulation—it will
just sit there because there is no blood to pick it up and carry it
throughout the body to be metabolized—the IV route is the only
reliable way to get the drug into the body
Body fluid and the adequacy of fluid therapy during the first 48 hours
after a major burn is measured by:
a. hourly body weight
b. serum electrolyte level
c. rate of urinary output
d. amount of fluid intake - Answer-c. rate of urinary output
for the first couple of days, the hourly urine output indicates how well
the patient is being perfused—once the interstitial fluids begin to be
reabsorbed back into the vascular space (48-72 hours) urine output
won't be as accurate—get the foley out as soon as possible so the
patient won't get septic
A patient with massive thermal burns is in danger of which type of
shock?
a. cardiogenic
b. hypovolemic
c. neurogenic
d. vasogenic - Answer-b. hypovolemic
plasma moves to the interstitial space and the patient will go into
hypovolemic shock unless there is adequate fluid resusiation
Treatment and/or assessment for an electrical burn would include:
a. applying ice
b. flushing with water
c. continuous ECG monitoring
pg. 3
, d. calling the poison control center - Answer-c. continuous ECG
monitoring
electrical burns often do not look that bad on the surface but the
electric current runs along blood vessels, muscle, bone...—blood
vessels will clot—including coronary vessels—always be on the
lookout for cardiac injury with electrical burns
You recall that patients with severe burns will have massive edema
the first few days after injury. What type of fluid shift is occurring?
a. intracellular to extracellular
b. extracellular to intracellular
c. interstitial to intravascular
d. intravascular to interstitial - Answer-d. intravascular to interstitial
the capillaries get leaking and plasma moves out of the vessels into
the interstitial space
Initial treatment for a chemical burn would generally include:
a. applying ice
b. applying an ointment such as vaseline
c. flushing the skin with water
d. calling the poison control center
- Answer-c. flushing the skin with water
as a rule, always flush, flush, flush, flush with water and then flush
some more—20 minutes
Visual inspection of a full-thickness burn would reveal:
a. a swollen, reddened area that blanches when pressure is applied
b. blisters of varying sizes with a cherry-red base
c. moist skin surface with a mottled, reddened area
pg. 4
