Pediatric Primary Care NCLEX Complex Question Bank 2025/2026

Burns & Wound Care — 25 Questions (NCLEX Complex) 1. Priority / Clinical Judgment Q1. A 4-year-old is brought to the ED after a scald injury. He has partial-thickness burns over 15% TBSA. He is crying and restless. Which action should the nurse perform first? a) Apply silver sulfadiazine b) Start IV fluid resuscitation c) Administer oral ibuprofen d) Cover burns with sterile dressing Answer: b Rationale: Fluid resuscitation is priority in burns 10% TBSA in children to prevent hypovolemia. Q2. A child with burns is restless and has an elevated heart rate despite fluids. The nurse should suspect: a) Pain b) Infection c) Hypoglycemia d) Overhydration Answer: a Rationale: Pain increases sympathetic response and tachycardia. Q3. A 2-year-old with burns on the face is at risk for airway compromise. The nurse should prioritize: a) Pain control b) Airway assessment and oxygen c) Dressing change d) Feeding Answer: b Rationale: Facial burns can cause airway edema and respiratory compromise. 2. SATA (Select All That Apply) Q4. A 3-year-old with 2nd-degree burns is admitted. Which interventions are appropriate? ☐ Elevate burned limbs ☐ Administer high-calorie diet ☐ Apply ice directly ☐ Monitor urine output hourly ☐ Encourage frequent ambulation Correct: Elevate burned limbs Administer high-calorie diet Monitor urine output hourly Rationale: Ice can worsen tissue damage; ambulation is not recommended early. Q5. Which findings indicate potential infection in a burn wound? ☐ Increased pain ☐ Yellow-green drainage ☐ Fever ☐ Pink granulation tissue ☐ Decreased redness Correct: Increased pain Yellow-green drainage Fever Rationale: Infection signs include purulent drainage, fever, and increased pain.