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1) Your patient asks how he could be septic from a fire. You say --

1. No blood supply to the gut, bacteria goes to the bloodstream
2. We're trying to see if you already had an active infection
3. Fumes contain areal toxins that enter the blood
4. Your antibodies do night fight off phospherous flames

Reveal answer 2) Your patient has a RR of 22, Pulse of 106. Preburn weight is 185 lbs, now weighs 189 lbs. Burns are 49%. You would administer _____mL of lactated ringers in the first 8 hours --

1. 000 mL
2. 8,240.5 mL
3. 9,000 mL
4. 1012 mL

Reveal answer 3) You can give tetanus in the _____ phase of a burn --

1. Acute
2. Acute and emergent
3. Emergent and restoration
4. Any time during care

Reveal answer 4) During the accute phase, you would expect to see electrolytes --

1. Raise
2. Lower
3. Stabilize
4. None of the above

Reveal answer 5) You assess a wound that has blisters, will not scar a nd has mild edema. You would assess this as --

1. Superficial wound
2. Partial Thickness (Superficial)
3. Partial thickness (Deep)
4. Full thickness (Superficial)

Reveal answer 6) Your burn patient is given positive end - expiratory pressure to augment the decreased lung volume. This will accomplish --

1. Deeper lung capacity
2. Better alveolar-capillary exchange
3. Less pain upon breathing
4. Reduction in dysrhythmia

Reveal answer 7) Your patient just had a thermal burn. You cover the patient with a clean cloth. You tell your patient this is because --

1. This will help reduce hypothermia
2. This will prevent the spread of infection
3. This is to protect from the light
4. This will help retain fluid balance by insulating the tissues

Reveal answer 8) Your burn patient has been assigned deep endotracheal suctioning. To help the patient before, you would administer --

1. Pain medications since this is painful
2. Beta blockers, because this procedure increases the heart rate
3. Antidiuretics, because suctioning removes allot fluid
4. Antipsychotics, because the o2 loss during this procedure induces hallucinations

Reveal answer 9) Your patient was burned at 1230 and arrived at the hospital at 1345. You would base fluid volume based on what time --

1. 1200
2. 1230
3. 1345
4. 1400

Reveal answer 10) Your patent inhales steam. You would assess --

1. Oral cavity
2. Lower airway
3. Upper airway
4. Larynx

Reveal answer 11) Your patient was burned in a tar incident. You know you have to flush with cool water for 15 seconds. The most likely cause of the fire --

1. Electrical power line
2. Smoking carlessly
3. Bleach
4. Heating pad

Reveal answer 12) The patient got burned by a slow manifesting heating pad incident. He says the burns aren't that bad. You would say --

1. Lower temperatures are not harmful, as long as you don't feel allot of pain
2. Lower temperatures can damage tissue when it's exposed over a longer period of time
3. Decreased blood flow will occur, but the tissues will remain intact since temperature elevations were minimal
4. These burns are more dangerous than high termperature burns --

Reveal answer 13) Patient's weight is 122 lbs. and has 36% burn wounds. Burn took place at 0630 and arrived at 0715. You would administer the second infusion set at --

1. 1430
2. 1525
3. 1600
4. 1729

Reveal answer 14) You would give Cimetidine to --

1. Treat burn pain
2. Prevent burn stress ulcers
3. Prevent extreme eschar
4. A blood thinner

Reveal answer 15) Your patient has a mass infusion of carbon monoxide from a fire. Your first prevention --

1. Assess for circulation damage
2. Raise head of the bed
3. Administer humidified oxygen
4. Give normal oxygen via partial rebreather

Reveal answer 16) Your patient has a mass infusion of carbon monoxide from a fire. Keep an extra close eye on this lab --

1. Magnesium lvel
2. Hemoglobin level
3. Hematocrit
4. Carboxyhemoglobin level

Reveal answer 17) Your patient was just burned. You would be surprised to see --

1. Sodium = 131
2. Potassium = 3.2
3. HGB = 15.3
4. HCT = 49

Reveal answer 18) Burn where no bv's are injured --

1. Superficial wound
2. Partial Thickness (Superficial)
3. Partial thickness (Deep)
4. Full thickness (Superficial)

Reveal answer 19) Your patient excreted 1700 mL of urine, 400 mL through the skin and 600 mL through the lungs in a 24 hour period.  The intake was 1100 mL Your first priority --

1. Have Dr. Place on fluid restriction
2. Have patient go on diuretics
3. Encourage fluid increase
4. Ambulate patient

Reveal answer 20) Not a finding you would see on a burn victim --

1. Urine >20 mL in two hours
2. Blood sugar = 40
3. Blood in the stool
4. Weight gain of 2lbs in one day

Reveal answer 21) Waxy wound that can be black, white or deep red --

1. Superficial wound
2. Partial Thickness (Superficial)
3. Partial thickness (Deep)
4. Full thickness (Superficial)

Reveal answer 22) Your patient has a circumferential wound. You would monitor --

1. Capillary refill
2. Arterial circulation
3. Venous return
4. Conciousness

Reveal answer 23) Your orders are to care for a burn patient. You would question these orders --

1. Half of the fluid volume for 24 hours is given in the first 8 hours
2. Use a large bore IV
3. Administer a fluid bolus to jumpstart the circulation
4. Monitor for elevated potassium and chloride

Reveal answer 24) You are assigned drugs for your patient that was burned three hours ago. You question this on the MAR --

1. Lassix
2. Morphine
3. Topical antibiotics
4. Enalapril

Reveal answer 25) Your patient suffered partial thickness burns. Which DX is priority --

1. Ineffective breathing pattern
2. Decreased cardiac output
3. Ineffectie breathing pattern
4. Ineffective airway clearance

Reveal answer 26) Fluid and electrolyte changes that occur during the early emergent phase include... --

1. adherence of albumin to vascular walls
2. movement of potassium into cells and out of the vascular space
3. movement of water, sodium and plasma proteins into interstitial spaces
4. hemolysis of red blood cells from large volumes of rapidly administered fluid

Reveal answer 27) Your patient endured a deep electrical burn injury. You would expect to assess for --

1. Lack of muscle contractions
2. Irregular muscle contractions
3. Slow muscle contractions
4. Sustained muscular contractions

Reveal answer 28) Your patient has burns on the face, a brassy cough, progressive hoarse voice, drools and has wheezing sounds on exhalation. Your first priority is --

1. Apply O2
2. Call rapid response team
3. Notify Dr
4. Raise head of the bed

Reveal answer 29) Your patient is burned. SIlver sulfadiazine is needed for what kind of burn should it not be used on --

1. Deep partial thickness
2. Full thickness
3. Superficial

Reveal answer 30) Burn patient is in the emergent phase of a burn injury. YOu should first --

1. Maintain body temp
2. Provide emotional support
3. Fluid replacement
4. Careful wound care

Reveal answer 31) Your patient asks you what silver sulfadiazine does. You say --

1. Prevents bacterial DNA synthesis
2. Helps skin regenerate
3. Works like aloe vera
4. Helps ease burn pain

Reveal answer 32) Your burn patient is in the acute stage and notices edema and ulceration of healthy skin surrounding the burn wound. You would assess for --

1. Heart failure
2. Increased 3rd spacing
3. Infection
4. CHF

Reveal answer 33) Your patient aks you why he needs fluid, you tell him that --

1. Burns increase thirst mechanism
2. Burns destroy blood vessels, which lose volume
3. Evaporation through burnd skin is much more rapid from intact
4. Smoke destroys the hypothalamus thirst mechanism

Reveal answer 34) Your patient received burns on both legs, front and back and the front and back torso as well. You would mark down --

1. 58%
2. 63%
3. 72%
4. 90%

Reveal answer 35) Your patient has a pressure garment. You teach the patient to wear the pressure garment --

1. 24/7
2. 23 hours a day until the scar tissue is mature
3. 21 hours a day until one month ends
4. When the grafts heal

Reveal answer 36) You must assess the patient's nureoendocrine make-up during the acute phase. You would most importantly --

1. Record weight and evaluate edema
2. Record weight and compare with ideal weight
3. Remove dressing and splints and compare this weight to preburn weight
4. Weigh and then subtract 3 lbs for water retention

Reveal answer 37) Patient's weight is 122 lbs. and has 36% burn wounds. Burn took place at 0630 and arrived at 0715. Your 1430 dosage would be ____mL of L. Ringers --

1. 1672
2. 1748
3. 1996
4. 2010

Reveal answer 38) Your burn patient has 27% burns, weighs 315 lbs. The burn took place at 0500 and arrived at the hospital at 0610. How much would your first dose of lacted ringers be? --

1. 7731 mL
2. 8830 mL
3. 9494 mL
4. 10231 mL

Reveal answer 39) Your patient burned both of her legs. You would set the fluid rate at ____ considering she weighs 88 Kg. First 8 hrs fluid dosage

1. 6336
2. 18,003
3. 12672
4. 830

Reveal answer 40) Your patient overheard that his burn was alkaline and not acidic. Your proper response --

1. Yes, acid is more dangerous
2. No, Alkaline burns penetrate deeper and are harder to neutralize
3. No, Alkaline and acid burns are equally dangerous
4. Alkaline can't burn since it has a bicarbonate component

Reveal answer 41) You would most likely hear crackles in a burn victims lungs would most likely occur at what point after the accident --

1. 12 hrs
2. 16 hrs
3. 18 hrs
4. 24 hrs

Reveal answer 42) You need a fecal blood sample from a patient. The patient had burns and aks why this is necessary. You then say --

1. THe burns release blood and it flows to the fecal matter
2. Ulceration can occur and bleeding can happen in the fecal matter
3. Fire becomes blood in the veins when chemicals mix
4. Your GI system releases chemicals that cause bleeding int he blood to get rid of infections

Reveal answer 43) A xenograff is skin from a --

1. Sibling
2. Human cadaver
3. Anonymous donor
4. Animal

Reveal answer 44) You see lab reports from a burn three hours after it took place and you question this lab value --

1. HGB 21
2. HCT 53
3. N = 130
4. K = 2.4

Reveal answer 45) Your patient has pulmonary edema and is in danger of failing left ventricular function. You would administer --

1. Antidiuretics
2. Beta Blockers
3. Digoxin
4. Morphine

Reveal answer 46) Your burn patient suffered a sunburn. You would assess it as a --

1. Superficial wound
2. Partial Thickness (Superficial)
3. Partial thickness (Deep)
4. Full thickness (Superficial)

Reveal answer 47) First priority with your new burn patient --

1. Assess airway
2. Keep patient on NPO
3. Cover with blanket
4. Administer oxygen

Reveal answer 48) Your burn patiennt has a distended abdomen, no flatus, no flatus and absent bowel sounds. Begin --

1. IV feeding
2. Dextrose water infusion
3. NG tube to left intercostal space
4. NG tube over manubrium

Reveal answer 49) Your patient has burns on the arms and torso. You treat the wounds on the arms. Your next move before treating the torso --

1. Avoid touching the wound itself
2. Put on another pair of gloves
3. Use penlight to examine wound
4. Chart then perform care on torso

Reveal answer 50) Your patient has a burn on his upper arm. You would assess what pulse --

1. Radial
2. Brachial
3. Axillary
4. Dorsal Pedis

Reveal answer 51) Your patient has 3rd degree full thickness burn. You are ordered to conduct hydrotherapy. You are to was with --

1. Mild soap/Detergent
2. Alcohol/Hydrogen Peroxide
3. Burn gel
4. Aloe vera

Reveal answer 52) Your patient has loose, noviable tissue. You would need to have this device to debride --

1. Forceps/Scissors
2. Gauze sponge
3. Water hose
4. All the above

Reveal answer 53) Your patient inahaled steam. You would suspect that the most damage will occur in the --

1. Bronchi
2. Upper airway
3. Lower airway
4. Alveoli

Reveal answer 54) Your patient worries about her fluid volume after being burned an hour ago. You tell her --

1. Fluid will shift back in 24-48 hrs
2. The receptors that control fluid have been burned. We are trying to compensate
3. Your body is reacting to water
4. You will see fluid return slowly over the next four days

Reveal answer 55) Your patient has a curling stress ulcer. You would monitor for --

1. Eye swelling
2. Hematuresis
3. Toe gangrene
4. Ulceration of nostrils

Reveal answer 56) Your burn patient was burned four days ago. This is a finding you would expect to see --

1. Diuresis
2. Concentrated, brown urine
3. Platelet increase
4. Fluid volume deficit

Reveal answer 57) Your burn patient has four family members. This is the one you allow her to see --

1. Two year old daughter
2. Grandfather who is healthy, but weak
3. Aunt who has the sniffles
4. The brother who is the florist who is coming to deliver plants to the hospital room

Reveal answer 58) Your patient was burned 12 hours ago near the neck and shows no signs of edema at all. YOu can then --

1. Remove the intubation equipment and raise the head of the bed
2. Test for cough, once fine, remove the intubation equipment
3. Keep intubation equipment in case patient has anxiety
4. Keep intubation eqiupment in case of edema forming

Reveal answer 59) Your patient has a chemical burn with some dry powder chemical resdue on clothing. You would --

1. Wet them to neutralize them
2. Brush them off
3. Mix with saline, then remove
4. Place tape on there to lift off of clothes, then send to lab

Reveal answer 60) You auscultate your burn patient's lungs and hear wheezing. You would conclude --

1. Infection
2. Fatigue
3. Obstruction
4. Lysis of tissue

Reveal answer 61) Your patient had an electrical burn. For arc burn, you would assess the --

1. Hand
2. ELbow
3. Axilla
4. Toes

Reveal answer 62) The doctor says that the burn victim's appearance is waxy white. YOu know you will delaing with --

1. Superficial
2. Partial Thickness
3. Deep partial thickness
4. Full thickness

Reveal answer 63) Your goals to maintain post-burn fluids can be met when --

1. Respirations >20
2. Capillary refill on all
3. Voids 30-50 mL per hour
4. No jaundiced eyes

Reveal answer 64) To rapidly identify infection of a fire wound, you would assess --

1. Temperature
2. WBC count
3. Wound appearance
4. HGB

Reveal answer 65) Your burn patient cannot do range of motion exercises. You would then --

1. Re-schedule
2. Assess pain in joint space
3. Passive range of motion
4. Extend extremities

Reveal answer 66) You have four burn patients prescribed with silvadine. You would not give it to this patient --

1. Patient who has no alergies to sulfa drugs
2. Patient who can handle wide spectrum antibiotics
3. Patient who has 75% TBSA
4. All the above

Reveal answer 67) surgical removal of foreign material and dead tissue from a wound in order to prevent infection and promote healing --

1. Excision
2. Debridement
3. Grafting
4. Hydrotherapy

Reveal answer 68) Your patient has soft and cheesy eschar. You would need to have this device to debride --

1. Forceps
2. Scissors
3. Gauze sponge
4. Water

Reveal answer 69) A sign that your patient's burn extends beyond a general area --

1. Ulceration of healthy skin at burn site
2. Pale granulation tissue
3. Nodular lesions in uninvolved skin
4. Tachycardia

Reveal answer 70) Your patient had a burn three hours ago. You would expect --

1. Urine output and IV intake rise
2. Urine output and IV intake decrease
3. Urine output decreases, IV intake rises
4. Urine outuput rises, IV intake lowers

Reveal answer 71) Patent has burns on the legs. To avoid contractures --

1. Lay legs straight
2. Pillow under the knees
3. Pillow under the feet
4. Pillow between legs

Reveal answer 72) Your patient is listed as in the rehabilitative stage. You know this began due to --

1. Fluids returning to the circulation
2. Potassium shifting in the cell
3. Closing of the wound
4. Restoration of urine flow

Reveal answer 73) Your patient's urine specific gravity is 1.045 after being burned three hours ago. You interpret this as --

1. Lower concentration of water in the urine
2. Higher concentration of the sodium in the serum
3. Lowe water count in the renal tubules
4. Higher concentration of particles in the urine

Reveal answer 74) Your patient's arterial oxygenation is 54 mm hg. This is an indication for --

1. O2 via nasal cannula
2. 02 via partial rebreather
3. O2 with a non-rebreather
4. Intubation

Reveal answer 75) Your patient was burned 48 hours ago. What stat would you find problematic? --

1. Sodium = 131
2. Potassium = 3.2
3. HGB = 15.3
4. HCT = 49

Reveal answer 76) Your burn patient has myoglobulinurea. You would note this by --

1. Patient has difficulty urinating
2. Voiding sample shows strains of wbc's
3. Dilute urine void of electrolytes
4. Dark brown urine

Reveal answer 77) Your burn patient is in the emergent phase and yoiu must administer --

1. Lactated ringers
2. Nomal saline
3. .9 Saline
4. Liquid lipids

Reveal answer 78) A finding during the acute stage of a burn that you would not see most likely --

1. Concentrated urine, frequently
2. Concentrated, Reduced urine
3. Dilute urine, frequently
4. Dilute urine, Reduced urine

Reveal answer 79) Your burn patient wants to go home 48 hours after burn injury and says her breathing is fine. You say no because --

1. More rest is required for tissue repair
2. Lining of trachea nad bronchi may slough up to 72 hrs after, which can narrow lumen and obstruct lower airways
3. Trachea might be infection and it wouldn't manifest yet
4. Bronchi might be severed

Reveal answer 80) Your burn patient has 27% burns, weighs 315 lbs. The burn took place at 0500 and arrived at the hospital at 0610. Dosage administrations would be how much (time and dose) --

1. 7731 mL q 8 hrs
2. 7731 mL 1300, 7731 at 0200
3. 7731 mL 1200, 3866 mL 0800, 7731 mL at 0300
4. 7731 mL 1300, 3866 at 2100 and 3866 at 0500

Reveal answer 81) Your patient has a synthetic dressing on the wound. YOu tell them to keep it on for --

1. 10 hours
2. 24 hours
3. Until feeling is regained in area
4. Until it falls off

Reveal answer 82) Your patient weighed 110 # before the burn and now weighs 115 %. Her ideal weight is 130 # You would base drug doses on --

1. 115 #
2. 130 #
3. 110 #

Reveal answer 83) The nurse suspects the possibility of sepsis in the burn client based on changes in --

1. vital signs
2. urinary output
3. gastrointestinal function
4. burn wound appearance

Reveal answer 84) Something that would alarm in the cbc report of a burn patient --

1. Hypokalemia
2. Myoglobinurea
3. Hyponatremia
4. Anemia

Reveal answer 85) Your patient asks why the morphine has to be in the IV and not pill form. You respond by saying --

1. There are problems of absorption from the muscle and stomach
2. This method will make you feel better
3. The absorption rate works too effectively with pills and you will lose that pain-free feeling fast
4. Pain meds swalled can damage the stomach lining after an exposure to burns

Reveal answer 86) Patient's weight is 122 lbs. and has 36% burn wounds. Burn took place at 0630 and arrived at 0715. Your first dose would be --

1. 2784 mL
2. 3993 mL
3. 4053 mL
4. 5022 mL

Reveal answer 87) True about Deep partial thickness burns --

1. BListers form
2. Leathery feel
3. Edema under eschar
4. Might blanche, might not

Reveal answer 88) Your patient's burn reached below the fascia and destroyed layers of muscle tissue. You would assess as --

1. Superficial wound
2. Partial Thickness (Superficial)
3. Partial thickness (Deep)
4. Full thickness (Superficial)

Reveal answer 89) Your patient just suffered a burn injury one hour ago. What finding would make you question the charting --

1. Pulse = 104
2. BP = 84/49
3. K+ = 5.8
4. HGB = 8.7

Reveal answer 90) Ambulation occurs once --

1. Pain meds actuate
2. After fluid shifts have resolved
3. once Eschar is removed
4. After patient rests

Reveal answer 91) Your burn patient wheezes and then doesn't wheeze. This means that --

1. The partial obstruction has passed nad is getting better
2. The kidneys have compensated
3. The lungs are compensating
4. Impending airway obstruction - get intubation going

Reveal answer 92) Your patient has a chemical burn on her arm and a rr of 23. Your first priority --

1. Cover with blanket
2. Raise the head of the bed
3. Turn patient on side and drain secretions
4. Lavage with water

Reveal answer 93) Your patient has burns all over and your highest priority --

1. Fluid infusion
2. Ventilation assessment/maintanence
3. Stable breathing rate
4. Perfusion stats

Reveal answer 94) Your patient is now recussitating from hypovolemia and now there is fluid overload. You hear cracles upon auscultation and the patient is short of breath in supine position and dyspnea. You would first --

1. Apply oxygen
2. Lift bed to head to 45 degrees
3. Apply humidified oxygen
4. Call rapid response team

Reveal answer 95) Biologic dressing can be aplied to --

1. Wounds full of eschar
2. Wounds free of eschar
3. Wounds clean and free of eschar
4. Wounds clear, no granulation and no eschar

Reveal answer 96) Your patient has burn wounds at the hip. To avoid contractures, do all but --

1. Prone with lower extremity extended
2. Trochanter roll
3. Foam wedge along lateral aspect of thigh
4. Supine with lower extremity extended

Reveal answer 97) You are about to administer a topic antibiotic to your wound victim. You would note that this will be (all except)

1. To be used on fresh graft
2. Open to air
3. Painless
4. No eschar penetration

Reveal answer 98) Patient has burns on the front of the head, front chest and right arm. You would mark --

1. 27%
2. 49%
3. 74%
4. 92%

Reveal answer 99) You want to avoid removing a dressing to see a wound due to infection possibility. You would then use a --

1. .A. Synthetic dressing
2. Heterograft
3. Normal dressing
4. Cultured skin

Reveal answer 100) To assess cardiac status of emergent phase, do all but --

1. Invasive blood monitoring
2. Manual blood pressure reading
3. Capillary refil
4. Pulse oximetry

Reveal answer 101) Your patient has burns on the face, a brassy cough, progressive hoarse voice, drools and has wheezing sounds on exhalation. Your assessment skills tells you your patient --

1. Is about to endure circulatory damage
2. Has smoke tinged embers in trachea
3. Is about to lose the airway
4. Has rickets

Reveal answer 102) You see lab reports from a burn three hours after it took place and you question this lab value --

1. HGB 10
2. HCT 53
3. N = 130
4. K = 5.9

Reveal answer 103) Your patient needs a frozen homograft. You would first --

1. Warm in a bath of normal saline
2. Wipe alcohol all over
3. Spray it with lysol
4. Dunk it in normal tap water

Reveal answer 104) Your patient has a burn that covers more than 40 % of surface area. Your first move --

1. Check pulse
2. Auscultate heart sounds
3. Assess for gangrene on extremities
4. Place patient in chair, sitting upright to help blood flow

Reveal answer 105) Nasotracheal or endotracheal intubation is instituted in burn clients who have.. --

1. electrical burns causing cardiac dysrhythmia
2. thermal burn injuries to the face, neck, or airway
3. symptoms of hypoxia secondary to carbon monoxide poisoning
4. respiratory distress due to inelastic eschar formation around the chest

Reveal answer 106) Not a good pca initiative --

1. Give a 5-10 mg bolus of morphine initially
2. Periodically lowering the drug level to avoid addictions
3. Change in dosing regimens at night
4. Evaluating pain levels through the evening

Reveal answer 107) Your patient is about to be givven Tracrium to buck the ventalator. You would also administer all but this class of meds --

1. Pain meds
2. Antihistamines
3. Antianxiety meds
4. Sedaties

Reveal answer 108) You would expect to see this in your burn patient --

1. Slow respiration rate due to burned tissue of the lungs
2. Decreased urine output
3. N/V
4. Warm and red extremities

Reveal answer 109) You place an amniotic membrane dressing to the wound. You would know that --

1. It takes 20 hours to develop a blood supply
2. It takes 10 hours to develop a blood supply
3. It must be changed every 20 hrs since it doesn't have a blood supply
4. It must be changed every 48 hrs since it doesn't havve a blood supply

Reveal answer 110) A patient has sloughed material in lungs. This is important to do every hour --

1. Inspect tube placement
2. Assess tube patency
3. Assess tube contents
4. Both A and B

Reveal answer 111) Your patient asks why she's receiving lacted ringers for her burns. You tell her ---

1. A body with burns reacts well to this fluid
2. Saline would compromise the electrolytes in the body
3. Potassium overload is something we are trying to avoid
4. This is the fluid that most resembles the balance of electrolytes in bv's

Reveal answer

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