A 7-year-old child accidentally touches a hot stove, resulting in redness on his palm without blisters.
What type of burn is this?
First-degree burn.
Second-degree burn.
Third-degree burn.
Full-thickness burn.
The Correct Answer is A
Choice A rationale
A first-degree burn involves only the epidermis, the outermost layer of the skin. It is characterized by redness (erythema), pain, and dryness, without the formation of blisters. The superficial damage affects the outer layer of epithelial cells, causing vasodilation and inflammation, leading to the observed redness and discomfort.
Choice B rationale
A second-degree burn involves the epidermis and a portion of the dermis, the layer beneath the epidermis. These burns are characterized by blisters, significant pain, redness, and swelling. The damage extends deeper into the skin, affecting nerve endings and blood vessels, leading to fluid leakage and blister formation.
Choice C rationale
A third-degree burn involves the destruction of the epidermis and the entire dermis, potentially extending into the subcutaneous tissue. These burns appear white or charred, are often painless initially due to nerve damage, and lack blisters. The full thickness destruction of skin layers impairs sensation and requires significant medical intervention, often including skin grafting.
Choice D rationale
Full-thickness burn is another term for a third-degree burn, indicating that all layers of the skin have been destroyed. This type of burn extends through the epidermis and dermis and may involve underlying subcutaneous tissue, muscle, or bone. The appearance is typically dry, leathery, and may be white, charred, or waxy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
The epidermis is the outermost layer of the skin, providing a protective barrier against the external environment. A first-degree burn, characterized by redness and pain without blisters, affects only this superficial layer. The heat causes vasodilation in the dermal blood vessels beneath the epidermis, resulting in the visible redness.
Choice B rationale
The dermis is the layer of skin beneath the epidermis, containing structures like hair follicles, sweat glands, and nerve endings. Second-degree burns extend into the dermis, causing damage to these structures and leading to blister formation due to fluid leakage from damaged blood vessels within this layer.
Choice C rationale
The subcutaneous tissue (hypodermis) is the deepest layer of the skin, composed mainly of fat and connective tissue. Third-degree or full-thickness burns extend into this layer, damaging or destroying it along with the epidermis and dermis.
Choice D rationale
Muscle tissue lies beneath the subcutaneous tissue and is not typically directly affected in a superficial burn that only causes redness without blisters. Burns that reach muscle tissue are very deep and would present with significant tissue damage and likely charring.
Correct Answer is D
Explanation
Choice A rationale
Initiating feeding too soon after pyloromyotomy, a surgical repair of the pyloric sphincter, can lead to vomiting and aspiration in the immediate postoperative period. The gastrointestinal system needs time to recover from anesthesia and the surgical manipulation to the pylorus, which controls the passage of food from the stomach to the small intestine. Introducing fluids prematurely can overwhelm the healing surgical site.
Choice B rationale
Encouraging parental bonding and cuddling is crucial for the psychosocial well-being of the infant and parents. However, in the immediate postoperative phase, physiological stability takes precedence. While emotional support is important, addressing potential complications and assessing the infant's physical status are the priority actions.
Choice C rationale
Documenting the surgical site appearance is an important nursing responsibility to monitor for signs of infection, bleeding, or dehiscence. However, assessing the infant's immediate postoperative condition, particularly pain, which can indicate complications or discomfort, is a more immediate concern. Pain management directly impacts the infant's physiological stability.
Choice D rationale
Identifying signs of pain using an appropriate pain scale is the priority intervention in a post-operative infant. Pain can lead to physiological instability, such as increased heart rate, blood pressure, and respiratory distress. Early identification and management of pain ensure the infant's comfort and facilitate recovery. Utilizing a validated pain scale for infants allows for objective assessment of pain levels and guides appropriate interventions.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.