A client with extensive electrical burn injuries is admitted to the emergency department. Which prescribed intervention should the nurse implement first?
Assess oral temperature.
Place on cardiac monitor.
Check a potassium level.
Assess for pain at contact points.
The Correct Answer is B
A. Assessing oral temperature is not a priority immediately after an electrical burn, as the focus should be on monitoring for cardiac issues and other life-threatening conditions.
B. Electrical burns can cause cardiac arrhythmias, including dysrhythmias like ventricular fibrillation, which can be life-threatening. The nurse should place the client on a cardiac monitor immediately to detect any abnormal rhythms and respond accordingly.
C. While checking potassium levels is important for assessing potential complications such as kidney damage or arrhythmias, cardiac monitoring should take precedence.
D. Assessing for pain at contact points is important, but it is secondary to ensuring cardiac stability in an electrical burn victim.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. The medication must be given as a rapid intravenous IV push due to its short half-life not slowly.
B. Asystole is a common and expected response after adenosine administration.
C. Adenosine has a very short half-life, contrary to this statement.
D. The onset of action is immediate, not in 5 minutes.
Correct Answer is B
Explanation
A. Not crossing legs is an important self-management strategy for PAD. It helps improve circulation and prevent further vascular damage. This statement is correct.
B. Warm, heavy socks can be harmful for PAD clients because they may reduce circulation. Clients should avoid excessive warmth and use loose-fitting socks instead. This statement indicates misunderstanding.
C. Smoking cessation is crucial for PAD management, as smoking worsens circulation. This statement is correct.
D. Heating pads can be dangerous for clients with PAD due to the risk of burns from impaired circulation. Low settings may still be too high, so this statement requires further education.
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