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A nurse is assessing a patient who sustained partial-thickness burns to the anterior chest and anterior left arm. Using the Rule of Nines, what percentage of total body surface area (TBSA) is affected?

22.5%

13.5%

18%

Answer and Explanation

The Correct Answer is B

A. 22.5%. This overestimates the affected TBSA based on the Rule of Nines.

B. 13.5%. Using the Rule of Nines:

Anterior chest = 9%
Anterior left arm = 4.5%
Total TBSA = 9% + 4.5% = 13.5%

C. 9%. This would account only for the anterior chest but does not include the anterior left arm.

D. 18%. This would be correct if both the anterior and posterior chest were involved, but the question specifies only the anterior chest and left arm.

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Correct Answer is D

Explanation

A. Hematocrit 40%: A hematocrit level of 40% is within the normal range for adult females (36%-48%) and does not require intervention.

B. Potassium 3.8 mEq/L: Normal potassium levels range from 3.5-5.0 mEq/L, so a value of 3.8 mEq/L is within normal limits and does not pose a risk for surgery.

C. Creatinine 0.9 mg/dL: Normal creatinine levels for adult females are 0.5-1.1 mg/dL. A level of 0.9 mg/dL indicates normal kidney function and does not require reporting.

D. WBC count 20,000/mm³: A WBC count of 20,000/mm³ is significantly elevated, indicating a possible infection or inflammatory response. This increases the risk of post-operative complications and should be reported to the surgeon immediately.

A. Apply an antibiotic ointment and reassess in two weeks. B. Refer the patient to a dermatologist for a biopsy. C. Reassure the patient that the lesion is benign and monitor for changes. D. Educate the patient on proper wound care and sun protection.

Correct Answer is B

Explanation

A. Apply an antibiotic ointment and reassess in two weeks. SCC is a form of skin cancer and requires biopsy for diagnosis. Simply applying an antibiotic and waiting could delay necessary treatment.

B. Refer the patient to a dermatologist for a biopsy. The priority action for a suspicious lesion that does not heal is to refer the patient for biopsy and further evaluation, as early detection and treatment of SCC are crucial.

C. Reassure the patient that the lesion is benign and monitor for changes. SCC can be aggressive if untreated, and assuming benignity without biopsy could result in delayed diagnosis and worsening prognosis.

D. Educate the patient on proper wound care and sun protection. While wound care and sun protection are important, the priority is obtaining a definitive diagnosis through biopsy.

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A nurse is assessing a patient who sustained partial-thickness burns to the anterior chest and anterior left arm. Using the Rule of Nines, what percentage of total body surface area (TBSA) is affected?

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