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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. “I will keep my cast dry and avoid inserting objects inside to scratch my skin.” Keeping the cast dry prevents it from softening or breaking down, which could lead to improper healing. Avoiding objects inside the cast prevents skin injuries and infections.

B. "If I notice increased swelling, numbness, or severe pain, I will elevate my leg and notify my provider immediately." Increased swelling, numbness, and severe pain can indicate compartment syndrome or impaired circulation. Elevating the leg and seeking medical attention is appropriate.

C. "It's okay to use a blow dryer on a cool setting to help dry my cast if it gets wet." A blow dryer on a cool setting can be used to help dry moisture inside the cast without causing burns or affecting the cast material.

D. “I should expect to feel extreme pain under the cast that doesn't improve with pain medication.” Extreme pain that is unrelieved by medication is abnormal and may indicate complications like compartment syndrome, infection, or pressure ulcers under the cast. The patient needs further education that severe pain should be reported immediately.

A. Obtain a prescription to adjust the weight amount. B. Administer an opioid analgesic C. Realign the client's position. D. Offer a muscle relaxant to the client.

Correct Answer is C

Explanation

A. Obtain a prescription to adjust the weight amount: Adjusting the weight could help relieve muscle spasms, but the nurse should first try non-invasive interventions such as repositioning before requesting a prescription change.

B. Administer an opioid analgesic: Pain medication can help manage discomfort, but it does not address the cause of the muscle spasms. Non-pharmacologic interventions should be attempted first.

C. Realign the client’s position: This is the first action the nurse should take. Incorrect positioning can contribute to muscle spasms, and realignment can often provide immediate relief. This intervention is non-invasive and should be attempted before medication or weight adjustments.

D. Offer a muscle relaxant to the client: Muscle relaxants can be helpful, but they should be considered only after non-pharmacologic measures like repositioning fail.

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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?

Nursing Test Bank

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