A nurse is caring for a client admitted with severe burns to both lower extremities and is scheduled for an escharotomy. The client's spouse asks the nurse what the procedure entails. Which of the following nursing statements is appropriate?

"A piece of healthy skin will be removed from an unburned area and grafted over the burned area."

"This procedure involves placing the client into a Whirlpool tub and removing the dead tissue."

"Dead tissue will be non-surgically removed."

"Incisions will be made in the burnt tissues to improve circulation."

Answer and Explanation

The Correct Answer is D

A. "A piece of healthy skin will be removed from an unburned area and grafted over the burned area.": This describes a skin graft, not escharotomy.

B. "This procedure involves placing the client into a Whirlpool tub and removing the dead tissue.": This describes hydrotherapy or wound debridement.

C. "Dead tissue will be non-surgically removed.": Describes enzymatic or mechanical debridement.

D. "Incisions will be made in the burnt tissues to improve circulation.": Escharotomy relieves pressure caused by tight, burned skin (eschar) to restore blood flow and prevent compartment syndrome.

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Correct Answer is B

Explanation

A. Draw blood for a CBC: Important, but not the priority.

B. Inspect the mouth for signs of inhalation injuries: Airway assessment is always the priority in facial/chest burns due to the risk of inhalation injury and impending airway compromise.

C. Administer intravenous pain medication: Important, but airway always comes first.

D. Insert an indwelling urinary catheter: Urine output monitoring is important for fluid resuscitation but follows airway stabilization.

A. Raisins B. Bananas C. Green beans D. Asparagus E. Tomatoes

Correct Answer is ["A","B","E"]

Explanation

A. Raisins: Dried fruits like raisins are concentrated sources of potassium and should be avoided in CKD.

B. Bananas: Bananas are high in potassium and commonly restricted in CKD to prevent hyperkalemia.

C. Green beans: Green beans are relatively low in potassium and generally safe for a renal diet.

D. Asparagus: Asparagus has moderate potassium levels but can be included in moderation depending on the client's labs.

E. Tomatoes: Tomatoes, especially in processed forms like sauce or juice, are high in potassium.

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A nurse is caring for a client admitted with severe burns to both lower extremities and is scheduled for an escharotomy. The client's spouse asks the nurse what the procedure entails. Which of the following nursing statements is appropriate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is ["A","B","E"]

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