A nurse is collecting data from a client who presents with a partial thickness burn. Which of the following does the nurse suspect as the cause of the client's condition?
An electrical source
Contact with hot liquid
A mild sunburn
Contact with a flame
The Correct Answer is B
A. An electrical source. Electrical burns often cause deep tissue damage that may not be visible on the surface. These burns can extend beyond the skin, affecting muscles, nerves, and internal organs, making them more severe than partial-thickness burns.
B. Contact with hot liquid. Scald burns from hot liquids (e.g., boiling water, coffee, soup) are a common cause of partial-thickness burns. These burns affect the epidermis and part of the dermis, leading to blistering, redness, and pain.
C. A mild sunburn. Mild sunburns typically cause superficial burns (first-degree burns), affecting only the epidermis and resulting in redness and discomfort without blisters. Partial-thickness burns involve deeper skin layers.
D. Contact with a flame. Direct contact with a flame is more likely to cause deeper burns, often resulting in full-thickness burns (third-degree) rather than partial-thickness burns.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Complete a screening test for autism spectrum disorder (ASD). By 18 months, most toddlers have said their first word, and a lack of speech development can be an early sign of ASD or other developmental delays. The M-CHAT (Modified Checklist for Autism in Toddlers) is a common screening tool used at this age to assess for autism. Early identification allows for timely interventions.
B. Ask the parent about recent immunizations. While immunization history is important for overall health, there is no connection between vaccines and delayed speech development. This question does not directly address the developmental concern at hand.
C. Educate the parent that toddlers do not typically say their first word until 18-20 months of age. This is incorrect. Most toddlers say their first word around 12 months, and by 18 months, they typically have a vocabulary of several words. A lack of speech at this age warrants further assessment.
D. Ask the parent if the toddler has a history of hospitalizations or surgeries. While medical history is important, hospitalizations or surgeries are not the most common causes of delayed speech. Developmental screening is the most appropriate next step in evaluating speech delays.
Correct Answer is B
Explanation
A. An electrical source. Electrical burns often cause deep tissue damage that may not be visible on the surface. These burns can extend beyond the skin, affecting muscles, nerves, and internal organs, making them more severe than partial-thickness burns.
B. Contact with hot liquid. Scald burns from hot liquids (e.g., boiling water, coffee, soup) are a common cause of partial-thickness burns. These burns affect the epidermis and part of the dermis, leading to blistering, redness, and pain.
C. A mild sunburn. Mild sunburns typically cause superficial burns (first-degree burns), affecting only the epidermis and resulting in redness and discomfort without blisters. Partial-thickness burns involve deeper skin layers.
D. Contact with a flame. Direct contact with a flame is more likely to cause deeper burns, often resulting in full-thickness burns (third-degree) rather than partial-thickness burns.
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