A nurse is reviewing the medical record of a client who has sustained a full-thickness burn and is in the emergent phase of the burn. Which of the following findings should the nurse expect?

Hypernatremia

Hypercalcemia

Hypermagnesemia

Hyperkalemia

Answer and Explanation

The Correct Answer is D

A.   Hypernatremia: Hypernatremia (elevated sodium levels) is not typically associated with the emergent phase of burn injuries.
B.   Hypercalcemia: Hypercalcemia (elevated calcium levels) is not typically associated with the emergent phase of burn injuries.
C.   Hypermagnesemia: Hypermagnesemia (elevated magnesium levels) is not typically associated with the emergent phase of burn injuries.
D.   Hyperkalemia: Hyperkalemia (elevated potassium levels) is a common electrolyte imbalance seen in the emergent phase of burn injuries due to the release of potassium from damaged cells.
It can lead to cardiac dysrhythmias and other complications if not promptly addressed.

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Correct Answer is B

Explanation

A. Hemoglobin (Hgb) of 12 g/dL is within the normal range for a pregnant individual and does not typically require notification of the provider.
B. Platelet count of 90,000/mm3 is below the normal range (typically 150,000 to 400,000/mm3) and may indicate thrombocytopenia, which can be associated with conditions such as
preeclampsia or HELLP syndrome. The nurse should notify the provider about this result.

C. Hematocrit of 37% is within the normal range for a pregnant individual and does not typically require notification of the provider.
D. Creatinine level of 0.7 mg/dL is within the normal range and does not typically require notification of the provider.

A. Massage areas around the edge of the client's cast with lotion. B. Avoid elevating the extremity when the client is resting in bed. C. Give the client a dull object to scratch the skin under the cast. D. Tell the client to report any numbness in their toes.

Correct Answer is D

Explanation

A. Massaging areas around the edge of the cast with lotion can introduce moisture and compromise the integrity of the cast, increasing the risk of skin breakdown and infection.
B. Elevating the extremity when the client is resting in bed helps reduce swelling and improve circulation, promoting healing. It is an appropriate action for a client with a cast.
C. Inserting objects under the cast can damage the skin, increase the risk of infection, or disrupt the integrity of the cast.

D. Numbness can indicate impaired circulation or nerve compression and warrants immediate assessment, making this the correct action.

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A nurse is reviewing the medical record of a client who has sustained a full-thickness burn and is in the emergent phase of the burn. Which of the following findings should the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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