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A patient received deep partial-thickness burns to the anterior trunk, perineum, and left posterior and anterior arm. Using the "Rule of nines," what is the percent of total body surface area (TBSA) that was burned?

18%

36%

40%

28%

Answer and Explanation

The Correct Answer is D

Adding these percentages together:

Anterior trunk: 18%
Perineum: 1%
Left anterior arm: 4.5%
Left posterior arm: 4.5%

Total = 18% + 1% + 4.5% + 4.5% = 28%

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Correct Answer is C

Explanation

Choice A rationale: this is important to assess the individual’s blood level and risk of infection but it is not a priority action compared to airway management.
Choice B rationale: The insertion of an indwelling urinary catheter is crucial for urine output monitoring but is not a priority action to take.
Choice C rationale: Inspection of the mouth for signs of inhalation injuries is a priority action for burns patients, especially those who have sustained facial burns since they can result in airway compromise and subsequent respiratory failure. The signs to look out for include; soot in the mouth and mouth, hoarseness, stridor, wheezes, or singed nasal hairs. In cases of suspected inhalation injuries, the nurse should inform the healthcare provider to assess for the need for intubation.
Choice D rationale: administration of analgesics is crucial for pain relief for all burn patients. However, this is not a priority action to take compared to airway management.

A. Metabolic alkalosis B. Low hemoglobin C. Hypervolemia D. Hyperkalemia

Correct Answer is D

Explanation

Choice A rationale: individuals with extensive burn wounds are highly likely to develop metabolic acidosis and not metabolic alkalosis due to the increased risk of tissue hypoxia, increased lactic acid levels, and renal failure.
Choice B rationale: low hemoglobin is not an expected finding in individuals with extensive burn wounds but instead increased hemoglobin levels are expected due to hemoconcentration resulting from excessive fluid loss.
Choice C rationale: A patient with extensive burn wounds is expected to have hypovolemia and not hypervolemia due to increased fluid loss from the burned tissues and increased capillary permeability.
Choice D rationale: hyperkalemia is a common finding in individuals with extensive burn wounds due to massive cell destruction which releases potassium from the intracellular compartment to the extracellular compartment.

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A patient received deep partial-thickness burns to the anterior trunk, perineum, and left posterior and anterior arm. Using the "Rule of nines," what is the percent of total body surface area (TBSA) that was burned?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in an emergency room is caring for a client who sustained partial-thickness burns to both lower legs, chest, face, and both forearms Which of the following is the priority action the nurse should take?

Correct Answer is C

Explanation

A nurse in an emergency department is reviewing the medical record of a client who has an extensive burn injury. Which of the following laboratory results should the nurse expect?

Correct Answer is D

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