A triage nurse in the emergency department admits a male client with second-degree burns on the anterior and posterior portions of both legs. Using the attached image and based on the Rule of Nines, what percentage of the body is burned?

A. Instill normal saline into the nose to clear any possible obstructions: Flushing the nasal passages could increase intracranial pressure or dislodge clots, potentially worsening a skull fracture or causing CSF leakage. This intervention is unsafe in suspected basilar skull fractures.

B. Use a sterile dressing to collect the nasal drainage and send it for testing: Raccoon eyes and clear rhinorrhea suggest a possible basilar skull fracture with cerebrospinal fluid (CSF) leakage. Collecting drainage on a sterile dressing and testing for glucose or beta-2 transferrin confirms the presence of CSF. This intervention protects the patient from infection and provides diagnostic information safely.

C. Apply ice packs to the nose to reduce swelling and drainage: While ice may reduce swelling in minor facial injuries, it does not address the risk of CSF leakage or confirm the diagnosis of a skull fracture. Applying ice does not take priority over diagnostic assessment and infection prevention.

D. Instruct the patient to cough to clear nasal passages: Coughing increases intracranial pressure and may exacerbate CSF leakage or worsen the fracture. Patients with suspected basilar skull fractures should avoid actions that increase pressure in the skull.

A. "An EEG can be used alone to determine if brain activity is still present in patients who are unresponsive.": EEG cannot be used in isolation to declare brain death because it may be affected by medications, metabolic disturbances, or hypothermia, and clinical assessment is required for a comprehensive evaluation.

B. "An EEG is not needed to determine brain death as clinical signs are sufficient.": While clinical criteria are central to brain death determination, EEG may be used as an ancillary test in certain situations, such as when confounding factors prevent full clinical assessment, to provide objective confirmation of electrical inactivity.

C. "The EEG will confirm brain death when no electrical activity is present in the brain.": EEG records cortical electrical activity, and the absence of detectable activity (electrocerebral silence) supports the diagnosis of brain death when combined with a complete clinical evaluation. This makes it a reliable confirmatory tool in specific cases.

D. "An EEG may show normal brain activity in patients who are close to brain death.": Patients nearing brain death generally exhibit severely diminished or absent cortical activity. Normal EEG findings would indicate preserved brain function and are inconsistent with imminent brain death.