A patient experiences a gasoline tank fire when riding a motorcycle and is admitted to the emergency department (ED) with partial-thickness burns on the anterior surfaces of both lower extremities. Which percentage of body surface area should the nurse document in the electronic medical record (EMR)?
18%.
45%.
9%.
36%.
The Correct Answer is C
Choice A reason: This is incorrect because 18% is the percentage of body surface area for the entire anterior trunk, not just the lower extremities.
Choice B reason: This is incorrect because 45% is the percentage of body surface area for the entire anterior and posterior trunk, plus the head and neck, not just the lower extremities.
Choice C reason: This is correct because 9% is the percentage of body surface area for the anterior surfaces of both lower extremities, according to the rule of nines.

Choice D reason: This is incorrect because 36% is the percentage of body surface area for the entire anterior and posterior surfaces of both lower extremities, not just the anterior surfaces.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Replacing the IV catheter with a smaller gauge is not an intervention that the nurse should implement, as this does not address the problem of the client picking at the dressing and tape. This is a distractor choice.
Choice B reason: Applying soft bilateral wrist restraints is an intervention that the nurse should implement, as this can prevent the client from harming themselves or dislodging the dressing and IV line. This is a last resort measure that requires a physician's order and close monitoring. Therefore, this is the correct choice.
Choice C reason: Leaving the light on in the room at night is not an intervention that the nurse should implement, as this can disturb the client's sleep and worsen their confusion. This is another distractor choice.
Choice D reason: Redressing the abdominal incision is not an intervention that the nurse should implement, as this does not prevent the client from picking at it again. This is another distractor choice.
Correct Answer is ["B","C","D","E"]
Explanation
Choice A reason: This is incorrect because instructing the client and family to reconsider end of life choices is disrespectful and insensitive. The nurse should respect the client's autonomy and preferences and support their decisions.
Choice B reason: This is correct because teaching the client how to use guided imagery is a helpful intervention for coping with feelings related to death and dying. Guided imagery is a relaxation technique that involves visualizing positive images and scenarios that can reduce stress, anxiety, and pain.
Choice C reason: This is correct because recording the client's desire to live is an important intervention for coping with feelings related to death and dying. The nurse should acknowledge and validate the client's emotions and help them express their hopes and fears.
Choice D reason: This is correct because encouraging family to visit frequently is a beneficial intervention for coping with feelings related to death and dying. The nurse should facilitate family involvement and communication and help the client maintain meaningful relationships.
Choice E reason: This is correct because encouraging family to bring the client old photographs is a useful intervention for coping with feelings related to death and dying. The nurse should assist the client in reminiscing and reviewing their life story and achievements.
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