The nurse is caring for a client with superficial partial thickness burn injuries to the upper and lower extremities. The client is ordered IV morphine for pain. The nurse recognizes that narcotics are given IV during the initial management of pain based on which on which of the following rationales?

Bleeding may occur at injection sites when the intramuscular route is used.

The client can experience nausea and vomiting when given oral medications.

Pain resulting from a burn injury requires relief by the fastest route available.

Damaged tissue and edema may interfere with drug absorption via other routes.

Answer and Explanation

The Correct Answer is D

A. Bleeding may occur at injection sites when the intramuscular route is used: While possible, this is not the primary concern.

B. The client can experience nausea and vomiting when given oral medications: This may be true but is secondary to absorption issues.

C. Pain resulting from a burn injury requires relief by the fastest route available: Although IV is fast, the key issue is absorption.

D. Damaged tissue and edema may interfere with drug absorption via other routes: Burned and edematous tissue reduces IM and subcutaneous absorption, making IV the preferred route.

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Correct Answer is A

Explanation

A. Hyperkalemia: In AKI, the kidneys cannot excrete potassium efficiently, leading to elevated potassium levels.

B. Hypernatremia: More common in dehydration but not typically associated with prerenal AKI, where sodium may actually be low due to dilution.

C. Hypophosphatemia: Phosphate tends to increase due to impaired excretion in AKI, not decrease.

D. Hypercalcemia: Calcium levels tend to decrease in AKI due to phosphate retention and reduced vitamin D activation.

A. Maintain adequate IV hydration B. Administer broad-spectrum antibiotics C. Give IV potassium chloride D. Prepare intramuscular pain medications

Correct Answer is A

Explanation

A. Maintain adequate IV hydration: The first priority in major burns is fluid resuscitation due to massive fluid shifts and risk of hypovolemic shock.

B. Administer broad-spectrum antibiotics: Not a priority during the initial resuscitative phase. Infection control comes later unless signs of sepsis appear.

C. Give IV potassium chloride: Burn patients often experience hyperkalemia initially due to cell lysis; potassium is not given early.

D. Prepare intramuscular pain medications: IM route is avoided due to poor perfusion and risk of inadequate absorption in burn patients.

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing the laboratory test results from a client who has prerenal acute kidney injury (AKI). Which of the following electrolyte Imbalances should the nurse expect?

Correct Answer is A

Explanation

A nurse has accepted care of a client with a major burn injury. The burns are 2nd and 3rd degree and estimated at 45% of total body surface area (TBSA). In addressing the pathophysiologic changes resulting from major burns the nurse is aware that the priority intervention for this client is?

Correct Answer is A

Explanation

A nurse is reviewing laboratory values of a client with chronic renal failure and discovers the client has a serum potassium of 6.2 mEq/L. Which of the following interventions should the nurse anticipate?

A nurse is assessing a client who has sustained burns on the entire left arm and the anterior chest. Using the rule of nines, the nurse calculates what percentage of total body surface area is affected by the burns?

A nurse is teaching a client diagnosed with chronic kidney disease (CKD) about limiting foods that are high in potassium. Which of the following foods should the nurse instruct the client to avoid? (Select all that apply.)

A nurse is assessing a client diagnosed with chronic renal disease for fluid volume excess. The nurse should recognize that which of the following provides a reliable measure of fluid retention?

A 65-year-old patient is admitted to the hospital with complaints of decreased urine output, fatigue, and swelling in the legs. Which of the following clinical cues is most indicative of acute kidney injury?

A nurse is preparing to administer a large dose of prescribed opioid analgesic and light sedation for a dressing change for a client with significant burn injuries. The nurse is aware that which of the following is part of preparing for the opioid analgesic and sedative administration?

A nurse is caring for a client who has acute kidney injury (AKI). Which of the following arterial blood gas values would the nurse expect this client to have?