The severity of each burn injury is determined by which of these factors?

Depth of the burn, weight of the client

Gender of the client, duration of the burn

Depth of the burn, presence of inhalation injury

Amount of surface area of the body that is burned, gender of the client

Answer and Explanation

The Correct Answer is C

A. depth of the burn, weight of the client: Burn depth is indeed an important factor in determining severity, but client weight does not play a direct role in classifying burn severity. Weight may influence fluid needs but does not determine how severe the burn injury itself is.

B. gender of the client, duration of the burn: Neither gender nor the duration of contact alone determines burn severity. Duration may influence burn depth, but it is not an independent classification factor, and gender is not related to burn injury severity.

C. depth of the burn, presence of inhalation injury: Burn severity is primarily determined by how deeply the tissues are damaged and whether inhalation injury is present. Inhalation injury significantly increases morbidity and mortality, making it a critical factor in assessing overall severity.

D. amount of surface area of the body that is burned, gender of the client: The total body surface area burned is important, but gender is not used in determining severity. Burn assessment tools evaluate surface area, but gender has no clinically relevant effect on the classification.

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Correct Answer is B

Explanation

A. Blood pressure 148/78, pulse 112, respirations 28: Mild increases in blood pressure, pulse, and respirations can be compensatory responses to stress or pain. These changes are concerning but not immediately indicative of life-threatening complications.

B. Blood pressure 156/60, pulse 58, respirations 12: This pattern represents Cushing’s triad—hypertension with widened pulse pressure, bradycardia, and irregular respirations—indicating increased intracranial pressure. It is a neurologic emergency requiring immediate intervention to prevent brain herniation.

C. Blood pressure 130/72, pulse 90, respirations 32: Slightly increased respirations with stable blood pressure and pulse are not as alarming. They may reflect pain, anxiety, or mild hypoxia but are not emergent signs of intracranial pressure elevation.

D. Blood pressure 110/70, pulse 120, respirations 30: This pattern suggests early compensation for hypovolemia or stress. While it requires monitoring, it does not indicate imminent neurologic deterioration like Cushing’s triad.

A. Creatinine level, blood urea nitrogen (BUN) level, and urine specific gravity B. Alkaline phosphatase level, creatinine level, and blood urea nitrogen level C. Urine specific gravity, albumin level, and alkaline phosphate level D. Serum albumin level, alkaline phosphate level, and blood urea nitrogen level

Correct Answer is A

Explanation

A. creatinine level, blood urea nitrogen (BUN) level, and urine specific gravity: These values directly reflect renal perfusion and kidney function. A low MAP of 50 mmHg reduces renal blood flow, causing rising creatinine and BUN levels, while urine specific gravity helps determine whether kidneys can concentrate urine appropriately during acute kidney injury.

B. alkaline phosphatase level, creatinine level, and blood urea nitrogen level: Alkaline phosphatase is a liver and biliary enzyme and does not help assess acute kidney injury. Although creatinine and BUN are relevant, the inclusion of alkaline phosphatase makes this combination less useful for evaluating renal damage.

C. urine specific gravity, albumin level, and alkaline phosphatase level: Urine specific gravity is helpful, but albumin and alkaline phosphatase reflect nutritional or hepatic status rather than renal perfusion. These do not provide the needed information to determine acute kidney injury onset.

D. serum albumin level, alkaline phosphatase level, and blood urea nitrogen level: Albumin and alkaline phosphatase are not indicators of kidney function. BUN alone cannot determine acute kidney injury without creatinine or urine concentration data.

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The severity of each burn injury is determined by which of these factors?

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Naxlex Comprehensive Predictor Exams

A client admitted with a head injury has admission vital signs of temperature 98.6 F (37 C), blood pressure 128/68, pulse 110, and respirations 26. Which of these vital signs, if taken several hours after admission, will be of the most concern to the nurse?

Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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