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NCLEX-RN Exam Questions - Part 16
1. The initial treatment for a client with a liquid chemical burn injury is to:
A) Irrigate the area with neutralizing solutions
B) Flush the exposed area with large amounts of water
C) Inject calcium chloride into the burned area
D) Apply lanolin ointment to the area
2. The most important reason to closely assess circumferential burns at least every hour is that they may result in:
A) Hypovolemia
B) Renal damage
C) Ventricular arrhythmias
D) Loss of peripheral pulses
3. During burn therapy, morphine is primarily administered IV for pain management because this route:
A) Delays absorption to provide continuous pain relief
B) Facilitates absorption because absorption from muscles is not dependable
C) Allows for discontinuance of the medication if respiratory depression develops
D) Avoids causing additional pain from IM injections
4. The medication that best penetrates eschar is:
A) Mafenide acetate (Sulfamylon)
B) Silver sulfadiazine (Silvadene)
C) Neomycin sulfate (Neosporin)
D) Povidone-iodine (Betadine)
5. When the nurse is evaluating lab data for a client 1824 hours after a major thermal burn, the expected physiological changes would include which of the following?
A) Elevated serum sodium
B) Elevated serum calcium
C) Elevated serum protein
D) Elevated hematocrit
A) Irrigate the area with neutralizing solutions
B) Flush the exposed area with large amounts of water
C) Inject calcium chloride into the burned area
D) Apply lanolin ointment to the area
2. The most important reason to closely assess circumferential burns at least every hour is that they may result in:
A) Hypovolemia
B) Renal damage
C) Ventricular arrhythmias
D) Loss of peripheral pulses
3. During burn therapy, morphine is primarily administered IV for pain management because this route:
A) Delays absorption to provide continuous pain relief
B) Facilitates absorption because absorption from muscles is not dependable
C) Allows for discontinuance of the medication if respiratory depression develops
D) Avoids causing additional pain from IM injections
4. The medication that best penetrates eschar is:
A) Mafenide acetate (Sulfamylon)
B) Silver sulfadiazine (Silvadene)
C) Neomycin sulfate (Neosporin)
D) Povidone-iodine (Betadine)
5. When the nurse is evaluating lab data for a client 1824 hours after a major thermal burn, the expected physiological changes would include which of the following?
A) Elevated serum sodium
B) Elevated serum calcium
C) Elevated serum protein
D) Elevated hematocrit
1. Right Answer: B
Explanation: (A) In the past, neutralizing solutions were recommended, but presently there is concern that these solutions extend the depth of burn area. (B) The use of large amounts of water to flush the area is recommended for chemical burns. (C) Calcium chloride is not recommended therapy and would likely worsen the problem.(D) Lanolin is of no benefit in the initial treatment of a chemical injury and may actually extend a thermal injury.
2. Right Answer: D
Explanation: (A) Hypovolemia could be a result of fluid loss from thermal injury, but not as a result of the circumferential injury. (B) Renal damage is typically seen because of prolonged hypovolemia or myoglobinuria. (C) Electrical injuries and electrolyte changes typically cause arrhythmias in the burn client. (D) Full-thickness circumferential burns are nonelastic and result in an internal tourniquet effect that compromises distal blood flow when the area involved is an extremity.Circumferential full-thickness torso burns compromise respiratory motion and, when extreme, cardiac return.
3. Right Answer: B
Explanation: (A) Absorption would be increased, not decreased. (B) IM injections should not be used until the client is hemodynamically stable and has adequate tissue perfusion. Medications will remain in the subcutaneous tissue with the fluid that is present in the interstitial spaces in the acute phase of the thermal injury. The client will have a poor response to the medication administered, and a 'dumping' of the medication can occur when the medication and fluid are shifted back into the intravascular spaces in the next phase of healing. (C) IV administration of the medication would hasten respiratory compromise, if present. (D) The desire to avoid causing the client additional pain is not a primary reason for this route of administration.
4. Right Answer: A
Explanation: (A) Mafenide acetate is bacteriostatic against gram-positive and gram-negative organisms and is the agent that best penetrates eschar. (B) Silver sulfadiazine poorly penetrates eschar. (C) Neomycin sulfate does not penetrate eschar. (D) Povidoneiodine does not penetrate eschar.
5. Right Answer: D
Explanation: (A) Sodium enters the edema fluid in the burned area, lowering the sodium content of the vascular fluid. Hyponatremia may continue for days to several weeks because of sodium loss to edema, sodium shifting into the cells, and later, diuresis. (B) Hypocalcemia occurs because of calcium loss to edema fluid at the burned site (third space fluid). (C) Protein loss occurs at the burn site owing to increased capillary permeability. Serum protein levels remain low until healing occurs. (D)Hematocrit level is elevated owing to hemoconcentration from hypovolemia. Anemia is present in the postburn stage owing to blood loss and hemolysis, but it cannot be assessed until the client is adequately hydrated.
Explanation: (A) In the past, neutralizing solutions were recommended, but presently there is concern that these solutions extend the depth of burn area. (B) The use of large amounts of water to flush the area is recommended for chemical burns. (C) Calcium chloride is not recommended therapy and would likely worsen the problem.(D) Lanolin is of no benefit in the initial treatment of a chemical injury and may actually extend a thermal injury.
2. Right Answer: D
Explanation: (A) Hypovolemia could be a result of fluid loss from thermal injury, but not as a result of the circumferential injury. (B) Renal damage is typically seen because of prolonged hypovolemia or myoglobinuria. (C) Electrical injuries and electrolyte changes typically cause arrhythmias in the burn client. (D) Full-thickness circumferential burns are nonelastic and result in an internal tourniquet effect that compromises distal blood flow when the area involved is an extremity.Circumferential full-thickness torso burns compromise respiratory motion and, when extreme, cardiac return.
3. Right Answer: B
Explanation: (A) Absorption would be increased, not decreased. (B) IM injections should not be used until the client is hemodynamically stable and has adequate tissue perfusion. Medications will remain in the subcutaneous tissue with the fluid that is present in the interstitial spaces in the acute phase of the thermal injury. The client will have a poor response to the medication administered, and a 'dumping' of the medication can occur when the medication and fluid are shifted back into the intravascular spaces in the next phase of healing. (C) IV administration of the medication would hasten respiratory compromise, if present. (D) The desire to avoid causing the client additional pain is not a primary reason for this route of administration.
4. Right Answer: A
Explanation: (A) Mafenide acetate is bacteriostatic against gram-positive and gram-negative organisms and is the agent that best penetrates eschar. (B) Silver sulfadiazine poorly penetrates eschar. (C) Neomycin sulfate does not penetrate eschar. (D) Povidoneiodine does not penetrate eschar.
5. Right Answer: D
Explanation: (A) Sodium enters the edema fluid in the burned area, lowering the sodium content of the vascular fluid. Hyponatremia may continue for days to several weeks because of sodium loss to edema, sodium shifting into the cells, and later, diuresis. (B) Hypocalcemia occurs because of calcium loss to edema fluid at the burned site (third space fluid). (C) Protein loss occurs at the burn site owing to increased capillary permeability. Serum protein levels remain low until healing occurs. (D)Hematocrit level is elevated owing to hemoconcentration from hypovolemia. Anemia is present in the postburn stage owing to blood loss and hemolysis, but it cannot be assessed until the client is adequately hydrated.
80% DISCOUNT: NCLEX-RN PRACTICE EXAMS
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