Patients with burns have varied needs, and the nurse needs to assess which of these needs to be prioritized above others in the provision of care. Fluid and electrolyte balance, maintenance of patent airway, prevention of infection and contractures as well as pain management are usually the top priority in care provision.
This Burns NCLEX Questions allows you to review your understanding of caring for patients who have sustained burn injuries. Concepts such as fluid resuscitation, pain control, diet, and nutrition therapy, as well as psychosocial aspects of caring for these patients, are included in the test questions below.
In taking this practice test, it is recommended that you time yourself while answering each question, ensuring that 1 minute is allocated to answer each item. After all the questions are answered, take some time to review them and check the answers and rationales for this practice test in the next page.
Burns NCLEX Questions
1. An adult client was burned in an explosion. The burn initially affected the client’s entire face (anterior half of the head) and the upper half of the anterior torso, and there were circumferential burns to the lower half of both arms. The client’s clothes caught on fire, and the client ran, causing subsequent burn injuries to the posterior surface of the head and the upper half of the posterior torso. Using the rule of nines, what would be the extent of the burn injury?
2. The nurse is preparing to care for a burn client scheduled for an escharotomy procedure being performed for a third-degree circumferential arm burn. The nurse understands in which finding is the anticipated therapeutic outcome of the escharotomy?
A. Return of distal pulses
B. Brisk bleeding from the site
C. Decreasing edema formation
D. Formation of granulation tissue
3. A client is undergoing fluid replacement after being burned on 20% of her body 12 hours ago. The nursing assessment reveals a blood pressure of 90/50 mm Hg, a pulse rate of 110 beats/minute, and a urine output of 20 mL over the past hour. The nurse reports the findings to the health care provider (HCP) and anticipates which prescription?
A. Transfusing 1 unit of packed red blood cells
B. Administering a diuretic to increase urine output
C. Increasing the amount of intravenous (IV) lactated Ringer’s solution administered per hour
D. Changing the IV lactated Ringer’s solution to one that contains 5% dextrose in water
4. A client is brought to the emergency department with partial-thickness burns to his face, neck, arms, and chest after trying to put out a car fire. The nurse should implement which nursing actions for this client? Select all that apply.
A. Restrict fluids.
B. Assess for airway patency.
C. Administer oxygen as prescribed.
D. Place a cooling blanket on the client.
E. Elevate extremities if no fractures are present.
F. Prepare to give oral pain medication as prescribed.
5. The nurse is caring for a client who sustained superficial partial-thickness burns on the anterior lower legs and anterior thorax. Which finding does the nurse expect to note during the resuscitation/emergent phase of the burn injury?
A. Decreased heart rate
B. Increased urinary output
C. Increased blood pressure
D. Elevated hematocrit levels
6. A client arrives at the emergency department following a burn injury that occurred in the basement at home, and an inhalation injury is suspected. What would the nurse anticipate to be prescribed for the client?
A. 100% oxygen via an aerosol mask
B. Oxygen via nasal cannula at 6 L/minute
C. Oxygen via nasal cannula at 15 L/minute
D. 100% oxygen via a tight-fitting, nonrebreather face mask
7. The nurse is administering fluids intravenously as prescribed to a client who sustained superficial partial-thickness burn injuries of the back and legs. In evaluating the adequacy of fluid resuscitation, the nurse understands that assessment would provide the most reliable indicator for determining the adequacy?
A. Vital signs
B. Urine output
C. Mental status
D. Peripheral pulses
8. The nursing instructor is going over burn injuries. The instructor tells the students that the nursing care priorities for a patient with a burn injury include wound care, nutritional support, and prevention of complications such as infection. Based on these care priorities, the instructor will most likely discuss a patient in what phase of burn care?
B. Immediate resuscitative
9. A patient in the emergent/resuscitative phase of a burn injury has drawn her lab work. Upon analysis of the patient’s laboratory studies, the nurse will expect the results to indicate what?
A. Hyperkalemia, hyponatremia, elevated hematocrit, and metabolic acidosis
B. Hypokalemia, hypernatremia, decreased hematocrit, and metabolic acidosis
C. Hyperkalemia, hypernatremia, decreased hematocrit, and metabolic alkalosis
D. Hypokalemia, hyponatremia, elevated hematocrit, and metabolic alkalosis
10. The nurse cares for a patient who has an electrical burn and has developed thick eschar over the burn wound. Which of the following topical antibacterial agents will the nurse expect the physician to order for the wound?
A. Silver sulfadiazine 1% (Silvadene) water-soluble cream
B. Mafenide acetate 10% (Sulfamylon) hydrophilic-based cream
C. Silver nitrate 0.5% aqueous solution
11. A patient has been admitted to a burn intensive care unit with extensive full-thickness burns over 25% of the body. What would be the nurse’s priority concern about this patient?
A. Fluid status
B. Risk of infection
C. Body image
D. Level of pain
12. A patient with a partial-thickness burn injury had Biobrane applied 2 weeks ago. The nurse notices that the Biobrane is separating from the burn wound. What is the appropriate nursing intervention when this separation occurs?
A. Reinforce the Biobrane dressing with another piece of Biobrane.
B. Remove the Biobrane dressing and apply a new dressing.
C. Trim away the separated Biobrane.
D. Notify the physician of further emergency-related orders.
13. An emergency department nurse learns from the paramedics that they are transporting a patient who has suffered injury from a scald from a hot kettle. What factors does the nurse know are considered when determining the depth of burn?
A. Causative agent
B. Visual observation of the burned area
C. Area of body burned
D. Circumstances of the accident
14. A patient is brought to the ED by paramedics who report the patient has partial-thickness burns on the chest and legs. The patient has also suffered smoke inhalation. What is a priority in the care of a patient who has been burned and suffered smoke inhalation?
B. Fluid balance
C. Anxiety and fear
D. Airway management
15. The nursing instructor is teaching about the emergent/resuscitative phase of burn injury. During this phase, what would the nursing instructor tell the students they should closely monitor in the laboratory values?
A. Sodium deficit
B. Bleeding time
C. Potassium deficit
D. Decreased hematocrit
16. A nurse taking care of a burn patient is asked why the patient is losing so much weight. What would be the nurse’s most appropriate answer?
A. “Your body has built up extra fat deposits even though you haven’t been eating very much.”
B. “Your body has used your fat deposits for fuel because you haven’t been eating very much.”
C. “Your reserve fat deposits have been catabolized because you have been eating so much.”
D. “You have lost fluids, and you haven’t eaten very much.”
17. A 45-year-old man is brought in by Life-Flight after a motor vehicle accident in which he was trapped in a burning vehicle. The burn team estimates the patient’s likelihood of survival based on the severity of the burn injury. The emergency department nurse knows that the severity of the injury is based on what factors? (Mark all that apply.)
B. Depth of the burn
C. Presence of inhalation injury
D. Family support
E. Psychological state of the patient
18. A burn victim is admitted to the Intensive Care Unit to stabilize and begin fluid resuscitation before transport to the burn center. If inadequate fluid resuscitation occurs, what happens to the patient?
A. Becomes unresponsive
B. Distributive shock
D. Hypovolemic shock
19. A male patient, 16 years old, comes to the emergency department (ED) after burning his right hand and arm while working on a friend’s car. The injury is determined to be a superficial burn, and it is treated. What would the nurse teach the patient before discharging him home to return on a daily basis for dressing changes?
A. “As your arm swells, push on your fingernails. If it takes longer than 5 seconds for them to get pink, come back to the ED.”
B. “You should be fine until you come back tomorrow for your dressing change.”
C. “Drink lots of fluids and elevate the arm.”
D. “The burned area will start to swell in about 4 hours, and blisters will form. If you think the dressing is too tight, come back to the ED.”
20. A patient is admitted to the burn unit after being transported from a facility 1000 miles away. The patient has burns to the groin area and both legs. The burns to the lower legs are circumferential. The nurse knows to monitor closely for what as the edema in this patient increases?
C. Hyper-profusion to the burned area
D. Increased fluid loss through the burned area
21. As the patient begins the acute phase of a burn, cautious administration of fluids and electrolytes continues. The nurse knows that this caution is because of what? (Mark all that apply.)
A. Patient is considered in critical condition
B. Cardiac function is decreased
C. Patient’s physiologic responses to the burn injury
D. Losses of fluid from large burn wounds
E. Shifts in fluid from the interstitial to the intravascular compartment
22. A nurse is caring for a patient during the acute phase of the burn. The nurse knows he is responsible for what?
A. Restricting visitors to prevent infection
B. Closely scrutinizing the burn wound to detect early signs of infection
C. Cleaning the patient’s room
D. Maintaining the patient in a sterile environment
23. You are caring for a burn patient who is in the later stages of the acute phase of the burn injury. What is an important factor in your care of the patient?
A. Immobilizing the patient
B. Maintaining splints and functional devices
C. Maintaining ongoing discussion about the patient with a psychologist
D. Prevention of DVT
24. A patient is admitted to the burn center with burns of his head and neck, chest, and back after an explosion in his garage. On assessment, the nurse auscultates wheezes throughout the lung fields. On reassessment, the wheezes are gone, and the breath sounds are greatly diminished. Which action is the most appropriate for the nurse to take next?
A. Obtain vital signs and a STAT ABG
B. Encourage the patient to cough and auscultate the lungs again
C. Document the findings and continue to monitor the patient’s breathing
D. Anticipate the need for endotracheal intubation and notify the physician
25. A patient has 25% TBSA burned from a car fire. His wounds have been debrided and covered with a silver-impregnated dressing. The nurse’s priority intervention for wound care would be to:
A. Reapply a new dressing without disturbing the wound bed
B. Observe the wound for signs of infection during dressing changes
C. Apply cool compresses for pain relief in between dressing changes
D. Wash the wound aggressively with soap and water three times a day.
26. A patient is recovering from second-and third-degree burns over 30% of his body and is now ready for discharge. The first action the nurse should take when meeting with the patient would be to:
A. arrange a return-to-clinic appointment and prescription for pain medications
B. teach the patient and caregiver proper wound care to be performed at home
C. review the patient’s current health care status and readiness for discharge to
D. give the patient written discharge information and websites for additional information for burn survivors.
27. A nurse cares for a patient with second-and third-degree burns to 50% of the body. The nurse prepares fluid resuscitation based on knowledge of the Parkland (Baxter) formula that includes which recommendation?
A. The total 24-hour fluid requirement should be administered in the first 8 hours.
B. One-half of the total 24-hour fluid requirement should be administered in the first 8 hours.
C. One-third of the total 24-hour fluid requirement should be administered in the first 4 hours.
D. One-half of the total 24-hour fluid requirement should be administered in the first 4 hours.
28. The nurse is planning care for a patient with partial- and full-thickness skin destruction related to burn injury of the lower extremities. Which interventions should the nurse expect to include in this patient’s care? (select all that apply)
B. Administration of diuretics
C. IV and oral pain medications
D. Daily cleansing and debridement
E. Application of topical antimicrobial agent
29. When teaching the patient about the use of range-of-motion (ROM), what explanations should the nurse give to the patient? (select all that apply)
A. the exercises are the only way to prevent contractures
B. active and passive ROM maintain the function of body parts
C. ROM will show the patient that movement is still possible
D. movement facilitates mobilization of leaked exudates back into the vascular bed.
E. active and passive ROM can only be done while the dressings are being changed
30. The patient in the acute phase of burn care has electrical burns on the left side of her body, type 2 diabetes mellitus, and a serum glucose level of 485 mg/dL. What should be the nurse’s priority intervention to prevent a life-threatening complication of hyperglycemia for this burned patient?
A. Replace the blood lost
B. Maintain a neutral pH
C. Maintain fluid balance
D. Replace serum potassium