Burns (10 Questions)

1. Mr. Étienne Boucher, 45 years old, arrives in the ED 30 minutes after escaping a house fire. He is anxious and restless. Assessment findings: soot around the nostrils, singed nasal hairs, hoarse voice, and a persistent cough. He has circumferential burns to the chest and both arms. Vital signs: T 36.4°C, HR 118, RR 26, BP 146/88, SpO₂ 96% on room air.

Question:
Which nursing action should be performed first? *

Start two large-bore IV lines and begin warmed lactated Ringer’s

Apply silver dressing to the burned arms to reduce infection risk

Obtain a full burn history and photograph the wounds for documentation

Prepare for early airway management and notify the physician

2. Ms. Claire Tremblay, 32 years old, is brought to the ED after exposure to smoke in an apartment fire. She reports headache and nausea. She is mildly confused and her skin appears pink. Vital signs: HR 110, RR 20, BP 118/70, SpO₂ 99% on pulse oximetry.

Question:
What is the most appropriate nursing intervention? *

Reassure her because a normal SpO₂ rules out hypoxia

Administer 100% oxygen via non-rebreather mask

Encourage deep breathing and use incentive spirometry

Position her in high Fowler’s and provide oral fluids

3. Mr. Luc Desjardins, 27 years old, spilled boiling water on his left forearm 2 hours ago. The area is bright red, very painful, moist, and has several intact clear blisters. Capillary refill is present distal to the injury.

Question:
Which type of burn should the nurse document? *

Superficial (first-degree) burn

Superficial partial-thickness (second-degree) burn

Full-thickness (third-degree) burn

Fourth-degree burn involving muscle and bone

4. Mr. Jean-Marc Pelletier, 40 years old, has thermal burns involving the entire anterior trunk and the entire left arm. No other areas are burned.

Question: Using the adult Rule of Nines, what is the estimated total body surface area (TBSA) burned? *

18%

27%

36%

45%

5. Ms. Élodie Beaulieu, 56 years old, has a circumferential full-thickness burn to the right forearm after a propane flash burn. Two hours after admission, the nurse notes increasing pain, cool fingers, delayed capillary refill, and the radial pulse is weak compared with the left side.

Question:
What is the nurse’s priority action? *

Elevate the limb and reassess in 1 hour

Apply a warm compress to improve blood flow

Notify the burn team immediately

Decrease IV fluids to reduce swelling

6. Mr. Simon Gervais, 29 years old, sustained an electrical injury at a worksite. There is a small entry burn on the right hand and an exit wound on the left foot. He is alert and reports muscle pain. Vital signs are stable.

Question:
Which nursing intervention is most important to initiate? *

Apply ice packs to the entry wound to limit tissue damage

Place the patient on continuous cardiac monitoring

Cover the wounds tightly with occlusive dressings to prevent oxygen exposure

Encourage ambulation to prevent stiffness

7. Ms. Amélie Fortin, 34 years old, splashed a cleaning product containing a strong alkali on her forearm. She arrives to urgent care with severe burning pain and visible wet chemical residue on the skin.

Question:
What should the nurse do first? *

Neutralize the chemical with a weak acid solution

Apply antibiotic ointment and cover with gauze

Remove contaminated clothing and irrigate with copious running water

Apply an ice pack to reduce pain and swelling

8. Mr. Pascal Lavoie, 62 years old, has 28% TBSA burns and is receiving frequent wound care and dressing changes. During care, the room is cool and multiple areas are exposed. He begins shivering; temperature drops to 35.6°C.

Question:
Which nursing action is most appropriate to add to the therapeutic nursing plan to prevent hypothermia? *

Leave burned areas uncovered to allow them to “dry out”

Restrict oral fluids to reduce metabolic demand

Apply cold compresses to decrease inflammation

Use warmed IV fluids, warm the room, and minimize exposure time by covering areas not being treated

9. Ms. Marianne Dubé, 48 years old, has 35% TBSA partial- and full-thickness burns. Two days after admission, she is scheduled for a dressing change. The nurse notes increased drainage but no confirmed culture results yet.

Question:
Which nursing practice is most appropriate to reduce infection risk during wound care? *

Perform wound care without gloves to better assess tissue texture

Use strict hand hygiene and appropriate PPE

Reuse unopened dressing supplies between patients to reduce waste

Apply systemic antibiotics routinely before each dressing change

10. Ms. Marianne Dubé, 48 years old, has 30% TBSA partial-thickness burns. On day 4, she tells the nurse, “Food tastes awful and I’m not hungry.” Her intake has been low, and the team emphasizes nutrition to support healing. The nurse discusses meal choices with her.

Question:
Which meal choice should the nurse encourage to best promote wound healing? *

Green salad with cucumber, diet gelatin, and herbal tea

White toast with jam and apple juice

Low-fat broth soup and crackers

Grilled chicken and a peanut butter sandwich