A nurse is assessing a client with a major burn injury.
Which of the following findings should the nurse prioritize?
The client is producing black colored sputum.
The client has large blistered areas over his chest.
The client has edema at the burn site.
The client has decreased sensation over the burn areas.
The Correct Answer is A
Choice A rationale
The production of black colored sputum in a client with a major burn injury could indicate inhalation injury, which is a serious complication associated with burns. Inhalation injury can lead to respiratory failure, a leading cause of death in patients with burn injuries.
Choice B rationale
While large blistered areas over the chest indicate a significant burn injury, they are not immediately life-threatening. These areas will require wound care and monitoring for infection.
Choice C rationale
Edema at the burn site is a common response to burn injuries. It is caused by an increase in capillary permeability following the injury. While it needs to be monitored, it is not the highest priority.
Choice D rationale
Decreased sensation over the burn areas could indicate a deep partial-thickness or full-thickness burn. While this is a serious condition that will require treatment, it is not as immediately life-threatening as an inhalation injury.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
The production of black colored sputum in a client with a major burn injury could indicate inhalation injury, which is a serious complication associated with burns. Inhalation injury can lead to respiratory failure, a leading cause of death in patients with burn injuries.
Choice B rationale
While large blistered areas over the chest indicate a significant burn injury, they are not immediately life-threatening. These areas will require wound care and monitoring for infection.
Choice C rationale
Edema at the burn site is a common response to burn injuries. It is caused by an increase in capillary permeability following the injury. While it needs to be monitored, it is not the highest priority.
Choice D rationale
Decreased sensation over the burn areas could indicate a deep partial-thickness or full-thickness burn. While this is a serious condition that will require treatment, it is not as immediately life-threatening as an inhalation injury.
Correct Answer is B
Explanation
Choice A rationale
Hepatitis C is not typically transmitted through saliva. It is a bloodborne virus, meaning it is most commonly transmitted through exposure to infected blood.
Choice B rationale
Hepatitis C is most commonly transmitted through exposure to infected blood. This can occur through sharing drug injection equipment, receiving a tattoo or piercing at a place with poor infection control, and other ways. Coming into contact with infected blood, such as from a used needle, is a common way the virus is transmitted.
Choice C rationale
Hepatitis C is not typically transmitted through consuming contaminated food or water. It is a bloodborne virus.
Choice D rationale
While it is possible to contract Hepatitis C by sharing personal items like toothbrushes or razors with an infected person, this is less common. The virus is most commonly transmitted through exposure to infected blood.
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