The nurse is caring for a client with superficial partial thickness burn injuries to the upper and lower extremities. The client is ordered IV morphine for pain. The nurse recognizes that narcotics are given IV during the initial management of pain based on which on which of the following rationales?

Bleeding may occur at injection sites when the intramuscular route is used.

The client can experience nausea and vomiting when given oral medications.

Pain resulting from a burn injury requires relief by the fastest route available.

Damaged tissue and edema may interfere with drug absorption via other routes.

Answer and Explanation

The Correct Answer is D

A. Bleeding may occur at injection sites when the intramuscular route is used: While possible, this is not the primary concern.

B. The client can experience nausea and vomiting when given oral medications: This may be true but is secondary to absorption issues.

C. Pain resulting from a burn injury requires relief by the fastest route available: Although IV is fast, the key issue is absorption.

D. Damaged tissue and edema may interfere with drug absorption via other routes: Burned and edematous tissue reduces IM and subcutaneous absorption, making IV the preferred route.

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Correct Answer is B

Explanation

A. Oxygen saturation 93%:
While this is slightly below normal, it is not a definitive or specific indicator of fluid overload.

B. Distended neck veins:
Jugular vein distention is a classic sign of fluid overload and increased central venous pressure.

C. The client has gained 1 pound since yesterday:
A 1-pound weight gain could be due to fluid retention, but it's not significant enough on its own to confirm fluid overload.

D. Return of skin to previous position when the client's shin is palpated:
This indicates normal skin turgor and does not suggest fluid overload; instead, it rules out dehydration.

A. "A piece of healthy skin will be removed from an unburned area and grafted over the burned area." B. "This procedure involves placing the client into a Whirlpool tub and removing the dead tissue." C. "Dead tissue will be non-surgically removed." D. "Incisions will be made in the burnt tissues to improve circulation."

Correct Answer is D

Explanation

A. "A piece of healthy skin will be removed from an unburned area and grafted over the burned area.": This describes a skin graft, not escharotomy.

B. "This procedure involves placing the client into a Whirlpool tub and removing the dead tissue.": This describes hydrotherapy or wound debridement.

C. "Dead tissue will be non-surgically removed.": Describes enzymatic or mechanical debridement.

D. "Incisions will be made in the burnt tissues to improve circulation.": Escharotomy relieves pressure caused by tight, burned skin (eschar) to restore blood flow and prevent compartment syndrome.

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a client diagnosed with end-stage renal disease (ESRD) that is receiving hemodialysis. Which of the following findings should the nurse identify as an indication that the client is experiencing fluid overload?

Correct Answer is B

Explanation

A nurse is caring for a client admitted with severe burns to both lower extremities and is scheduled for an escharotomy. The client's spouse asks the nurse what the procedure entails. Which of the following nursing statements is appropriate?

Correct Answer is D

Explanation

A nurse is caring for a client who has acute kidney injury (AKI). Which of the following arterial blood gas values would the nurse expect this client to have?

A nurse is caring for a client with a burn injury. Which assessment findings by the nurse would indicate a deep partial-thickness burn?

A nurse is assessing a client who has sustained burns on the entire left arm and the anterior chest. Using the rule of nines, the nurse calculates what percentage of total body surface area is affected by the burns?

A nurse is monitoring the fluid replacement of a client who has sustained burns over 40% total body surface area (TBSA). The client weight is 100kg According to the Parkland Formula, how much fluid will the client require in the first 8 hours?

A client who is in the acute phase of recovery from a burn injury has yet to experience adequate pain control. The nurse recognizes that which pain management strategy should best meet this client's pain control needs?

A nurse is caring for a client experiencing fatigue secondary to anemia from chronic kidney disease (CKD). How should the nurse respond when the client asks about the cause of the anemia symptoms they are experiencing?

A client has been admitted to a burn intensive care unit with extensive full thickness burns over 36% of the body. After ensuring cardiopulmonary stability, which should be the nurse's highest priority when planning the client's care in the early acute phase of the injury?