1. The nurse is changing a dressing and providing wound care. Which activity should she perform first? a. b. c. d.

assess the drainage in the dressing slowly remove the soiled dressing wash hands thoroughly put on latex gloves

2. The client presents with blistering wounds caused by an unknown chemical agent. How should the nurse intervene? a. b. c. d. Do nothing until the chemical agent is identified Irrigate the wounds with water Wash the wounds with soap and water and apply a cream Insert a IV catheter and infuse PNSS at 150 cc/hr

3. Which nursing intervention can help a client maintain healthy skin? a. b. c. d. Keeping the client well hydrated Avoiding bathing the client with mild soap Removing adhesive tape quickly from the skin Recommending wearing tight fitting clothes in warm weather

4. A client received burns to his entire back and left arm. Using rule of nines, the nurse can calculate that he has sustained burns on what percentage of his body? a. b. c. d. 1.9% 18% 27% 36%

5. A client has partial thickness burns on both lower extremities and portions of the trunk. Which IV fluid does the nurse plan to administer first? a. b. c. d. albumin dextrose 5% in water lactated Ringers solution normal saline solution with 20 meq potassium in 1 liter

6. a client returns from the operating room with a partial-thickness skun graft on his left arm. The donor tissue was taken from his left hip. This type of graft is known as: a. b. c. d. autograph heterograph homograph allograph

7. a nurse is assessing a client admitted with deep partial thickness and full thickness burns on the face, arms and chest. Which finding indicates a potential problem?

d. d. The nurse’s primary concern should be: a. elevating the foot of the bed . applying knee splints b. a client with a superficial partial thickness burn (sunburn) of the chest. In a client with burns on the legs. b. which nursing intervention helps prevents contractures? a. a nurse should assess: a. PaO2 of 80 mmHg Urine output of 20 ml/hr White pulmonary secretions Temp of 38C 8. planning for the client’s rehabilitation and discharge providing emotional support to the client and family maintaining the client’s fluid and electrolyte. c. the nurse knows that the most important immediate goal of therapy is: a. After maintaining respirations. which nursing diagnosis should take the highest priority? a. When planning care for a client with burns on the upper chest. complains of intense thirst moderate to severe pain urine output of 70ml per hour hoarseness of the voice 12. b. When assessing a client with partial thickness burns over 60% of the body. and acid base balance preserving full range of motion in all affected joints 11. c. ineffective airway clearance r/t edema of the respiratory passages impaired physical mobility related to disease process disturbed sleep pattern r/t environment risk for infection r/t breaks in the skin 9. d. face and arms is seen in the ER. b. A nurse is developing a care plan for a client recovering from a serious thermal burn. d. fluid resuscitation infection body image pain management 10. c. c. d. b. b. During the acute phase of a burn.a. d. b. the client’s lifestyle alcohol use tobacco use circulatory status 13. back. which finding should the nurse report immediately? a. c. c.

Which nursing intervention is the most important? a. and vomiting. The nurse should monitor this client for: a. nausea and vomiting dyspnea and cyanosis fatigue and weakness thrush and circumoral palor A client comes to the emergency room complaining of severe pain in the right flank. Acute pain Risk for infection Impaired urinary elimination Imbalanced nutrition: less than body requirements A nurse is caring for a client in acute renal failure. b. insulin infusions and sodium bicarbonate to be used to treat: a. d. b. d. b. fluid intake should be double the urine output fluid intake should be about equal to the urine output fluid intake should be half the urine output fluid intake should be inversely proportional to the urine output a nurse is caring for a client with acute pyelonephritis. d. When planning this client’s care. nausea. c. hypernatremia hyperkalemia hypokalemia hyponatremia a nurse is reviewing the client’s fluid intake and output record. Fluid intake and urine output should relate in which way? a. hyperextending the client’s palms d. administering sitz bath twice per day increasing fluid intake to 3l/day using an indwelling catheter to measure urine output accurately encouraging the client to drink cranberry juice to acidify the urine a client is admitted for treatment of glomerulonephritis. c.c. Such signs include: . c. The nurse should expect hypertonic glucose. d. The physician tentatively diagnoses right urolithiasis. d. performing shoulder range of motion exercise A client with chronic renal failure has developed faulty red blood cell (RBC) production. the nurse detects one of the classic signs of acute glomerulonephritis. b. c. On initial assessment. the nurse should assign the highest priority to which nursing diagnosis? a. b. c.

b. d.a. b. d. b. c. c. blood pressue respirations temperature pulse Which clinical finding should a nurse look for in a client with chronic renal failure? a. specific gravity of 1. d. hypotension uremia metabolic alkalosis polycythemia . c. periorbital edema green-tinged urine moderate to severe hypotension polyuria a nurse is reviewing a report of a client’s routine urinalysis.03 urine pH of 3 absence of protein absence of glucose a client with chronic renal failure has a serum potassium level of 6. b. Which value requires further investigation? a. what should the nurse assess first? a. d. c.8 meq/L.

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