ABSITE – burn QUESTIONS AND ANSWERS LATEST DOWNLOAD 2024/2025 ACTUAL COMPLETE EXAM SOLUTIO, Exams of Nursing

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What are the 5 different causal categories for burns? - CORRECT ANSWERS Flame Scald Contact Electrical Chemical What is a 1st-degree burn? - CORRECT ANSWERS Epidermis only What is a superficial 2nd-degree burn? - CORRECT ANSWERS Epidermis and superficial dermis What is a deep 2nd-degree burn? - CORRECT ANSWERS Epidermis through deep dermis What is a 3rd-degree burn? - CORRECT ANSWERS Full-thickness burn involving epidermis and dermis to the subcutaneous fat What is a 4th-degree burn? - CORRECT ANSWERS Burn through epidermis, dermis, subcutaneous fat to the underlying muscle and bone A painful, erythematous burn with an intact epidermal barrier that blanches to the touch? - CORRECT ANSWERS 1st degree Painful burn with blebs and blisters; hair follicles intact; blanches to the touch? - CORRECT ANSWERS Superficial second degree Burn with sensation decreased; loss of hair follicles? - CORRECT ANSWERS Deep 2nd degree Burn with leathery feeling, no sensation - CORRECT ANSWERS 3rd degree

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Three zones of a burn (from inner to outer) - CORRECT ANSWERS Coagulation Stasis Hyperemia Define the zone of coagulation - CORRECT ANSWERS Irreversibly necrotic tissue where cells have been disrupted Define the zone of stasis - CORRECT ANSWERS Area associated with vascular damage and leakage, adjacent to zone of coagulation. Moderately damaged tissue and impaired perfusion. Tissue can either survive or progress to coagulative necrosis. Zone of hyperemia: - CORRECT ANSWERS Area around burn with vasodilation and viable tissue. Healing begins from here. How can you differentiate a superficial 2nd-degree from a deep 2nd-degree burn? - CORRECT ANSWERS Superficial 2nd degree burn will blanch, a deep 2nd degree burn will not. Where does a superficial 2nd-degree burn re-epithelialize from? - CORRECT ANSWERS Rete ridges, hair follicles, sweat glands (7-14 days) Where does a deep 2nd-degree burn re-epithelialize from? - CORRECT ANSWERS Hair follicles, sweat gland keratinocytes (14-35 days) Where does a 3rd-degree burn re-epithelialize from? - CORRECT ANSWERS Wound edges (zone of hyperemia?) According to the rules of nines, what percentage of total body surface area (TBSA) do these regions represent in an adult? - CORRECT ANSWERS Each upper extremity?

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(Out of date? 2ml x kg x %tbsa for adults, 3 ml for peds, 4 ml for high-voltage electrical burns) What is the best measure of adequate resuscitation? - CORRECT ANSWERS UOP Adults: >0.5 ml/kg/h (30-50 ml/h) Peds: >1.0 ml/kg/h How do you calculate the Galveston formula for maintenance fluid in the first 24 hours for a pediatric burn patient? - CORRECT ANSWERS 5000 ml/tbsa burned in m^2 + 1500/total tbsa in m^ What is the treatment for a 1st-degree burn? - CORRECT ANSWERS Topical salves PO NSAIDs What is the treatment for a superficial 2nd-degree burn? - CORRECT ANSWERS Clean with antiseptic solution Remove foreign bodies and dead skin Unroof blisters Apply topical antibiotic and dress wound What is the treatment for a deep 2nd- and 3rd-degree burns? - CORRECT ANSWERS Initially treat like superficial 2nd degree burn Early excision and grafting (within 72h) Early mobilization What is an allograft or homograft? - CORRECT ANSWERS Skin graft from human cadaver (temporary wound coverage, until autograft can be done)

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What is a xenograft? - CORRECT ANSWERS Graft from another species (porcine) What antimicrobial soak can cause methemoglobinemia? - CORRECT ANSWERS 0.5% silver nitrate What antimicrobial soak can cause metabolic acidosis? - CORRECT ANSWERS 5% mafenide acetate (inhibits carbonic anhydrase) What topical antibiotic can cause a transient leukopenia? - CORRECT ANSWERS 1% silver sulfadiazene (aka silvadene) What topical antibiotic can penetrate eschar? - CORRECT ANSWERS 11% mafenide acetate (aka sulfamylon) Side effects of mafenide acetate (aka sulfamylon) - CORRECT ANSWERS Pain when applied to skin Allergic reaction Metabolic acidosis (inhibits carbonic anhydrase) What antimicrobial soak can stain surface a gray or black color when dry? - CORRECT ANSWERS 0.5% silver nitrate solution What causes most of the damage with inhalation injury? - CORRECT ANSWERS Inhaled toxins What is an abnormal carboxyhemoglobin? - CORRECT ANSWERS >10% in non-smokers

20% in smokers

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What 3 factors are involved in the mechanism of alkali burns? - CORRECT ANSWERS Saponification of fat Denatures and combines with proteins to form protein alkalis Massive extraction of water from cells Hydroxide ions induce further tissue injury What is the strongest inorganic acid? - CORRECT ANSWERS Hydrofluoric acid What is the treatment of hydrofluoric acid burn? - CORRECT ANSWERS Copious irrigation with water 2.5% calcium gluconate gel; re-apply q15min until burning sensation subsides If pain persists or recurs, intradermal injection of 10% calcium gluconate, or intra-arterial injection of calcium gluconate into the affected limb How does calcium gluconate work in treating hydrofluoric acid burn? - CORRECT ANSWERS Treats hypocalcemia caused by HF: fluoride ion complexes with bivalent cations (Ca, Mg) to form insoluble salts; systemic absorption of fluoride ion results in intravascular hypocalcemia chelation which can lead to fatal arrhythmia A 45-year-old female presents to the hospital after falling into a fire and suffering 2nd- degree burns to her right hand and entire arm. What is the percent of TBSA burned for this patient? - CORRECT ANSWERS 9% A 76-year-old male who weighs 80 kg suffered a 25% TBSA 2nd-degree scald burn when a large pot of boiling water spilled onto his torso and lower extremities. He was immediately transferred to the hospital. He has been given 200 mL of lactated Ringer thus far. What is the amount of additional fluid needed to resuscitate this patient in the first 24 hours? - CORRECT ANSWERS 3800

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A 16-year-old female is admitted to the hospital after suffering a 36% 2nd- and 3rd-degree burns to the face and torso after being involved in a house fire. She is intubated. On the 2nd day of hospitalization, her morning arterial blood gas shows a metabolic acidosis. What is most likely the cause of her lab abnormality? - CORRECT ANSWERS Mafenide acetate (inhibits carbonic anhydrase) A 43-year-old male suffers a 5% TBSA 2nd-degree burn to his right leg. He is treated with topical ointment and discharged from the emergency room. He returns to the hospital on the 3rd day complaining of increased pain at the burn site. On examination, there is a dark brown discoloration of the wound and presence of blood below the eschar. A biopsy of viable tissue near the eschar is taken, which shows >100,000 microbial organisms per gram. What is the most appropriate treatment? - CORRECT ANSWERS Surgical excision of infected tissue the most important factor in the diagnosis of a burn infection - CORRECT ANSWERS

100,000 organisms/g in non-necrotic tissue (other signs: dark brown discoloration, blood below the eschar) A 23-year-old male spills hydrofluoric acid on the dorsum of his left hand. What is the most appropriate treatment? - CORRECT ANSWERS Copious irrigation with water, application of calcium gluconate gel A 4-year-old male presents to the emergency department after knocking over a cup of hot soup onto himself. On examination, he has an area of erythema with visible blisters over his right forearm. There is blanching with palpation. He cries with examination of the burned arm. What is the degree of his burn? - CORRECT ANSWERS Superficial 2nd degree A 45-year-old woman is brought to the trauma bay after being rescued from a burning house. She was intubated at the scene due to obvious burns to the face and decreased oxygen saturation. During primary survey, you note that the ET tube is 24 cm at the lip, and she has bilateral breath sounds on auscultation. Her heart rate is 104 and BP is 100/78. However, her saturation is 89% with 100% FiO2. She is noted to have 1st- and 2nd-degree burns to the face and both arms. She also has deep 2nd- and 3rd-degree burns to the torso. A chest x-ray shows endotracheal tube in good position above the carina and no