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2. The client presents with blistering wounds caused by an unknown chemical agent.
How should the nurse intervene?
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. 1.9%
b. 18%
c. 27%
d. 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. albumin
b. dextrose 5% in water
c. lactated Ringers solution
d. 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. autograph
b. heterograph
c. homograph
d. 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?
a. PaO2 of 80 mmHg
b. Urine output of 20 ml/hr
c. White pulmonary secretions
d. Temp of 38C
8. When planning care for a client with burns on the upper chest, which nursing
diagnosis should take the highest priority?
9. a client with a superficial partial thickness burn (sunburn) of the chest, back, face
and arms is seen in the ER. The nurse’s primary concern should be:
a. fluid resuscitation
b. infection
c. body image
d. pain management
10. A nurse is developing a care plan for a client recovering from a serious thermal
burn. After maintaining respirations, the nurse knows that the most important
immediate goal of therapy is:
11. When assessing a client with partial thickness burns over 60% of the body, which
finding should the nurse report immediately?
13. In a client with burns on the legs, which nursing intervention helps prevents
contractures?
A client with chronic renal failure has developed faulty red blood cell (RBC)
production. The nurse should monitor this client for:
A client comes to the emergency room complaining of severe pain in the right flank,
nausea, and vomiting. The physician tentatively diagnoses right urolithiasis. When
planning this client’s care, the nurse should assign the highest priority to which
nursing diagnosis?
a. Acute pain
b. Risk for infection
c. Impaired urinary elimination
d. Imbalanced nutrition: less than body requirements
A nurse is caring for a client in acute renal failure. The nurse should expect
hypertonic glucose, insulin infusions and sodium bicarbonate to be used to treat:
a. hypernatremia
b. hyperkalemia
c. hypokalemia
d. hyponatremia
a nurse is reviewing the client’s fluid intake and output record. Fluid intake and urine
output should relate in which way?
a nurse is caring for a client with acute pyelonephritis. Which nursing intervention is
the most important?
a client with chronic renal failure has a serum potassium level of 6.8 meq/L. what
should the nurse assess first?
a. blood pressue
b. respirations
c. temperature
d. pulse
Which clinical finding should a nurse look for in a client with chronic renal failure?
a. hypotension
b. uremia
c. metabolic alkalosis
d. polycythemia