TCRN - Burn Trauma test
questions and answers
A patient sustains full thickness (third degree) burns to 20% of the
body surface area, deep partial thickness burns (second degree) to
20% of the body surface area, superficial partial thickness burns
(second degree) to 20% of the body surface area and superficial
burns (first degree) to 20% of the body surface area. When
calculating the total body surface area burned to determine the
amount of fluid resuscitation required, what percentage of body
surface area burned should be utilized?
a. 20%
b. 40%
c. 60%
d. 80%
Answer: C
When determining the body surface area burned to be utilized in a
burn fluid resuscitation formula (such as Modified Parkland Burn
Formula), second, third and fourth degree burns are utilized. First
degree burns are not included. Since this patient has 20% of the
body surface area covered with third degree burns and 40% covered
with varying depths of second degree burns (superficial and deep
partial thickness burns), the amount of body surface area burned
for purposes of fluid resuscitation formulas is 60%. The 20% of the
body surface area that has first degree burns is not included in this
calculation.
Which of the following descriptions captures the likely appearance
of a deep partial thickness burn?
a. A deep red color that blanches when pressure is applied.
b. An erythematous area that blanches when pressure is applied.
, c. A mottled pink color that does not blanch when pressure is
applied.
d. Dry, leathery skin that does not blanch when pressure is applied.
Answer: C
Deep partial thickness burns appear mottled pink or white
immediately after the injury. As time progresses, they may blister or
appear dry with a cherry red color. Because of altered circulation to
the area, deep partial thickness burns do not blanch when pressure
is applied. Dry, leathery skin that does not blanch when pressure is
applied is more consistent with a full thickness burn.
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The Modified Parkland Burn Formula is used to determine the
amount of fluid to deliver to an adult patient weighing 90 kg with
burns over 40% of the body surface area. It is determined that 450
mL of fluid should be delivered per hour. After the first hour of fluid
resuscitation, the patient's urinary output is noted to be 45 mL. The
trauma nurse should:
a. Increase the rate of intravenous fluid administration.
b. Decrease the rate of intravenous fluid administration.
c. Continue with the current rate of intravenous fluid
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