CBRN Electrical, Chemical & Cold Injuries

Question 1

What is the priority nursing action for a patient with an alkali chemical burn to the arm?

Accepted Answer

Remove contaminated clothing and irrigate with copious water, continuing longer than for acid burns

Answer

Immediate dilution with large volumes of water and removal of contaminated clothing is the priority. Alkalis penetrate deeper and need prolonged irrigation. Neutralizing agents generate heat and cause further injury. Dry powders should be brushed off first.

Question 2

A patient with a hydrofluoric acid burn develops muscle twitching and a prolonged QT interval. Which treatment is most appropriate?

Accepted Answer

Calcium gluconate

Answer

Fluoride ions bind calcium and magnesium, causing hypocalcemia and hypomagnesemia, which lead to dysrhythmias and tetany. Topical, subcutaneous, or IV calcium gluconate, with electrolyte replacement and cardiac monitoring, is the treatment.

Question 3

A worker has a high-voltage electrical injury with small entry and exit wounds. Why is the visible skin injury misleading?

Accepted Answer

Current travels along low-resistance tissue, causing extensive deep muscle damage, possible rhabdomyolysis, and dysrhythmias

Answer

High-voltage current passes through nerves, vessels, and muscle, causing deep injury under small skin wounds. Nursing priorities include continuous cardiac monitoring, assessing for compartment syndrome, and maintaining urine output to flush myoglobin.

Question 4

A patient with an electrical injury has dark, tea-colored urine. What is the appropriate fluid goal?

Accepted Answer

Increase fluids to maintain urine output of about 75–100 mL/hr until the urine clears

Answer

Dark urine suggests myoglobinuria from muscle breakdown. Higher urine output protects the kidneys from myoglobin-induced acute kidney injury. Fluids are increased and urine is monitored until the pigment clears.

Question 5

What is the recommended rewarming method for frostbitten fingers once refreezing can be prevented?

Accepted Answer

Rapid rewarming in circulating water at about 37–39°C (98.6–102°F) for 15–30 minutes

Answer

Rapid rewarming in warm circulating water restores perfusion while minimizing scald risk. Rubbing and dry heat cause additional tissue damage. Refreezing after thawing is more harmful than delaying rewarming.

(CBRN) Certified Burn Registered Nurse Practice Test

(CBRN) Certified Burn Registered Nurse Practice Test

CBRN Electrical, Chemical & Cold Injuries