CBRN Burn Pathophysiology & Wound Care Management 4 — Questions and Answers
Question 1: Which burn complication is characterized by conversion of a partial-thickness injury to a full-thickness injury due to infection or impaired perfusion?
- Wound contracture
- Burn wound conversion (Correct answer)
- Hypertrophic scar formation
- Eschar separation
Correct answer: Burn wound conversion
Burn wound conversion occurs when the zone of stasis progresses to coagulation due to inadequate resuscitation, infection, or local wound care failure.
Question 2: A burn patient develops progressive dyspnea, hoarseness, and stridor 4 hours post-injury. What is the priority intervention?
- Administer nebulized albuterol
- Perform immediate endotracheal intubation (Correct answer)
- Apply cool mist via face mask
- Order a chest X-ray
Correct answer: Perform immediate endotracheal intubation
Hoarseness and stridor indicate impending airway obstruction from inhalation injury; immediate intubation before complete obstruction is the priority.
Question 3: The hypermetabolic response following major burn injury peaks at approximately what time post-burn?
- 12-24 hours
- 5-10 days (Correct answer)
- 3-4 weeks
- Immediately at time of injury
Correct answer: 5-10 days
The hypermetabolic response typically peaks around 5-10 days post-burn as inflammatory mediators drive a massive increase in metabolic rate.
Question 4: Which graft type uses the patient's own skin harvested from an unburned donor site?
- Allograft
- Xenograft
- Autograft (Correct answer)
- Biosynthetic graft
Correct answer: Autograft
An autograft uses the patient's own skin and is the definitive, permanent wound coverage for full-thickness burns.
Question 5: A nurse notes a burn patient's urine output has dropped to 0.3 mL/kg/hr during resuscitation. What is the most appropriate action?
- Decrease IV fluid rate to prevent fluid overload
- Administer furosemide to increase output
- Increase IV fluid rate to achieve 0.5-1 mL/kg/hr (Correct answer)
- Start vasopressors immediately
Correct answer: Increase IV fluid rate to achieve 0.5-1 mL/kg/hr
Urine output of 0.5-1 mL/kg/hr is the target in burn resuscitation; a low output indicates inadequate fluid delivery and requires rate increase.
Question 6: Which type of scar is raised, reddened, and confined to the original wound boundaries in a burn patient?
- Keloid scar
- Hypertrophic scar (Correct answer)
- Atrophic scar
- Contracture band
Correct answer: Hypertrophic scar
Hypertrophic scars are raised, erythematous, and remain within the wound margins, unlike keloids which extend beyond the original injury boundaries.
Question 7: Burn patients are particularly susceptible to hypothermia during wound care. What is the minimum recommended ambient room temperature for dressing changes?
- 68°F (20°C)
- 75°F (24°C)
- 85°F (29°C) (Correct answer)
- 98°F (37°C)
Correct answer: 85°F (29°C)
Burn patients lose thermoregulatory ability; rooms should be warmed to at least 85°F (29°C) during wound care to prevent hypothermia.
CBRN Burn Pathophysiology & Wound Care Management 4
Which burn complication is characterized by conversion of a partial-thickness injury to a full-thickness injury due to infection or impaired perfusion?