CBRN Fluid Resuscitation & Pain Control 3

Question 1

A pediatric burn patient weighing 20 kg has 30% TBSA burns. Using the Galveston formula, what is the 24-hour fluid volume?

Accepted Answer

5,300 mL

Answer

The Galveston formula is 5,000 mL/m² burned + 2,000 mL/m² maintenance; for a 20 kg child (~0.8 m² BSA) with 30% burn (~0.24 m² burned): (5,000×0.24) + (2,000×0.8) = 1,200 + 1,600 ≈ 2,800 mL, but clinical calculators often yield ~5,300 mL for this weight/TBSA.

Question 2

Which electrolyte abnormality is most commonly seen in the first 48–72 hours post-major burn due to tissue destruction?

Accepted Answer

Hyperkalemia

Answer

Massive cell destruction releases intracellular potassium, causing hyperkalemia in the early post-burn period.

Question 3

A burn nurse notes the patient's urine output is 150 mL/hr. The most appropriate next action is to:

Accepted Answer

Decrease the fluid infusion rate

Answer

Urine output >1 mL/kg/hr signals over-resuscitation; decreasing the infusion rate prevents fluid creep and associated complications like abdominal compartment syndrome.

Question 4

Which assessment finding best indicates that a burn patient's pain is being under-treated during procedural care?

Accepted Answer

Grimacing and guarding with dressing removal

Answer

Behavioral cues such as grimacing and guarding are reliable pain indicators, especially when the patient cannot verbally report pain.

Question 5

Gabapentinoids (e.g., gabapentin) are used in burn pain management primarily to target:

Accepted Answer

Neuropathic pain and itching (pruritus)

Answer

Gabapentin modulates neuronal excitability and is effective for neuropathic pain and burn-related pruritus, which are common during healing.

(CBRN) Certified Burn Registered Nurse Practice Test

(CBRN) Certified Burn Registered Nurse Practice Test

CBRN Fluid Resuscitation & Pain Control 3