TCRN TCRN Burn and Inhalation Injuries 3

Question 1

A patient with inhalation injury has a PaO2 of 55 mmHg on 100% non-rebreather mask. Which intervention should be initiated?

Accepted Answer

Increase PEEP on the ventilator

Answer

Refractory hypoxemia in intubated inhalation injury patients is treated with increased PEEP to recruit collapsed alveoli and improve oxygenation.

Question 2

Which wound characteristic distinguishes a deep partial-thickness burn from a full-thickness burn?

Accepted Answer

Painful response to pinprick testing

Answer

Deep partial-thickness burns are painful to pinprick because sensory nerve endings in the dermis remain intact, whereas full-thickness burns destroy nerves and are insensate.

Question 3

Hydrogen cyanide (HCN) toxicity is suspected in a burn patient from a structure fire. What is the antidote of choice?

Accepted Answer

Hydroxocobalamin (Cyanokit)

Answer

Hydroxocobalamin binds cyanide to form cyanocobalamin (vitamin B12), is the preferred antidote, and does not cause methemoglobinemia unlike nitrite-based regimens.

Question 4

A patient with 30% TBSA burns develops fever, tachycardia, and wound purulence on day 5. Which organism is the most common cause of early burn wound infection?

Accepted Answer

Staphylococcus aureus

Answer

Staphylococcus aureus (including MRSA) predominates in early burn wound infections during the first week, while Pseudomonas aeruginosa becomes more common later.

Question 5

When calculating fluid resuscitation using the Parkland formula for a 70 kg patient with 30% TBSA burns, what is the total 24-hour lactated Ringer's volume?

Accepted Answer

8,400 mL

Answer

Parkland formula: 4 mL × 70 kg × 30% TBSA = 8,400 mL total over 24 hours.

TCRN Exam Practice Test

TCRN Exam Practice Test

TCRN TCRN Burn and Inhalation Injuries 3