TCRN TCRN Burn and Inhalation Injuries 4

Question 1

A burn patient develops myoglobinuria after electrical injury. What is the minimum target urine output to prevent acute kidney injury?

Accepted Answer

1–2 mL/kg/hr

Answer

With myoglobinuria, urine output should be increased to 1–2 mL/kg/hr (with IV fluids and possible sodium bicarbonate to alkalinize urine) to flush myoglobin and prevent tubular obstruction.

Question 2

Which sign indicates that a burn patient's inhalation injury has progressed to involve the lower airway?

Accepted Answer

Wheezing and bronchospasm on auscultation

Answer

Wheezing and bronchospasm indicate lower airway involvement from inhaled toxins and heat, while stridor and hoarseness suggest upper airway injury.

Question 3

What is the rationale for NOT using iced water or ice packs for initial burn cooling?

Accepted Answer

Ice causes further tissue damage by direct freezing and hypothermia

Answer

Ice and iced water can cause vasoconstriction and hypothermia, worsening tissue damage; cool (not cold) running water at 15–25°C for 20 minutes is recommended.

Question 4

A patient transferred from an outside hospital with 50% TBSA burns has received 3 liters of NS. On arrival, the patient is in burn shock. What is the most appropriate fluid adjustment?

Accepted Answer

Recalculate Parkland formula from time of injury and adjust LR rate accordingly

Answer

The Parkland formula should be recalculated from the time of injury, credit given for fluids already received, and the remaining volume adjusted using lactated Ringer's.

Question 5

Which laboratory finding is most consistent with cyanide toxicity in a burn victim from a closed-space fire?

Accepted Answer

High anion gap metabolic acidosis with elevated serum lactate

Answer

Cyanide inhibits cytochrome oxidase, blocking cellular respiration and causing a high anion gap lactic acidosis with markedly elevated lactate levels.

TCRN Exam Practice Test

TCRN Exam Practice Test

TCRN TCRN Burn and Inhalation Injuries 4