TNCC Burn and Thermal Trauma 3

Question 1

How does burn shock differ from simple hypovolemic shock from hemorrhage?

Accepted Answer

Burn shock involves both intravascular volume loss and massive capillary leak from systemic inflammatory mediator release

Answer

Burn shock responds more rapidly to fluid resuscitation than hemorrhagic shock

Answer

Burn shock only occurs when burns exceed 50% TBSA

Answer

Burn shock is caused solely by fluid shifts without any inflammatory component

Question 2

Why is tetanus prophylaxis a standard component of burn wound management?

Accepted Answer

Burn wounds create a necrotic, anaerobic environment ideal for Clostridium tetani proliferation

Answer

Major burns cause immediate systemic immunosuppression requiring prophylaxis

Answer

Tetanus toxin is commonly found in smoke and combustion products

Answer

All trauma patients receive tetanus regardless of wound type

Question 3

In a patient rescued from a fire involving burning synthetic materials who remains hemodynamically unstable despite 100% oxygen therapy, the trauma nurse should suspect:

Accepted Answer

Concurrent cyanide poisoning in addition to carbon monoxide toxicity

Answer

Isolated thermal burns causing distributive shock

Answer

Cherry-red skin discoloration indicating CO poisoning only

Answer

Nicotine toxicity from burning tobacco products

Question 4

A patient with high-voltage electrical burns develops dark, cola-colored urine. What is the correct initial management?

Accepted Answer

Increase urine output to 1–2 mL/kg/hour and consider urinary alkalinization with sodium bicarbonate

Answer

Restrict IV fluids to prevent worsening acute kidney injury

Answer

Administer diuretics to concentrate and clear the urine

Answer

Begin emergent dialysis immediately upon detection

Question 5

When decontaminating a patient with tar or asphalt burns, the recommended technique is:

Accepted Answer

Application of a lipophilic agent such as petroleum jelly to dissolve and gently remove the tar

Answer

Vigorous mechanical scrubbing with a surgical brush to dislodge the material

Answer

Immediate surgical excision of tar-involved skin

Answer

Cold water immersion for 30 minutes to harden and chip away the material

Question 6

In a patient with combined blast injury and thermal burns, what assessment takes priority after the airway is secured?

Accepted Answer

Assessing for blast lung injury (pulmonary barotrauma) as a life-threatening cause of hypoxia

Answer

Calculating total TBSA burned using the Rule of Nines

Answer

Applying topical antimicrobial agents to burn wounds

Answer

Beginning Parkland formula fluid calculations

Question 7

Which clinical finding is most characteristic of a full-thickness (third-degree) burn wound?

Accepted Answer

Dry, leathery, insensate wound with white, brown, or charred appearance

Answer

Moist, blistered surface with extreme pain to light touch

Answer

Erythema with intact epidermis and pain without blistering

Answer

Intact epidermis with subepidermal blistering and moderate pain