TNCC Burn Management 5

Question 1

A patient with 25% TBSA partial-thickness burns develops decreased breath sounds on the right with tracheal deviation to the left after needle decompression for suspected tension pneumothorax from a blast injury.
The next step is:

Accepted Answer

Insert a chest tube (tube thoracostomy) on the right

Answer

Repeat needle decompression on the left side

Answer

Obtain a portable chest X-ray before further intervention

Answer

Increase positive pressure ventilation settings

Question 2

In pediatric burn patients, the Rule of Nines is modified because:

Accepted Answer

The head represents a proportionally larger surface area than in adults

Answer

Children have thinner skin requiring smaller TBSA calculations

Answer

The lower extremities are proportionally larger in children

Answer

Children's palms equal 2% rather than 1% TBSA

Question 3

Which laboratory finding is most specific for rhabdomyolysis in an electrical burn patient requiring increased urine output targets?

Accepted Answer

Myoglobinuria (dark, tea-colored urine with positive dipstick for blood but no RBCs)

Answer

Elevated serum creatinine

Answer

Elevated serum troponin

Answer

Leukocytosis greater than 15,000

Question 4

A patient with significant burns to both hands should have dressings applied in which configuration to preserve function?

Accepted Answer

Individual digit wrapping with the hand in a position of function

Answer

Circumferential wrapping of the entire hand as a unit

Answer

Pressure dressings with fingers adducted to minimize edema

Answer

Open exposure technique without dressings to monitor perfusion

Question 5

A nurse is caring for a patient 72 hours post-burn who suddenly develops decreasing urine output, increasing edema, and rising CVP. This constellation most likely represents:

Accepted Answer

Fluid remobilization causing volume overload

Answer

Septic shock from wound infection

Answer

Renal failure from acute tubular necrosis

Answer

Abdominal compartment syndrome

Question 6

Which burn location automatically qualifies a patient for transfer to a burn center regardless of burn size?

Accepted Answer

Burns involving the face, hands, feet, genitalia, perineum, or major joints

Answer

Burns to the anterior trunk

Answer

Burns to the lower extremities bilaterally

Answer

Burns with greater than 5% full-thickness involvement

Question 7

When evaluating for inhalation injury, which diagnostic tool provides direct visualization of supraglottic airway injury and is considered the gold standard?

Accepted Answer

Bronchoscopy

Answer

Chest X-ray

Answer

Arterial blood gas analysis

Answer

Carboxyhemoglobin level