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

Persistent findings after needle decompression indicate failure of needle relief and require definitive chest tube placement for effective pneumothorax management.

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

A child's head represents up to 18% TBSA (versus 9% in adults), and the legs are proportionally smaller; the Lund and Browder chart accounts for age-related differences.

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

Myoglobinuria causes dark urine that tests positive for blood on dipstick without microscopic RBCs, indicating muscle breakdown requiring urine output of 1–1.5 mL/kg/hr.

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

Each digit is dressed individually and the hand is positioned in the intrinsic-plus (position of function) to prevent contracture formation.

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

Around 48–72 hours post-burn, capillary integrity is restored and mobilized third-space fluid returns to the vascular compartment, potentially causing volume overload.

(TNCC) Trauma Nursing Core Course Certified Practice Test

(TNCC) Trauma Nursing Core Course Certified Practice Test

TNCC Burn Management 5