Nursing student studying burn injuries

Burns NCLEX Questions: How to Study for This Part of the Exam

Preparing for the NCLEX exam means preparing to demonstrate your knowledge of all areas of nursing practice, including burns NCLEX questions. You’ll need to know both about burns pathophysiology and caring for burn victims.

 

Burn treatment doesn’t involve one-size-fits-all solutions, because there are many types and extents of burn injuries. When taking the NCLEX exam, it’s important to clearly understand these differences so you can appropriately answer your burns NCLEX questions. 

 

To show you some burns NCLEX questions in action, we included a few sample ones for you with answer explanations. This should give you a preview of what to expect on this part of the NCLEX exam and how to apply that knowledge. Let’s get started so you pass with flying colors.

Causes of Burn Injuries

There are five primary causes of burn injuries to be aware of for these NCLEX questions. These include: 

 

  • Thermal burns: caused by heat such hot liquids or steam, the most common type of burn injury
  • Chemical burns: caused by an irritating substance, likely a strong acid or base such as bleach or ammonia
  • Electrical burns: caused by electricity or lightning, often resulting in organ damage
  • Radiation burns: caused by energy from things like infrared radiation, x-rays, or ultraviolet radiation (sunlight)
  • Inhalation injury and burns: caused by smoke inhalation and suspected carbon monoxide poisoning

 

Burn injuries can be internal or external, meaning a burn can occur inside or outside of the body. In addition, the extent of a burn injury can extend past the area you see on the skin. Burns can even produce systemic responses that affect far more than just the burned area. But don’t worry — we’ll cover all this in more detail.

Types of Burn Injuries

Nurse taking care of burn injury

Burns are classified according to their depth and surface area. However, a single burn wound can have more than one depth.

 

The deeper the burn, the more damage that is done. For example, deeper burns can get infected, need skin grafts, and can even be a cause for amputation. On that note, if a burn is deep and covers a large part of the body, it can even cause death.

 

The types of burn injuries to know for burns NCLEX questions include:

First-Degree Burns 

First-degree burns are also called superficial burns and affect the outermost layer of skin, the epidermis. These burns heal quickly and don’t require hospitalization. 

 

In this category, you can expect to see warm, red, painful skin. These burns are often caused by a sunburn. First-degree burns usually don’t have blisters and blanch (whiten) to touch.

Second-Degree Burns

Second-degree burns are also called partial-thickness burns and affect the epidermis and the layer underneath, the dermis. These burns may need a skin graft, and the burn depth can vary within a single burn location. Also, these burns can extend deep into the dermis or only touch the surface of the dermis, resulting in some superficial partial-thickness burns and some deep partial-thickness burns.

 

Second-degree burns are very painful, red, moist, blistered, and blanch when touched. Some common causes are fire, hot liquids, or hot surfaces like stovetops. 

Third-Degree Burns

Third-degree burns are also called full-thickness burns and go through the epidermis, dermis, and fat layer (or even deeper). Hair follicles and sweat glands are destroyed. With this degree of burn, a skin graft is always needed. 

 

You can expect the patient to have no pain or very little pain, as these burns result in destroyed nerve endings. Third-degree burns feel firm and look charred, white, or brown. They don’t blanch when touched. 

Fourth-Degree Burns

Fourth-degree burns are so deep that even skin grafts don’t work as a treatment. At this point, muscles, tendons, and even bone can be badly damaged. Organ damage in addition to permanent body damage can result, and these burns can even be fatal.

How to Find the Extent of a Burn Injury

Burns can cover a small or large amount of a patient’s body. When studying for burns NCLEX questions, remember that the total body surface area (TBSA) is the area covered by a burn. Often, the “rule of nines” is used to calculate this percentage. Let’s look more closely at this rule and other ways to calculate burn areas.

Rule of Nines

In adults, the rule of nines is calculated using a chart that designates each body part as a certain percentage of the total body surface area (TBSA) that is burned. If a burn covers more than 20-25% of TBSA, the patient needs IV fluid replacement. But if the burn covers more than 30-40% of TBSA, the patient can die without immediate treatment. Keep in mind burns affecting adults over the age of 50 tend to have worse outcomes than burns on adults under 50.

Lund-Browder

The extent of burn injuries for children is calculated differently because a child’s head is larger than an adult’s in proportion to the body. Also, an infant’s legs are proportionally smaller than an adult’s. The Lund-Browder method is much more accurate for children because it accounts for these differences. Take note that burns affecting children, particularly children under the age of 10, are more dangerous than those affecting adults.

Nursing Interventions and Management for Burns NCLEX Questions 

So now that you understand the types and causes of burns, let’s cover how you as a nurse should care for your burn injury patients. Whether you want to be an RN or LPN, it’s important to have a firm grasp on how to care for burn patients. Plus, this knowledge should help you accurately answer burns NCLEX questions.

 

Some expected nursing interventions to know for patient care and burns NCLEX questions include:

  • Minor burns:
    • Cool with tap water to reduce pain.
    • Clean, cover with ointment, then bandage.
  • Moderate to severe burns:
    • Increase fluid volume with IV fluids.
    • Maintain airways.
    • Monitor vital signs.
    • Monitor peripheral pulses.
    • Monitor cardiac status and blood pressure.
    • Assess neurological status frequently.
    • Perform frequent suctioning if the patient is on a ventilator.
    • Closely monitor all ordered laboratory values including electrolytes.
    • Manage the patient’s pain.
    • If there are no bowel sounds, set nasogastric (NG) to low intermittent suction.
    • Monitor accurate intake and urine output.
    • Monitor for skin breakdown and reposition the patient as needed. 
    • Promote exercise and proper splint placement to avoid contractures.
    • Wound care including dressing changes, skin graft care, and monitor status.

 

While doing these nursing interventions, watch for complications of burn injuries such as:

  • Respiratory failure
  • Renal failure
  • Distributive shock
  • Hypovolemic shock
  • Compartment syndrome
  • Ileus
  • Sepsis
  • Contractures
  • Tissue ischemia
  • Hypothermia
  • Infection
  • Keloids
  • Decreased cardiac output due to hypovolemia
  • Edema

Sample Burns NCLEX Questions

Now that you reviewed some background on burns, it’s time to practice for this part of the NCLEX exam. Read the following practice burns NCLEX questions and choose the correct answer. Be sure to read the answer rationales to gain a deeper understanding of the choices.

Question #1

You are providing wound debridement at a burn center for a 32-year-old female with a second-degree burn on the right anterior upper leg. Which nursing action should you perform first?

  1. Place a dressing on the burned tissue
  2. Apply silver sulfadiazine 
  3. Remove loose, dead tissue
  4. Administer pain medication

 

Answer: D — Always administer pain medication to your patient prior to performing wound debridement as the procedure itself is painful. Next, remove loose, dead tissue to encourage wound healing. Lastly, only apply silver sulfadiazine if a doctor orders it. Finally dress the wound to protect it, reduce infection risk, and promote wound healing.

Question #2

A patient enters the emergency department with a deep partial-thickness burn and needs fluid resuscitation to replace fluid loss and improve over blood flow. Which of the following laboratory values would indicate dehydration in this patient?

  1. Decreased serum sodium
  2. Decreased red blood cells
  3. Decreased white blood cells
  4. Fluctuating C-reactive protein

 

Answer:A — Decreased serum sodium is a sign of dehydration. The other laboratory values are not consistent with dehydration.

Question #3

A patient with a circumferential burn to the left arm is in need of an escharotomy to reperfuse the limb and release the eschar. What type of burn does this patient likely have?

  1. Superficial partial-thickness burn
  2. Full-thickness burn
  3. Deep partial-thickness burn
  4. Second-degree burn

 

Answer: B — Patients undergoing an escharotomy have full-thickness, circumferential burns. The escharotomy removes the eschar (tough, leathery tissue).

 

If you answered the above questions correctly, congratulations. If not, you likely just need some extra preparation. Regardless of where you’re at in your studies, we provide additional test practice to help you prepare for this section (and more) of the NCLEX exam.

Practice Makes Perfect: More Study Questions

Nursing students studying for burns section of NCLEX exam

We know how overwhelming it can be to study for the NCLEX — that’s why we decided to help. Answering an NCLEX question of the day each day gives you a headstart on preparing. 

 

If you’d like more burns NCLEX questions head to the Daily NCLEX Challenge. Every day, we send you one new NCLEX practice question on various nursing areas. 

 

If you want to go above and beyond in your preparation, sign up for our premium version that offers comprehensive answer rationales and the chance to win prizes. Studying doesn’t have to feel like studying, and investing in NCLEX test prep should help you succeed on this important exam.


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