Initial Burn Management and Airway Care Practice Questions
20 free Initial Burn Management and Airway Care practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
What should be the nurse's priority for a patient arriving after a house fire with facial burns, singed nasal hairs, and hoarseness of voice?
- A Begin fluid resuscitation first and defer any airway assessment
- B Assess for inhalation injury and prepare for early airway protection or intubation
- C Apply antibiotic cream to the facial burns and observe overnight
- D Complete wound dressing of the burns before assessing the airway
Correct answer: Assess for inhalation injury and prepare for early airway protection or intubation
Facial burns, singed nasal hairs, hoarseness, and enclosed-space exposure are high-risk for airway compromise; early airway assessment and potential intubation are critical before edema closes the airway.
Why is the 'Rule of Nines' used in the immediate assessment of a burn patient?
- A To estimate the depth of the burn injury
- B To estimate percent body surface area burned and guide fluid resuscitation
- C To select the appropriate prophylactic antibiotic
- D To determine whether tetanus prophylaxis is required
Correct answer: To estimate percent body surface area burned and guide fluid resuscitation
The Rule of Nines gives a rapid estimate of percent total body surface area (TBSA) burned, which guides fluid resuscitation and care planning.
What should be initiated for a burn patient with a large-surface-area burn (>20% TBSA) during the first 24 hours?
- A Restrict fluids to limit tissue swelling
- B Administer high-dose corticosteroids to reduce inflammation
- C Begin isotonic crystalloid resuscitation and monitor urine output
- D Withhold fluid therapy for the first 24 hours
Correct answer: Begin isotonic crystalloid resuscitation and monitor urine output
Large burns (>20% TBSA) cause massive fluid shifts; early isotonic crystalloid resuscitation titrated to urine output is essential in the first 24 hours.
Which finding suggests inhalation injury requiring aggressive airway management?
- A Isolated superficial burns confined to the hands
- B Hoarseness of voice, stridor, and black sooty sputum
- C A mild cough developing slowly without facial burns
- D Stable vital signs with no facial or airway involvement
Correct answer: Hoarseness of voice, stridor, and black sooty sputum
Hoarseness, stridor, and black or sooty sputum indicate upper-airway injury from inhalation and a risk of rapid airway obstruction requiring aggressive management.
What is the appropriate first-aid measure immediately after a thermal burn?
- A Apply ice directly to the burned area
- B Cool with running water for about 20 minutes and cover with a clean dressing
- C Deroof the blisters and apply ointment straight away
- D Soak the burn in very cold water for a full 60 minutes
Correct answer: Cool with running water for about 20 minutes and cover with a clean dressing
Cooling with running water for around 20 minutes limits tissue damage; applying ice or prolonged cold-water soaking can worsen the injury and cause hypothermia.
When is early intubation recommended in the airway management of burn patients?
- A Only minor, superficial burns are present
- B Inhalation injury, facial or neck burns, or rapidly progressing airway edema
- C The patient is alert and speaking without any difficulty
- D All of the burns are located below the waist
Correct answer: Inhalation injury, facial or neck burns, or rapidly progressing airway edema
Early intubation is indicated for facial/neck burns, signs of inhalation injury, or progressive airway swelling, before intubation becomes difficult or impossible.
How often should the nurse assess for circulation and potential compartment syndrome in a circumferential extremity burn?
- A Once every 24 hours during the admission
- B Hourly, or per protocol, with neurovascular checks and limb elevation
- C Only when the patient reports new pain
- D Only after fluid resuscitation has been completed
Correct answer: Hourly, or per protocol, with neurovascular checks and limb elevation
Circumferential extremity burns can cause vascular compromise and compartment syndrome; frequent (hourly or per-protocol) neurovascular checks and elevation are necessary.
Which statement about 'tetanus prophylaxis' in burn care is correct?
- A Tetanus prophylaxis is never required in burn patients
- B Tetanus status should be reviewed and prophylaxis given when indicated
- C Tetanus prophylaxis is needed only after chemical burns
- D Tetanus prophylaxis should be deferred until the wound has healed
Correct answer: Tetanus status should be reviewed and prophylaxis given when indicated
Because burn wounds breach the skin barrier, tetanus immunization status should be reviewed and prophylaxis given according to the patient's immunization history.
After securing airway and circulation in the initial burn management protocol, what is the next priority?
- A Proceeding directly to detailed wound debridement
- B Estimating burn size and starting fluid resuscitation
- C Initiating early physical therapy and mobilization
- D Applying cosmetic dressings to the burned areas
Correct answer: Estimating burn size and starting fluid resuscitation
After securing airway, breathing, and circulation, the next priority is estimating burn size (TBSA) and depth and initiating fluid resuscitation based on those findings.
Which formula is commonly used to calculate fluid requirements in the first 24 hours after a burn?
- A Cockcroft-Gault formula (creatinine clearance estimation)
- B Parkland formula (4 mL × kg × %TBSA)
- C Body mass index formula (weight/height squared)
- D Framingham risk formula (cardiovascular risk scoring)
Correct answer: Parkland formula (4 mL × kg × %TBSA)
The Parkland formula is widely used in burns: 4 mL × kg × %TBSA of second/third-degree burns, with half given in the first 8 hours.
What should be done if pulse oximetry may be inaccurate in burn patients with suspected carbon monoxide poisoning?
- A Ignore CO risk entirely if the measured SpO2 reading is normal
- B Obtain CO-oximetry and give 100% oxygen if CO poisoning is suspected
- C Use a non-rebreather mask only when SpO2 stays above 98 percent
- D Delay all oxygen therapy until arterial blood gas labs return
Correct answer: Obtain CO-oximetry and give 100% oxygen if CO poisoning is suspected
Carbon monoxide may falsely elevate SpO₂; thus, obtain CO-oximetry and treat with high-flow oxygen if suspected.
What is the appropriate intervention for a patient with a circumferential chest burn and increasing respiratory effort?
- A Reassure the patient that no special action is needed
- B Continue routine monitoring of respirations only
- C Prepare for escharotomy to relieve chest restriction
- D Elevate the patient's legs to improve circulation
Correct answer: Prepare for escharotomy to relieve chest restriction
Circumferential chest burns may restrict chest expansion causing respiratory compromise; escharotomy may be required.
What is the most appropriate first aid for chemical exposure in burn wound care?
- A Neutralise the chemical with an acid or base of opposite type
- B Irrigate immediately with copious water and remove contaminated clothing
- C Delay any treatment until a burn specialist arrives on scene
- D Cover the wound with the contaminated dressing already in place
Correct answer: Irrigate immediately with copious water and remove contaminated clothing
Prompt irrigation and removal of contaminated clothing are key; neutralising chemical manually is not recommended in the field.
What does the nurse need to understand about body temperature in burn victims?
- A Hypothermia is not a meaningful concern after a burn
- B Patients risk hypothermia from skin loss and should be kept warm
- C Always cool the environment to slow the patient's metabolism
- D Only hyperthermia, not hypothermia, is clinically relevant
Correct answer: Patients risk hypothermia from skin loss and should be kept warm
Large burns reduce skin barrier and cause heat loss; warming measures are important to prevent hypothermia.
Why are burns to critical areas (face, hands, feet, perineum) considered high-risk?
- A They are always superficial injuries that heal quickly on their own
- B They may threaten airway, mobility, and function and need specialist referral
- C They do not require any fluid resuscitation regardless of size
- D They can be managed entirely with routine outpatient care
Correct answer: They may threaten airway, mobility, and function and need specialist referral
Burns to critical areas are high-risk for airway compromise, mobility loss, functional disability, and often need specialist care.
What is the most appropriate pain-management approach for a burn patient with deep dermal/third-degree burns?
- A No analgesia is required at all until the patient reaches surgery
- B Give pre-emptive analgesia before procedures and dressing changes
- C Use only non-pharmacologic measures such as distraction and positioning
- D Assume pain is negligible because third-degree burns destroy nerves
Correct answer: Give pre-emptive analgesia before procedures and dressing changes
Deep burns are extremely painful especially during dressing changes; pre-emptive analgesia is part of early care.
What is the target urine output for adult burn patients during initial resuscitation?
- A About 0.1 mL/kg/hr of urine
- B About 0.5 mL/kg/hr of urine
- C About 1.0 mL/kg/hr of urine or more per protocol
- D Urine output does not need to be monitored
Correct answer: About 1.0 mL/kg/hr of urine or more per protocol
Adequate urine output (about 0.5-1 mL/kg/hr in adults) indicates effective resuscitation; output is closely monitored.
What is the next best step for a patient exposed to a closed-space fire with soot in the nostrils, burned face hair, and wheezing?
- A Wait for overt respiratory distress to develop before acting
- B Give high-flow oxygen now and watch for inhalation injury
- C Treat only the visible burns on the patient's limbs
- D Discharge the patient if the SpO2 reading is 99 percent
Correct answer: Give high-flow oxygen now and watch for inhalation injury
The presence of closed-space exposure necessitates high-flow oxygen and monitoring for delayed airway compromise.
Which statement about fluid resuscitation for major burns is true?
- A Formulas can be relied on alone without any ongoing reassessment
- B Fluid rates are titrated to urine output and vitals, not formula alone
- C Keeping fluids minimal is always the safer resuscitation strategy
- D Colloid is the preferred resuscitation fluid in the first 8 hours
Correct answer: Fluid rates are titrated to urine output and vitals, not formula alone
Formulas provide initial guidance, but resuscitation must be adjusted based on patient response because individual needs vary.
Which wound care statement is correct for the initial phase of burn management?
- A The burn wound is already infected and must not be touched at all
- B Assess depth and TBSA, cover with a clean dry dressing, then reassess
- C Apply thick occlusive field dressings as the only initial measure
- D There is no need to reassess the wound after initial presentation
Correct answer: Assess depth and TBSA, cover with a clean dry dressing, then reassess
Initial wound care includes assessment (depth, area), covering with clean dressings, and recognizing that depth may change.