1. Your adult patient has partial- and full- ● D.

Cyanide
thickness burn injuries to his anterior chest, Rationale: Answer: C. If a patient has
anterior abdomen, and entire right arm. ingested methyl salicylates, his breath will
Using the rule of nines, the percent of total have a wintergreen odor.
body surface area involved can be
estimated at: 1. A 65 year old male patient has
● A. 18%. experienced full-thickness electrical burns
● B. 27%. on the legs and arms. As the nurse you
● C. 45%. know this patient is at risk for the following:
● D. 50%. Select all that apply:
Rationale: Answer: B. The anterior chest A. Acute kidney injury
and abdomen constitute 18% of the BSA, B. Dysrhythmia
and the entire right arm is 9%, for a total of C. Iceberg effect
27%. D. Hypernatremia
E. Bone fractures
2. A patient admitted to the ED is suspected F. Fluid volume overload
of taking an overdose of atropine. Which The answers are A, B, C, and E. Electric
clinical finding would you look for? burns are due to an electrical current
● A. Kussmaul respirations passing through the body that leads to
● B. Diarrhea and nausea and damage to the skin but also the muscles
vomiting and bones that are underneath the skin.
● C. Hot, dry skin and dilated pupils The patient is at risk for AKI (acute kidney
● D. Extrapyramidal tremors injury) because when the muscles become
Rationale: Answer: C. A patient who has affected they release myoglobin and the red
overdosed on atropine will have blood cells release hemoglobin in the blood,
flushed, dry skin and dilated pupils. which can collect in the kidneys leading to
injury. In addition, the heart's electrical
3. Your patient has a core body temperature system can become damaged leading to
of 80° F (26.7° C). Which classification of dysrhythmia. The iceberg effect can present
hypothermia is this? as well because the extent of damage is not
● A. Low clearly visible on the skin (there can be
● B. Mild severe damage underneath). In addition, if
● C. Moderate the electrical current is strong enough it can
● D. Severe lead to bone fractures (specifically cervical
Rationale: Answer: D. Severe hypothermia spine injuries) due to the severe contraction
is a core body temperature of of the muscles involved.
less than 82.4° F ( 28° C).

4. An unconscious patient is admitted to the 2. True or False: A patient who experiences

ED with a very strong wintergreen odor on an alkali chemical burn is easier to treat
his breath. What might he have ingested? because the skin will neutralize the
● A. Ethanol chemical rather than with an acidic chemical
● B. Acetone burn.
● C. Methyl salicylates True
False that is burned (use the rule of nine to
False: Alkali burns are harder to treat than calculate), depth of the burn, age, location
acidic chemical burns because the skin will of the burn, and patient’s medical history.
neutralize the acidic burn. The patient in option B has 40.5% TSBA
burned (option A 27%, C: 4.5%, D: 9%).
Remember that the higher the total of the
3. As the nurse providing care to a patient body surface area that is burned the higher
who experienced a full-thickness electrical the risk of complications due to an increase
burn you know to monitor the patient's urine in capillary permeability (swelling,
for: hypovolemic shock etc.). In addition, the
A. Hemoglobin and myoglobin location of the burn is a major issue with the
B. Free iron and white blood cells patient in option B. The burns are on the
C. Protein and red blood cells head and neck and front and back of the
D. Potassium and Urea torso. Therefore, with head and neck burns
The answer is A. Patients who've always think about respiratory issues
experienced a severe electrical burn or full- because the airway can become
thickness burns are at risk for acute kidney compromised due to swelling or an
injury. This is because the muscles can inhalation injury. And with torso burns that
experience damage from the electrical are on the front and back, the patient is at
current leading them to release myoglobin. risk for circumferential burns that can lead
In addition, the red blood cells will release to further respiratory compromise. The other
hemoglobin. These substances will collect options have burns that are isolated.
in the kidneys leading to acute tubular
necrosis (hence leading to AKI). Therefore,
the nurse should monitor the patient's urine 5. The _____________ layer of the skin
for these substances. helps regulate our body temperature.
A. Epidermis
B. Dermis
4. Select the patient below who is at MOST C. Hypodermis
risk for complications following a burn: D. Fascia
A. A 42 year old male with partial-thickness The answer is C. This layer contains fatty
burns on the front of the right and left arms tissue, veins, arteries, nerves and helps
and legs. insulate the muscles, bones, organs and
B. A 25 year old female with partial- helps REGULATE our body temperature.
thickness burns on the front of the head and
neck and front and back of the torso.
C. A 36 year old male with full-thickness 6. You receive a patient who has
burns on the front of the left arm. experienced a burn on the right leg. You
D. A 10 year old with superficial burns on note the burn contains small blisters and is
the right leg. extremely pinkish red and shiny/moist. The
The answer is B. When thinking about patient reports severe pain. You document
which patient will have the MOST this burn as:
complications following a burn think about: A. 1st Degree (superficial)
percentage of the total body surface area B. 2nd Degree (partial-thickness)
C. 3rd Degree (full-thickness) the flow rate during the FIRST 8 hours
D. 4th Degree (deep full-thickness) (mL/hr) based on the total you calculated?
The answer is B. These are the classic A. 921 mL/hr
characteristics of a 2nd degree (partial- B. 938 mL/hr
thickness) burn. C. 158 mL/hr
D. 789 mL/hr
The answer is A: 921 mL/hr....First calculate
7. Based on the depth of the burn in figure 1 the total amount of fluid needed with the
(picture is above), you would expect to find: formula: Total Amount of LR = 4 mL x BSA
A. report of sensation to only pressure % x pt's weight in kg. The pt's weight 63 kg.
B. blanching BSA percentage: 58.5%...Front and back of
C. anesthetization to feeling right and left leg (36%), front of right arm
D. extreme pain (4.5%), anterior trunk (18%) which equals
The answer is C. This is a 3rd degree to 4th 58.5%. ......4 x 58.5 x 63 = 14,742
degree burn (full-thickness) and the nerves mL......Remember during the FIRST 8 hours
that detect pain are destroyed. The patient 1/2 of the solution is infused, which will be
would have no feeling or experiences an 14,742 divided by 2 = 7371 mL......Hourly
extreme decrease sensation to pain. Rate: 7371 divide by 8 equals 921 mL/hr

8. A 58 year old female patient has 10. A patient has a burn on the back of the
superficial partial-thickness burns to the torso that is extremely red and painful but
anterior head and neck, front and back of no blisters are present. When you pressed
the left arm, front of the right arm, posterior on the skin it blanches. You document this
trunk, front and back of the right leg, and as a:
back of the left leg. Using the Rule of Nines, A. 1st degree (superficial) burn
calculate the total body surface area B. 2nd degree (partial-thickness) burn
percentage that is burned? C. 3rd degree (full-thickness) burn
A. 63% D. 4th degree (deep full-thickness) burn
B. 81% The answer is A. These are the classic
C. 72% characteristics of a 1st degree, superficial
D. 54% burn.
The answer is A. Anterior head and neck
(4.5%), front and back of the left arm (9%),
front of the right arm (4.5%), posterior trunk 11. A patient has experienced full-thickness
(18%), front and back of the right leg (18%), burns to the face and neck. As the nurse it
back of the left leg (9%) which equals 63%. is priority to:
A. Prevent hypothermia
B. Assess the blood pressure
9. A 30 year old female patient has deep C. Assess the airway
partial thickness burns on the front and back D. Prevent infection
of the right and left leg, front of right arm, The answer is C. Due to the location of the
and anterior trunk. The patient weighs 63 burns (face and neck), the patient is at
kg. Use the Parkland Burn Formula: What is major risk for respiratory issues due to
damage to the upper airways and the risk of elevate the extremity ABOVE heart level to
an inhalation injury. decrease swelling and assess distal pulses
in the extremity to confirm circulation is
present.
12. A patient is in the acute phase of burn
management. The patient experienced full-
thickness burns to the perineum and sacral 14. A patient arrives to the ER with full-
area of the body. In the patient’s plan of thickness burns on the front and back of the
care, which nursing diagnosis is priority at torso and neck. The patient has no spinal
this time? injuries but is disoriented and coughing up
A. Impaired skin integrity black sooty sputum. Vital signs are: oxygen
B. Risk for fluid volume overload saturation 63%, heart rate 145, blood
C. Risk for infection pressure 80/56, and respiratory rate 39. As
D. Ineffective coping the nurse you will:
The answer is C. The patient is now in the A. Place the patient in High Fowler’s
acute phase where fluid resuscitation was positon.
successful and ends with wound closure. B. Prep the patient for escharotomy.
Therefore, during this stage diuresis occurs C. Prep the patient for fasciotomy.
(so fluid volume deficient could occur NOT D. Prep the patient for intubation.
overload) and INFECTION. The location of E. Place a pillow under the patient’s neck.
the burns increases the risk of infection F. Obtain IV access at two sites.
because these areas naturally harbor G. Restrict fluids.
bacteria. Therefore, this takes priority The answers are A, B, D, and F. After
because during this phase wound healing is reading this scenario the location of the
promoted. burns and the patient’s presentation should
be jumping out at you. The patient is at risk
for circumferential burns due to the location
13. The nurse notes a patient has full- of the burns and the depth (full-
thickness circumferential burns on the right thickness….will have eschar present that
leg. The nurse would: select all that apply will restrict circulation or here in this
A. Place cold compressions on the burn and example the ability of the patient to breathe
elevate the right leg below the heart level in and out). Based on the patient's VS, we
B. Assess the distal pulses in the right see that the respiratory effort is
extremity compromised majorly AND that there is a
C. Elevate the right leg above the heart risk of inhalation injury since the patient is
level coughing up black sooty sputum. Therefore,
D. Place gauze securely around the leg to the nurse should place the patient in high
prevent infection Fowler’s position to help with respiratory
The answer is B and C. The patient has effort (unless contraindicated with spinal
burns that completely surround the front and injuries), prep the patient for escharotomy
back of the right leg. This can lead to (this will cut the eschar and help relieve
compartment syndrome where the edema pressure and allow for breathing) and prep
from the burn compromises circulation to for intubation to help with the respiratory
the distal extremity. The nurse should distress. In addition, obtain IV access in at
least two sites for fluid
replacement….remember the first 24 hours
after a burn a patient is at risk for 17. A patient experienced a full-thickness
hypovolemic shock. burn 72 hours ago. The patient's vital signs
are within normal limits and urinary output is
50 mL/hr. This is known as what phase of
15. A patient arrives to the ER due to burn management?
experiencing burns while in an enclosed A. Emergent
warehouse. Which assessment findings B. Acute
below demonstrate the patient may have C. Rehabilitative
experienced an inhalation injury? The answer is B. This phase starts when
A. Carbonaceous sputum capillary permeability has returned to
B. Hair singeing on the head and nose normal and the patient's vitals are within
C. Lhermitte's Sign normal limits and ends with wound closure.
D. Bright red lips The phase after this is rehabilitative.
E. Hoarse voice
F. Tachycardia
The answers are A, B, D, E, and F. These 18. What are some patient priorities during
are all signs of a possible inhalation injury. the emergent phase of burn management?
Bright red lips and tachycardia are present A. Fluid volume
in carbon monoxide poisoning as well. B. Respiratory status
C. Psychosocial
D. Wound closure
16. You're providing education to a group of E. Nutrition
local firefighters about carbon monoxide The answer is A and B. This phase starts
poisoning. Which statement is correct about from the onset of the burn and ends with the
the pathophysiology regarding this restoration of capillary permeability. Wound
condition? closure, and nutrition would be during the
A. "Patients are most likely to present with acute phase, and would continue into the
cyanosis around the lips and face." rehabilitative phase. Psychosocial would be
B. "In this condition, carbon monoxide binds in the rehab phase.
to the hemoglobin of the red blood cell
leading to a decrease in the ability of the
hemoglobin to carry oxygen to the body." 19. During the emergent phase of burn
C. "Carbon monoxide poisoning leads to a management, you would expect the
hyperoxygenated state, which causes following lab values:
hypercapnia." A. Low sodium, low potassium, high
D. "Carbon monoxide binds to the glucose, low hematocrit
hemoglobin of the red blood cell and B. High sodium, low potassium, low
prevents the transport of carbon dioxide out glucose, high hematocrit
of the blood, which leads to poisoning." C. High sodium, high potassium, high
The answer is B. This is the only correct glucose, low hematocrit
statement about carbon monoxide D. Low sodium, high potassium, high
poisoning. glucose, high hematocrit
The answer is D. Think about the increase A. Swelling and pain on the area distal to
in the capillary permeability that happens the burn
with severe burns, which causes the plasma B. Burning, gnawing sensation pain in the
to leave the intravascular system and enter stomach and vomiting
the interstitial tissue: Low sodium..why: C. Dark red or gray sores on the soles of
sodium leaves with the plasma to the the feet
interstitial tissue and drops the levels in the D. Difficulty swallowing and gagging
blood; High potassium...why? damaged The answer is B. This is a type of ulcer that
cells lysis and leak potassium which occurs in the stomach, duodenum, due to a
increases the leave in the blood; high high amount of stress on the body from a
glucose...why? stress response leads the burn. The blood supply to the factors that
liver to release glycogen and this increases help protect the stomach lining from gastric
levels; high hematocrit...why? when the erosion decreases and this allows for ulcers
plasma leaves the intravascular system (the to form.
fluid) it causes the blood to become more
concentrated so hematocrit increases (this
will decrease when the patient's fluid is 22. During the acute phase of burn
replaced). management, what is the best diet for a
patient who has experienced severe burns?
A. High fiber, low calories, and low protein
20. A patient is receiving IV Lactated B. High calorie, high protein and
Ringers 950 mL/hr post 18 hours after a carbohydrate
receiving a severe burn. The patient urinary C. High potassium, high carbohydrate, and
output is 20 mL/hr. As the nurse your next low protein
nursing action is to: D. Low sodium, high protein, and restrict
A. Increase the IV fluids fluids to 1 liter per day
B. Continue to monitor the patient The answer is B. This type of diet promotes
C. Decrease the IV fluids wound healing and meets the caloric
D. Notify the physician of this finding demands of the body.
The answer is D. The patient's urinary
output is too low and needs more fluids. It
should be at least 30 mL/hr. Therefore, the 23. You're assisting the nursing assistant
nurse must notify the physician for further with repositioning a patient with full-
orders. The nurse can NOT increase or thickness burns on the neck. Which action
decrease IV fluids without a physician's by the nursing assistant requires you to
order. intervene?
A. The nursing assistant elevates the head
of the bed above 30 degrees.
21. A patient who is being treated for partial B. The nursing assistant places a pillow
thickness burns on 60% of the body is now under the patient's head.
in the acute phase of burn management. C. The nursing assistant places rolled
The nurse assesses the patient for a towels under the patient's shoulders.
possible Curling's Ulcer. What signs and D. The nursing assistant covers the patient
symptoms can present with this condition? with sterile linens.
The answer is B. If a patient has severe 26. Your patient with severe burns is due to
burns to the neck (head as well) a pillow have a dressing change. You will pre-
should NOT be used under the head medicate the patient prior to the dressing
because this can cause wound contractions. change. The patient has standing orders for
Instead rolled towels should be placed all the medications below. Which medication
under the shoulders. is best for this patient?
A. IM morphine
B. PO morphine
24. A patient has full-thickness burns on the C. IV morphine
front and back of both arm and hands. It is D. Subq morphine
nursing priority to: The answer is C. The best route that is
A. Elevate and extend the extremities predictable and easily absorbed is via the IV
B. Elevate and flex the extremities route in burn victims.
C. Keep extremities below heart level and
extended
D. Keep extremities level with the heart 27. After receiving report on a patient
level and flexed receiving treatment for severe burns, you
The answer is A. This position will decrease perform your head-to-toe assessment. On
edema, which will help prevent arrival to the patient's room you note the
compartment syndrome. room temperature to be 75'F. You will:
A. Decrease the temperature by 5-10
degrees to prevent hyperthermia.
25. A patient has an emergency B. Leave the temperature setting.
escharotomy performed on the right leg. C. Increase the temperature to a minimum
The patient has full-thickness of 85'F.
circumferential burns on the leg. Which The answer is C. Patients with severe burns
finding below demonstrates the procedure can NOT regulate their temperature and are
was successful? at risk for hypothermia. The room
A. The patient can move the extremity. temperature should be a minimum of 85'F.
B. The right foot's capillary refill is less than
2 seconds.
C. The patient reports a new sensation of 28. You are about to provide care to a
extreme pain. patient with severe burns. You will don:
D. The patient has a positive babinski reflex. A. gloves
The answer is B. Escharotomy is performed B. goggles
when a full-thickness burn, due to eschar C. gown
(which is burned tissue that is hard), is D. N-95 mask
compromising blood flow to the distal E. surgical mask
extremity. The eschar is cut and this F. shoe covers
relieves pressure and allows blood to flow to G. hair cover
the extremity. The answer is A, C, E, F, and G. Before
providing care to a patient with severe burns
the nurse would want to wear protective
isolation apparel like: gloves, gown, surgical
mask, shoe covers, and hair cover. This
protects the patient from potential infection. 2. A 68 year old male patient has partial
thickness burns to the front and back of the
right and left leg, front of right arm, and
29. While collecting a medical history on a anterior trunk. Using the Rule of Nines,
patient who experienced a severe burn, calculate the total body surface area
which statement by the patient's family percentage that is burned?
member requires nursing intervention? A. 40.5%
A. "He takes medication for glaucoma". B. 49.5%
B. "I think it has been 10 years or more C. 58.5%
since he had a tetanus shot." D. 67.5%
C. "He was told he had COPD last year." The answer is C. Front and back of right
D. "He smokes 2 packs of cigarettes a day." and left leg (36%), front of right arm (4.5%),
The answer is B. Patients who have had anterior trunk (18%) which equals 58.5%.
burns need a tetanus shot if they have not
had a vaccine within the past 5 to 10 years.
3. A 35 year old male patient has full
thickness burns to the anterior and posterior
30. A patient is presenting with bright red head and neck, front of left leg, and
lips, headache, and nausea. The physician perineum. Using the Rule of Nines,
suspects carbon monoxide poisoning. As calculate the total body surface area
the nurse, you know the patient needs: percentage that is burned?
A. Oxygen nasal cannula 5-6 Liters A. 37%
B. 100% oxygen via non-rebreather mask B. 14.5%
C. Continuous Bipap C. 29%
D. Venturi mask 6 L oxygen D. 19%
The answer is B. This is the treatment for The answer is D. Anterior and posterior
carbon monoxide poisoning. head and neck (9%), front of left leg (9%),
perineum (1%) which equals 19%.
1. A 25 year old female patient has
sustained burns to the back of the right arm,
posterior trunk, front of the left leg, anterior 4. A 66 year old female patient has deep
head and neck, and perineum. Using the partial-thickness burns to both of the legs on
Rule of Nines, calculate the total body the back, front and back of the trunk, both
surface area percentage that is burned? arms on the front and back, and front and
A. 46% back of the head and neck. Using the Rule
B. 37% of Nines, calculate the total body surface
C. 36% area percentage that is burned?
D. 28% A. 72%
The answer is B. Back of right arm (4.5%), B. 63%
posterior trunk (18%), front of left leg (9%), C. 81%
anterior head and neck (4.5%) and D. 45%
perineum (1%) which equals 37%. The answer is C. Both of the legs on the
back (18%), front and back of the trunk
(36%), both arms on the front and back
(18%), front and back of the head and neck
(9%) which equals 81%.

5. A 58 year old female patient has

superficial partial-thickness burns to the
anterior head and neck, front and back of
the left arm, front of the right arm, posterior
trunk, front and back of the right leg, and
back of the left leg. Using the Rule of Nines,
calculate the total body surface area
percentage that is burned?
A. 63%
B. 81%
C. 72%
D. 54%
The answer is A. Anterior head and neck
(4.5%), front and back of the left arm (9%),
front of the right arm (4.5%), posterior trunk
(18%), front and back of the right leg (18%),
back of the left leg (9%) which equals 63%.

6. A 35 year old male patient has superficial

partial-thickness burns to the anterior right
arm, posterior left leg, and anterior head
and neck. Using the Rule of Nines, calculate
the total body surface area percentage that
1. A 45 year old female patient has
is burned?
superficial partial thickness burns on the
A. 36%
posterior head and neck, front of the left
B. 9%
arm, front and back of the right arm,
C. 18%
posterior trunk, front and back of the left leg,
D. 29%
and back of right leg. The patient weighs 91
The answer is C. Anterior right arm (4.5%),
kg. Use the Parkland Burn Formula to
posterior left leg (9%), and anterior head
calculate the total amount of Lactated
and neck (4.5%) which equals 18%.
Ringers that will be given over the next 24
hours?
A. 22,932 mL
B. 26,208 mL
C. 16,380 mL
D. 12,238 mL
The answer is A: 22,932 mL. Formula: Total
Amount of LR = 4 mL x BSA % x pt's weight
in kg. Pt's weight 91 kg. BSA percentage: The answer is A: 921 mL/hr....First calculate
63%... posterior head and neck (4.5%), front the total amount of fluid needed with the
of the left arm (4.5%), front and back of the formula: Total Amount of LR = 4 mL x BSA
right arm (9%), posterior trunk (18%), front % x pt's weight in kg. The pt's weight 63 kg.
and back of the left leg (18%), back of right BSA percentage: 58.5%...Front and back of
leg (9%) equals: 63%......4 x 63 x 91 = right and left leg (36%), front of right arm
22,932 mL (4.5%), anterior trunk (18%) which equals
58.5%. ......4 x 58.5 x 63 = 14,742
mL......Remember during the FIRST 8 hours
2. A 30 year old female patient has deep 1/2 of the solution is infused, which will be
partial thickness burns on the back of the 14,742 divided by 2 = 7371 mL......Hourly
right arm, posterior trunk, front of the left Rate: 7371 divide by 8 equals 921 mL/hr
leg, anterior head and neck, and perineum.
The patient weighs 150 lbs. Use the
Parkland Burn Formula to calculate the total 4. A 59 year old male patient has full
amount of Lactated Ringers that will be thickness burns on both of the legs on the
given over the next 24 hours? back, front and back of the trunk, both arms
A. 14,960 mL on the front and back, and front and back of
B. 12,512 mL the head and neck. The patient weighs 186
C. 10,064 mL lbs. Use the Parkland Burn Formula: You've
D. 16,896 mL already infused fluids during the first 8
The answer is C: 10,064 mL Formula: Total hours. Now what will you set the flow rate
Amount of LR = 4 mL x BSA % x pt's weight during the next 16 hours (mL/hr) based on
in kg. Pt's weight 150 lbs....convert to the total you calculated?
kg....150 divided by 2.2 = 68 kg. BSA A. 563 mL/hr
percentage: 37%...Back of right arm (4.5%), B. 854 mL/hr
posterior trunk (18%), front of left leg (9%), C. 289 mL/hr
anterior head and neck (4.5%) and D. 861 mL/hr
perineum (1%) which equals 37%......4 x 37 The answer is D: 861 mL/hr First calculate
x 68 = 10,064 mL the total amount of fluid needed with the
formula: Total Amount of LR = 4 mL x BSA
% x pt's weight in kg. The pt's weight 186
3. A 30 year old female patient has deep lbs...need to convert to kg: 186 divided by
partial thickness burns on the front and back 2.2 = 85 kg. BSA percentage: 81%...Both of
of the right and left leg, front of right arm, the legs on the back (18%), front and back
and anterior trunk. The patient weighs 63 of the trunk (36%), both arms on the front
kg. Use the Parkland Burn Formula: What is and back (18%), front and back of the head
the flow rate during the FIRST 8 hours and neck (9%) which equals 81%.......4 x 81
(mL/hr) based on the total you calculated? x 85 = 27,540 mL. You've already infused
A. 921 mL/hr half of the solution during the first 8
B. 938 mL/hr hours...so 13,770 mL is left and it needs to
C. 158 mL/hr be infused over 16 hours. Hourly rate:
D. 789 mL/hr 13,770 mL divided by 16 hours equals 861
mL/hr
 3. Tall peaked T-waves, flat P-waves,
prolonged PR intervals and widened QRS
5. A 29 year old male patient has superficial complexes can present in which of the
partial thickness burns on the anterior right following conditions?
arm, posterior left leg, and anterior head A. Hypocalemia
and neck. The patient weighs 78 kg. Use B. Hypercalemia
the Parkland Burn Formula to calculate the C. Hypokalemia
total amount of Lactated Ringers that will be D. Hyperkalemia
given over the next 24 hours? The answer is D: Hyperkalemia
A. 11,232 mL
B. 5,616 mL
C. 2,808 mL 2. Which of the following is not a symptom
D. 16,848 mL of hyperkalemia?
The answer is B: 5,616 mL. Formula: Total A. Positive Chvostek’s sign
Amount of LR = 4 mL x BSA % x pt's weight B. Decreased blood pressure
in kg. Pt's weight 78 kg. BSA percentage: C. Muscle twitches/cramps
18%...Anterior right arm (4.5%), posterior D. Weak and slow heart rate
left leg (9%), and anterior head and neck The answer is A: Positive Chvostek’s sign
(4.5%) which equals 18%.....4 x 18 x 78 =
5,616 mL

1. A patient has a potassium level of 9.0. 6. A patient with nasogastric suctioning is

Which nursing intervention is priority? experiencing diarrhea. The patient is
A. Prepare the patient for dialysis and place ordered a morning dose of Lasix 20mg IV.
the patient on a cardiac monitor Patient’s potassium level is 3.0. What is
B. Administer Spironolactone your next nursing intervention?
C. Place patient on a potassium restrictive A. Hold the dose of Lasix and notify the
diet doctor for further orders
D. Administer a laxative B. Administered the Lasix and notify the
The answer is A: Prepare the patient for doctor for further orders
dialysis and place the patient on a cardiac C. Turn off the nasogastric suctioning and
monitor administered a laxative
D. No intervention is need the potassium
level is within normal range
4. Which patient is at risk for hyperkalemia? The answer is A: Hold the dose of Lasix and
A. Patient with Parathyroid cancer notify the doctor for further orders
B. Patient with Cushing’s Syndrome
C. Patient with Addison’s Disease
D. Patient with breast cancer 5. A patient’s potassium level is 3.0. Which
The answer is C: Patient with Addison’s foods would you encourage the patient to
Disease consume?
A. Cheese, collard greens, and fish
B. Avocados, strawberries, and potatoes
C. Tofu, oatmeal, and peas
D. Peanuts, bread, and corn
The answer is B: Avocados, strawberries, 9. A patient has a potassium level of 2.0.
and potatoes What would you expect to be ordered for
this patient?
A. Potassium 30 meq IV push
7. A patient is presenting with an orthostatic B. Infusion of Potassium intravenously
blood pressure of 80/40 when she stands C. An oral supplement of potassium
up, thready and weak pulse of 58, and D. Intramuscular injection of Potassium
shallow respirations. In addition, the patient The answer is B: Infusion of Potassium
has been having frequent episodes of intravenously
vomiting and nausea and is taking
hydrochlorothiazide. Which of the following
findings would explain the patient’s
condition?
A. Potassium level of 7.0
B. Potassium level of 3.5
C. Potassium level of 2.4
D. None of the options are correct
The answer is C: Potassium level of 2.4

8. Which patient is at a potential risk for

Digoxin toxicity?
A. A patient with Cushing’s syndrome taking
Laxis 20 mg IV twice a day
B. A patient with a calcium level of 8.9
C. A patient with a potassium level of 3.8
D. A patient presenting with painful muscle
spasms and positive Trousseau’s sign
The answer is A: A patient with Cushing’s
syndrome taking Laxis 20 mg IV twice a day

9. Which of the following is indicative of an

EKG change in a case of hypokalemia?
A. Widened QRS complex and prolonged
PR interval
B. Prolonged ST interval and Widened T-
wave
C. Tall T-waves and depressed ST segment
D. ST depression and inverted T-wave
The answer is D: ST depression and
inverted T-wave