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Quizzes > Health & Medicine

Rule of Nines Quiz: Burns Assessment for NCLEX Practice

Quick, free TBSA calculation quiz and burn assessment questions. Instant results.

Editorial: Review CompletedCreated By: Leonelaa LeaUpdated Aug 25, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art style illustration of nurse applying burn dressing to arm beside NCLEX quiz sheet icon on dark blue background

This Rule of Nines quiz helps you practice estimating TBSA and prioritizing burn care for the NCLEX. Work through short items on assessment, fluids, airway, wound care, and pain with instant feedback. For extra prep, try our nursing assessment questions and emergency nursing quiz, or build your base with a fundamentals of nursing quiz.

A burn that presents with painful blistering and a moist red wound bed is classified as:
Superficial burn
Superficial partial-thickness burn
Full-thickness burn
Deep partial-thickness burn
A superficial partial-thickness burn involves damage to the epidermis and upper dermis, resulting in pain, blistering, and a moist red appearance. Superficial burns are limited to the epidermis only and do not blister. Deep partial-thickness burns extend deeper into the dermis, often causing less fluid-filled blistering and more mottled color. Full-thickness burns destroy the entire dermis and epidermis, leaving a leathery appearance. For more detail, see .
Using the Rule of Nines in an adult patient, what is the percentage of total body surface area (TBSA) for the anterior trunk?
9%
36%
18%
27%
The Rule of Nines divides the adult body into regions of 9% (or multiples thereof). The anterior trunk accounts for 18% of TBSA, while the posterior trunk is another 18%. Each upper extremity is 9%, each lower extremity is 18%, the head and neck is 9%, and the perineum is 1%. Precise assessment guides fluid resuscitation. See .
In the initial management of a major burn injury, which priority action should the nurse take first?
Initiate fluid resuscitation
Assess airway and breathing
Cleanse and cover the burn wound
Administer pain medication
Airway assessment and management are the top priorities in the emergent phase of burn care due to the risk of inhalation injury and airway compromise. Fluid resuscitation and pain control follow once the airway and breathing are stabilized. Wound cleansing is important but secondary to ensuring adequate oxygenation. More information is available at .
Using the Parkland formula, calculate the total fluid requirement in 24 hours for a 70 kg adult with 30% TBSA burns.
8.4 liters
12.6 liters
4.2 liters
16.8 liters
The Parkland formula is 4 mL × body weight (kg) × percentage TBSA burned. For a 70 kg patient with 30% burns: 4 × 70 × 30 = 8400 mL (8.4 L) in 24 hours. Half of this volume is given in the first 8 hours from the time of injury. Precise calculations guide successful resuscitation. Learn more at .
According to the Parkland formula, how much fluid should be administered in the first 8 hours post-burn?
Half of the total 24-hour volume
One-third of the total 24-hour volume
One-quarter of the total 24-hour volume
Three-quarters of the total 24-hour volume
The Parkland formula prescribes that half of the calculated 24-hour fluid volume be administered in the first 8 hours after injury. The remaining half is given over the subsequent 16 hours. This timing is critical for maintaining adequate perfusion. Further details can be found at .
In electrical burn injuries, which complication requires immediate monitoring?
Renal stones
Pulmonary embolism
Cardiac arrhythmias
Hyperglycemia
Electrical currents can disrupt cardiac conduction, leading to arrhythmias or even cardiac arrest. Continuous ECG monitoring is essential in the emergent phase. While fluid shifts and myoglobinuria can affect the kidneys, the immediate threat is arrhythmia. For more, see .
Which pain management strategy is most appropriate for a patient with extensive third-degree burns?
Intramuscular opioid injections
Topical lidocaine gel
Oral NSAIDs on schedule
Intravenous patient-controlled analgesia (PCA) with opioids
Patients with extensive third-degree burns experience severe pain that is best managed with intravenous opioid PCA, allowing for timely and adjustable dosing. Oral NSAIDs and topical agents are insufficient for severe burn pain. Intramuscular injections are unpredictable in absorption due to fluid shifts. Details are available at .
An indication for performing an escharotomy in a circumferential full-thickness burn is:
Improved capillary refill
Sustained hypertension
Absent distal pulses and increasing pain
Elevated urine output
Circumferential full-thickness burns can constrict underlying tissue, leading to compartment syndrome. Absent distal pulses, pain with passive stretch, and tense swelling indicate the need for escharotomy. Hypertension and good capillary refill would not prompt this procedure. Read more at .
Which clinical sign is most indicative of compartment syndrome in a patient with a circumferential burn?
Bounding distal pulses
Decreased skin temperature only
Bradycardia
Pain on passive stretch of the affected extremity
Pain out of proportion to the injury and pain on passive stretch are early and specific indicators of compartment syndrome. Bounding pulses do not occur; instead pulses become weak or absent. Bradycardia is unrelated. Skin changes alone are late signs. For further reading, see .
During the acute phase of burn recovery, which nutritional intervention is a priority?
Low-protein diet
Fluid restriction
High-protein, high-calorie diet
Low-carbohydrate diet
Burn injuries induce a hypermetabolic state, increasing protein and caloric needs to support wound healing and prevent muscle wasting. A high-protein, high-calorie diet is recommended. Fluid restriction is contraindicated during resuscitation, and low-protein/carbohydrate diets do not meet increased metabolic demands. More information is at .
To minimize infection risk in burn wounds, which type of dressing is most appropriate?
Dry gauze only
Standard adhesive bandage
Silver-impregnated antimicrobial dressing
Hydrocolloid dressing without antimicrobials
Silver-impregnated dressings provide broad-spectrum antimicrobial activity and support a moist healing environment, reducing infection risks. Dry gauze and standard bandages lack antimicrobial properties. Hydrocolloids without antimicrobials may harbor bacteria. For detailed guidelines, see .
During the rehabilitative phase, which intervention best prevents joint contractures in burn patients?
Elevation only
Allowing natural wound contraction
Complete immobilization of the burned area
Positioning and splinting in functional alignment
Positioning and splinting maintain joints in functional alignment, preventing contractures as healing and scar tissue develop. Immobilization leads to stiff joints and contractures. Elevation reduces swelling but doesn't maintain range of motion, and relying on natural contraction increases contracture risk. See .
A patient with suspected inhalation injury presents with facial burns and singed nasal hairs. What is the nurse's priority intervention?
Administer 100% humidified oxygen and prepare for possible intubation
Obtain arterial blood gases
Start IV corticosteroids
Initiate bronchodilator therapy
Inhalation injuries can rapidly compromise the airway due to edema. Administering 100% humidified oxygen and preparing for early intubation ensure airway patency and adequate oxygenation. While ABGs and bronchodilators may be needed, securing the airway takes priority. Corticosteroids are not routinely recommended. More on this at .
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Study Outcomes

  1. Identify Burn Depth and Classification -

    Determine the different degrees of burns and understand their pathophysiology to answer burns NCLEX questions with confidence.

  2. Prioritize Emergent Burn Care -

    Outline the initial assessment and interventions for airway, breathing, and circulation, reflecting real-world burn NCLEX questions quizlet scenarios.

  3. Calculate Fluid Resuscitation Needs -

    Use formulas like Parkland to compute fluid replacement requirements in burn patients, a common focus of NCLEX questions on burns quizlet.

  4. Apply Wound Care and Infection Prevention -

    Implement evidence-based dressing techniques and sterility protocols to reduce infection risk and excel in burn NCLEX questions quizlet challenges.

  5. Implement Nutritional Support Strategies -

    Develop high-protein, high-calorie plans to meet the hypermetabolic demands of burn patients, reinforcing content from burn NCLEX questions.

  6. Evaluate Rehabilitation and Patient Education -

    Formulate mobility, range-of-motion exercises, and discharge teaching to support long-term recovery and address burn nclex questions comprehensively.

Cheat Sheet

  1. TBSA Estimation: Rule of Nines & Lund - Browder -

    Use the Rule of Nines (adult head = 9%, each arm = 9%, anterior torso = 18%) for quick TBSA assessments and switch to the Lund - Browder chart for pediatric patients (Journal of Burn Care & Research). Reinforce with diagram flashcards in burns nclex questions quizlet style to boost speed and accuracy.

  2. Fluid Resuscitation: Parkland Formula -

    Apply the Parkland formula (4 mL × body weight in kg × %TBSA) to calculate fluid needs: administer half of the total volume within the first 8 hours and the remainder over the next 16 hours (American Burn Association guidelines). For example, a 70 kg patient with 30% TBSA requires 4 × 70 × 30 = 8,400 mL of lactated Ringer's solution, with 4,200 mL given in the first 8 hours.

  3. Airway Management: Inhalation Injury Signs -

    Recognize inhalation injury signs - facial burns, singed nasal hairs, hoarseness, and carbonaceous sputum - and prioritize early airway management. Intubation within 4 hours for suspected airway edema can be lifesaving (UpToDate).

  4. Nutrition Support: Hypermetabolism & Mnemonic -

    Anticipate a hypermetabolic response that raises caloric demands by 1.5 - 2 times basal rates; prioritize high-protein, high-carbohydrate nutrition with micronutrient supplementation (Lippincott Nursing). Use the mnemonic PCV (Protein, Carbs, Vitamins) to remember essential macronutrients for burn nclex questions.

  5. Rehabilitation: Preventing Contractures & Scarring -

    Initiate early range-of-motion exercises and splinting in the functional position (MCP flexion, IP extension, thumb abduction) to prevent contractures. Apply pressure garments 23 hours per day for up to a year to minimize hypertrophic scarring (American Burn Association).

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