Virginia HESI Level 4 Practice Test

When a burn fully encircles a limb, swelling inside a nonelastic eschar can raise tissue pressure and squeeze blood flow, risking vascular compromise. The most concerning finding is evidence of reduced distal perfusion: slow capillary refill in the digits with absent distal pulse points. This combination indicates the circulation to the hand or foot is severely threatened and needs prompt assessment and potential intervention (such as releasing constrictive tissue or surgical means) to prevent ischemia. By contrast, normal sensation, warm pink skin distal to the burn, or rapid capillary refill with strong pulses show preserved perfusion and do not signal an urgent need for intervention.