Which condition would NOT require a nurse practitioner to refer to a physician?

The scenario describes a situation where a nurse practitioner faces several burn-related conditions and must determine which one does not necessitate a referral to a physician. Second-degree burns on the lower arm typically involve damage to both the outer layer of skin (epidermis) and a portion of the underlying layer (dermis). While these burns can be painful and may involve blistering, they are considered manageable in an outpatient setting, particularly if they cover a limited area and do not show signs of infection or other complications.

In contrast, severe facial burns, electrical burns, and burns involving the cartilage of the ear are deemed more complex situations. Severe facial burns can significantly affect appearance and functionality and may involve deeper layers of tissue, necessitating specialized care. Electrical burns can cause internal injuries and secondary complications that are not immediately visible, requiring advanced evaluation and management. Burns affecting the cartilage of the ear may have implications for cosmetic and functional outcomes, often needing surgical expertise to ensure proper healing and aesthetic results.

Given the manageable nature of second-degree burns on a small area such as the lower arm, referring these patients to a physician is not typically required, allowing nurse practitioners to provide appropriate care independently.