A nurse is assessing a client who has sustained burns on the entire left arm and the anterior chest. Using the rule of nines, the nurse calculates what percentage of total body surface area is affected by the burns?

A. 36%: This value would apply to much larger burn areas, such as the entire torso and an entire leg. It exceeds the surface area involved in burns to one arm and the anterior chest. B. 27%: This percentage is also too high for the affected areas. It would require additional regions like both arms and anterior or posterior torso to be involved. C. 9%: This accounts for either one full arm or the anterior chest alone but does not include both. It underestimates the total burn surface area in this scenario. D. 18%: According to the rule of nines, the entire arm accounts for 9% and the anterior chest accounts for another 9%, totaling 18% of the total body surface area affected.