Porth's Pathology Chapters 1-4

In which of the following patients should the nurse anticipate the necessity of regulating body temperature through a heat-gain response? Select all that apply.

-Patient in a huddle position -Patient with hyperthyroidism p. 64 and 66

A 99-year-old woman has experienced a decline of cell function associated with age. Which focus on cellular programming is associated with the group of theories related to senescence? Changes resulting from telomere shortening DNA mutation or faulty repair Elimination of cell receptor sites Insufficient telomerase enzyme

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A client has been brought to the emergency department with a large, gaping wound from a farming accident. The client is critically ill and has required blood products and surgery to clean and close the wound. The nurse, mentoring a student nurse, explains the inflammatory phase, beginning by discussing which role of macrophages play in wound healing? Select all that apply.

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Which of the following patients should be assessed for fever based on other presenting symptoms? Select all that apply The patient who is hyperactive The patient with bradycardia The patient with anorexia The patient with myalgia The patient who is unable to sleep

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Which physiologic functions are the responsibility of the plasma membrane? Select all that apply. Aids in the regulation of cell growth. Acts as a key regulator of apoptosis. Provides receptors for hormones. Controls the cell shape and movement. Participates in the electrical events that occur in nerve and muscle cells.

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The rehabilitation nurse is caring for a client who is recovering from a cerebrovascular accident (CVA) with hemiplegia. The family asks the nurse if the paralysis will be permanent. Upon which of these physiologic rationales should the nurse base the response? a) It is likely that paralysis is permanent, as nerve cells do not normally regenerate. b) Paralysis is likely permanent, as inflammation causes brain swelling. c) Permanent paralysis will probably not occur because the neurologic cells are stable cells that divide only when tissue damage occurs. d) Permanent paralysis is unlikely as the cells of the brain are labile cells that can replicate throughout the life span.

A. It is likely that paralysis is permanent, as nerve cells do not normally regenerate.

Which of the following statements by a student demonstrates a sound understanding of the cellular processes of hypertrophy and hyperplasia? A) "I know that cells like neurons have little capacity for hyperplastic growth." B) "A remaining kidney can sometimes undergo hyperplasia in response to one that has been removed." C) "When male patients experience 'an enlarged prostate,' they are describing a form of hypertrophy." D) "Clients with cardiomyopathy undergo myocardial hypertrophy with proportional increases in cell length and width."

Ans: A Feedback: Because they do not normally divide, neurons do not undergo hyperplasia. Remaining organs can display hypertrophy, not hyperplasia, and prostate enlargement is a form of hyperplasia. Cardiomyopathic hyperplasia involves greater increases in cell length than width.

Which cellular adaptation to changes in the internal environment would be most concerning to the nurse? Select all that apply. Apoptosis Necrosis Metaplasia Hyperplasia Hypertrophy

Apoptosis, Necrosis Necrosis is irreversible cell death and is most concerning. Apoptosis is linked to many pathological processes and diseases, and some may be irreversible. Metaplasia refers to a change in forms of the cell and is a normal cellular adaptation as is hyperplasia (an increase in the number of cells). Hypertrophy represents an increase in cell size and with it an increase in the amount of functioning tissue mass. Necrosis and apoptosis are the most concerning

Which of the following is an appropriate action by a nurse to take in attempting to decrease a patient's temperature through conduction?

Apply cooling blanket p. 65

Following an injury, scar formation builds on the granulation tissue framework. Proliferation of fibroblasts occur with the assistance of which growth factors that have been released from enothelial and inflammatory cells at the site of injury? Select all that apply. a) Platelet-derived growth factor (PDGF) b) Fibroblast growth factor (FGF) c) Keratinocyte growth factor (KGF) d) Vascular endothelial cells growth factor (VEGF) e) Transforming growth factor-beta (TGF-beta)

B. • Fibroblast growth factor (FGF) D. • Transforming growth factor-beta (TGF-beta)

A nurse assessing an older adult for signs and symptoms of infection in the absence of a fever should assess for which of the following? Select all that apply. a) Fatigue b) Change in fuctional capacity c) Decreased mental status d) Weight gain e) Depression

C. • Decreased mental status B. • Change in fuctional capacity A. • Fatigue

An adult client who recently worked in an overseas metal smelter has developed several symptoms that cause the care team to suspect lead poisoning. Which clinical manifestations should the nurse attribute to this problem? Select all that apply. Elevated creatinine and blood urea nitrogen Atrial fibrillation Jaundice Dental caries Decreased hemoglobin and hematocrit

Elevated creatinin and blood urea nitrogen, decreased hemoglobin and hematocrit Anemia (decreased hemoglobin and hematocrit) is characteristic of lead poisoning and renal damage is likely, leading to elevated creatinine and BUN levels. Lead poisoning does not typically lead to dysrhythmias, dental caries, or jaundice.

What is the most common cause of drug fever?

Hypersensitivity reaction to medication p. 66-67

Which statements are true regarding chronic inflammation? Select all that apply. The condition is self-limiting in nature. The inflammatory agent is usually resistant to phagocytosis. It involves the presence of mononuclear cells like lymphocytes. Granulocytes are generally observed at sites of chronic inflammation. It is usually a result of persistent irritants.

It is usually a result of persistent irritants. The inflammatory agent is usually resistant to phagocytosis. It involves the presence of mononuclear cells like lymphocytes.

A client has just returned to the nursing unit following stent placement in her right femoral and popliteal artery related to severe peripheral artery disease. Upon assessment, the nurse is unable to palpate pulses in the right foot (pedal pulse and posterior tibial) or hear pulses with doppler. The nurse knows oxygen is required for which aspects of wound healing? Select all that apply. Killing of bacteria by phagocytic white blood cells Proper absorption of pain medications Collagen synthesis Prevention of clot formation in the venous system Destruction of microbes neutrophils and macrophages

Killing of bacteria by phagocytic white blood cells Collagen synthesis

Which of the following patients is most likely to have impairments to the wound healing process? A patient with:

Poorly controlled blood sugars with small blood vessel disease. p. 61

Which cell is responsible for the activation of the immune system?

T cells

While reviewing the phases of wound healing, the students note that the first cells to arrive after the injury are the:

neutrophils -The cellular phase of inflammation follows and is evidenced by the migration of phagocytic white blood cells that digest and remove invading organisms, fibrin, extracellular debris, and other foreign matter. The neutrophils arrive within minutes and are usually gone by day 3 or 4. They ingest bacteria and cellular debris. Within 24 to 48 hours, macrophages, which are larger phagocytic cells, enter the wound area and remain for an extended period. These cells, arising from blood monocytes, are essential to the healing process. The final component of the proliferative phase is epithelialization, which is the migration, proliferation, and differentiation of the epithelial cells at the wound edges to form a new surface layer that is similar to that destroyed by the injury.

Which statements are true regarding the contraction and remodeling of a wound? Select all that apply.

• This phase generally begins about 3 weeks after the injury. • The development of a fibrous scar is important to the success of the process. • This phase can take up to 6 months or longer to complete. This phase begins approximately 3 weeks after injury with the development of the fibrous scar, and can continue for 6 months or longer, depending on the extent of the wound. During this phase, there is a decrease in vascularity and continued remodeling of scar tissue by simultaneous synthesis of collagen by fibroblasts and lysis by collagenase enzymes. As a result of these two processes, the architecture of the scar is capable of increasing its tensile strength, and the scar shrinks so it is less visible.