PCCII T1 Inflammation MNL
What is true regarding duodenal ulcers? (Select all that apply.) More common in men than in women More common in individuals who smoke Typically develop between the ages of 30 and 55 Typically develop between the ages of 55 and 70 More common in individuals who eat poorly
A B D Duodenal ulcers typically develop between the ages of 30 and 55, are more common in men than in women, and in individuals who smoke. Dietary intake does not seem to cause PUD. Next Question
The nurse is evaluating teaching provided to a client with chronic appendicitis. Which observation indicates that teaching has been effective? Client eats fruit with breakfast and a salad for lunch Client walks for 30 minutes three times a week Client meets with family or friends at least once a week Client engages in quiet activity 1 hour before going to slee
A Chronic appendicitis has periods of exacerbation. Ingesting foods with high fiber content, such as fresh fruits and vegetables, can help to decrease the incidence of fecaliths and subsequent bouts of acute appendicitis. Exercise, sleep, and social activities will not help reduce the risk of developing acute appendicitis.
Why are nonsteroidal anti-inflammatory agents (NSAIDs) used to treat rheumatoid arthritis? To reduce inflammation To slow the development and progression of bone erosion To alter the course of the disease To reduce joint destruction
A Clients with rheumatoid arthritis are given NSAIDs to reduce inflammation. NSAIDs are not prescribed to slow the development and progression of bone erosion, alter the course of the disease, or reduce joint destruction. Corticosteroids are used to slow the development and progression of bone erosion, and disease-modifying antirheumatic drugs (DMARDs) are used to alter the course of the disease and reduce joint destruction. Next Question
A client telephones the health clinic with complaints of vague abdominal pain. The client has not been able to eat for a day and is nauseated. What advice should the nurse provide to this client? Seek immediate medical attention Take a warm shower and apply a heating pad to the abdomen Rest in bed and drink warm fluids Take an over-the-counter laxative
A Manifestations of appendicitis begin with vague abdominal pain. Nausea and anorexia are additional manifestations. If medical attention is not provided, gangrene can develop within 24 to 36 hours. The client should be instructed to seek immediate medical attention. Resting in bed and drinking warm fluids is not going to prevent the appendix from developing gangrene. When appendicitis is suspected, the client should be instructed to avoid laxatives and not to apply heat to the abdomen because heat could encourage the appendix to rupture.
A nurse is caring for William Sanders, a 65-year-old male with a history of peptic ulcer disease (PUD), who presents to the emergency department via ambulance gurney. Mr. Sanders called first responders to his house when he developed severe upper abdominal pain that radiated to his right shoulder. Mr. Sanders's heart rate is 114 and blood pressure is 90/55. Mr. Sanders's nurse notes that his skin is cool and clammy, his abdomen is hard, and no bowel sounds can be auscultated. What complication associated with PUD does the nurse suspect that Mr. Sanders has? Perforation Gastric outlet obstruction Hemorrhage Zollinger-Ellison syndrome
A Mr. Sanders is likely experiencing a perforation of either the duodenum or stomach. This is the most lethal complication that may occur with PUD. Symptoms of perforation include a rigid abdomen, severe abdominal pain which radiates to the shoulder, and signs of shock (low blood pressure, tachycardia, and cool/clammy skin). Hemorrhage would also present as a symptom of shock; however, the client's abdomen would not be rigid and boardlike as in perforation. Gastric outlet obstruction is a complication associated with PUD; however, symptoms are gradual with feelings of fullness. Zollinger-Ellison syndrome is a condition that causes PUD, not a complication of it. Next Question
A nurse is caring for a client with peptic ulcer disease (PUD). The client tells the nurse, open double quote"I don't understand why I have pain in the middle of the night. It's like my pain starts 2dash-3 hours after I eat, not right away. Why does this happen?close double quote" What is the nurse's best response? open double quote"The pain occurs when your stomach is empty.close double quote" open double quote"The acid in your stomach is increased at night, causing pain.close double quote" open double quote"The food that you ate for dinner likely contained too much fat, causing pain.close double quote" open double quote"The food in your stomach takes longer to digest at night, which causes pain.
A Pain from PUD occurs when the stomach is empty, typically 2dash-3 hours after a meal. The other responses are incorrect.
The nurse is caring for a client recently diagnosed with rheumatoid arthritis (RA). The client states, "I always take care of myself, how could this happen to me?" Which response by the nurse is most appropriate regarding the client's risk for developing RA? "RA occurs when there is a family history of the disease." "RA occurs for clients with a history of using herbal remedies." "RA occurs when there is a family history of coronary artery disease." "RA occurs for clients who are underweight."
A Risk factors for RA include a family history of the disease and heavy smoking. Use of herbal remedies, a family history of coronary artery disease, and being underweight do not increase the risk for developing RA.
The results of an abdominal ultrasound were inconclusive for a client experiencing vague right lower quadrant abdominal pain. Which diagnostic test will the nurse prepare the client for at this time? Abdominal x-rays Myelogram Paracentesis Upper gastrointestinal study
A The abdominal ultrasound is the diagnostic test of choice for appendicitis. Since the results were inconclusive, an additional test to either confirm or rule out appendicitis would be abdominal x-rays. A myelogram is used for a neurologic health problem. Paracentesis is appropriate if fluid or ascites is present in the abdominal cavity. An upper gastrointestinal study is appropriate if the client was experiencing abdominal pain in the upper abdominal regions.
A client with severe arthritis of the right hip is scheduled for total hip replacement surgery. What is the first action that the nurse should take at this time? Determine who will help the client at home after surgery. Ensure a bed is available for the client after surgery. Prepare needed preoperative teaching. Discuss the length of rehabilitation.
A The client with inflammation may need surgery to help stop or reduce the progression of the disorder. The nurse's role at this time will be to provide preoperative client teaching. The length of rehabilitation would not be a priority at this time. Ensuring that a bed is available for the client after surgery can be completed by other unit personnel. Determining who will help the client at home after the surgery would be a part of postoperative teaching.
What does the erythrocyte sedimentation rate blood test measure? The speed in which a red blood cell settles in a test tube The number of red blood cells in a milliliter of blood The speed in which a red blood cell destructs in a test tube The number of red blood cells that line an injured vessel
A The erythrocyte sedimentation rate (ESR) test measures how far a red blood cell settles in a test tube over a specific period of time. With inflammation the rate of settling will be faster leading to a higher reading. The erythrocyte sedimentation rate test does not measure the number of red blood cells in a milliliter of blood, the speed in which a red blood cell destructs in a test tube, or the number of red blood cells that line an injured vessel. Next Question
While caring for a client recovering from an appendectomy, the nurse monitors urine output, intravenous fluid intake, and the amount of nasogastric drainage. Which nursing diagnosis is the nurse using to guide this client's care? Risk for deficient fluid volume Acute pain Risk for infection Alteration in perfusion and oxygenation
A The interventions are all focused on measuring or monitoring fluid balance. The diagnosis most likely being used to guide this client's care is an increased risk for inadequate fluid balance. The nurse's actions are not addressing the risk for infection, abdominal pain, or perfusion and oxygenation.
Which nursing intervention is most appropriate for a client with peptic ulcer disease (PUD)? Monitor stools for occult blood. Encourage the client to have a bedtime snack to avoid hunger pains. Assess the client's abdomen every 6 hours. Encourage the client to walk the halls.
A The most appropriate nursing intervention for a client with PUD is monitoring stools for occult blood. The nurse should assess the client's abdomen every 4 hours. The client should maintain bed rest, not activity. The nurse should discourage the client from having a bedtime snack to avoid pain associated with PUD. OK
A nurse is planning care for a client with inflammatory bowel disease. What goal or outcome is the best choice for this client? Client recognized the early signs of a flare up. Client's symptoms of infection have not worsened. Client lost less than 5% of pre-illness body weight. Client's skin excoriation has not worsened.
A The most correct goal or outcome for the client with inflammatory bowel disease is the client recognized the early signs of a flare up. The client should be free from infection with no loss of skin integrity or weight loss.
The nurse is caring for a pregnant client in the obstetrics clinic. The client has a history of rheumatoid arthritis. Which statement by the client would require a follow up by the nurse? "When my joints hurt I can take an aspirin." "Now that I am in my second trimester, I actually feel good, and my joints are not hurting either." "I need to schedule extra rest periods throughout the day." "I might carry my baby longer than the normal 40 weeks for the pregnancy."
A The nurse needs to follow up with the client's statement of taking aspirin (salicylates); these drugs can prolong labor and may induce teratogenic effects; therefore they should be stopped during pregnancy. Pregnant clients need to be taught to schedule extra rest periods throughout the day; remission during pregnancy happens often; clients also may have prolonged gestation.
The nurse is planning care for a client in the early stages of ulcerative colitis. The nurse understands that which part of the colon is initially affected by ulcerative colitis? Rectosigmoid area Ileocecal junction Duodenum Transverse colon
A Ulcerative colitis begins with inflammation at the rectosigmoid area of the anal canal and progresses proximally. Ulcerative colitis can progress to the entire colon, stopping at the ileocecal junction. The duodenum is part of the small intestine and is not affected by ulcerative colitis. The transverse colon is not initially affected by ulcerative colitis.
What is the clinical term for abnormal tissue that leads to joint damage and immobilization in the pathophysiology of rheumatoid arthritis? Pannus Synovial membrane Uveitis Pleurodesis
A he abnormal granulation tissue that leads to joint damage in rheumatoid arthritis is called pannus. Uveitis is inflammation of the uvea, the middle layer of the eye, and is a clinical manifestation of juvenile idiopathic arthritis. Synovial membrane is the normal connective tissue that lines the cavity of a joint and produces the synovial fluid. Pleurodesis is a medical procedure in which the pleural space is artificially scarred. It involves the adhesion of the two pleurae.
Eli Schwartz is a 15-year-old boy who was recently diagnosed with ulcerative colitis and is admitted to the hospital with severe diarrhea. Which nursing intervention would Eli's nurse provide for Eli? Infuse intravenous fluids as prescribed Avoid anti-inflammatory medications Weigh every other day Avoid placing any kind of cream on the perianal region
A Eli's ulcerative colitis is causing severe diarrhea, and he is most likely dehydrated. Therefore, the nurse should provide intravenous fluids as prescribed. Anti-inflammatory medications should be administered as prescribed to help ameliorate the diarrhea episodes. The nurse should assess the perianal region for irritation or excoriation and apply a protective cream to the irritated areas as indicated. Daily weights should be performed to help assess Eli's hydration status. OK
How is appendicitis classified? (Select all that apply.) Simple Gangrenous Perforated Infected Inflamed
A B C Appendicitis can be classified as simple, gangrenous, or perforated. In simple appendicitis, the appendix is inflamed. In gangrenous appendicitis, there are areas of necrotic tissue and small perforations that may be infected. In perforated appendicitis, the appendix has ruptured. Next Question
A 16-year-old female client is brought to the emergency department experiencing severe right lower quadrant abdominal pain. In addition to appendicitis, which other health problems will the nurse also assess for during the examination? (Select all that apply.) Ectopic pregnancy Pelvic inflammatory disease Mittelschmerz Kidney stone Fecalith
A B C In adolescent and young adult females, the symptoms of appendicitis must be differentiated from the pain of ovulation or mittelschmerz, possible ruptured ectopic pregnancy, and pelvic inflammatory disease. A fecalith is one cause for appendicitis. A kidney stone will not cause severe right lower quadrant abdominal pain.
The home care nurse is visiting a client recovering from an acute inflammation. Which observations indicate that client teaching has been effective? (Select all that apply.) Client has a cup of warm tea while reading the afternoon mail. Client props left ankle on a pillow. Client applies ice to the right wrist for 10 minutes. Client puts weight on right knee while reaching for dishes in cabinet. Client uses the knee to close silverware drawer in the kitchen.
A B C Management of inflammation will depend upon the cause. The client will need teaching to control symptoms, prevent further harm or injury, and maintain an adequate nutritional and fluid intake. Evidence that teaching was effective includes the client propping the ankle with a pillow, applying ice, and ingesting warm tea. Using the knee to close a drawer and putting weight on an injured knee indicates that teaching has not been successful.
Which are nonmodifiable risk factors for the development of asthma? (Select all that apply.) Male age 4 years Female age 16 years African American race Positive family history Asian American culture
A B C Nonmodifiable risk factors for the development of asthma include children having a higher rate of developing this disorder than adults. It is more prevalent in African Americans than Whites and less prevalent in Asians than Whites. It is more common in males up to adolescence at which time it becomes more prevalent in females. A positive family history is not identified as being a nonmodifiable risk factor for the development of asthma. Next Question
Which nursing diagnoses are appropriate for acute appendicitis? (Select all that apply.) Risk for postoperative infection Risk for increased pain Altered fluid balance Altered nutritional intake Potential change in blood flow
A B C Nursing diagnoses that may be appropriate for the client with appendicitis include fluid volume balance alterations, risk of pain, and risk for postoperative infection. Nutritional status and change in blood flow are not nursing diagnoses appropriate for the client with appendicitis. Next Question
The nurse plans to assess a client for inflammation. Which questions should the nurse include when interviewing this client? (Select all that apply.) open double quote"What surgeries have you had?close double quote" open double quote"Do you take vitamins?close double quote" open double quote"Are you experiencing any pain?close double quote" open double quote"How much exercise do you get each day?close double quote" open double quote"Did you receive the annual influenza vaccination?close double quote
A B C Questions appropriate when interviewing a client for inflammation include asking about vitamin intake, previous surgeries, and current level of pain. Exercise and inoculations are not routine questions to ask when assessing a client for inflammation.
The nurse is questioning a client with Crohn disease about the presence of current symptoms. Which symptoms would the nurse find in the client? (Select all that apply.) Persistent diarrhea Blood in the stool Malaise Fissures, ulcers, fistulas, and abscesses of the anorectal area Left lower quadrant abdominal pain relieved by defecation
A B C D Blood may or may not be present in the stool of a client with Crohn disease, and the nurse would assess for it. The client with Crohn disease will have right, not left, lower quadrant abdominal pain relieved by defecation. Persistent diarrhea is a symptom of Crohn disease. Malaise may be present in a client with Crohn disease. Fissures, ulcers, fistulas, and abscesses of the anorectal area may be present in a client with Crohn disease, and the nurse would assess the client for them.
During a home visit, the nurse is concerned that a client is experiencing an acute inflammation. What did the nurse assess in this client? (Select all that apply.) Skin area reddened Pain level 7 on a scale from 1 to 10 Skin area swollen Skin area hot to touch Pink and red wound tissue
A B C D With acute inflammation the typical signs of inflammation long dash— redness, swelling, pain, heat, and impaired function long dash— occur. The presence of pink and red wound tissue indicates granulation, or healing of an acute inflammatory process, is occurring.
The nurse is discussing the incidence of inflammatory bowel disease with a group of nursing students. Which information would the nurse include in the discussion? (Select all that apply.) The disease is often linked to heredity. The peak incidence of the disease is in adolescence and young adulthood. Environmental factors can contribute to the etiology of chronic inflammatory bowel disease. Chronic inflammatory bowel disease does not affect older adults. The disease occurs more frequently in the United States and northern European nations.
A B C E Chronic inflammatory bowel disease tends to run in families, with 15% to 25% of clients having a family member with one of the diseases. Although the peak incidence of chronic inflammatory bowel disease is in adolescence and young adulthood, it can also affect older adults. Chronic inflammatory bowel disease is not caused by environmental factors alone, but these factors do play a role in the etiology of the disease. The peak incidence of chronic inflammatory bowel disease is in adolescence and young adulthood, between the ages of 15 and 30 years. Chronic inflammatory bowel disease occurs more frequently in the United States and northern European nations. As many as 1 million Americans have chronic inflammatory bowel disease.
A nurse is preparing to obtain a health history from a client with peptic ulcer disease (PUD). Which factors should the nurse include in this portion of the nursing assessment? (Select all that apply.) Presence of nausea and vomiting History of chronic use of NSAIDs History of smoking History of a high-fat diet Complaints of heartburn
A B C E Factors of the health history for a client with PUD include: presence of nausea and vomiting, complaints of heartburn, history of chronic use of NSAIDs, and history of smoking. History of a high-fat diet does not appear to factor into the development of PUD.
Which risk factors contribute to the development of appendicitis? (Select all that apply.) Adolescent male Low-fiber diet Caucasian race High-carbohydrate diet Age less than 4 years
A B D Risk factors for the development of appendicitis promote the development of fecaliths and gastrointestinal infections and include being an adolescent male and consuming a diet low in fiber and high in carbohydrates. Cultural factors may influence the progress of appendicitis but do not influence the onset or development of appendicitis. It is not common for children under the age of 4 to develop appendicitis. Next Question
A client with severe right lower quadrant abdominal pain says that the pain has suddenly stopped. Which nursing interventions are appropriate for this client? (Select all that apply.) Anticipate intravenous fluid administration Notify the physician Anticipate discharge orders to be written Expect orders for intravenous antibiotics Prepare the client for surgery
A B D E A sudden reduction in abdominal pain in appendicitis could indicate that the appendix has ruptured. The nurse needs to anticipate care for a ruptured appendix and potential peritonitis by notifying the physician, preparing the client for surgery to remove the appendix, expecting intravenous antibiotics to be prescribed, and expect intravenous fluids to be prescribed for fluid resuscitation.
The nurse is identifying goals of care with a client seeking treatment for appendicitis. Which outcomes are appropriate for the nurse to include in the plan of care? (Select all that apply.) The abdominal wound will heal without infection. Questions about surgical procedure will be addressed. Perfusion status will improve after surgery. Abdominal pain will be relieved with pain medication. Fluid and electrolyte balance will be maintained.
A B D E Goals of care for a client with appendicitis should focus on treatment approaches and the client's response. For appendicitis, surgery will most likely be performed, so goals should focus on answering questions about the surgical procedure, healing of the wound without infection, maintaining fluid and electrolyte balance, and relieving abdominal pain with medication. Perfusion status is not a priority problem for the client with appendicitis.
An 8-year-old child is scheduled for an invasive diagnostic procedure. What should the nurse do to prepare this child for the test? (Select all that apply.) Teach the child about the test. Discuss the use of anesthesia with the healthcare provider. Remind the child that only grownups get this test. Teach the parents about the test. Encourage the parents to attend during the test.
A B D E The nurse should provide teaching to both child and parents to reduce anxiety and promote adherence. Parents should be encouraged to attend an invasive procedure to reduce the anxiety for both the child and parents. If noninvasive testing is not available, the child may need to have local or general anesthesia. Anesthesia decreases pain and resistance and ensures for the child's safety.
The nurse is working in a primary care office. A client diagnosed with rheumatoid arthritis has returned for a follow-up visit. The client states that his pain is controlled on NSAIDs. The nurse would supply what education related to the disease process and supportive care? (Select all that apply.) Exercise in the shower because warm, moist heat promotes mobility Be aware of the adverse effects of prescribed medications Avoid exercise Take NSAIDs at regular intervals with food or milk Application of heat or cold to relieve pain
A B D E The priorities of care for the client with rheumatoid arthritis are supportive care and education. Taking NSAIDs at regular intervals will provide continued control of pain and discomfort. Taking NSAIDs with food or milk will decrease the incidence of gastrointestinal upset. Clients should consume a well-balanced diet, use the application of heat and cold for pain, exercise in the shower because warm, moist heat promotes mobility; be aware of adverse effects of medications; lose weight if necessary; follow prescribed physical therapy; avoid smoking; and use muscle-strengthening exercises.
The nurse is volunteering in one of the local free autoimmune disease clinics. The next client was recently diagnosed with rheumatoid arthritis. What are the goals of care for clients with rheumatoid arthritis? (Select all that apply.) Reduce pain Reduce inflammation Cure the disease Preserve function Prevent deformity
A B D E The treatment goals for clients with rheumatoid arthritis are to reduce pain, reduce inflammation, preserve function, and prevent deformity. There is no cure for rheumatoid arthritis.
The nurse is caring for a client with inflammatory bowel disease who is being treated with corticosteroids. Which information would the nurse provide for the client about the medications? (Select all that apply.) Reduce intake of foods high in sodium Take with food or at mealtimes It may cause low blood pressure. Expect weight loss Take medication consistently and do not stop abruptly
A B E Corticosteroids should be taken with food or at mealtimes to reduce the gastrointestinal side effects. A client taking corticosteroids tends to retain fluid, and sodium tends to exacerbate the retention. Therefore, the client should reduce the intake of foods that are high in sodium. Corticosteroids should be taken consistently and not be stopped abruptly to reduce the possibility of adrenal shutdown. A client taking corticosteroids tends to gain, not lose, weight. A client taking corticosteroids tends to have high, not low, blood pressure.
A nurse is caring for a client with peptic ulcer disease (PUD) who asks the nurse, open double quote"I don't understand how I can help to prevent my ulcers from recurring.close double quote" What is the nurse's best response? (Select all that apply.) open double quote"Be cautious with your intake of over-the-counter pain medications.close double quote" open double quote"Stop smoking.close double quote" open double quote"Eliminate all alcohol intake.close double quote" open double quote"Eliminate all high-fat foods from your diet.close double quote" open double quote"Reduce your stress as much as possibl
A B E Educating the client regarding the prevention of PUD should include: smoking cessation, stress reduction, and education about the use of OTC NSAIDs. It is not necessary for the client to completely eliminate alcohol. Although high-fat foods are not recommended for a healthy diet, they have not been shown to cause PUD.
Which are systemic manifestations of inflammation? (Select all that apply.) Respiratory rate 22 breaths per minute Heart rate 104 beats per minute Blood pressure 148/88 mmHg White blood cell count 4000/mm3 Oral temperature 101degrees°F
A B E Systemic manifestations of inflammation include an oral temperature greater than 100.4degrees°F, respiratory rate greater than 20 breaths per minute, and heart rate greater than 90 beats per minute. There is no specific parameter for blood pressure and systemic inflammation. A white blood cell count of 4000/mm3 is a low normal value and does not indicate the presence of inflammation. Next Question
What home care teaching is needed when surgery is not performed for acute appendicitis? (Select all that apply.) Ingesting a diet as tolerated Increasing physical activity Recognizing manifestations of infection Notifying the physician with changes Avoiding aspirin products
A C D Home care for the client with appendicitis who does not have surgery includes teaching the client about resuming a nutritious diet as tolerated, recognizing the signs and symptoms of infection, and when to seek treatment. Aspirin products do not need to be avoided. Physical activity does not need to be increased. OK
The nurse is planning care for a client with ulcerative colitis. Which characteristics associated with ulcerative colitis will the nurse recognize? (Select all that apply.) Attacks last 1 to 3 months. It affects the mucosa and submucosa of the small intestine. A secondary peak of ulcerative colitis occurs between the ages of 40 and 50 years. Mild to moderate symptoms are present. The onset is usually insidious.
A D E Attacks of ulcerative colitis usually last 1 to 3 months. These attacks occur at intervals over months to years. Ulcerative colitis, a chronic inflammatory bowel disease, affects the mucosa and submucosa of the colon and rectum, not the small intestine. A secondary peak of ulcerative colitis occurs between the ages of 60 and 80 years, not 40 and 50 years. The onset of ulcerative colitis is usually insidious. Most clients with ulcerative colitis have mild to moderate symptoms with six or fewer stools per day.
The nurse is admitting a client with ulcerative colitis who is scheduled for surgery. The client tells the nurse that he is having his bowel removed and will have a temporary ostomy for 2 to 3 months. Which upcoming surgical procedure is the client describing? Strictureplasty Total colectomy ileal pouch-anal anastomosis (IPAA) Gastric resection Pyloroplasty
B A total colectomy IPAA is a treatment for a client with ulcerative colitis. It entails the removal of the entire colon and rectum and the formation of a temporary or loop ileostomy at the same time. The ileostomy is used for 2 to 3 months. A strictureplasty is used to treat bowel strictures and does not involve the removal of the bowel or creation of an ostomy. A gastric resection is the removal of part of the stomach, not the bowel. It does not involve the creation of an ostomy. A pyloroplasty is a surgical procedure to widen the opening of the pyloric valve at the lower portion of the stomach. It does not involve the removal of the bowel or the creation of an ostomy.
Which is the most common inflammatory disorder in the United States? Appendicitis Arthritis Ulcerative colitis Nephritis
B Arthritis is the most common inflammatory disorder and the leading cause of disability in the United States. Nephritis, appendicitis, and ulcerative colitis have an inflammatory component within the disease process. Next Question
The nurse is caring for Ms. Ruiz, a client recently diagnosed with rheumatoid arthritis. Ms. Ruiz is being seen by the primary care provider for a follow-up visit after a recent hospitalization. The nurse prepares to assess Ms. Ruiz. Which clinical manifestation found during the assessment process supports this client's diagnosis? Increased energy Low-grade fever Morning stiffness that lasts for thirty minutes Weight gain over the last several months
B Clients diagnosed with rheumatoid arthritis will often have a low-grade fever. This finding supports the client's diagnosis. Weight loss, morning stiffness that lasts more than one hour, and fatigue are other symptoms that support this diagnosis. Next Question
The nursing student is preparing an educational handout for the parents of a client with juvenile idiopathic arthritis (JIA). Based on the etiology, risk factors, and clinical manifestations of the disease, which topic will be addressed in the handout? Teaching about the permanent and progressive nature of the disorder. Teaching about the importance of monitoring growth rates in children. Teaching about the frequency of the disease: JIA is more frequent in boys than girls. Teaching about the symptoms: JIA can affect multiple joints and organs and clients might experience acromegaly.
B Clients with JIA need to be educated about the etiology, risk factors, and clinical manifestations of the disease. Teaching the children's parents about the monitoring of growth rates is important for proper development. JIA is more frequent in girls than boys. Although JIA can affect multiple organs and joints, it does not result in acromegaly (a condition in which there is too much growth hormone and the body tissues get larger over time). 70% of children experience remission of the disease by adulthood.
While eating a peanut butter sandwich as a bedtime snack, the nurse observes a client begin to wheeze and complain of dizziness. What should the nurse do first? Notify anesthesia for intubation. Prepare to administer epinephrine. Provide an antihistamine. Lower the head of the bed.
B Epinephrine is the first line of treatment for an anaphylactic reaction. Epinephrine dilates the airways and narrows the blood vessels to counteract the allergic response. An antihistamine may be provided immediately after an anaphylactic response. The head of the bed should be raised to ensure adequate lung expansion. Notifying anesthesia for intubation might be premature. The client needs to receive epinephrine first to counteract the effect of the peanut allergy.
The nurse is preparing to provide newly prescribed anti-inflammatory medication to a 33-year-old female client with systemic lupus erythematosus. What should the nurse ask this client before providing the medication? open double quote"Does your health insurance have a pharmacy plan?close double quote" open double quote"Is it possible that you are pregnant?close double quote" open double quote"Do you need to drive or operate electronic machinery?close double quote" open double quote"How many hours of sleep do you get each night?close double quote
B Medications used to treat inflammation include NSAIDs, glucocorticosterids, opioid analgesics, and natural products such as omega-3 fish oil. Each of these medication classifications are Pregnancy Category C. The nurse needs to ask the client if pregnancy is a possibility before providing the medication. These medications do not impact sleep. There is no reason to assess the client's health insurance for a pharmacy plan. These medications do not cause drowsiness.
During a physical assessment, the nurse becomes concerned that 75-year-old Hattie Jackson is experiencing acute appendicitis. Which assessment finding supports this diagnosis? Hyperactive bowel sounds Confusion 2 cm mass in right lower abdominal quadrant Pain with abduction of the left hip
B The leading manifestation of acute appendicitis in the older adult is confusion. Hyperactive bowel sounds are not a manifestation of acute appendicitis. Appendicitis is not associated with a palpable mass. Appendicitis is associated with an increase in abdominal pain that occurs when the right hip is either extended or internally rotated. Next Question
A nurse is caring for Mohammed Hassad, a 34-year-old man who has a 20-pack-year history of smoking and works as an construction worker. Recently, Mohammed has been complaining of hungerlike pain in his upper abdomen that occurs in the middle of the night but seems to subside once he eats. Mr. Hassad's healthcare provider has ordered an upper GI series to aid in diagnosing his condition. What instruction will Mr. Hassad's nurse provide to Mohammed regarding this diagnostic test? "This procedure is a type of biopsy." "This procedure is a type of x-ray that uses contrast." "This procedure requires sedation." "This procedure requires an IV
B The upper GI series uses barium as a contrast medium and can detect 80%-90% of peptic ulcers via x-ray. The other statements are incorrect. Next Question
`The nurse on the inpatient orthopedic unit is preparing the client for surgery. The client was admitted for right knee joint replacement surgery. The nurse wants to use the right teaching handouts for this type of surgery. Which surgical teaching handout is the nurse going to use? Arthrodesis Arthroplasty Synovectomy Arthroscopy
B Arthroplasty (total joint replacement) is used in severe joint destruction and bone deformities. Arthrodesis (joint fusion) stabilizes joints such as ankles, wrist and cervical vertebrae. Synovectomy is an excision of the synovial membrane and is used early in the disease to provide pain relief and decrease inflammation. Arthroscopy is a minimally invasive surgical procedure during which an endoscope is inserted into the joint trough a small incision for examination or treatment of the joint.
The mother of a 10-year-old client is pleased to hear that the child's blood work for inflammation was negative but asks why the child continues to have symptoms. Which response by the nurse is the most appropriate? open double quote"The child is experiencing a mild case of inflammation.close double quote" open double quote"Normal results are common in children with inflammation.close double quote" open double quote"The level of inflammation has subsided.close double quote" open double quote"Blood tests are not useful to diagnose the presence of inflammation.close double quote
B Blood tests will be used when assessing a child with an inflammatory disorder. Caution must be taken when interpreting the results of blood tests for these clients since normal blood test results are common for children with inflammatory disorders. A normal blood test in a child with inflammation does not mean that the level of inflammation has subsided or the child is experiencing a mild case of the inflammation. Blood tests are useful to diagnose the presence of inflammation.
The mother of 4-year-old Kerry Washington asks why the nurse is concerned about the client's breathing after she was stung by a bee. Which response by the nurse is the most appropriate? "Children have a longer epiglottis which can become easily obstructed after a bee sting." "Bee stings can cause a release of inflammatory substances that can lead to airway obstruction." "The longer and wider trachea in children can cause excess mucous to accumulate after a bee sting." "The larynx is in the posterior position in children which can become swollen after a bee sting."
B In the event of a rapid release of inflammatory mediators, anaphylaxis can occur. This acute response to inflammatory mediators can lead to airway obstruction, vascular collapse, and death. The most common causes of anaphylaxis include insect stings. Children have a shorter epiglottis. In children the larynx is in the anterior position. The trachea is shorter and more narrow in children. Next Question
A nurse is participating in a community health fair. Which statement made by a participant indicates the teaching about rheumatoid arthritis was understood? "Rheumatoid arthritis results in increased uric acid due to impaired purine metabolism." "Rheumatoid arthritis is an autoimmune disorder and has associated genetic factors." "Rheumatoid arthritis is the most common arthritis in the United States and may affect only one joint." "Rheumatoid arthritis causes joint inflammation related to a history of joint trauma."
B The etiology of rheumatoid arthritis includes autoimmune disorders and genetic factors. The etiology of rheumatoid arthritis does not include joint trauma or increased uric acid. Osteoarthritis, not rheumatoid arthritis, is the most common arthritis in the United States and may affect only one joint.
The nurse notes that a client is prescribed a dietary consult as part of treatment for inflammation. What should the nurse expect to assess in this client? Cool and mottled extremities Body mass index 42 Reduction in pedal pulses Blood pressure 148/90 mmHg
B The nurse collaborates with other healthcare professionals when planning and providing care to the client with inflammation. A nutritionist may be consulted for inflammation caused by obesity. A body mass index of 42 is would be within the range of obesity. A nutritionist would not be consulted for a reduction in pedal pulses, cool and mottled extremities, or a blood pressure of 148/90 mmHg.
A nurse is caring for a client who complains of diarrhea and epigastric pain. The client tells the nurse that he has recently been diagnosed with a gastrinoma. What additional condition does the nurse suspect the client has? Sick sinus syndrome Zollinger-Ellison syndrome Gastric ulcer Esophageal ulcer
B The nurse would suspect that the client has Zollinger-Ellison syndrome because of the presence of a gastrinoma, which is present in this condition. The client may have a gastric or esophageal ulcer; however, the gastrinoma is unique to Zollinger-Ellison syndrome. Sick sinus syndrome is cardiac condition which does not manifest with a gastrinoma, diarrhea, or epigastric pain.
A nurse is planning care for Peter Carroll, a 55-year-old man who was recently diagnosed with peptic ulcer disease (PUD). Peter is hospitalized after several days of nausea and vomiting in addition to complaining of epigastric pain. When planning care for Mr. Carroll, which nursing diagnosis takes priority? imbalanced nutrition: less than body requirements risk of deficient fluid volume disturbed sleep pattern risk for impaired skin integrity
B While Mr. Carroll may have imbalanced nutrition: less than body requirements and disturbed sleep pattern, these do not take priotiry. Mr. Carroll's greatest concern is risk for deficient fluid volume due to vomiting. He is not at risk for impaired skin integrity. OK
The nurse is planning care for a client with inflammatory bowel disease. What problem is priority for the nurse to address when caring for this client? Impaired skin integrity Impaired fluid balance Fatigue Impaired nutrition
B While all choices are problems, which should be addressed in planning care for the client with inflammatory bowel disease, impaired fluid balance is priority as this problem may be life-threatening if not addressed.
A client diagnosed with rheumatoid arthritis (RA) is being seen in an outpatient clinic. Which diagnostic test results would indicate presence of RA? (Select all that apply.) Negative antinuclear antibodies Negative rheumatoid factor (RF) Positive anti-citrulline antibodies Increased erythrocyte sedimentation rate (ESR) Decreased bone density
B C D Increased ESR would indicate presence of inflammation in the joints, which occurs with rheumatoid arthritis. Rheumatoid arthritis may be present with a negative RF. A positive anti-citrulline antibody test indicates the presence of RA in the absence of RF. Positive, not negative, antinuclear antibodies indicate presence of RA. Decreased bone density is found in clients with psoriatic arthritis, not with RA.
The nurse is caring for a client is admitted for a burst appendix. Which information is appropriate for the nurse to provide to this client? (Select all that apply.) A laparoscopic appendectomy will be performed. Intravenous fluids will be provided. Antibiotic medication will be provided before and after the surgery. A laparotomy will be performed. Pain medication will be provided after the surgery.
B C D E For a burst appendix, a laparotomy will be performed. The client will receive antibiotics before and after the surgery to prevent the development of infection from fecal contents, which have spilled into the abdominal cavity. Intravenous fluids will be provided to maintain fluid and electrolyte balance. Pain medication will be provided after the surgery. A laparoscopic appendectomy is performed for clients whose appendix has not burst.
The client was admitted to an inpatient unit for uncontrolled pain caused by rheumatoid arthritis (RA). Which ongoing problems will the client have in relation to the RA? (Select all that apply.) Weight gain Chronic pain Poor self-esteem Fatigue Ineffective role performance
B C D E Ongoing problems related to RA include chronic pain, fatigue, poor self-esteem related to body image issues, and ineffective role performance. Weight loss, not weight gain, is an issue for clients with RA.
The nurse is preparing to conduct a physical examination on a client experiencing vague abdominal pain. What should the nurse include in this assessment? (Select all that apply.) Presence of blood in the stool Contour of the abdomen Presence of abdominal pain on palpation Current body temperature Characteristics of bowel sounds
B C D E When conducting the physical assessment on a client with appendicitis, the nurse should include abdominal contour, current body temperature, characteristics of bowel sounds, and whether the client is experiencing tenderness to light palpation. Blood in the stool is not an area to assess in the client with appendicitis.
A nurse is caring for a client with inflammatory bowel disease and is planning for the most appropriate client interventions. Which nursing diagnosis best supports the interventions needed for the client with inflammatory bowel disease? (Select all that apply.) Acute confusion Diarrhea Risk for deficient fluid volume Risk for injury Constipation
B C E The client with inflammatory bowel disease is at greatest risk for deficient fluid volume, diarrhea and constipation. This client does not generally display acute confusion or risk for falls.
While conducting a health history, the nurse determines that a client is at risk for developing an inflammatory disorder. What did the nurse most likely assess during the health history? (Select all that apply.) Treated with antispasmodics for back strain 3 months ago. Hospitalized with gallstones 6 months ago. Received surgery for carpal tunnel syndrome 2 years ago. Experiences allergic rhinitis every spring and fall. Treated for peptic ulcer disease within the last year.
B D E Many disorders have an inflammatory component. Examples of these disorders include gallbladder disease, peptic ulcer disease, and allergic rhinitis. Carpal tunnel and back strain do not have an inflammatory component.
he nurse is caring for a client with chronic inflammatory bowel disease who is prescribed antibiotics to treat the condition. The client reports an allergy to sulfa. Which medication orders will the nurse question? (Select all that apply.) Ciprofloxacin (Cipro) Olsalazine (Dipentum) Clarithromycin (Biaxin) Sulfasalazine (Azulfidine) Mesalamine (Asacol, Rowasa)
B D E Mesalamine is a sulfa-based medication that has the same active ingredients as sulfasalazine and therefore should not be administered to a client with a sulfa allergy. Cipro is a fluoroquinolone, not a sulfa drug, and could be given to a client with a sulfa allergy. Sulfasalazine is a sulfonamide and therefore should not be administered to a client with a sulfa allergy. Olsalazine is a sulfa-based medication that has the same active ingredients as sulfasalazine and therefore should not be administered to a client with a sulfa allergy. Clarithromycin is a macrolide, not a sulfa drug, and could be given to a client with a sulfa allergy.
The nurse is evaluating a client recovering at home after an emergency appendectomy. Which observations indicate that self-care has been effective? (Select all that apply.) Client snacks on pretzels and club soda during the visit Client plans to recover at home until cleared by the surgeon Client requests a prescription for more pain medication Client performs abdominal wound care appropriately Client uses a pillow to splint incision before coughing
B D E Observations that indicate that the client is appropriately providing self-care after an appendectomy include using a pillow to splint the incision before coughing, performing wound care appropriately, and planning to recover at home until cleared by the surgeon. Observations that indicate that self-care could improve include the need for more pain medication and ingesting a less-than-nutritious snack.
The mother of a 3-year-old child newly diagnosed with an allergy says that she has the same allergy as the child but the child seems to have worse symptoms. What should the nurse explain to the mother? open double quote"Adults have faster metabolisms than children.close double quote" open double quote"Adults have more chemicals that encourage inflammation.close double quote" open double quote"Children have more chemicals that encourage inflammation.close double quote" open double quote"Children have more chemicals that block inflammation.close double quote
C Differences within the pediatric client that influence the inflammatory response include an increased production of inflammatory mediators and less production of anti-inflammatory mediators. Children have faster metabolisms than adults. Adults do not have an increased production of inflammatory mediators.
What is a strategy to prevent the onset of an inflammatory response? Take aspirin prophylactically. Avoid using anything with latex. Avoid a trigger. Engage in frequent hand washing.
C A major strategy to prevent the onset of an inflammatory response is to avoid a known trigger for the response. Prophylactic aspirin, avoiding latex, and engaging in frequent hand washing are not strategies to prevent the onset of an inflammatory response. Next Question
A nurse is caring for a client with congestive heart failure (CHF) who has recently been diagnosed with peptic ulcer disease (PUD). The client takes digoxin to manage symptoms associated with CHF. The healthcare provider has ordered antacids for the client to help heal the gastric mucosa as a result of PUD. What is true regarding antacids and digoxin? Antacids do not affect digoxin. Antacids cancel all therapeutic effects of digoxin. Antacids interfere with the absorption of digoxin. Antacids absorb digoxin's therapeutic effect.
C Antacids interfere with the absorption of digoxin. Antacids do not cancel all therapeutic effects of digoxin, nor do antacids absorb digoxin's therapeutic effect.
What will be included in the health history of the client with irritable bowel disease? Weight General appearance Current medications Vital signs
C Current medications would be included in the client health history. All other answer choices are part of the client physical assessment, not health history. OK
Which nursing diagnosis is most appropriate for a client with peptic ulcer disease (PUD)? disturbed body image fluid volume excess disturbed sleep pattern anxiety
C Disturbed sleep pattern is the most appropriate nursing diagnosis for a client with peptic ulcer disease (PUD). Pain associated with PUD often occurs during the night, placing the client with PUD at risk of a disturbed sleep pattern. The other diagnoses do not specifically pertain to the client with PUD. Next Question
A client being treated for a leg wound says that it must be improving because of the milky white discharge. What should the nurse explain to the client about the wound drainage? open double quote"This type of drainage is only seen in healing wounds.close double quote" open double quote"This drainage means you have a mild inflammation.close double quote" open double quote"This type of drainage is seen with an infection.close double quote" open double quote"This exudate means blood vessels have been ruptured.close double quote
C Drainage that is milky in appearance is considered purulent and is associated with an infection. This does not mean that the wound is healing. Serous drainage is associated with mild inflammation and is clear or straw-colored with a thin watery consistency. Hemorrhagic drainage contains blood from ruptured blood vessels and is thick and red. It is associated with infection or injury.
A nurse is planning care for a client with peptic ulcer disease (PUD) who presents with intractable nausea and vomiting and epigastric pain. What is an appropriate outcome for this client? The client will maintain a urine output of at least 0.1 mL/kg/hr. The client will have minimal bleeding. The client will maintain adequate fluid volume. The client will report pain as 5 or less on standard pain scale.
C For the client with PUD who is experiencing vomiting, an appropriate outcome would be to maintain fluid volume. The client should have a urine output of at least 0.5 mL/kg/hr, no bleeding, and report a level of pain that is acceptable for the client.
What is true regarding the diagnostic testing used for peptic ulcer disease (PUD)? In Zollinger-Ellison syndrome, gastric acid levels are decreased. The upper GI series requires sedation. Gastroscopy allows visualization of the esophageal, gastric, and duodenal mucosa, and direct inspection of ulcers. The gastric analysis can detect 80%dash-90% of peptic ulcers via x-ray.
C Gastroscopy allows visualization of the esophageal, gastric, and duodenal mucosa, and direct inspection of ulcers. The upper GI series does not require sedation. In Zollinger-Ellison syndrome, gastric acid levels are increased. The upper GI can detect 80%dash-90% of peptic ulcers via x-ray.
Why is a heating pad not applied to the abdomen for acute appendicitis? Increases the need for fluids Increases spread of infection Encourages perforation Reduces white blood cell count
C Heat should not be applied to the abdomen since this increases circulation to the appendix and could cause perforation. It is not true that heat is avoided in acute appendicitis because it increases the need for fluids, increases the spread of infection, or reduces the white blood cell count. Next Question
A nurse is providing discharge orders for a client with peptic ulcer disease (PUD). What statement will the nurse include regarding client diet and lifestyle modifications for the prevention of PUD? open double quote"Restrict your diet to nonfat and sugar-free foods.close double quote" open double quote"Be sure to eat a bland diet to avoid a flare-up of PUD.close double quote" open double quote"Do not skip any meals.close double quote" open double quote"You must eliminate intake of all alcohol.close double quote
C Nonpharmacologic therapy for the treatment of PUD includes education of diet and lifestyle modifications to avoid a flare-up of the disease. The nurse should instruct the client to eat meals at regular intervals. Mild alcohol intake is acceptable. Bland or restrictive diets are not necessary.
A nurse manager is teaching a group of staff nurses about the complications related to peptic ulcer disease (PUD). What statement regarding peritonitis will the nurse manager include in the teaching? Chemical peritonitis occurs between 6 and 12 hours after perforation, when the acids from the stomach or duodenum create an inflammatory response. Bacterial peritonitis happens immediately after perforation as bacteria proliferate in the peritoneal cavity. Peritonitis occurs when the ulcer penetrates through the mucosal wall, causing gastric or duodenal contents to enter the peritoneum. Peritonitis occurs due to the obstruction of the pyloric region of the stomach and duodenum. The increased pressure from the obstruction leads to peritonitis.
C Peritonitis occurs due to the ulcer penetrating through the mucosal wall, causing gastric or duodenal contents to enter the peritoneum. Chemical peritonitis is immediate after perforation. Bacterial peritonitis occurs between 6 and 12 hours after perforation. Gastric outlet obstruction, not perforation, occurs due to the obstruction of the pyloric region of the stomach and duodenum.
The nurse is providing discharge instructions for a client with peptic ulcer disease (PUD). What will the nurse include in teaching? Importance of using over-the-counter analgesics for mild pain Importance of rest if client feels dizzy Importance of stress management techniques Importance of continuing treatment until symptoms of PUD subside
C The nurse should discuss the importance of stress management with the client, as stress can contribute to the development of peptic ulcers. The client should continue to take medications used to treat the disease even after symptoms subside. The client should be told to avoid aspirin and other over-the-counter NSAIDs. The nurse should instruct the client to seek medical attention if the client feels dizzy.
While reviewing laboratory results, the nurse notes that one client has an elevated C-reactive protein level. What should the nurse identify as a priority for this client? Teaching to reduce aggravation of inflammation after discharge Administration of medications to reduce symptoms of inflammation Interventions to rule out the diagnosis of liver failure Actions to reduce localized inflammation
C The C-reactive protein (CRP) is a protein that is produced by the liver and fat cells in response to inflammation. When liver failure is not present, an increase in this blood level indicates inflammation somewhere in the body. Since it is not known if the client has liver failure, the priority would be to provide interventions to rule out the presence of liver failure. Once liver failure has been ruled out, other actions might be appropriate such as teaching to avoid aggravating the inflammation and providing medications to reduce inflammation. There is no evidence to support that the client is experiencing localized inflammation.
Alicia Meritt, a 22-year-old woman with complaints of fatigue and persistent diarrhea, is suspected of having Crohn disease and is scheduled to have a colonoscopy. Which finding would Alicia's nurse expect to see from the colonoscopy if Alicia has Crohn disease? Red, edematous, and friable tissue Inflammation that begins at the crypts of Lieberkühn in the distal large intestine and rectum Cobblestone appearance of bowel Continuous inflammatory lesions of bowel
C With Crohn disease, the bowel lumen begins to appear as "cobblestones," as fissures and ulcers surround islands of intact tissue over edematous submucosa. The inflammatory lesions are not continuous and often occur as "skip" lesions with intervals of normal-appearing bowel. Clients with ulcerative colitis have a bowel that appears red, edematous, and friable. The inflammation of ulcerative colitis begins at the crypts of Lieberkühn in the distal large intestine and rectum. Next Question
The nurse is reviewing the blood test results conducted on Carmen Pataglia, a 68-year-old female with rheumatoid arthritis. On which laboratory value should the nurse focus to determine the presence of chronic inflammation in Ms. Pataglia? Lymphocytes 30% Neutrophils 40% Monocytes 10% Basophils 0.6%
C Within the white blood cell count differential, monocytes greater than 4 to 6% indicate a chronic inflammatory process which is consistent with rheumatoid arthritis. Basophils are normally between 0.4 to 1%. Neutrophils are normally between 50 and 70%. A value below 50% indicates bone marrow depression or a viral infection. Lymphocytes are normally between 25 and 35%. Next Question
The nurse is performing an assessment on a client who complains of joint pain and stiffness. The client was admitted to the unit with a diagnosis of rheumatoid arthritis. Which reported signs and symptoms from the client interview would not be consistent with the clinical manifestations of rheumatoid arthritis? "I am in so much pain in the morning! It is very hard for me to get out of bed and start my day. I can hardly move my legs; my knees feel like they are frozen." "I am just tired all the time, and feel very weak." "I have trouble with walking because of the pain, and when I am finally done with my morning chores and sit down; my knees get so stiff I can hardly get up after I rested." "Whenever my disease gets worse, my joints get red, hot and swollen."
C Osteoarthritis, not rheumatoid arthritis, is characterized by pain with activity and stiffness following the activity. Pain and stiffness on arising, lasting more than 1 hour; red, hot swollen joints; and fatigue and weakness are all signs and symptoms of rheumatoid arthritis.
What diagnostic tests are used for rheumatoid arthritis? (Select all that apply.) Antinuclear antibody (ANA) test Kidney biopsy C-reactive protein (CRP) Erythrocyte sedimentation rate (ESR) Renal function test
C D Laboratory tests used to diagnose rheumatoid arthritis include C-reactive protein levels and erythrocyte sedimentation rate. The antinuclear antibody (ANA) test, renal function test, and kidney biopsy are diagnostic tests for systemic lupus erythematosus, not rheumatoid arthritis. Next Question
A nurse is caring for a client with peptic ulcer disease (PUD) who is taking a proton pump inhibitor (PPI) for the treatment of PUD. Prior to administering this medication, what does the nurse need to know about a PPI? (Select all that apply.) It stimulates gastric mucosal defenses. It inhibits histamine binding to the receptors on the gastric parietal cells to reduce acid secretion. It may be used in combination with two antibiotics to eliminate H. pylori. It stimulates secretion of mucus, bicarbonate, and prostaglandin. It inhibits an acid-secreting enzyme to reduce gastric acid content.
C E A proton pump inhibitor (PPI) inhibits an acid-secreting enzyme to reduce gastric acid content. A PPI may be used in combination with two antibiotics to eliminate H. pylori. Antacids stimulate gastric mucosal defenses. A histamine2-receptor blocker inhibits histamine binding to the receptors on the gastric parietal cells to reduce acid secretion. Sucralfate stimulates secretion of mucus, bicarbonate, and prostaglandin.
The nurse is preparing teaching materials for the parents of a 7-year-old child newly diagnosed with a severe allergy to dust. What should the nurse include in this teaching? Ensure all rooms in the home are carpeted. Avoid exposure to all animals and pets. Place plants on high shelves in the home. Remove stuffed toys from the home.
D A major strategy to prevent the onset of an inflammatory response is to avoid a known trigger for the response. Clients with a history of hypersensitivity to substances such as dust should avoid them. Stuffed toys accumulate dust and should be removed from the home. Animals and pets are not associated with a dust allergy. Plants are not associated with a dust allergy. Carpeting will accumulate dust and should be removed from the home.
Why does anaphylaxis occur? Leukocytes line up within the injured vessels Damaged tissues are replacement by other cells Release of heparin and histamine Rapid release of inflammatory mediators
D Anaphylaxis occurs when inflammatory mediators are rapidly released. Histamine and heparin cause blood flow to increase to the body area. The combination of these two chemicals leads to redness and swelling associated with inflammation. Regeneration is the replacement of tissues by other cells that are the same or similar in structure and function. The lining up of leukocytes along the inner surface of blood vessels is margination which occurs during the first phase of the inflammatory process. Next Question
The nurse is evaluating teaching provided to a client with chronic inflammation. Which client statement indicates that teaching has been successful? open double quote"I lay in bed most days.close double quote" open double quote"I ignore the pain until I can't stand it anymore.close double quote" open double quote"I think it would be best if I just died right now.close double quote" open double quote"I limit doing things that aggravate the pain.close double quote
D For chronic inflammation, the client should be instructed to use coping techniques to minimize effects of physical limitations and emotional distress and disease-appropriate methods to reduce the impact of the disease on the client's lifestyle. Evidence that teaching has been effective is the patient limiting activities that aggravate the pain. Lying in bed, wishing to die, and ignoring the pain all indicate that teaching has not been effective.
Which pharmacologic therapy is used in the treatment of peptic ulcer disease (PUD) for reducing gastric acid content? Sucralfate Bismuth compounds Antacids Histamine2-receptor blockers
D Histamine2-receptor blockers are used for reducing gastric acid content in the treatment of PUD. Sucralfate, bismuth compounds, and antacids are all used in the treatment of PUD; however, their function is to protect the gastric mucosa, not reduce gastric acid content. Next Question
Manny Domingo, a 45-year-old gardener is being treated for severe inflammation of the right lower leg. Why should the nurse teach Manny infection control techniques prior to being discharged? An abnormal inflammatory response can cause airway obstruction. Temporary or long-term impairment of function can occur. The body will perceive normal tissue as being foreign. Pathogens could cause the inflammatory process to become worse.
D Pathogens trigger the activation of the inflammatory and immune responses. White blood cells are attracted to the pathogen and increase their production with the goal of destroying the invading pathogen. The body perceiving normal tissue as being foreign explains the impact of immunity on inflammation. Impairment in function is a potential effect of inflammation, but it is a concept that is not directly related to the impact of infection on the inflammatory process. An abnormal inflammatory response causing airway obstruction explains the impact of oxygenation on inflammation. Next Question
The nurse is caring for a client who has chronic inflammatory bowel disease. The client tells the nurse the she is taking nutritional supplements that help reduce the inflammation. Which supplements are used in the treatment of chronic inflammatory bowel disease? Vitamin K tablets Glucose tablets Energy drinks Probiotics
D Probiotics help reduce inflammation in the bowel and would be used in the treatment of inflammatory bowel disease. Glucose is needed for cellular energy. It is not considered an anti-inflammatory agent. Vitamin K is used for clotting. It is not considered an anti-inflammatory agent. Energy drinks contain sugars and electrolytes. They are not considered anti-inflammatory agents.
Your client, Alexandra Kowalski, is a 16-year-old cross-country runner diagnosed with juvenile idiopathic arthritis. Which diagnostic test does the nurse anticipate will be ordered for Alexandra? Coagulation tests Urine cultures Electrolyte panel Erythrocyte sedimentation rate
D The diagnosis of JIA will be identified based on a combination of diagnostic tests. Erythrocyte sedimentation rate is a laboratory test that will be used for the diagnosis of arthritis. Urine cultures, coagulation tests, and electrolyte panels are not used for the diagnosis of JIA.
During an assessment, the nurse becomes concerned that a client is experiencing early signs of acute appendicitis. Which assessment finding causes this concern? Mid-epigastric abdominal pain aggravated by bending forward Mid-lower abdominal pain aggravated by palpating over the bladder Left lower quadrant abdominal pain aggravated by bending the left leg Right lower quadrant abdominal pain aggravated by coughing
D The first manifestation of acute appendicitis is continuous, mild, generalized pain or upper abdominal pain. The pain eventually intensifies and localizes in the right lower abdominal quadrant. The pain is aggravated by moving, walking, or coughing. Mid-epigastric, left lower, or mid-lower quadrant abdominal pain is not associated with acute appendicitis.
When does the onset of ulcerative colitis most commonly occur? Between the ages of 5 and 15 years Between the ages of 30 and 60 years Between the ages of 25 and 55 years Between the ages of 15 and 30 years
D The most common age of onset for ulcerative colitis is between 15 and 30 years, with a secondary peak between the ages of 60 to 80 years. The most common age of onset for ulcerative colitis is not between 5 and 15, 25 and 55, or 30 and 60 years. Next Question
A nurse is planning care for a client who is going to be admitted to the nurse's unit. The client has a diagnosis of peptic ulcer disease (PUD) and is complaining of nausea, heartburn, and epigastric pain. What nursing intervention will the nurse plan to implement? Listen to client's bowel sounds every shift. Allow client to have bathroom privileges. Insert a nasogastric tube upon client admission. Discourage the client from eating a nighttime snack.
D The nurse should discourage the client from eating a nighttime snack because this can exacerbate the client's condition. The client should maintain strict bed rest. The nurse should assess the client's abdomen every 4 hours. Inserting a nasogastric tube is a collaborative nursing intervention, requiring the order of the healthcare provider. The nurse will not automatically insert a nasogastric tube for all clients with PUD.
A clinic nurse is assessing a client with a history of rheumatoid arthritis. The nurse would anticipate which assessment finding? Multiple joints and organs affected, and may have high fever and rheumatoid rash Intermittent joint pain, mostly in the great toe Joint stiffness in the spine, hips, and knees Progressive joint stiffness and deformation
D The progressive joint stiffness and deformation is due to the fibrosis and calcification that occurs in the pathophysiology of rheumatoid arthritis. This client has rheumatic arthritis; therefore, the following choices are incorrect: Uric acid crystal formation in the joints causes the excruciating pain experienced by clients with gout. Osteoarthritis involves loss of joint elasticity, particularly of weight-bearing joints such as the knees, hips, and spine. Juvenile idiopathic arthritis (JIA) affects multiple joints and internal organs. Rheumatoid rash and fever can develop with JIA.
A nurse is caring for a client who has recently been diagnosed with peptic ulcer disease (PUD). The client asks the nurse, open double quote"My doctor told me I might have bacteria that is causing my ulcers. How will I know if I do?close double quote" What is the nurse's best response? open double quote"Your healthcare provider may order a skin test to determine the presence of H. pylori.close double quote" open double quote"Your healthcare provider may order an x-ray with contrast to visualize the H. pylori bacteria.close double quote" open double quote"Your healthcare provider may order a test to analyze your stomach contents.close double quote" open double quote"Your healthcare provider may order a breath test to determine the presence of H. pylori.close double quote
D The urea breath test is used to measure the urease produced by H. pylori bacteria. H. pylori are not detected with a skin test. A gastric analysis of stomach contents is ordered when the healthcare provider suspects Zollinger-Ellison syndrome. An upper GI uses barium as contrast for an x-ray to visualize the structures of the GI system, not to detect the presence of H. pylori.
Where is the most common site for peptic ulcers to develop? Large intestine Esophagus Duodenum Stomach
c Peptic ulcers may occur in any area of the GI tract exposed to acid-pepsin secretions, including the esophagus, stomach, and duodenum. The most common site for peptic ulcers to develop is the duodenum. Peptic ulcers do not occur in the large intestine. Next Question
An older client with a ruptured appendix and peritonitis wants to know why the abdomen is swollen. Which explanation by the nurse is the most appropriate? "I really don't know but I'll ask your doctor to explain it to you." "This health problem causes chronic constipation." "All of the fluids that you are ingesting are leaking into the abdominal area." "The contents of the appendix are causing inflammation of the abdominal cavity."
d When the appendix bursts, all of the infected contents of the appendix spread into the abdominal cavity. These contents cause inflammation and infection. The client's abdomen is not swelling because of chronic constipation. The nurse does not need to ask the physician to explain the health problem to the client. Fluids that the client is ingesting are not leaking into the abdominal cavity.
