Inflammation Prep U Questions

D) Continuously monitor pain

A boy is seen in the ER for possible appendicitis, what is a top priority nursing action? A) Administer saline to enemas to cleanse the bowels B) Apply heat to reduce pain C) Measure abdominal girth D) Continuously monitor pain

C)metabolic acidosis Diarrhea causes a bicarbonate deficit. With loss of the relative alkalinity of the lower GI tract, the relative acidity of the upper GI tract predominates, leading to metabolic acidosis. Loss of acid, which occurs with severe vomiting, may lead to metabolic alkalosis. Diarrhea doesn't lead to respiratory acid-base imbalances, such as respiratory acidosis and respiratory alkalosis.

A client with enteritis reports frequent diarrhea. What assessment should the nurse should anticipate? A)respiratory acidosis B)respiratory alkalosis C)metabolic acidosis D)metabolic alkalosis

D)Absent Since lack of bowel motility typically accompanies peritonitis, bowel sounds are absent. Therefore, the nurse will not observe mild, high-pitched, or hyperactive bowel sounds.

After assessing a client with peritonitis, how would the nurse most likely document the client's bowel sounds? A)Mild B)High-pitched C)Hyperactive D)Absent

A)Histamine Histamine causes dilation of arterioles and increases the permeability of venules. It acts at the level of the microcirculation by binding to histamine 1 receptors on endothelial cells and is considered the principal mediator of the immediate transient phase of increased vascular permeability in the acute inflammatory response. Arachidonic acid is a 20-carbon unsaturated fatty acid found in phospholipids of cell membranes. Release of arachidonic acid by phospholipases initiates a series of complex reactions that lead to the production of the eicosanoid family of inflammatory mediators (prostaglandins, leukotrienes, and related metabolites). Fibroblasts and cytokines are not the principal mediator of the transient phase of an acute inflammatory response.

During the acute inflammatory response, there is a period called the transient phase where there is increased vascular permeability. What is considered the principal mediator of the immediate transient phase? A)Histamine B)Arachidonic acid C)Fibroblasts D)Cytokines

D)inhibiting the aggregation of platelets. Salicylates inhibit production of prostaglandins, making pain receptors less likely to send the pain message to the brain. This reduction also is thought to account for the anti-inflammatory effect. Aspirin does also prolong the bleeding time by inhibiting the aggregation of platelets. This, however, does not have anything to do with decreasing pain in the client.

The nurse is aware that aspirin not only lowers the client's fever but can also reduce the pain the client is experiencing by: A)promoting the production of prostaglandins. B)inhibiting the production of prostaglandins. C)prolonging the bleeding time. D)inhibiting the aggregation of platelets.

B) Ulcerative colitis The presence of mucus and pus in the stool suggests ulcerative colitis. Watery stools are characteristic of small-bowel disease. Loose, semisolid stools are associated more often with disorders of the colon. Voluminous, greasy stools suggest intestinal malabsorption.

The nurse is conducting a gastrointestinal assessment. When the client reports the presence of mucus and pus in the stool, the nurse assesses for additional signs/symptoms of which disease/condition? A)Small-bowel disease B)Ulcerative colitis C)Disorders of the colon D)Intestinal malabsorption

C) Leukocytosis

The patient has altered LOC, fever, & abdominal distension. What will confirm the diagnosis of toxic megacolon? A) Bradycardia B) Splenomegaly C) Leukocytosis D) Constipation

A)viral set point. The amount of virus in the body after the initial immune response subsides is referred to as the viral set point, which results in an equilibrium between HIV levels and the immune response that may be elicited. During the primary infection period, the window period occurs because a person is infected with HIV but negative on the HIV antibody blood test. The period from infection with HIV to the development of antibodies to HIV is known as the primary infection stage. The amount of virus in circulation and the number of infected cells equals the rate of viral clearance.

The term used to define the amount of virus in the body after the initial immune response subsides is A)viral set point. B)window period. C)primary infection stage. D)viral clearance rate.

D) Upper respiratory infections

When discussing diseases of the middle ear, the nursing instructor distinguishes the different types of otitis media. What generally causes purulent otitis media? A) Irritation associated with respiratory allergies and enlarged adenoids B) Bronchial tree C) Outer ear D) Upper respiratory infections

C) 7 to 10 days

When preparing a teaching plan for a client diagnosed with otitis externa, the nurse instructs the client to avoid any water sport for which duration? A)3 to 5 days B)5 to 7 days C)7 to 10 days D)10 to 14 days

C)The clusters of ulcers take on a cobblestone appearance. The clusters of ulcers take on a cobblestone appearance. It is characterized by remissions and exacerbations. The pain is located in the lower right quadrant. The lesions are not in continuous contact with one another and are separated by normal tissue.

Which is a true statement regarding regional enteritis (Crohn's disease)? A)It has a progressive disease pattern. B)It is characterized by pain in the lower left abdominal quadrant. C)The clusters of ulcers take on a cobblestone appearance. D)The lesions are in continuous contact with one another.

D) Augmentin

Which of the following is NOT a causative agent for a peptic ulcer? A) NSAIDS B) Heliobactor Pylori C) Physiological Stress D) Augmentin

A)Histamine

A deficiency in which of these would result in an inhibition of the inflammatory response? A)Histamine B)Helper T cells C)B cells D)Vitamin K

C) Adhesions Adhesions are scar tissue that forms as a result of inflammation and infection. Adhesions are the most common cause of small-bowel obstruction, followed by tumors, Crohn's disease, and hernias. Other causes include intussusception, volvulus, and paralytic ileus.

What is the most common cause of small-bowel obstruction? A)Hernias B)Neoplasms C)Adhesions D)Volvulus

D)high purine To control uric acid calculi, the client would follow a low-purine diet, which excludes high-purine foods such as organ meats. The other diets do not control uric acid calculi.

When providing discharge teaching for a client with uric acid calculi, the nurse would include an instruction to avoid which type of diet? A)low calcium B)low oxalate C)high oxalate D)high purine

D) Swelling

Which manifestations of inflammation is caused by increased capillary permeability? A) Increased production of leukocytes B) Warmth or fever C) Phagocytosis D) Swelling

B) Hypovolemia

A Patient with Inflamatory Bowel Disease (IBD) has an obstruction in their small bowel. What will teh nurse anticipate to assess? A) Scaphoid Abdomen B) Hypovolemia C) Increased Flatus D) Passage of Melana

D) loss of pigmentation from lichenified skin In persons with dark skin, pigmentation may be lost from lichenified skin. The other answers do not occur in people with dark skin who have eczema.

Atopic dermatitis, or eczema, occurs at all ages and in all races. What happens in dark-skinned people who have eczema? A)hyperpigmentation of the skin B)papules covering the area affected C)prominent erythema D)loss of pigmentation from lichenified skin

A) True

Cardinal signs of inflamtatoin are redness, swelling, heat, pain, and loss of function. A) True B) False

D)Semi-Fowler A semi-Fowler's position encourages lochia to drain so it will not become stagnant and cause further infection. Placing the woman flat in bed, on her left side, or in the Trendelenburg position would not accomplish this goal and could result in the infection spreading to other parts of the body.

The nurse is caring for a postpartum woman who is diagnosed with endometritis. Which position should the nurse encourage the client to maintain? A)Flat in bed B)On her left side C)Trendelenburg D)Semi-Fowler

D) Exacerbations and remissions The course of regional enteritis is prolonged and variable. There is mild bleeding, fistulas are rare, and diarrhea is less severe than ulcerative colitis.

Which of the following is accurate regarding regional enteritis? A)Fistulas are common B)Severe diarrhea C)Severe bleeding D)Exacerbations and remissions

D) Monitor the patients blood glucose per protocol

Which of these interventions is the priority when caring for patients with TPN? A) Monitor urine specific gravity every shift B) Change the administration set every 72 hours C) Infuse the solution in a peripheral vein D) Monitor the patients blood glucose per protocol

D)"Has the baby been around any crowds?" Acute bronchiolitis is caused by a viral infection, most often, respiratory syncytial virus. Viruses are often spread between groups of people in close contact. Hereditary and environmental complications do not relate to this disorder.

A 4 week old is diagnosed with bronchiolitis. The parent states, "I do not know how the baby got this!" The nurse is most correct to ask which question? A)"Do you have allergies in the family?" B)"Do any family members have history of asthma?" C)"Do you have air conditioning in your house?" D)"Has the baby been around any crowds?"

A)Allow the diaper area to air dry. B)Apply petroleum jelly to the diaper area. C)Apply ointment with vitamin A to the diaper area. E)Use ointments containing zinc on the diaper area.

A 4-month-old infant is experiencing dermatitis in the diaper area. What treatments will be beneficial to this condition? Select all that apply. A)Allow the diaper area to air dry. B)Apply petroleum jelly to the diaper area. C)Apply ointment with vitamin A to the diaper area. D)Apply powder to the diaper area. E)Use ointments containing zinc on the diaper area.

A) Connective tissue encapsulating and isolating the splinter Granulomatous inflammatory response to a splinter would involve the connective tissue encapsulating and isolating it for removal. Each of the other options is part of the normal inflammatory response, and would not apply in this situation.

A client has a splinter. The nurse expects a granulomatous inflammatory response. What does this involve? A)Connective tissue encapsulating and isolating the splinter B)Normal inflammatory mechanisms acting on the splinter C)Splinter being digested and dissolved D)Macrophages attacking the splinter in order to dissolve it

C)Inflammatory The term "inflammatory bowel disease" is used to designate two related inflammatory intestinal disorders: Crohn disease and ulcerative colitis. Both diseases produce inflammation of the bowel. The clinical manifestations of both Crohn disease and ulcerative colitis are ultimately the result of inflammatory cells with elaboration of inflammatory mediators that cause nonspecific tissue

A client is admitted to the medical surgical unit with a history of inflammatory bowel disease. The nurse knows that the clinical manifestations of both Crohn disease and ulcerative colitis are the result of activation of which cells? A)Beta B)Alpha C)Inflammatory D)Parietal

A)Granulocyte CSF (G-CSF) Granulocyte CSF (G-CSF) promotes growth and maturation of neutrophils consumed in inflammatory reactions. Impaired macrophage function and subsequent impairment of G-CSF activity have been associated with the development of neutrophilia.

A client is experiencing a decrease in the number of circulating neutrophils (neutropenia) during an active bacterial infection. The nurse examines the client's lab results looking for which cytokines that is responsible for promoting growth and maturation of neutrophils during inflammatory reactions? A)Granulocyte CSF (G-CSF) B)Monocyte CSF (M-CSF) C)Interferon (IFN) D)Histamine

A)Cellulitis Cellulitis is a deeper infection affecting the dermis and subcutaneous tissues. It is usually caused by group A beta-hemolytic streptococci or Streptococcus aureus but can be caused by bacteria specific to certain activities, such as fish handling, swimming in fresh or salt water, or from animal bites or scratches. Legs are the most common sites. It is frequently accompanied by fever, erythema, heat, edema, and pain and often involves the lymph system. The other options would not have these manifestations.

A client presents to the urgent care and tells the health care provider he came home from vacation 4 days ago and does not feel well. Upon assessment, the provider notes the client's right upper thigh area is red, warm, and painful, and the lymph nodes are palpable. The client states he had been swimming in a lake all week. The health care provider recognizes these manifestations as: A)Cellulitis B)Impetigo C)Scabies D)Rosacea

B)Upper endoscopy with biopsy Upper endoscopy with biopsy confirms esophagitis. Barium-swallow would reveal inflammation or stricture formation from chronic esophagitis. Tests of stool may show positive findings of blood. Ambulatory 24-hour esophageal pH monitoring allows for observation of the frequency of reflux episodes and their associated symptoms.

A client with GERD develops espophagitis. Which diagnostic test would the nurse expect the physician to order to confirm the diagnosis? A)Barium swallow B)Upper endoscopy with biopsy C)Stool testing for occult blood D)24-hour esophageal pH monitoring

A)inflammatory bowel disease (IBD) IBD is a collective term for several GI inflammatory diseases with unknown causes. The most prominent sign of IBD is mild diarrhea, which sometimes is accompanied by fever and abdominal discomfort. Colorectal cancer is usually diagnosed after the client complains of bloody stools; the client will rarely have abdominal discomfort. A client with diverticulitis commonly states he has chronic constipation with occasional diarrhea, nausea, vomiting, and abdominal distention. Jaundice, coagulopathies, edema, and hepatomegaly are common signs of liver failure.

A nurse is assessing a client and obtains the following findings: abdominal discomfort, mild diarrhea, blood pressure of 100/80 mm Hg, pulse rate of 88 beats/minute, respiratory rate of 20 breaths/minute, temperature 100° F (37.8° C). What diagnosis will the nurse suspect for this client? A)inflammatory bowel disease (IBD) B)colorectal cancer C)diverticulitis D)liver failure

A)"The ESR tests for the presence of inflammation in the body." In anticoagulated blood, red blood cells aggregate and are deposited to the bottom of a tube. The rate of fall is often increased in inflammatory diseases. Normal values are 0-15 mm/hour for men and 1-20 mm/hour for women. Increased sedimentation rate indicates inflammation and is used as a baseline and trend indicator in managing inflammatory disorders. The nurse can explain the purpose of the test but cannot medically diagnose a client.

A nurse is assessing a client presenting with symptoms of fatigue, fever, severe joint pain, and headache. Laboratory results reveal an erythrocyte sedimentation rate (ESR) rate of 60 mm/hour. The client asks what the blood test results mean. What is the most appropriate explanation for the nurse to provide? A)"The ESR tests for the presence of inflammation in the body." B)"Your ESR is high; this means you have an inflammatory disease." C)"I will ask your doctor to explain to you what the ESR test is used for." D)"The ESR tests for the presence of white blood cells in your body, which can indicate an infection."

A)A board-like abdomen Peritonitis is an inflammatory response. The abdomen usually is rigid and can be described as being "board-like" because of reflex muscle guarding. Paralytic ileus occurs shortly after the onset of widespread peritonitis and is accompanied by abdominal distention. Diarrhea and rectal bleeding do not result from peritonitis.

What manifestations would a nurse expect while assessing a client who has recently developed peritonitis? A)A board-like abdomen B)Sluggish bowel sounds C)Intermittent diarrhea D)Rectal bleeding

B) Pancreatic enzymes are activated before leaving the pancreas, causing injury. The pathogenesis of acute pancreatitis involves the autodigestion of pancreatic tissue by prematurely activated pancreatic enzymes. Trypsin is activated, then can activate a variety of digestive enzymes that cause pancreatic injury, resulting in an intense local inflammatory and systemic inflammatory response syndrome.

When teaching the client about the cause of acute pancreatitis, which of these points should be included in the teaching session? A)The pancreas has developed inflammation due to ingestion of acetaminophen. B)Pancreatic enzymes are activated before leaving the pancreas, causing injury. C)An infection of the pancreas has occurred. D)The only way to get pancreatitis is from alcohol abuse.

A)Diarrhea The primary symptoms of IBS include constipation, diarrhea, or a combination of both. Pain, bloating, and abdominal distention often accompany changes in bowel pattern.

Which is one of the primary symptoms of irritable bowel syndrome (IBS)? A)Diarrhea B)Pain C)Bloating D)Abdominal distention

C) Assessing for symptoms of peritonitis

Which of the following is a priority nursing intervention to manage a client with appendicitis? A) Encouraging oral intake of clear fluids B) Provide discharge teaching C) Assessing for symptoms of peritonitis D) Administering Tylenol for an elevated temperature

B)Vasoconstriction While vasoconstriction is a component of the immediate inflammatory response, the later cellular phase of inflammation is accompanied by vasodilation. Platelet aggregation, migration of phagocytic white cells, and macrophage activity are all associated with the cellular phase.

Which process would most likely be considered an anomaly during the cellular phase of inflammation? A)Platelet aggregation B)Vasoconstriction C)Migration of phagocytic white cells D)Macrophage activity

B)age Age is the most significant risk factor for developing primary osteoarthritis. Development of primary osteoarthritis is influenced by genetic, metabolic, mechanical, and chemical factors. Secondary osteoarthritis usually has identifiable precipitating events such as trauma.

A nurse is assessing a client with possible osteoarthritis. What is the most significant risk factor for primary osteoarthritis? A)congenital deformity B)age C)trauma D)obesity

D)Carefully assess the client for infections. It is important to monitor clients who are taking prednisone carefully for signs of infection, because prednisone's immunologic activity may mask the symptoms of infection. Antacids may normally be used alongside prednisone. Headaches are not associated with the use of prednisone and IV administration is not typical.

A nurse is overseeing the care of a young man whose ulcerative colitis is being treated with oral prednisone. Which action should the nurse take in order to minimize the potential for risks associated with prednisone treatment? A)Avoid OTC antacids for the duration of treatment. B)Advocate for intravenous, rather than oral, administration. C)Teach the client strategies for dealing with headaches. D)Carefully assess the client for infections.

A)Eyes The symptoms of nephrotic syndrome include periorbital edema upon awakening with progressive edema throughout the day in all extremities and abdomen. Ascites can develop in the abdomen and the nurse should assess the child regularly for this development. The child with nephrotic syndrome generally does not have sacral edema, unless the edema is extreme and has not been treated.

The nurse is caring for a child with nephrotic syndrome. The child is noted to have edema. The edema would most likely be seen where on this child? A)Eyes B)Fingers C)Abdomen D)Sacrum

A)Deficient fluid volume Clients with acute pancreatitis often experience deficient fluid volume, which can lead to hypovolemic shock. Vomiting, hemorrhage (in hemorrhagic pancreatitis), and plasma leaking into the peritoneal cavity may cause the volume deficit. Hypovolemic shock will cause a decrease in cardiac output. Gastrointestinal tissue perfusion will be ineffective if hypovolemic shock occurs, but this wouldn't be the primary nursing diagnosis.

What is the most appropriate nursing diagnosis for the client with acute pancreatitis? A)Deficient fluid volume B)Excess fluid volume C)Decreased cardiac output D)Ineffective gastrointestinal tissue perfusion

A) A fecalith A fecalith is a stone made of feces. It is a hardening of feces into lumps of varying size and may occur anywhere in the intestinal tract but is typically found in the colon. It is also called appendicolith when it occurs in the appendix and is sometimes concomitant with appendicitis.

Which of the following complications is thought to be the most common cause of appendicitis? A) A fecalith B) Bowel Kinking C) Internal Bowel Occlusion D) Abdominal Bowel Swelling

A)increasing fluid intake to prevent dehydration. Because stool forms in the large intestine, an ileostomy typically drains liquid waste. To avoid fluid loss through ileostomy drainage, the nurse should instruct the client to increase fluid intake. The nurse should teach the client to wear a collection appliance at all times because ileostomy drainage is incontinent, to avoid high-fiber foods because they may irritate the intestines, and to avoid enteric-coated medications because the body can't absorb them after an ileostomy.

A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, the nurse should stress the importance of A)increasing fluid intake to prevent dehydration. B)wearing an appliance pouch only at bedtime. C)consuming a low-protein, high-fiber diet. D)taking only enteric-coated medications.

B)Positioning the client on the side with the knees flexed The nurse should place the client with acute pancreatitis in a side-lying position with knees flexed; this position promotes comfort by decreasing pressure on the abdominal muscles. The nurse should administer an analgesic, as needed and ordered, before pain becomes severe, rather than once each shift. Because the client needs a quiet, restful environment during the acute disease stage, the nurse should discourage frequent visits from family and friends. Frequent oral feedings are contraindicated during the acute stage to allow the pancreas to rest.

When caring for a client with acute pancreatitis, the nurse should use which comfort measure? A)Administering an analgesic once per shift, as ordered, to prevent drug addiction B)Positioning the client on the side with the knees flexed C)Encouraging frequent visits from family and friends D)Administering frequent oral feedings

A)Withholding all oral intake, as ordered, to decrease pancreatic secretions The nurse should withhold all oral intake to suppress pancreatic secretions, which may worsen pancreatitis. Typically, this client requires a nasogastric tube to decompress the stomach and GI tract. Although pancreatitis may cause considerable pain, it's treated with I.M. meperidine (Demerol), not morphine, which may worsen pain by inducing spasms of the pancreatic and biliary ducts. No clinical evidence supports the use of meperidine for pain relief in pancreatitis, and, in fact, accumulation of its metabolites can cause CNS irritability and possibly seizures. Pancreatitis places the client at risk for fluid volume deficit from fluid loss caused by increased capillary permeability. Therefore, this client needs fluid resuscitation, not fluid restriction. A client with pancreatitis is most comfortable lying on the side with knees flexed.

Which nursing action is most appropriate for a client hospitalized with acute pancreatitis? A)Withholding all oral intake, as ordered, to decrease pancreatic secretions B)Administering meperedine, as ordered, to relieve severe pain C)Limiting I.V. fluids, as ordered, to decrease cardiac workload D)Keeping the client supine to increase comfort

B) Histamine

During the inflammatory response, what do mast cells release? A) Chemicals B) Histamine C) Toxins D) None of the above