HA SET 1

The nurse is caring for a client in the burn unit who has sustained partial and full thickness burns over 16 percent of the body. What type of etiologic factor does the nurse recognize these burns are?

Physical forces

Which physiologic effect of aging is associated with slowed wound healing among the older adult population?

reduced collagen synthesis

Select the option that best describes the type of tissue that is capable of regeneration when appropriately stimulated.

Stable

A client tested positive for the tuberculosis antibody and has been told this does not mean the client will ever develop active tuberculosis. This client is considered to be in which stage of the disease process?

subclinical

A client has been diagnosed with a heart attack and has been placed on beta-blockers to reduce the workload on the heart, as well as a statin drug and a low-fat diet to lower cholesterol. Which level of prevention of disease would these therapies be classified?

tertiary

A nurse who has worked with ostomy clients for several years is adept at measuring and cutting the stoma wafer to the correct size for each client's stoma. This is an example of the nurse using:

clinical expertise.

Researchers have designed a study where the health of a large group of recent newborns will be followed for several years. What type of study is this?

cohort

The nurse is planning care for a client. Which information is most important for the nurse to apply in developing a plan of care?

current clinical practice guidelines combined with the client's health care goals

The nurse is assessing a client for acute inflammation of a wound. Which symptom does the nurse attribute to the acute inflammatory response?

edema

Why are some diseases termed syndromes?

They are a compilation of signs and symptoms characteristic of a specific disease state.

A client sustained an injury 3 days ago. The nurse is assessing the status of the wound and anticipates the wound to be in which phase of healing?

Proliferative

A client with hypertension is given an IV medication and has an anaphylactic reaction. This is considered to be:

a complication.

Facility policies on wound dressing selection refer the nurse to a dressing algorithm. The nurse anticipates that the algorithm will include:

a step-by-step decision-making tree for dressing selection.

Which client conditions illustrate acquired defects?

colon cancer rheumatoid arthritis

Which information should a public nurse collect when assessing components of the social determinants of health in a population?

unemployment rate education levels Crime rates

What do morbidity and mortality statistics refer to?

Functional effects and death-producing characteristics of a disease

A group of nurses have been tasked with developing a policy for their facility aimed at ideal care for the client with diabetes. Which resource should the group prioritize as most informative for the goal?

Clinical practice guidelines

A nurse is evaluating findings from the Nurses' Health Study, a study that has followed a group of nurses since 1976 to study the relationship between oral contraceptive use and breast cancer. The nurse evaluates the findings using criteria for which type of study?

Cohort

A nurse plans to conduct a research study on a group of clients who had laparoscopic gastric bypass. Which term describes this type of study?

Cohort

While explaining to a young child why he should be careful with a wound, the nurse reviews healing with the parent. The nurse educates the parent about how strength in the healing wound site is developed based on which substance being available?

Collagen synthesis

A client delivers a child born with an extra digit. The client states that she had the same thing when she was born. What term would the nurse document in the record regarding this defect?

Congenital condition

Which response best describes a granulomatous inflammatory response to a foreign body like a splinter?

Connective tissue encapsulates the splinter and isolates it.

The Framingham cohort study examined characteristics of people who would later develop which disease?

Coronary disease

Select the statement that best describes the formation of a keloid.

"Benign, tumor-like mass"

Which client is most likely to experience impaired (slow) wound healing?

A client with a diagnosis of type 1 diabetes and a history of poor blood sugar control

The nurse completing an assessment on a client in systemic inflammatory response syndrome anticipates which finding?

Circulatory shock

Which science is called on to study the risk factors in multifactorial diseases?

Epidemiology

Following a severe automobile accident, a client is scheduled to have surgery to either repair or remove his spleen, pancreas, and stomach. The client wants the organs repaired and not removed if at all possible. However, the nursing staff understands that extensive regeneration in parenchymal organs can only occur if:

the residual tissue is structurally and functionally intact.

Following surgery for appendicitis, a teenaged client notes four small "stab" wounds on the abdomen. The client is obviously worried about body appearance. The nurse explains, "Your body will heal quickly and tissue repair will allow for regeneration of any cells needed." The client asks, "What does regeneration mean?" The nurse responds that tissue repair by regeneration means:

"Any injured cells are replaced with cells of the same type. Therefore, after healing, the wound will look like your surrounding skin."

Which of the nurse's assessment questions most directly addresses the client's level of health, based on the World Health Organization's definition of health?

"How would you rate your overall sense of well-being?"

A client cuts herself with a sharp knife while cooking dinner. The client describes how the wound started bleeding and had a red appearance almost immediately. The nurse knows that in the vascular stage of acute inflammation, the vessels:

vasodilate, causing the area to become congested and resulting in the red color and warmth.

A client presents with fever and fatigue of an unknown cause. Which diagnostic test should the nurse request to investigate the cause of the client's symptoms?

white blood cell differential

An infant has a difficult time passing through the birth canal and the physician uses forceps to deliver the child. In the process, the facial nerve was damaged, resulting in a facial droop. Which condition does the nurse recognize this to be?

Acquired defect

A nurse documenting a client's health history places hypertension under which category?

Acquired

The nurse is providing discharge instructions for a postoperative client. The nurse determines the teaching is effective when the client verbalizes which statement about wound healing?

"I will regain almost full-tensile strength of an unwounded skin at the end of 3 months."

A physician is providing care for a number of clients on a medical unit of a large, university hospital. The physician is discussing with a colleague the differentiation between diseases that are caused by abnormal molecules and molecules that cause disease. Which client most clearly demonstrates the consequences of molecules that cause disease?

A 30-year-old homeless man who has pneumocystis carinii pneumonia (PCP) and is HIV positive.

When the nurse is assisting with the diagnostic process for a client with an illness, what is a priority when compiling all of the data to have an accurate diagnosis? Select all that apply.

A careful history Detailed physical examination Diagnostic tests

A client presents with an oral temperature of 101.7°F (38.7°C) and painful, swollen cervical lymph nodes. Laboratory results indicate neutrophilia with a shift to the left. Which diagnosis is most likely?

A severe bacterial infection

The nurse is performing an assessment on a client who states she fell and twisted her right ankle during a softball game. The nurse notes that the right ankle is edematous and will probably need to be x-rayed. What term does the nurse use to describe the changes that accompany this finding?

A sign

The nurse is evaluating the wounds of four clients. Select the client most likely to be treated with hyperbarically delivered oxygen.

An infected foot wound on a 45-year-old client with peripheral vascular disease

The community health nurse is creating a program to improve the health of a select group of clients in the community, based on Healthy People 2030 by the U.S. Department of Health and Human Services. The nurse will base the program on which determinant(s) of health?

Attain lives free of preventable disease, disability, injury, and premature death. Achieve health equity and eliminate disparities. Promote healthy behaviors across the lifespan. Promote good health for all.

A client tests positive for an infectious disease but does not have any symptoms. The physician informs the client that she is capable of infecting others. Which stage of the clinical course is this client experiencing?

Carrier state

A client develops an infection with a resistant organism while hospitalized for surgery. After treatment, there are no obvious signs of infection, but a culture shows that the organism is present. Which term describes the client's status?

Carrier status

Which child has the highest risk of experiencing a wound complication?

Child recently been diagnosed with type 2 diabetes

During an assessment, a client tells the nurse that he has suffered from asthma since childhood. He is not experiencing any symptoms at this time but takes an inhaled steroidal medication daily. The nurse should document the asthma as being which type of condition?

Chronic

Which client conditions would be considered a congenital defect?

Cleft lip and palate Club foot Hypospadias

A nurse is interpreting the test results of a client's screening test for cancer. If the client's result is negative and the test has a 95% specificity, the nurse should conclude that there a 95% chance of which outcome?

Client does not have cancer.

A client is experiencing signs and symptoms of congestive heart failure. The client's disease is in which phase of its clinical course?

Clinical

When assessing a client's incision, the nurse notes that the edges of the once approximated incision has begun to pull apart. The nurse documents that the client's incision has:

Dehisced

A group of teenagers spent an entire day on the beach without using sunscreen. The first night, their skin was reddened and painful to touch. The second day, they awoke to find large fluid-filled blisters over several body areas. The nurse recognizes the development of blisters as which type of inflammatory response?

Delayed response

The nurse assesses a client for signs and symptoms of infection. Which findings will the nurse record as signs of infection?

Diaphoresis Fever Cough

When the nurse is performing a skin assessment on a client, a small wound is noted on the client's right leg. The wound is covered with a desiccated scab. The appropriate action by the nurse is:

Document the finding

A client diagnosed with chlamydia asks the nurse how this infection has occurred. The explanation by the nurse would involve a description of which aspect of the disease?

Etiology

When caring for a client during the proliferative phase of wound healing, the nurse teaches the client that which of these processes is taking place?

Fibroblasts secrete collagen for wound healing.

A client is being treated for a pressure injury and the care team has observed that the wound is healing. Which activity will take place during the proliferative phase?

Fibroblasts secrete collagen to promote wound healing.

The nurse is caring for a client whose temperature is increasing. Which other vital sign/body response will the nurse monitor for an increase?

Heart rate

Pathogenesis is the term used to describe the sequence of cellular and tissue events that occur from the time of first contact with an etiologic agent until the disease becomes evident. What is another way of defining pathogenesis?

How the disease process evolves

If a client has a bacterial infection in the blood, the nurse will note which laboratory value that correlates with this?

Increased neutrophils

In contrast to acute inflammation, chronic inflammation is characterized by which physiologic phenomena?

Infiltration of lymphocytes and macrophages

The parents of a child with spina bifida ask what caused the condition. Which factor would the nurse identify as the most likely etiologic factor in the child's history?

Insufficient maternal folic acid intake

The nurse is interested in conducting an epidemiologic research study. Which research question should the nurse choose as appropriate for an epidemiologic study?

Is there a relationship between smoking rates and incidence of heart disease?

The cardinal signs of inflammation include swelling, pain, redness, and heat. What is the fifth cardinal sign of inflammation?

Loss of function

For the past 6 months, the visiting nurse has been caring for a client with a chronic venous stasis ulcer. Which of these cells that assist with wound healing does the nurse recognize is present in the wound at this time?

Lymphocytes

A disease agent can affect more than one organ of the body, and more than one disease agent can affect the same organ of the body. Which term best describes this aspect of disease etiology?

Multifactorial in origin

A physician is examining a college student who is exhibiting the classic symptoms of schizophrenia. In the course of the evaluation, the physician begins developing a treatment strategy based on what he knows about the disease, available therapies, medications, and consequences of not following the treatment regimen. What aspect of the disease is the physician using?

Natural history

During a lecture on wound care, the instructor mentions the final stage of the cellular response of acute inflammation. Which statement describes what physiologically occurs in the final stage?

Neutrophils, monocytes, and macrophages engulf and degrade the bacteria/cellular debris.

A nurse is conducting a staff development program on the Healthy People 2030 determinants of health. The nurse notes that the participants need additional education based on which statement?

Nursing practice should focus solely on the management of chronic disease.

When attempting to reach a health diagnosis, the health care provider commonly applies four primary steps. Place the steps for reaching a diagnosis in order.

Obtain clinical history. Conduct a physical examination. Perform diagnostic testing. Determine the most likely cause of the client's presentation.

An older adult client has just sheared the skin on the elbow, precipitating acute inflammation. Which event will occur during the vascular phase of the client's inflammation?

Outpouring of exudate into interstitial spaces

The nurse is assessing the wound of a postoperative client. The client has a 6-inch abdominal wound that is well approximated and closed with surgical suture. The wound does not display any redness or drainage. The nurse would document the healing process as:

Primary intention

The nurse is providing a prenatal class for a group of women at the local women's center. The nurse informs the group about the importance of taking their folic acid supplements for the prevention of neural tube defects. What type of prevention is the nurse providing?

Primary prevention

The nurse would identify the presence of granulation tissue at a wound site by which characteristic?

Red, moist tissue

Diagnostic tests are used to gain information about the client that is pertinent to the presenting signs and symptoms. Diagnostic tests are judged for their validity, reliability, sensitivity, specificity, and predictive value. In the field of clinical laboratory measurements, standardization is aimed at increasing the trueness and reliability of measured values. Standardization relies on which of the following?

Reference measurement procedures Written standards Reference materials

The nurse notes that a colleague neglects to wipe away the first drop of blood from the sample during point-of-care blood glucose testing; this in contradiction of the unit policy. What action should the nurse take first?

Remind the colleague that the purpose of discarding the first drop is to improve the reliability of the results.

A client who had an implantable cardioverter-defibrillator (ICD) returns the next week with a fever, chills, and elevated WBC. The physician suspects the wound is infected. If this wound does not respond to antibiotic therapy, the nurse can anticipate the client will undergo:

Removal of device

There are three fundamental types of prevention used in health care: primary, secondary, and tertiary. Which statement accurately describes secondary prevention?

Secondary prevention detects disease early, and most is done in clinical settings.

The nurse is assessing the results of a client's laboratory tests and determining what levels are within normal limits. Which result would be important for the nurse to obtain?

Serum sodium level of 142 mEq/L (142 mmol/L)

Which responsibility of the extracellular matrix (ECM) is most accurate?

The ECM provides the scaffolding for tissue renewal.

The nurse notes a client's screening test for bowel cancer is positive. The test has a sensitivity level of 50% and a specificity level of 80% for identifying clients with bowel cancer. Which conclusions would the nurse draw from this information?

The chance that the client has bowel cancer is as likely as the client not having bowel cancer. The client will need to undergo further diagnostic testing to determine if the client has bowel cancer.​​ For every 10 people who test negative for bowel cancer, 2 will actually have bowel cancer.

A client has been admitted for exacerbation of his chronic obstructive pulmonary disease (COPD), and a respiratory therapist (RT) is assessing the client for the first time. Which aspect of the client's current state of health would be best characterized as a symptom rather than a sign?

The client notes that he has increased work of breathing when lying supine.

The nurse is caring for a client with an infected wound that is left to heal by secondary intention. Which observation does the nurse expect to make during assessment of the wound area?

The wound is healing slowly with epithelial and scar tissues present.

A client with anemia has a regularly scheduled hemoglobin test result of 10 g/dL (100 g/L). While traveling a week later, the client went to urgent care where a hemoglobin level of 15 g/dL (150 g/L) was reported. For which reason will the nurse question the findings of the second result?

Validity

When the nurse questions the blood glucose level obtained via a glucometer, a serum blood level is ordered. This protocol is directed toward ensuring which measure of standardization?

Validity

When caring for a postoperative client, in order to promote wound healing, which of these nutrients does the nurse encourage the client to consume?

Vitamin C

The nurse is caring for a client with a chronic wound. The most important intervention for the nurse to include in the plan of care would be:

Vitamin C and zinc supplements

The nurse is caring for an obese client who has had abdominal surgery. The medical record states the wound has developed a dehiscence. Which finding does the nurse anticipate observing when changing the dressing?

Wound edges are 1.5 inches apart.

A client comes to the clinic stating, "I feel terrible. I feel feverish and it hurts when I cough." The nurse documents this report to be:

a symptom.

A client who was treated for an animal bite to the hand has completed a course of prescribed antibiotics but reports continued pain and swelling at the site. The nurse prioritizes assessing for which possible complication?

abscess formation

The public health nurse is creating a program to reduce childhood mortality rates in a population. To have the greatest impact, the nurse should focus on:

accident prevention.

The nurse is selecting a dressing for a vascular wound that has a dry wound surface. The most appropriate dressing for this wound is one that:

adds moisture to wound bed.

The nurse is assessing the laboratory results of a client with an infection and suspected systemic inflammatory response. Which laboratory result(s) will the nurse interpret as supporting the client is experiencing an acute-phase inflammatory response?

erythrocyte sedimentation rate (ESR) 175 mm/h (high) white blood cell (WBC; leukocyte) count 18.7 cells/μL (high) C-reactive protein (CRP) 10.0 mg/L (95.24 nmol/L) (high)

Inflammation can be either local or systemic. What are the most prominent systemic manifestations of inflammation?

fever, leukocytosis or leukopenia, and the acute phase response

A client with COPD controlled with long-term corticosteroids has developed an infection following bowel surgery. The nurse anticipated this complication since steroids:

impair the phagocytic property of leukocytes.

In 2014, an outbreak of Ebola virus disease began in West Africa in which there was a sharp increase in the number of people being diagnosed with this disease. At the same time, a very high proportion of those who were diagnosed died from the disease. The epidemiologic characteristics of this disease include:

increased incidence and high mortality.

An infant was born with facial nerve paralysis that occurred with delivery. As the infant ages, it becomes apparent that the facial muscles affected by the nerve damage are not moving. Seeking surgical repair, the family asks why the damage to the child's face is not being repaired by the body. The health care provider states that neurons (connected to the facial muscles) are highly specialized cells that:

lose their ability to proliferate once development of the nervous system is complete.

Which action(s) will a nurse teach as primary prevention of disease?

measles, mumps, rubella (MMR) vaccination to school-aged children wearing a seat belt when in a motor vehicle

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

neutrophils

The nurse is conducting a staff educational program on screening tests. The nurse determines that the participants understand the information when they identify the proportion of true positive test results in a given population as being:

positive predictive value.

A nurse researcher is collecting data on the number of people who have a current diagnosis of diabetes in a local population. Which term categorizes the aspect of epidemiology the nurse is collecting?

prevalence

After many years of cigarette smoking, a client is admitted to have a "mass" removed from the lung. When explaining the surgery and recovery, the physician notes that the client is likely to have a good amount of fibrosis develop at the surgical area. After the physician leaves the room, the client asks the nurse what was meant by "fibrosis" in the lung. The nurse bases the response on the fact that tissue repair can:

result in replacement tissue in the form of connective (fibrous) tissue, which leads to scar formation or fibrosis of the lung.