Patho quiz 1a
Select the statement that best describes the formation of a keloid.
"Benign, tumor-like mass"
The nurse is caring for a client who has had a full leg cast for the past 6 months. What teaching should the nurse offer about using the affected leg?
Gradually increase exercise, engaging in activities like swimming or cycling.
The most common forms of peptic ulcer are duodenal and gastric ulcers. What are the most common risk factors for peptic ulcer disease?
Helicobacter pylori (H. pylori)
An older adult client has had mobility and independence significantly impaired by the progression of rheumatoid arthritis (RA). What is the primary pathophysiologic process that has contributed to this client's decline in health?
Immunologically mediated joint inflammation
When caring for a client with a pressure injury, the nurse collaborates with the provider to obtain a prescription for which of these interventions to promote wound healing?
Keep dressing of the wound bed moist.
the nurse is teaching the client with rheumatoid arthritis (RA) about the role of corticosteroid therapy in disease management. What information does the nurse include about the use of corticosteroids in RA? Select all that apply.
Are reserved for poorly controlled, systemic symptoms Can increase the risk of opportunistic infections Do not affect the disease process or prevent joint damage
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 client is being seen in the dermatology clinic for a follow-up appointment for a second-degree full-thickness burn. What are characteristics of second-degree burns? Select all that apply
-Painful -Blistered -Mottled, pink red
A client has presented to the emergency department after he twisted his ankle while playing soccer. Which assessment findings are cardinal signs that the client is experiencing inflammation? Select all that apply.
-The client's ankle is visibly red -The ankle appears to be swollen -The ankle is warmer than the unaffected ankle -The client is experiencing pain
A client has experienced an acute inflammatory response with an elevation of white blood cells. The nurse is reviewing the client's most recent lab results to determine if the counts have returned to a normal range. Select the result that suggests the client is now within normal range.
4000 to 10,000 cells/μL
Which client likely faces the greatest risk of a gastrointestinal bleed?
A client who takes aspirin with each meal to control symptoms of osteoarthritis
Which condition is an example of wound healing by secondary intention?
An infected burn of the arm
A 79-year-old woman reports a recent onset of "nearly constant heartburn." During the assessment interview, she states that she has "lots of aches and pains." She states that she is not on any prescription medications but often takes aspirin for pain. The nurse should suspect what diagnosis?
Acute gastritis
The parents of a child diagnosed with rheumatic disease are shocked by the diagnosis and tell the nurse that they did not think children could acquire the disease. The best response would be:
Children can be affected with almost all of the rheumatic diseases that occur in adults."
Crohn disease is recognized by sharply demarcated, granulomatous lesions that are surrounded by normal-appearing mucosal tissue. The nurse recognizes these lesions to be defined by which description?
Cobblestone
A client underwent an open cholecystectomy 2 days ago, and the incision is now in the proliferative phase of healing. What is the dominant cellular process that characterizes this phase of the client's healing?
Collagen secretion by fibroblasts
A nurse reading a sigmoidoscopy report notes that a client was found to have skip lesions. The nurse interprets this as an indication of:
Crohn disease
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
The nurse is reviewing assessment documentation of a client's wound and notes "purulent drainage." The nurse would interpret this as:
Exudate containing white blood cells, protein, and tissue debris
Which response by the nurse answers a client's question regarding the most common objective sign of systemic inflammation during the acute-phase response?
Fever
Which body response to an acute inflammation will the nurse assess if the client is experiencing a systemic response?
Fever and tachycardia
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 nurse is teaching a client diagnosed with Crohn disease about potential complications. The mostappropriate information for the nurse to include would be:
Fistula formation
Crohn disease has a distinguishing pattern in the gastrointestinal (GI) tract. The surface has granulomatous lesions surrounded by normal-appearing mucosal tissue. A complication of the pattern includes:
Fistula formation
Crohn disease is treated by several measures. Treatment with sulfasalazine will focus on which aspect of this disease?
Inflammatory suppression
While the nurse is performing a skin assessment on a dark-skinned client, the nurse notes that the client has a healed wound on the leg but that the wound has an excess of scar tissue. The nurse documents this as:
Keloid
The nurse is evaluating the bloodwork results of a client with an infected leg ulcer. The white blood cell count is 18,000 cells/uL. The nurse interprets this as:
Leukocytosis
During a lecture on inflammation, the physiology instructor discusses the major cellular components involved in the inflammation response. The instructor asks, "Which cells arrive early in great numbers?" Which student response is correct?
Neutrophils
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
he 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
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
The nurse would identify the presence of granulation tissue at a wound site by which characteristic?
Red, moist tissue
The nurse has just finished teaching a client newly diagnosed with rheumatoid arthritis about the disease. The nurse determines that teaching is effective when the client makes which statement?
Rheumatoid arthritis includes joint involvement that is usually symmetric and polyarticular.
The nurse has just finished teaching a client newly diagnosed with rheumatoid arthritis about the disease. The nurse determines that teaching is effective when the client makes which statement?
Rheumatoid arthritis includes joint involvement that is usually symmetric and polyarticular."
A client has a burn that involves the entire epidermis and various degrees of the dermis. It is painful, moist, and blistered. The nurse recognizes the burn as:
Second-degree partial thickness
When caring for a client with a wound that is healing by primary intention, the nurse recognizes which characterization best describes this type of wound?
Surgical incision
While explaining wound healing to an older adult client with a diabetic ulcer on the foot, which statement best explains the early process of how the body restores structural integrity
The basement membrane must be restored before epithelial cells can form a covering over the wound.
The nurse is caring for a client with rheumatoid arthritis (RA) with a positive rheumatoid factor (RF). What does the nurse understand is true about this finding?
The client has severe disease
The nurse is assessing a client with reports of knee joint pain. Which findings does the nurse document as supporting osteoarthritis? Select all that apply.
The joint is firm upon palpation Crepitus is felt with joint movement The client's body mass index is 35
A nurse is caring for a client with a fever. The client is requesting more blankets and to increase the room temperature. Which biological action occurs as a result of the pyrexia in a client?
The temperature stimulates the phagocytosis of microorganisms.
Which statement is true regarding proteinases and their function in chronic inflammation? (Select all that apply).
They are responsible for ongoing tissue destruction They are produced by mature macrophages They break down dead tissue They are enzymes that destroy elastin
the nurse is caring for a client who has experienced hypovolemic shock secondary to penetrating multiple trauma. When caring for the client postoperatively, which of these factors does the nurse recognize places the client at risk for poor wound healing?
Tissue hypoxia
The nurse is assessing a client with diabetes and notes an area on the client's right foot as inflamed, necrotic, and eroded. The client states he accidentally slammed his foot in a door 2 weeks ago. The nurse would document this finding as a(n):
Ulceration
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 apar
the nurse is caring for a client with chronic pancreatitis who reports abdominal pain. Which location will the client's pain radiate?
back
The nurse is assessing a client for acute inflammation of a wound. Which symptom does the nurse attribute to the acute inflammatory response?
edema
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:
esult in replacement tissue in the form of connective (fibrous) tissue, which leads to scar formation or fibrosis of the lung
The surgeon has documented that a client is developing "proud flesh" at the postoperative wound site. The nurse recognizes this as:
excessive granulation tissue.
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
client is experiencing the early stages of an inflammatory process and develops leukocytosis. The nurse recognizes this as a/an:
increase in circulating neutrophils.
A client is newly diagnosed with irritable bowel syndrome (IBS). The nurse explains how the nervous system affects gastrointestinal (GI) disorders. The nurse mentions which statement in regard to IBS?
increase in parasympathetic nervous system activity
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.
he nurse is assessing a client with acute sinusitis. What is the primary cause of this condition?
viral infection transmitted via respiratory droplets
When assessing the client with acute pancreatitis, which of these diagnostic tests—consistent with the disease— does the nurse anticipate will be altered
Amylase and lipase
Crohn disease not only affects adults but also can occur in children. The nurse assesses for which major manifestation in children with Crohn disease?
malnutrition
A client in the acute stage of inflammation will experience vasodilation of the arterioles and congestion in the capillary beds. The nurse would assess the client's skin for:
redness