delete.
A client is suspected to have developed chronic inflammation. Select the potential causes of the chronic condition. Select all that apply:
Asbestos, Silica, Suture, Talc, Tubercle bacillus
The nurse is educating a client who is about to undergo a stem cell transplant. The nurse mentions that a single stem cells can give rise to many cells needed for normal tissue repair. What type of replication is this process?
Asymmetric
During a review session discussing cells, a student asks, "What do you call it when a cell becomes more specialized in terms of structure?" Which response answers the question correctly?
Cell proliferation
During a review session discussing cells, a student asks, "What do you call it when a cell undergoes a process of increasing cell numbers by mitotic division?" Which response answers the question correctly?
Cell proliferation
A patient with a rising temperature is pale and has begun to shiver. The nurse reports that the patient is in which of the following phases of fever development?
Chill
A patient has a fever that was induced by damage to the hypothalamus due to intercranial bleeding. The nurse plans care for the patient with which of the following types of fever?
Neurogenic
Which of the following cells will likely stay in a permanent resting state known as G0, unless there is a change in nutrients, growth factors, or hormones that trigger cell renewal?
Neurons
While reviewing the phases of wound healing, the students note that the first cells to arrive after the injury are the:
Neutrophil
A patient presented to the emergency department of the hospital with a swollen, reddened, painful leg wound and has been diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) cellulitis. The patient's physician has ordered a complete blood count and white cell differential. Which of the following blood components would the physician most likely anticipate to be elevated?
Neutrophils
Which of the following can the nurse tell a patient about antipyretic drugs during fever?
"Antipyretics help to protect the body"
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 time. Therefore, after healing, the wound will look like your surrounding skin."
Select the statement that best describes stem cells.
"Benign tumor-like mass"
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 of the following patients would have a very poor response related to tissue regeneration of their injured area?
54 year old male who had a massive MI 4 days ago and came to the ED today for treatment.
A client states, "I heard that my healed wound tissue is stronger than my normal tissue. Is that true?" The nurse responds that roughly 3 months after a wound; the wound tensile strength is approximately what percentage from normal?
70% of normal
Which of the following is an appropriate action by a nurse to take in attempting to decrease a patient's temperature through conduction?
Apply a cooling blanket
Which patient is at greatest risk for decreased wound healing?
A 30-year-old patient with type 1 diabetes and a foot ulcer
A physician is noting the recent vital signs for several patients on an acute medical ward of a hospital. Which of the following hospital patients with non-infectious diagnoses would be most likely to have a fever?
A 33 year old female with a post-op deep
A nurse is providing care for several clients on a neurological unit of a hospital. With which of the following clients would the nurse be justified in predicting a problem with thermoregulation?
A 66 year old male with damage to his thalamus secondary to a cerebral vascular accident
Which symptom indicates the next stage of a fever after a prodrome?
A chill
A client has been diagnosed with a FUO fever of unknown cause; the nurse recognizes this as:
A prolonged fever that does not have an identified source
A 24-year-old woman presents with fever and painful, swollen cervical lymph nodes. Her blood work indicates neutrophilia with a shift to the left. She most likely has:
A severe bacterial infection
Of the following list of patients, which would likely benefit the most from hyperbaric oxygen therapy?
A trauma patient who developed Clostridium spp., an anaerobic bacterial infection in their femur
A client with diabetes has an admission hemoglobin A1c (HbA1c) level of 13 (goal is 6) and an abdominal wound that will not heal. The nurse knows that hyperglycemia (poor blood glucose control) has an effect on wound healing, especially related to neutrophils affecting:
Ability to engulf and kill bacteria because of poor phagocytic function
Select the option that best describes an observable physiological behavior exhibited by an individual attempting to conserve body heat.
Adducting the extremities
A client with right lower quadrant abdominal pain is suspected to have acute appendicitis. When assessing the laboratory studies, what results would the nurse know indicate that the client has an acute infection?
An increase in bands
Which of the following is an example of wound healing by secondary intention?
An infected burn of the arm
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 patient with peripheral vascular disease
Which of the following clients would be considered a good candidate for hyperbaric oxygen therapy?
An older adult with history of diabetes and intermittent claudication
An 88 year old resident of a long term care home has been suffering from a three day onset of increasing shortness of breath and decreased oxygen saturation. At the hospital, an anterior-posterior chest X-ray and sputum culture and sensitivity has confirmed a diagnosis of bacterial pneumonia, yet the client's tympanic temperature has not exceeded 37.3°C (99.2°F). The health care team would recognize that which of the following phenomena likely underlies this situation?
An older adult's hypothalamus has diminished thermoregulatory ability
Which of the following patients should be assessed for fever based on other presenting symptoms? Select all that apply
Anorexia, myalgia
The microbiologist is explaining cell communication. Which of the following statements is accurate?
Autocrine signaling occurs when a cell releases a chemical into the extracellular fluid that affects its own activity.
Fever in infants and young children is not an uncommon event. Many trips to the pediatrician's office occur because of fever in children ages 1 day to 3 years. Which sign or symptom does not indicate fever in an infant?
Avid feeding
An oncology client on chemotherapy has had an episode of GI bleeding. The client has been receiving an erythropoietin stimulating agent, epoetin alfa. The client reports severe bone pain (arthralgia). Knowing the basic pathophysiologic principles, the nurse explains that the bone pain is related to:
Bleeding that is stimulating the rapid proliferation of replacement cells by the blood-forming cells in the bone marrow
A client with a complete tear of the rotator cuff in the right shoulder was given the choice between surgery and stem cell transplant. The client chose to try the stem cell injection. The client asked the health care provider, "How does this work on my shoulder?" The best response would be:
Bone marrow stem cells have been shown to generate cartilage, bone, and muscle when injected into the injured site
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
Researchers wish to reactivate the cell cycle in nonproliferating cells to assist the body to repair tissue. To reactivate the cycle, which substance will the researchers need to remove from the cell?
CDK inhibitors
What does it mean that some cell populations have self-renewing multipotent stems cells? Some cells:
Can differentiate into different epithelial cell types throughout life
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 patient has a splinter. The nurse expects a granulomatous inflammatory response. What does this involve?
Connective tissue encapsulating and isolating the splinter
A patient diagnosed with bacterial pneumonia is admitted to the hospital. The nurse reviewing the patient's laboratory results notes an increase in the number of bands in the white blood cell count. Which of the following is the priority action of the nurse?
Continuing to monitor the client's laboratory results; this is an expected finding in an acute infection
The loss of heat from the body through the circulation of air currents is known as which of the following?
Convection
A nurse's hand-off report states that a patient's temperature is 106.6°F. Which of the following may have caused the patient's temperature to elevate past 105.8°F? Select all that apply.
Convolusions, hyperthermic state
A client taking the typical antipsychotic agent haloperidol (Haldol) experiences neuroleptic malignant syndrome. What nursing intervention is highest priority after stopping the medication?
Cooling blanket
A pregnant patient comes to the clinic with symptoms of body aches, headache, and fatigue. A physical assessment reveals enlarged lymph nodes. A diagnosis of toxoplasmosis with chronic inflammation caused by a parasitic organism is determined. Which of the following would most likely also be present? Select all that apply.
Cysts due to granuloma formation, increase in eosinophil count
Regulation of blood cells is thought to be controlled in part by which of the following hormonelike growth factors?
Cytokines
A nurse's hand-off reports states that the patient has pyrexia. The nurse plans care for the patient with which of the following events?
Fever
A nurse assessing an older adult for signs and symptoms of infection in the absence of a fever should assess for which of the following? Select all that apply.
Decreasd mental status, change in functional capacity, fatigue
A 79-year-old female resident of an assisted living facility receives care from a community nurse on a regular basis for treatment of a chronic venous leg ulcer. Which of the following factors would the nurse be most justified in ruling out as a contributing factor to the client's impaired wound healing?
Decreased antibody levels
An older adult's dysfunctional temperature regulator function places the client at greatest risk for:
Delayed initiation of appropriate treatment
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 caring for a client with a large leg wound notes that the client's past medical history includes diabetes, chronic atrial fibrillation, asthma controlled by maintaninence medication, and neuropathy. Which one has the greatest potential to negatively impact the healing of the client's wound?
Diabetes
Select the option that most accurately describes the process resulting in specialized cells.
Differentiation
A patient has an increase in core temperature. Which of the following does the nurse expect to assess with this finding? (Select all that apply.)
Dilation of superficial vessels, sweating
A patient's body temperature has been documented as follows: 12 noon: 37.0C; 6 p,: 37.5C; 3 am: 36.0C. Which of the following actions should the nurse take?
Document the temperature
The nurse is assessing a client for acute inflammation of a wound. For which of these symptoms of infection does the nurse assess?
Edema
Pyrogens are substances that produce fever in the body. Substances such as bacterial products, bacterial toxins, or whole microorganisms enter the body and stimulate the host cells to produce certain mediators. What are these called?
Endogenous pyrogens
A nurse who is providing a staff development in-service determines that the participants understand the information when they state that which of the following aids heat conservation by reducing surface area for heat loss?
Erection of pilomotor muscles
Which of the following diagnostic lab tests is used to diagnose the presence of inflammation?
Erythrocyte sedimentation rate
Which of the following lab results confirm the client has developed an acute-phase inflammatory response? Select all that apply.
Erythrocyte sedimentation rate, Leukocytes, C-reactive protein
The surgeon has documented that a client is developing proud flesh at the postoperative wound site. The nurse recognizes this as:
Excessive granulation tissue
A patient tells the nurse that she was treated at a local urgent care center for a bacterial infection that caused a temperature of 102.5°F. The nurse documents which of the following?
Exogenous pyrogen
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
Tissues are composed primarily of cells in the M phase.
False
The nurse is assessing a client who is in the prodromal stage of a fever. The nurse anticipates the client will exhibit:
Fatigue
A client asks the nurse what is the most common objective symptom of systemic inflammation during the acute-phase response. The best response would be:
Fever
Inflammation can be either acute or chronic. The immune system is believed to play a role in chronic inflammation and may be one of the reasons chronic inflammation may persist for days to months to years. Why is the risk of scarring and deformity greater in chronic inflammation than it is in acute inflammation?
Fibroblasts instead of exudates proliferate in chronic inflammation
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 asks the nurse why a scar developed after an injury. The best response would be:
Fibrous tissue
A client has an increase in core body temperature. What assessment findings does the nurse expect?
Flushed skin
Which assessment findings of a client with an elevated temperature would be considered a "normal" finding? Select all that apply.
Flushed skin, pain when moving joints to sit up in bed, unusual fatigue and drowsiiness
When discussing the cell cycle in oncology lecture, the faculty mentions that highly specialized cells like neurons may permanently stay in which cell cycle?
G0 phase
Which stage of a cell's life cycle is where the preparation of mitosis occurs?
G1
Achild is brought to the emergency department after falling and cutting the leg on a piece of fencing. While explaining the process of normal tissue repair, the nurse explains that certain cells, like fibroblasts, proliferate at times like this with the production of:
Growth factors to help the cells respond and expand in numbers to repair the injury
The nurse is caring for a client whose temperature is increasing. The nurse is aware that the client will also experience an increase in:
Heart rate
An eight year old boy has fallen through the ice while skating on a frozen pond. By the time paramedics arrive, the boy has been removed from the water by his friends, but his core body temperature is 31.1°C (88.0°F). The responders would recognize that which of the following physiological processes would have been active during the boy's accident?
Heat production through increased body metabolism
Neurogenic fevers begin in the central nervous system. By what characteristics are neurogenic fevers known?
High temperatures that are not associated with sweating
A deficiency in which of the following would result in an inhibition of the inflammatory response?
Histamine
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?
Histamine
When explaining the final stages of the inflammatory response to pathogens, the nurse will educate the patient about:
How the body can kill the pathogen by generating toxic oxygen and nitrogen products producing such things as nitric oxide and hydrogen peroxide
What is the most common cause of drug fever?
Hypersensitivity reaction to medication
A nurse instructing unlicensed personnel on temperature regulation includes that core body and skin temperatures are sensed by which of the following parts of the brain?
Hypothalamus
The nurse is providing discharge instructions for a postoperative client. The nurse determines that teaching about the wound was effective when the client states:
I will regain tensile strength of unwounded skin at the end of 3 months
The nurse is caring for an 83-year-old client recovering from hip replacement surgery. The nurse recognizes that the client is at risk for several potential complications. Select the option that places the client at greatest risk for complications of wound healing.
Immobility resulting from his surgery
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
A client is experiencing the early stages of an inflammatory process and develops leukocytosis. The nurse recognizes this as an:
Increase in circulating neutrophils
When educating a patient with a wound that is not healing, the nurse should stress which of the following dietary modifications to ward off some of the negative manifestations that can occur with inflammation?
Increase your intake of oily fish and fish oil so that you will increase absorption of omega 3 polyunsaturated fatty acids
The nurse caring for older adults in an extended care facility suspects one of the clients has an infection. What is the earliest manifestation the client could exhibit?
Increased mental confusion
A nurse notes that a patient with a fever has begun to shiver. The nurse should assess for which of the following events?
Increased temperature
A patient undergoes a splenectomy following an automobile accident. The nurse monitors for which of the following anatomical changes most likely to occur following surgery?
Increased white blood cell (WBC) count
In which of the following patients with a transecting spinal cord injury should the nurse anticipate an impaired ability for temperature regulation?
Injury at T2
Question: A school-aged child asks the nurse why his wound has a scab on it. The nurse walks the child through the inflammatory phase of wound healing. Place the steps of the inflammatory phase in proper sequence.
Injury occurs on playground. Injured blood vessels vasoconstrict. Platelet activation initiates blood clotting. Following brief period of constriction, vessels dilate. Capillaries increase permeability, allowing plasma to leak into the area. Clot loses fluid and becomes hard (scab protects the area).
There are two types of stimuli that affect the raising or lowering of body temperature. What are these stimuli?
Innocuous and noxious
A patient's temperature readings are as follows: 99.6°F at 4 pm; 102°F at 8 pm; and 97.9°F at 12 am. The nurse's hand-off should include which of the following?
Intermittent fever
In which of the following stages of mitosis does the cell not undergo division but does double its mass?
Interphase
A client with a history of several previous abdominal surgeries has been admitted to the hospital with several abdominal pains. Knowing that fibrous strands of collagen can form following abdominal surgery resulting in adhesions, the nurse should assess the client for:
Intestinal obstruction causing constipation
Subcutaneous fat affects the body's ability to insulate itself because of which of the following? Select all that apply.
It adds thickness to the body's outer shell, its poor ability to conduct body heat
The rehabilitation nurse is caring for a client who is recovering from a cerebrovascular accident (CVA) with hemiplegia. The family asks the nurse if the paralysis will be permanent. Upon which of these physiologic rationales should the nurse base the response?
It is likely that paralysis is permanent, as nerve cells do not normally regenerate
An instructor is explaining to a group of students the way in which muscles and their associated tendons can be so strongly attached. The instructor makes references to the role of the basal lamina. Which of the following statements most accurately captures an aspect of the basal lamina?
It is present where connective tissue contacts the tissue it supports
Which statements are true regarding chronic inflammation? Select all that apply.
It is usually a result of persistent irritants, the inflammatory agent is usually resistance to phagocytosis, it involves the presence of mononuclear cells like lymphocytes
When caring for a client with a pressure ulcer, the nurse collaborates with the provider to obtain an order for which of these interventions to promote wound healing?
Keep dressing of the wound bed moist
The nurse is caring for a client with an accumulation of 2.5 cm. of darkened tissue scar over the area of a 3 mm. injury. How does the nurse correctly document this finding in the medical record?
Keloid
While the nurse is performing a skin assessment on an African American 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 which of the following?
Keloid
A nurse is changing the wound dressing on the coccyx-region pressure ulcer of an immobilized patient. The existing dressing is saturated with both watery, clear discharge and foul, grayish-colored liquid. Which of the following entries in the patient's chart best captures this?
Large amounts of supperative and serous exudates noted
A normal response to fever is an elevated heart rate. A client with a fever who is not exhibiting an elevated heart rate would indicate to the nurse that the cause of the fever might be which of the following?
Legionnaires disease
An emergency room nurse caring for a 24-day-old infant for signs of bacterial infection toxicity should assess for which of the following symptoms? Select all that apply.
Lethargy, poor feeding, cyanosis
The nurse evaluating the blood work results of a client with an infected leg ulcer. The white blood cell count is 18,000 cells/uL. The nurse interprets this as:
Leukoctosis
When caring for a client who has developed bacterial pneumonia, the nurse assesses for which of these abnormalities that supports presence of infection?
Leukocytosis
When discussing cellular replication with a client with chronic kidney disease, the client asks, "Can't my body just repair or grow a new kidney?" The nurse responds, "The kidney is a stable tissue and has only limited replicative capacity. In humans, the exception to this is the:
Liver
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 healthcare 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
The cardinal signs of inflammation include swelling, pain, redness, and heat. What is the fifth cardinal sign of inflammation?
Loss of function
A 16-year-old girl has broken her arm while snowboarding. When she arrives at hospital, she is shocked at the amount of swelling at the injury site. Which of the following statements best explains the physiological rationale for her swelling?
Loss of plasma proteins causes an increase in interstitial osmotic pressure.
One of the pathophysiology students recognized hyaluronic acid (a component of the extracellular matrix) as a supplement she buys at the health store following a knee injury. Knowing what this substance is, the student shares with her peers that it:
Lubricates joints and serves as a supportive structure in the extracellular space throughout the body
A nursing professor is teaching nursing students about the immune system. The instructor knows that teaching has been successful when a student correctly identifies which of the following cells as being responsible for the activation of the immune system?
Macrophages
Most febrile illnesses are due to common infections and are relatively easy to diagnose. In certain instances, however, it is difficult to establish the cause of a fever. In these instances, the elevation in temperature is referred to as a fever of unknown origin (FUO). What is a common cause of FUO?
Malignancies
Diagnosing the primary cause is one of several methods used to treat fever. What are some other methods? (Select all that apply.)
Modification of external environment to increase heat transfer from the internal environment to the external environment, support of hypermetabolic state that accompanies fever, protection of vulnerable body organs
During lecture on wound care, the instructor mentions the final stage of the cellular response of acute inflammation. Of the following statements, which describes what physiologically occurs in the final stage?
Neutrophils, monocytes, and macrophages engulf and degrade
A client asks why his temperature is always below 98.6°F. The nurse responds:
Normal core temperature varies between individuals within the range of 97.0F to 99.5F
A two-day postoperative patient's temperature was 98.5°F at 3:00 pm. At 6:00 pm, the unlicensed assistant notifies the nurse that the patient's temperature is 102.0°F. Which of the following actions should the nurse take?
Notify the physician
A client is said to be in the chill stage of the fever process when the nurse does which of the following?
Observes piloerection on the skin
The nurse is assessing patients who are febrile. Which of the following patients is at greatest risk due to fever?
Older adult patient with heart failure
Tissue repair through regeneration occurs in which cells?
Parenchymal
The nurse is assessing a patient with an elevated temperature. Which of the following additional assessment findings provides the most useful information for the nurse?
Patient's heart rate is more rapid than anticipated
Which of the following patients is most likely to have impairments to the wound healing process? A patient with:
Poorly controlled blood sugars with small blood vessel disease
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 caring for a post operative patients documents that the surgical incision is healing by which of the following?
Primary intention
Place the four successive stages of fever in correct order.
Prodromal, Chill, Flush, Defervescence
A patient has a mild headache and fatigue. He also states he has some aches and pains. Which of the following stages of fever does the nurse determine the patient is experiencing?
Prodrome
While discussing the various types of cells, the instructor points out that cells that renew constantly throughout life also have specialized cells that are unable to divide without:
Progenitor cells that are differentiated so their daughter cells are limited to the same cell line
The nurse is assessing a 9 day old wound. The nurse notes that the edema surrounding the wound has diminished and that the wound is now blanchable. The nurse doucments that the wound is in which stage of the healing process?
Proliferation
A client sustained an injury 3 days ago. The nurse is assessing the status of the wound. The nurse anticipates the phase of healing to be:
Proliferative
A health educator is teaching a group of colleagues about the physiology of thermoregulation. Which of the following statements is most accurate?
Prostaglandin E2 (PGE2) exerts a direct fever-producing effect on the hypothalamus
Metabolism changes when an individual has a fever. What are the primary sources of energy during a fever? (Select all that apply.)
Proteins, fats
An elderly patient has a temperature of 101°F. The patient becomes confused and disoriented. The nurse's priority assessment would be to check which of the following?
Pulse oximetry
Which of the following patients are at increased risk for hyperthermia? Select all that apply.
Quadriplegic attending an outdoor summer event, patient with heart disease in an nonairconditioned vehicle, patient with schizophrenia taking haloperidol
The nurse is attempting to obtain the most accurate core body temperature of a patient. Which of the following methods should the nurse use?
Rectal
The nurse needs to assess a 1-year-old child for fever. Which approach will produce the most accurate reading?
Rectal
The route considered the most accurate to measure a core body temperature is which of the following?
Rectal
Which of the following interventions provides the most accurate information about core temperature?
Rectal temperature
The presence of granulation tissue at a wound site is identified by:
Red, moist tissue
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
An older adult client with a history of chronic obstructive pulmonary disease (COPD) develops a fever of 38.3ºC (101ºF). What is the primary reason for the nurse to implement temperature lowering measures?
Reduce oxygen demand
While a nurse is taking a patient's history, the patient states that he had a fever two ago that went away for a day and then returned. The nurse documents this as being which of the following types of fever?
Relapsing
When a patient reports having three episodes of fever that has lasted several days, with periods of normal temperature in between the episodes for 2 or more days. Which type of fever is the patient experiencing?
Relapsing fever
A nurse reading a patient's history and physical notes that the patient has had a remitting fever. The nurse interprets this to mean that the patient's temperature has done which of the following?
Remained elevated but varied a few degrees
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
When completing a dressing change, the nurse notes that the wound has proud flesh. Which is the appropriate action by the nurse?
Request surgical consult
The objective of tissue regeneration in wound healing is to:
Restore injured tissue to its original structure
A nurse is assessing a client for the classic signs of acute inflammation. The nurse would assess the client for:
Rubor, swelling, and pain
A client has a watery fluid leaking from a site of inflammation. The nurse would document this type of exudate as:
Serous
Which of the following would be an appropriate action for a nurse to take in attempting to decrease a patient's temperature through radiation heat loss?
Set the room to a lower temperature
A patient is experiencing anorexia, myalgia, arthralgia, headache, and fatigue. The nurse should assess for which of the following?
Temperature
Select the option that best describes the type of tissue that is capable of regeneration when appropriately stimulated.
Stable
Some tissues, such as the mucosal surface of the gastrointestinal tract, have cells that are capable of cell division and serve as a reserve source for specialized cells. These cells are which of the following?
Stem cells
A family member asks the nurse, "What do they mean when they start taking about stem cells?" Which is the nurse's best response?
Stem cells are undifferentiated cells with the capacity to generate multiple different cell types
A client has arrived in the emergency department with massive blood loss from a lacerated liver. Knowing the physiological principles behind the capacity for cells to regenerate, the client's body will likely:
Stimulate rapid proliferation of RBCs by the blood-forming progenitor cells of the bone marrow
While sponging a client who has a high temperature, the nurse observes the client begins to shiver. At this point, the priority nursing intervention would be to:
Stop sponging the client and retake a set of vital signs
When caring for a client with a wound that is healing by primary intention the nurse recognizes which of these best describes this type of wound?
Surgical incision
A client with pneumonia is admitted with these vital signs: temperature 99.7ºF, pulse 80 beats/min, respirations 18/minute, and BP 120/80 mmHg. Which set of vital signs does the nurse anticipate when the client begins to shiver and requests another blanket several hours later?
T 100.9F, P 90/min, R 20/min, BP 126/80 mmHG
The nurse notes the client has developed a systemic response of inflammation based on assessment findings. Which of the following clinical manifestations support this diagnosis? Select all that apply.
Temperature of 100.9F lethargy, pulse rate 130 beats/ min (high), generalized achiness
Which client manifestation indicates signs of drug fever?
Temperature reaches 40C (104F) every afternoon, pulse 76 beats/ min, pruritis
The nurse assessing a client admitted with a diagnosis of "fever of unknown origin" notes that the temperature is elevated, but the heart rate is within normal range. What further assessment will the client require?
Test for Legionnaire disease
Which responsibility of the extracellular matrix (ECM) most accurate?
The ECM provides the scaffolding for tissue renewal
Following hip replacement surgery, the client has had many weeks of physical therapy. Upon assessing the wound, it is still red and draining thick, green, odoriferous secretions. The client has limited range-of-motion and is constantly reporting pain. The physician explains that the hip device needs to be removed. Why is removal required?
The body considers the hip replacement device a foreign body and an infection has developed around the joint
All wounds are considered contaminated at the time they occur. Usually, the natural defenses in our bodies can deal with the invading microorganisms; however, there are times when a wound is badly contaminated and host defenses are overwhelmed. What happens to the healing process when host defenses are overwhelmed by infectious agents?
The formation of granulation tissue is impaired.
A nurse caring for an older adult who has been diagnosed with a urinary tract infection checks the patient's temperature on admission and finds that it is 96.6°F. Which of the following describes how the nurse should interpret the finding?
The patient may be exhibiting a blunted or absent febrile response
The nurse notes that a patient's core body temperature is 43°C. Which of the following is the correct interpretation by the nurse?
The patient's body's ability to thermoregulate is impaired
Following a severe automobile accident, a client is scheduled to have surgery to either repair or remove his spleen, pancreas, and stomach. The patient 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
Select the option that best describes why highly differentiated neuron cells are unable to increase their numbers after a certain point in time.
The stimuli to bring about mitosis are lacking
The medical team is assessing a newly-admitted patient who is hypothermic following a night spent lost on a ski slope. The health care professionals would recognize that which of the following phenomena most likely contributed to minimizing the client's heat loss in a cold environment?
The tissue thickness of the outer shell increased and preserved heat
The nurse is caring for a client with an infected wound that is left to heal by secondary intention. Which of these observations 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 a torn rotator cuff has been asked by his physician, a regenerative specialist, to consider allowing transplantation of his own stem cells into his area of injury. This is an example of:
Therapeutic cloning
While studying for a pathophysiology exam on cells and tissue repair, a student asks, "What happens if, in the process of going through the cell cycle, a cell is damaged?" Which is the best response?
There are built in checkpoints in the cell cycle to allow for defects to be edited and repaired
Following an injury that resulted in a major wound, the client notes that on day 2, the wound looks a little different. The client also notes that if he just brushes the skin accidentally with a towel, it bleeds easily. The client asks why this happens. Which is the best response by the nurse?
There is new granulation tissue forming that contains many newly developed capillary buds
The nurse is caring for a client with a stab wound. The nurse recognizes that deficiency of which of these elements of the blood will interfere with hemostasis at the site of injury?
Thrombocytes
Purulent exudate contains what substances? Select all that apply.
Tissue debris, white blood cell by products
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
A nurse is assisting a patient, who has a fever, order lunch. Which of the following would be the most appropriate choice?
Toast
Select the most likely source of a fever in a 16-month-old female child.
UTI
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
During the synthesis phase of the cell cycle, the cell is:
Undergoing a period DNA synthesis and replication of the chromosomes
Select the statement that best describes stem cells.
Undifferentiated cells of continuously dividing tissues that have the capacity to generate multiple cell types
A client with a diagnosed history of arthritis has experienced cartilage damage. The nurse recognizes this as resulting from:
Unregulated action of proteases
Which of the following processes would most likely be considered an anomaly during the cellular phase of inflammation?
Vasoconstriction
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 causing the red color and warmth
A client who has developed a fever is now complaining of a headache. The nurse would recognize this manifestation as a result from the:
Vasodilation of cerebral vessels
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
While educating a group of individuals about to undergo knee surgery, the nurse stresses the importance of eating a well-balanced diet, especially high in vitamins. Which vitamin promotes collagen synthesis to facilitate the wound to the knee to heal properly?
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
The nurse is caring for a client with an elevated temperature. Which of the following other symptoms might the nurse expect the patient to be experiencing? Select all that apply.
Weakness, fatigue
Fever and hyperthermia describe conditions in which body temperature is higher than the normal range. When does hyperthermia occur?
When the body's set point is unchanged, but the temperature goes up
Metalloproteinase requires which mineral to be present before degraduation of collagen occurs?
Zinc
Which clients are showing manifestations of infection? Select all that apply.
a. A 2 month old, temp 100.4F b. A 25 year old, temp 104F c. A 75 year old, temp 99.2F
A client on peritoneal dialysis awakens one night to find that the end of the catheter has become disconnected and is contaminated by microbes on the bed sheets. The client develops peritonitis and is admitted for IV antibiotic therapy. Of the following possible complications related to this situation, which should the nurse be educating the client to watch for? Select all that apply.
a. Adhesions trapping bowel loops b. Intestinal obstruction
A client with diabetes has a wound that will not heal. The client has been prescribed hyperbaric oxygen therapy. The client asks why he is going in an oxygen chamber instead of just having dressing changes and IV antibiotic therapy. The nurse knows that hyperbaric oxygen is currently used in wounds that have: Select all that apply.
a. An infection that is interfering with healing b. Limited oxygen supply which is common in clients with diabetes
In normal tissue, the size of the cell population is determined by which of the following? (Select all that apply.)
a. Balance of cell proliferation b. Death by apoptosis c. Emergence of newly differentiated cells
An oncology client is about to begin chemotherapy. During the education, the nurse mentions that continuously dividing cells will be most affected by the chemotherapy. The client asks, "What are continuously dividing cells?" The nurse responds, "These are cells that continue to divide and replicate like: Select all that apply.
a. Cells on the surface of your skin b. Cells in your mouth c. Cells lining your GI tract
While reviewing all the functions pertaining to growth factors, the study group of students will be discussing which cellular processes? Select all that apply.
a. Cellular proliferation b. Production by leukocytes activated at the site c. Ability to attract neutrophils and monocytes d. Stimulate angiogenesis
A client with severe peripheral artery disease has just return to the nursing unit following stent placement in her right femoral and popliteal artery to increase blood flow to the lower extremity. Upon assessment, the nurse is unable to palpate pulses in the right foot (pedal pulse and posterior tibial). No pulses are heard with doppler. The nurse knows oxygen is required for which aspects of wound healing? Select all that apply.
a. Collagen synthesis b. Killing of bacteria by phagocytic white blood cells c. Destruction of microbes neutrophils and macrophages
While reviewing a pathophysiology chapter on cell proliferation and tissue repair, the study group notices that the transition from G2 to M in the cell cycle is an important checkpoint and requires which proteins to be available to complete the process? Select all that apply.
a. Cyclin B b. Cyclin-depentend kinases 1
An oncology class is reviewing the cell cycle as it pertains to tumor growth. When talking about the G1 phase, the instructor describes that the processes occurring at this time include: Select all that apply.
a. DNA synthesis ceases b. Cell growth takes place
A nurse conduction a staff inservice on wound healing in older adults determines that the participants are understanding the information when they state that older adults may experience delayed wound healing due to which of the following aging processes? (Select ALL that apply)
a. Decreased collagen synthesis b. Slower reepithelialization c. Impaired wound contraction
During a lecture on stem cells, the professor mentions that the first few cells produced after fertilization are totipotent and divide into which types of cells? Select all that apply.
a. Embryonic cells b. Extraembryonic cells
The basement membrane surrounding a patient's foot wound remains intact, a fact that bodes well for the wound-healing process. Which of the following components constitute this form of the extracellular matrix (ECM)? Select all that apply.
a. Fibrous structural proteins b. Water-hydrated gels c. Glycoproteins
Following an injury, the client's healthcare provider states the wound is healing well. The client asks the nurse, "if my wound is healing so fine, why is it still swollen?" The nurses response is based on the principle that angiogenesis can result in blood vessels being leaky due to:
a. Incompletely formed interendothelial cell junctions b. VEGF, a growth factor, increasing vascular permeability
The nurse admitting a client with an infected leg wound notes that the client has a history of peripheral vascular disease, COPD, and diabetes, and GERD. Which disorders increase the client's risk for wound complications? (Select ALL that apply)
a. PVD b. COPD c. Diabetes
A continuing education nurse in a long-term care facility is discussing wound healing in elderly patients. Due to elderly patients being more likely to have co-morbidities like problems with mobility, diabetes, or vascular problems, the nurses should assess the patients for: Select all that apply.
a. Pressure wounds on buttocks b. Impaired healing related to diabetes c. Ischemic ulcer formation in feet
The physiology instructor asks the students, "How does growth factor affect cell proliferation?" Which students have the most accurate responses? Growth factors: Select all that apply.
a. Regulate the inflammatory process b. Act as a chemoattractant for many cells like neutrophils and macrophages c. Stimulate new blood vessel growth
A client recovering from an accident notices that she has developed excess tissue that extends above the edges of the wound. She asks "What can be done about this excess tissue?" The nurse responds that it can be removed by which procedures? Select all that apply.
a. Surgically removing the excess tissue b. Chemically cauterizing the defect
Following an injury, scar formation builds on the granulation tissue framework. Proliferation of fibroblasts occur with the assistance of which growth factors that have been released from endothelial and inflammatory cells at the site of injury? Select all that apply.
a. Transforming growth factor-beta b. Fibroblast growth factor
A child is brought to the emergency department after falling and cutting the leg on a piece of fencing. While explaining the process of normal tissue repair, the nurse explains that certain cells, like fibroblasts, proliferate at times like this with the production of:
growth factors to help the cells respond and expand in numbers to repair the injury.
A client with severe peripheral artery disease (PAD) has been educated about the various growth factors and their functions. This client is hoping that the growth factor, fibroblast growth factor (FGF), will be able to repair the circulation to his lower extremities because this growth factor's function is to:
grow new vessels into the damaged area (angiogenesis).
While explaining to a chemotherapy client the effect the medications have on bone marrow cells, the nurse mentions that bone marrow stem cells have been shown to not only generate blood cells but also which other type of cells? Select all that apply.
• Fat cells • Cartilage cells • Bone cells • Muscle cells
Following an injury, scar formation builds on the granulation tissue framework. Proliferation of fibroblasts occur with the assistance of which growth factors that have been released from enothelial and inflammatory cells at the site of injury? Select all that apply.
• Fibroblast growth factor (FGF) • Transforming growth factor-beta (TGF-beta)
The wound care nurse is teaching a group of nurses about wound healing. Presence of which of these situations that interfere with wound healing should the nurse include in the discussion? Select all that apply.
• Hyperglycemia • Malnutrition • Infections
A class of student nurses is hearing a lecture on wound healing. The professor explains about primary and secondary healing. The professor continues to talk about the phases of wound healing and states that in both primary and secondary healing the phases of wound healing occur at different rates. What are the phases of wound healing? (Select all that apply.)
• Proliferative phase • Inflammatory phase • Maturational phase
The professor is describing multipotent stem cells, mentioning that these hematopoietic stem cells give rise to a family of cells. Which cells are in this family? Select all that apply.
• Red blood cells • Leukocytes
Following an injury, the client's healthcare provider states the wound is healing well. The client asks the nurse, "If my wound is healing so fine, why is it still swollen?" The nurses response is based on the principle that angiogenesis (which is occurring in the wound)can result in blood vessels being leaky due to: Select all that apply.
• incompletely formed interendothelial cell junctions. • VEGF, a growth factor, increasing vascular permeability.
