Deck 14: Inflammation and Wound Healing

Question 1

A patient with massive trauma to the leg has extensive skeletal muscle damage and wide,irregular wound edges.Which of the following responses to the patient's questions best describes healing of the injury?

A) "All of the damaged tissue will regenerate if infection does not occur."
B) "Most of the skin and skeletal muscle will be replaced by connective tissue."
C) "The skin will regenerate to cover the injury,but the muscle will not be replaced."
D) "Regeneration of skin and skeletal muscle tissue is usually possible but may take months or years to occur."

Answer 1

"Most of the skin and skeletal muscle will be replaced by connective tissue."

Question 2

A patient arrives at the emergency department with a swollen ankle after an injury occurred while playing soccer.What is the cause of this patient's swelling?

A) Hyperemia from vasodilation
B) Increased metabolism at the inflammatory site
C) Fluid shift to interstitial spaces
D) Change in local ionic concentration

Answer 2

Fluid shift to interstitial spaces

Question 3

A patient is brought to the health care facility with abdominal pain and fever.A complete blood count and white blood cell differential are completed and indicate a shift to the left.What does the nurse understand this finding to indicate?

A) An infection caused by pyogenic pathogens
B) An infection that is in the vascular response phase of inflammation
C) A chronic infection that stimulates the increased release of monocytes into the bloodstream
D) An acute inflammation with release of increased immature neutrophils into the circulation

Answer 3

An acute inflammation with release of increased immature neutrophils into the circulation

Question 4

During which stage of the febrile response would the nurse expect to see the patient sweating?

A) Chill
B) Flush
C) Prodromal
D) Defervescence

Question 5

Following bowel surgery,a patient develops a bacterial peritonitis.The patient is diaphoretic,with a temperature of 38.4°C.What would the nurse plan to do after establishing the nursing diagnosis of hyperthermia related to the response to infection?

A) Reduce the patient's caloric intake to slow the body's metabolic rate.
B) Change linens frequently to prevent rapid heat loss and subsequent chilling.
C) Administer antipyretic drugs immediately to prevent fever-induced cell damage.
D) Cover the patient with additional blankets to promote heat loss through sweating.

Question 6

The charge nurse observes a new graduate performing a dressing change on a stage III sacral pressure ulcer.Which action by the new graduate indicates a need for further education about pressure ulcer care?

A) The new graduate uses a hydrocolloid dressing (DuoDerm)to cover the ulcer.
B) The new graduate inserts a sterile cotton-tipped applicator into the pressure ulcer.
C) The new graduate irrigates the pressure ulcer with a 30-mL syringe using sterile saline.
D) The new graduate cleans the ulcer with a sterile dressing soaked in half-strength peroxide.

Question 7

During administration of antipyretic drugs,what does the nurse understand about the mechanism of action of these agents in decreasing body temperature?

A) They dilate small arterioles in the skin,promoting heat loss through radiation.
B) They stimulate the activity of sweat glands,leading to heat loss through evaporation from the skin.
C) They block the release of interleukins to raise the core body temperature in the midbrain.
D) They interfere with the production of prostaglandins and their effect on the temperature-regulating centre in the hypothalamus.

Question 8

In evaluating a patient's inflammatory response,by what does the nurse understand that the activation of the classical complement pathway to mediate an inflammatory response is stimulated?

A) Lysis of bacterial cells
B) An antigen-antibody complex
C) Monocyte diapedesis to injured tissue
D) Release of histamine from injured cells

Question 9

An older adult patient has a large,open,infected surgical wound on the abdomen that contains a creamy exudate and small areas of red granulation tissue.How should the nurse classify this wound?

A) Black wound
B) Yellow wound
C) Superficial red wound
D) Full-thickness red wound

Question 10

Which one of the following types of macrophages would be found in bone tissue?

A) Type A cells
B) Microglial cells
C) Osteoclasts
D) Histiocytes

Question 11

Which of the following causes of lethal cell injury results in destruction of the cell membrane or nucleus and the production of lethal toxins?

A) Hypoxia
B) Chemical
C) Microbial
D) Immunological

Question 12

The nurse is preparing to perform a wet-to-dry dressing change for a patient with infected leg burns.Which action is appropriate for this type of dressing change?

A) Administer the ordered as-needed oral opioid 30 minutes before the dressing change.
B) Pour sterile saline onto the new dry dressings after the wound has been packed.
C) Soak the old dressings with sterile saline a few minutes before removing them.
D) Spread Silverderm ointment into the wound before repacking with moist dressings.

Question 13

A patient with a systemic bacterial infection has "goose pimples," feels cold,and has a shaking chill.At this stage of the febrile response,what would the nurse expect to find?

A) Flushing of the skin
B) Rising body temperature
C) Decreasing blood pressure
D) Relief of muscle aching and fatigue

Question 14

Which of the following activities occurs during the granulation phase of primary intention healing?

A) Migration of epithelial cells and clot formation
B) Remodelling of collagen and initiation of capillary growth
C) Migration of fibroblasts and secretion of collagen
D) Approximation of incision edges and increased capillary buds

Question 15

The physician has told a patient that her heart has hypertrophied because of damage to her heart when she had her heart attack.How should the nurse explain the damage to the heart to help the patient understand what has happened?

A) The cells in her heart have become larger in response to the loss of heart tissue.
B) The cells in her heart have changed from contractive muscle cells into scar tissue.
C) Some of her heart cells have decreased in size because of the loss of normal cells.
D) The number of heart cells has increased to compensate for the cells that died during her heart attack.

Question 16

A 34-year-old patient with diabetes mellitus had an abdominal cholecystectomy two years ago and has had intermittent abdominal pain and gastrointestinal distress since that time.An exploratory laparotomy was performed,and multiple adhesions were released.Why should the nurse expect that this patient's wound healing may be delayed?

A) Because of damage to her intestinal organs caused by the adhesions
B) Because of her prior history of adhesion development with a surgical procedure
C) Because of her diabetes,which decreases collagen synthesis and early capillary growth
D) Because of the lack of a gallbladder,which provides necessary mediators for healing

Question 17

Which local manifestation of inflammation causes a change in pH?

A) Heat
B) Pain
C) Redness
D) Swelling

Question 18

The nurse assesses a surgical patient the morning of the first postoperative day.Which of the following signs of a local inflammatory response would the nurse expect to find?

A) Redness and heat of the incision
B) Leukocytosis with elevated monocytes
C) Pain and purulent drainage of the incision
D) Fever and increased pulse and respiratory rate