Question 1

The post-surgical patient is experiencing delayed wound healing.The dietician believes the delay is related to nutritional intake.A deficiency in which of the following substances could directly affect healing?

Accepted Answer

Most of the factors that interfere with the production of collagen in healing tissues are nutritional.Scurvy,for example,is caused by lack of ascorbic acid-one of the cofactors required for collagen formation by fibroblasts.The results of scurvy are poorly formed connective tissue and greatly impaired healing.
Vitamin D deficiency will not directly affect healing; ascorbic acid does.
Melanin deficiency will not directly affect healing; ascorbic acid does.
Cholesterol deficiency will not directly affect healing; ascorbic acid does.

Question 2

An infant develops a fever secondary to a bacterial infection.Which of the following most likely triggered the fever?

Accepted Answer

Interleukin-1 is responsible for fever production.
Interleukin-6 stimulates growth and differentiation of blood cells.
Interleukin-10 helps decrease the immune response.
INFs are members of a family of cytokines that protect against viral infections.

Question 3

A 54-year-old male intravenous (IV)drug user is diagnosed with chronic hepatitis C.Testing revealed that he is a candidate for treatment.Which of the following could be used to treat his condition?

Accepted Answer

INFs are members of a family of cytokines that protect against viral infections.
Interleukin-1 is responsible for fever production.
Interleukin-6 stimulates growth and differentiation of blood cells.
Interleukin-10 helps decrease the immune response.

Question 4

A 12-year-old male is fighting with another child when he receives a puncture wound from a pencil.The school nurse cleans and bandages the wound.After about 1 week,the wound would be in which phase of healing?

Accepted Answer

Resolution occurs when repaired tissue is approaching close to normal.
Debridement is the scraping away of dead tissue and is not a phase of wound healing.
Primary intention is the stage of healing of wounds that are closely proximated.
Maturation is the result of severe wounds which would begin several weeks after injury and may take 2 years.

Question 5

The nurse is assessing a patient with a diagnosis of inflammation.The nurse would expect to find which of the following signs and symptoms consistent with acute inflammation? (Select all that apply.)

Accepted Answer

The classic symptoms of acute inflammation include redness (erythema),heat,swelling,pain,and loss of function.Exudates would indicate infection,not inflammation.

Question 6

A 30-year-old male was involved in a motor vehicle accident.The glass from the shattered window cut his face and neck.The scar,however,was raised and extended beyond the original boundaries of the wound.This pattern of scarring is caused by impaired:

Accepted Answer

Impaired production of collagen can cause surface overhealing,leading to a keloid or a hypertrophic scar.
Nutritional deficiencies would lead to healing problems,but not extended scarring.
Necrosis or steroid use leads to impaired epithelialization.
Impaired contraction would lead to drawing of tissues,not raised.

Question 7

A nurse is preparing to teach on the subject of opsonins.Which information should the nurse include? Opsonins are molecules that:

Accepted Answer

Opsonins coat the surface of bacteria and increase their susceptibility to being phagocytized.
Opsonins are not composed of fatty acids; they are antibodies.
Opsonins coat the surface of bacteria and increase their susceptibility to being phagocytized.They do not regulate inflammation; mast cells do.
Opsonins coat the surface of bacteria and increase their susceptibility to being phagocytized; they do not react with mast cells.

Question 8

A 65-year-old female is diagnosed with metastatic breast cancer.She has developed muscle wasting.Which of the following substances would be produced in large quantities to eliminate the tumor cells and cause muscle wasting?

Accepted Answer

Tumor necrosis factor causes muscle wasting.
Interleukin-6 stimulates growth and differentiation of blood cells.
Eosinophils are stimulated for parasites.
Platelets stimulate clotting.

Question 9

A nurse remembers the primary actions of the complement cascade include (select all that apply):

Accepted Answer

The actions of the complement cascade include increased vascular permeability and vasodilation,chemotaxis,opsonization,and cell killing.It does not involve vasoconstriction or increased clotting.

Question 10

A 10-year-old male is diagnosed with a parasite.Which lab result should the nurse check for a response to the parasite?

Accepted Answer

Eosinophils serve as the body's primary defense against parasites.
Monocytes are not the body's primary defense against parasite; eosinophils are.Monocytes are phagocytic.
Neutrophils are phagocytic; they are not the body's defense against parasites.
Macrophages are not active against parasites; they act as long-term defense against infections.

Question 11

The nurse is reviewing the lab data of a newly admitted patient.The nurse notes the patient had an erythrocyte sedimentation done,and the results are quite elevated.The nurse would focus the care plan on which of the following conditions?

Accepted Answer

Common laboratory tests for inflammation measure levels of acute phase reactants.An increase in fibrinogen is associated with an increased erythrocyte sedimentation rate,which is considered a good indicator of an acute inflammatory response.
Anemia would not result in an increased erythrocyte sedimentation rate.
An infection would result in an increase in white blood cell count,but not the erythrocyte sedimentation rate.
An electrolyte imbalance would not cause a rise in the sedimentation rate.

Question 12

Physical barriers that offer the body protection from damage and infection are located in the (select all that apply):

Accepted Answer

The physical barriers that cover the external parts of the human body offer considerable protection from damage and infection.These barriers are composed of tightly associated epithelial cells of the skin and of the linings of the gastrointestinal,genitourinary,and respiratory tracts.

Question 13

During inflammation,the liver is stimulated to release plasma proteins,collectively known as:

Accepted Answer

The synthesis of many plasma proteins by the liver is increased during inflammation.These proteins,which can be either proinflammatory or antiinflammatory in nature,are referred to as acute phase reactants.
Opsonins coat the surface of bacteria and increase their susceptibility to being phagocytized.
Antibodies are proteins of the immune system.
Phagolysosome destroys bacterium.

Question 14

The macrophage secretion that stimulates procollagen synthesis and secretion is:

Accepted Answer

Macrophages secrete transforming growth factor-beta to stimulate fibroblasts to secrete the collagen precursor procollagen.
Angiogenesis factor supports the growth of new vessels.
Matrix metalloproteinase remodels proteins at the site of injury.
Vascular endothelial growth factors are also involved in vessel growth.

Question 15

A 35-year-old male is diagnosed with lobar pneumonia (lung infection).Which of the following exudates would be present in highest concentration at the site of this advanced inflammatory response?

Accepted Answer

Fibrinous exudates occur in the lungs of individuals with pneumonia.
Serous fluid is watery fluid,as in a blister.
Purulent is characterized by an abscess,such as pus.
Hemorrhagic occurs when the exudates are filled with erythrocytes.

Question 16

Healing by secondary intention would occur in which of the following patients? A patient with a:

Accepted Answer

A patient with a stage IV pressure ulcer would heal by secondary intention.
A patient with a surgical wound would heal by primary intention.
A patient with a paper cut would heal by primary intention.
A patient with a sunburn would heal without needing either primary or secondary intention.

Question 17

The nurse identified each of the following clinical manifestations of inflammation.Which would the nurse classify as a local response? (Select all that apply.)

Accepted Answer

Local manifestations of inflammation are the result of the vascular changes associated with the inflammatory process,including vasodilation and increased capillary permeability.The symptoms include redness,heat,swelling,and pain.

Question 18

A 3-year-old is making play cakes in a sandbox and is eating the play cakes.The sand was also being used by cats as a litter box and was contaminated with toxoplasmosis.Which of the following would most likely also be present?

Accepted Answer

Infections caused by bacteria such as toxoplasmosis can result in granuloma formation.
Degranulation is a part of mast cell destruction.
Blood clots are not expected with chronic inflammation.
Exudate production is pus formation.

Question 19

When phagocytes begin to stick avidly to capillary walls,which process is occurring?

Accepted Answer

Both leukocytes and endothelial cells secrete substances that increase adhesion,or stickiness,causing the leukocytes to adhere more avidly to the endothelial cells in the walls of the capillaries and venules in a process called margination.
Exudation is the process of pus formation and does not result in stickiness.
Integration occurs in cells but is not a major function and does not lead to stickiness.
Emigration is similar to diapedesis and is not associated with increased stickiness.

Question 20

An 8-year-old female presents with edema of the cutaneous and mucosal tissue layers.Her mother reports that the condition is recurrent and seems to occur more often during stressful situations.The child is diagnosed with hereditary angioedema.Which of the following is deficient in this child?

Accepted Answer

A genetic defect in C1 esterase inhibitor (C1 INH deficiency)results in hereditary angioedema.
Hereditary angioedema is due to C1 esterase inhibitor.Carboxypeptidase degrades kinins.
Hereditary angioedema is due to C1 esterase inhibitor,not a disorder of neutrophils.
Plasmin is not associated with hereditary angioedema,but is associated with clots.

Quiz 5: Innate Immunity: Inflammation and Wound Healing