pathophysiology midterm | Inflammation, Tissue Repair, and Wound Healing | Questions With Complete Solutions A 23 -year-old man has received a recent diagnosis of append icitis. The nurse providing care for the man is explaining that the inflammation of his appendix is playing a role in his body's fight against the underlying infectious process. Which teaching points should the nurse eliminate from client education? A. "In flammation can help to remove the body tissue cells that have been damaged by infection." B. "Inflammation will start your body on the path to growing new, healthy tissue at the site of infection." C. "Inflammation helps your body to produce the right anti bodies to fight the infection." D. "Inflammation ultimately aids in eliminating the initial cause of the cell injury in your appendix." hhCorrect Answers hhAnswer: C Rationale: Antibody production is not a noted component of the inflammatory response. Removi ng damaged cells, generating new tissue, and eliminating the cause of cell injury are all documented components of the inflammatory response. A client presented to the emergency department of the hospital with a swollen, reddened, painful leg wound and ha s been diagnosed with methicillin -resistant Staphylococcus aureus (MRSA) cellulitis. The client's physician has ordered a complete blood count and white cell differential. Which blood component would the physician most likely anticipate to be elevated? A. Basophils B. Eosinophils C. Platelets D. Neutrophils hhCorrect Answers hhAnswer: D Rationale: Increased neutrophils are associated with inflammation, in general, and bacterial infections in particular. Platelets play a role in inflammation but their levels w ould not rise to the same extent as would neutrophils. Eosinophils are not strongly associated with bacterial infection and basophils would not increase to the same degree as neutrophils. A 16 -year-old girl has broken her arm while snowboarding and is shocked at the amount of swelling at the injury site. Which statement best explains the physiologic rationale for her swelling? A. Migration and proliferation of mast cells, neutrophils, and p latelets to the injury site occupy an increased volume of tissue. B. Potent vasodilation increases the total volume of vascular space at the site of inflammation. C. Osmotic flow of plasma into the intravascular space causes increased blood volume and inte rstitial fluid. D. Loss of plasma proteins causes an increase in interstitial osmotic pressure. hhCorrect Answers hhRationale: Swelling is the result of plasma proteins leaving the interstitial space, resulting in increased osmotic pressure of interstitial f luid and movement of fluid into tissues. Neither blood components, vasodilation, nor increased intravascular volume account for swelling. Which phenomena best accounts for the increased presence of leukocytes at the site of inflammation? A. Existing leuko cytes stick to the epithelial cells and move along blood vessel walls. B. Increased numbers of leukocytes are released into circulation via cytokine stimulation. C. Leukocytes are osmotically drawn from circulation into the interstitial space as a result o f swelling. D. Epithelium expresses leukocyte stimulation factors in response to cell injury. hhCorrect Answers hhAnswer: A Rationale: During inflammation, leukocytes accumulate at the point of epithelial contact in the processes of margination, adhesion, an d transmigration. This is not directly achieved by way of increased leukocyte production or release, nor by osmotic pressure. The epithelium does not produce leukocyte stimulation factors. When explaining the final stages of the inflammatory response to pathogens, the nurse should include which educational topics? PRIMEXAM.COM A. How the body can kill the pathogen by generating toxic oxygen and nitrogen products, producing such things as nitric oxide and hydrogen peroxide B. Margination, which is a process whereby white cells (leukocytes) stick to the endothelium and accumulate along the blood vessel C. The increase in vascular permeability, which lets fluids leak into the extravascular tissues D. The promotion of tissue regeneration, whereby monocytes and macrophages produce potent prostaglandins and leukotrienes. hhCorrect Answers hhAnswer: A Rationale: The latter stages of phagocytosis result in intracellular killing of pathogens, accomplished by several mechanisms, including toxic oxygen and nitrogen produ cts, lysozymes, proteases, and defensins. The metabolic burst pathways generate toxic oxygen and nitrogen products (e.g., nitric oxide, hydrogen peroxide, and hypochlorous acid). Margination is the early stages of the inflammatory response. Vascular change s occur with inflammation but are prior to the final stage. Macrophages arrive within hours at the inflammation site. A deficiency in which of these would result in an inhibition of the inflammatory response? A. Histamine B. Helper T cells C. B cells D. V itamin K hhCorrect Answers hhRationale: Histamine is a key mediator in the inflammatory system, unlike helper T cells, B cells, or vitamin K. When educating a client with a wound that is not healing, the nurse should stress which dietary modifications to wa rd off some of the negative manifestations that can occur with inflammation? A. Increase the amount of calcium in the diet, especially drinking milk and eating cheese. B. This is the one time whereby you should eat more fat (both polyunsaturated and satura ted) so you can absorb more fat -soluble vitamins. C. Since there is a loss of plasma proteins, you should increase your intake of organ meats like liver. D. Increase your intake of oily fish and fish oil so that you will increase absorption of omega -3 polyunsaturated fatty acids. hhCorrect Answers hhAnswer: D Rationale: Dietary modification of the inflammatory response through the use of omega -3 polyunsaturated fatty acids, specifically eicosatetraenoic acid and docosahexaenoic acid, which are present in oily fish and fish oil, may be effective in preventing some negative manifestations of inflammation. Tumor necrosis factor -α and IL -1 are major cytokines that mediate inflammation. If the client is developing a systemic response to an infection, the nurse wil l likely assess which clinical manifestations? Select all that apply. A. Elevated temperature B. Hypertension C. Tachycardia D. Decrease in urine output E. Anorexia hhCorrect Answers hhAnswer: A, C, E Rationale: IL -1 and TNF -α are mediators of the acute -phase responses associated with infection or injury. Features of these systemic responses include fever [elevated temperature], hypotension, tachycardia [increased heart rate], anorexia,
