Deck 10: Inflammation

Question 1

The nurse instructs an older adult client with arthritis on the side effects of nonsteroidal anti-inflammatory drug (NSAID)therapy. Which client statement would indicate that this teaching has been effective?

A)"I will report any abnormal bruising."
B)"Caffeine decreases the effectiveness of the medication."
C)"I cannot take other medications while using NSAIDs."
D)"If I notice a change in my mood after starting NSAID therapy, I will call the prescriber."

Answer 1

"I will report any abnormal bruising."

Question 2

A client with acute abdominal pain is scheduled for an appendectomy in 3 hours. While waiting for the surgery, the client reports that the pain has subsided. In this scenario, what is the priority action by the nurse?

A)Determine when the client can be medicated for pain.
B)Contact the surgery department.
C)Contact the healthcare provider.
D)Notify the nursing supervisor.

Answer 2

Contact the healthcare provider.

Question 3

The nurse is caring for a pediatric client recovering from surgery for a perforated appendix. Which nursing diagnosis should the nurse use to guide this client's care during the immediate postoperative period?

A)Risk for Chronic Pain
B)Risk for Impaired Perfusion
C)Risk for Deficient Fluid Volume
D)Risk for Infection

Answer 3

Risk for Infection

Question 4

A client with appendicitis is highly agitated and states that she is experiencing a great deal of pain. Which intervention will help decrease this client's anxiety?

A)Assess pain levels every 2 hours and administer ordered medication.
B)Provide reading material to help distract the client.
C)Distract the client with ambulation.
D)Administer pain medications when the client complains of pain.

Question 5

The nurse is conducting an assessment on a client who is 36 hours postoperative following an appendectomy. During the assessment, the nurse is unable to hear any bowel sounds. The client denies passing flatus. Given this information, which action is most appropriate by the nurse?

A)Withholding food and oral fluids until intestinal motility has returned
B)Encouraging the client to increase oral fluid intake to promote peristalsis
C)Encouraging the client to increase solid food intake to promote peristalsis
D)Encouraging the client to decrease the amount of oral food and fluid intake

Question 6

The nurse, caring for an older school-age client recovering from an appendectomy, is preparing to help the family ambulate the child for the first time after surgery. Which nonpharmacologic nursing strategy would be most appropriate for this client?

A)Placing a warm, moist pack over the site of the incision
B)Holding a splint pillow against the abdomen when moving or coughing
C)Administering appropriate narcotic analgesics
D)Applying an ice pack over the site of the incision

Question 7

The nurse is providing care to a client who experiences chronic inflammation due to arthritis. For which collaborative intervention should the nurse plan when providing care to this client?

A)Administering anti-inflammatory medications
B)Administering diuretics
C)Administering frequent doses of opioid medications
D)Administering antibiotics

Question 8

A client is admitted to the hospital with an elevated temperature, nausea, and pain and tenderness in the lower right quadrant of the abdomen. After receiving pain medication, the client continues to complain of pain at a level of 8 on a 0-10 pain scale. The client is not scheduled to receive pain medications for at least another 2 hours. Given these circumstances, which statement by the nurse is most appropriate?

A)"I will inform the healthcare provider about your continued pain."
B)"I do not have any medications ordered for you at this time."
C)"Try to rest for a while longer until it is time to receive your medication"
D)"Let's try a heating pad or warm blanket to see if that helps with your discomfort."

Question 9

An adult female client develops signs and symptoms of appendicitis during the night. The client is brought to the emergency department by her family. Which nursing intervention is the most culturally sensitive for this client?

A)Ask the healthcare provider who should assess the client.
B)Ask for a female healthcare provider to assess the client.
C)Ask for a male healthcare provider to assess the client.
D)Explain the assessment procedure and ask the client and family their preference.

Question 10

A client is admitted to the hospital with airway edema, bronchoconstriction, and increased mucus production after being exposed to an allergen. Which nursing interventions are appropriate to address this inflammation to the client's respiratory system? Select all that apply.

A)Turn and reposition every 2 hours.
B)Monitor oxygen saturation.
C)Administer oxygen as prescribed.
D)Restrict fluids.
E)Monitor lung sounds.

Question 11

The warmth and redness that accompany inflammation result from which of the following steps in the inflammatory process?

A)Exudate production
B)Cellular regeneration
C)Hyperemia
D)Margination of leukocytes

Question 12

The nurse is caring for a client who has experienced a sports-related injury to the knee. During the morning assessment, which signs of inflammation should the nurse anticipate? Select all that apply.

A)Pitting edema
B)Pallor
C)Swelling
D)Warmth
E)Pain

Question 13

The nurse is providing instructions to a client who has been prescribed a nonsteroidal anti-inflammatory drug (NSAID). Which information is highest priority for the nurse to explain to the client about this medication?

A)"Take your medication on an empty stomach."
B)"Drink at least 8-10 glasses of water a day while taking this medication."
C)"Constipation is common with your medication, so include roughage in your diet."
D)"Take your medication with food."

Question 14

The nurse is caring for a client in the emergency department who is suspected of having appendicitis. Based on this data, which orders should the nurse anticipate from the healthcare provider? Select all that apply.

A)A cephalosporin antibiotic
B)A barium enema
C)Regular diet
D)Pain medication
E)Complete white blood cell count

Question 15

The nurse in a rheumatology clinic is managing care for clients who receive nonsteroidal anti-inflammatory drugs (NSAIDs)for the treatment of their disease processes. Which of the following are the primary laboratory tests the nurse should assess prior to initiation of NSAID therapy? Select all that apply.

A)Serum amylase
B)Electrolytes
C)Creatinine clearance
D)Complete blood count (CBC)
E)Liver function tests

Question 16

In the presence of inflammation, a client's erythrocyte sedimentation rate (ESR)

A)decreases due to the decreased proportion of fibrinogen in the blood.
B)decreases due to the increased proportion of fibrinogen in the blood.
C)increases due to the decreased proportion of fibrinogen in the blood.
D)increases due to the increased proportion of fibrinogen in the blood.

Question 17

The nurse is teaching the family of a school-age client diagnosed with inflammatory bowel disease regarding the administration of prednisone at home. At which time should the nurse instruct the parents to provide this medication to the client?

A)1 hour before meals
B)At bedtime
C)With meals
D)Between meals

Question 18

A nurse is providing instruction to the parents of a pediatric client who is experiencing inflammation due to respiratory infection. Which of the following points would be most appropriate for the nurse to include as part of this teaching?

A)"Try to keep your child in a supine position to promote more effective oxygenation."
B)"Adequate fluid intake is even more important for children with inflammation than for adults with inflammation."
C)"If your child seems to be gasping for air, encourage him to tuck his chin against his chest."
D)"Rapid heartbeat is an early sign of dehydration and low blood volume in children."

Question 19

The nurse is caring for a client with severe inflammation. Which assessment findings would indicate a systemic reaction to inflammation? Select all that apply.

A)Erythema
B)Edema
C)Pain
D)Tachypnea
E)Tachycardia

Question 20

The nurse is caring for a client who has extensive deep tissue damage. The nurse notes that the client is also vegan. Which dietary information should the nurse teach this client to enhance the healing process?

A)"A low-fat, high-carbohydrate, low-protein diet is best for healing."
B)"A high-fat, low-carbohydrate diet is best for healing."
C)"A high-carbohydrate, high-protein diet is best for healing."
D)"A diet high in protein and vitamin D is best for healing."

Question 21

The nurse provides teaching related to the diagnosis of Risk for Deficient Fluid Volume to a client with ulcerative colitis. Which statement on the part of the client indicates that this teaching has been effective?

A)"I will drink at least 2 quarts of fluid each day."
B)"I will continue to use a moisturizer on my skin."
C)"I should report dry patches of skin immediately to my doctor."
D)"If I have two liquid stools in any day, I will report this to my healthcare provider."

Question 22

The nurse is caring for an older adult client with gallbladder disease who is recovering from a cholecystectomy. Which risk factors increase this client's susceptibility to infection? Select all that apply.

A)Dry skin
B)Advanced age
C)Intact mucous membranes
D)Nonintact skin
E)Active bowel sounds

Question 23

The nurse educator in a gastrostomy clinic is teaching a group of clients about factors that play a role in the formation of gallstones. Which client would the nurse identify as having the highest risk for gallstone formation due to genetic factors?"

A)A Native American client
B)An African American client
C)An Asian client
D)A Norwegian client

Question 24

Why is laparotomy typically the surgery of choice for a perforated appendix?

A)Surgeons are better able to remove contaminants from the peritoneal cavity via laparotomy than via laparoscopy.
B)Laparotomy requires a smaller incision than laparoscopy and thus involves less blood loss.
C)Laparotomy involves a shorter period of postoperative hospitalization than laparoscopy.
D)Laparotomy allows for direct visualization of the damaged appendix, whereas laparoscopy does not.

Question 25

Which of the following conditions is the leading indication for surgery in Crohn disease?

A)Bowel obstruction
B)Internal fistula
C)Perianal complications
D)Abscess

Question 26

An adolescent client is experiencing abdominal pain with diarrhea and bloody stools. Based on this data, which specific type of inflammatory bowel disease does the nurse suspect the client is experiencing?

A)Appendicitis
B)Ulcerative colitis
C)Crohn disease
D)Necrotizing enterocolitis

Question 27

Which of the following medications is used to reduce the cholesterol content of gallstones and lead to their gradual dissolution?

A)Cholestyramine
B)Chenodiol
C)Meperidine
D)Amoxicillin

Question 28

List the pathophysiologic processes involved in appendicitis in sequential order.

A)The appendix becomes distended with fluid secreted by its mucosa.
B)The proximal lumen of the appendix becomes obstructed.
C)Purulent exudate forms and causes further distention of the appendix.
D)Pressure within the lumen of the appendix increases.
E)Tissue necrosis occurs and gangrene develops.

Question 29

The nurse is caring for an older adult client with cholecystitis. The client has been admitted to the hospital for diagnostic testing and pain control. Which nursing diagnosis would be of highest priority for this client?

A)Anxiety
B)Risk for Infection
C)Impaired Comfort
D)Imbalanced Nutrition: Less than Body Requirements

Question 30

A client with cholelithiasis is in the clinic for a follow-up assessment after hospitalization. What lifestyle modification should the nurse teach the client to decrease the pain associated with the disease process?

A)Reduce sodium intake
B)Decrease fat consumption
C)Increase fluids
D)Decrease smoking

Question 31

A nurse checking for tenderness at McBurney point for a client with suspected appendicitis will palpate which area?

A)A
B)B
C)C
D)D

Question 32

The nurse is evaluating care provided to an older adult client with a history of cholecystitis 5 months ago. Which of the following statements on the part of the client indicates that the client met a goal in the plan of care?

A)"I have increased my intake of fat."
B)"I have been eating out often."
C)"I have been walking 1 mile every day."
D)"I have been able to gain 5 pounds on the new diet."

Question 33

A nurse who works in an extended care facility is planning a staff teaching session regarding the care of older adult clients with appendicitis. Which of the following points would be most appropriate for the nurse to include in the lesson plan?

A)"Almost all older clients with appendicitis present with a moderate to high fever."
B)"In older adults, the pain associated with appendicitis tends to fall closer to the midline than to McBurney point."
C)"Older adults with appendicitis rarely present with confusion, although they may be agitated due to severe abdominal pain."
D)"About half of older adult clients with appendicitis do not demonstrate rebound or involuntary guarding."

Question 34

The nurse is caring for a client who was admitted to the hospital 1 day prior with cholelithiasis. Which new assessment finding indicates that the stone has probably obstructed the client's common bile duct?

A)Nausea and vomiting
B)Jaundice
C)Right upper quadrant (RUQ)pain
D)Elevated cholesterol level

Question 35

The nurse is caring for an adolescent client who has been nonadherent to the medical plan of care to treat Crohn disease. In order to increase adherent behavior, which complication associated with Crohn disease should the nurse include in the client's teaching plan?

A)Vomiting
B)Bowel perforation
C)Intestinal obstruction
D)Diarrhea

Question 36

A client who is 4 days post-cholecystectomy has T-tube drainage totaling 600 mL in 24 hours. Which actions by the nurse are appropriate based on this data? Select all that apply.

A)Notify the healthcare provider.
B)Place the client in a supine position.
C)Assess drainage characteristics.
D)Clamp the tube q 2 hours for 30 minutes.
E)Encourage increased fluid intake.

Question 37

Which of the following statements is true with regard to ulcerative colitis and Crohn disease?

A)Clients with ulcerative colitis experience periods of remission, whereas clients with Crohn disease do not.
B)Ulcerative colitis is limited to the colon and rectum, whereas Crohn disease can affect any part of the GI tract.
C)The inflammatory lesions associated with Crohn disease are continuous, whereas those associated with ulcerative colitis are not.
D)Ulcerative colitis is more common in women, whereas Crohn disease is more common in men.

Question 38

A nurse is caring for a client with severe acute abdominal pain secondary to cholelithiasis. Which nursing actions promote effective pain management? Select all that apply.

A)Withhold oral food and fluids.
B)Insert nasogastric tube and connect to high suction.
C)Educate the client about decreasing protein in the diet, because protein increases gallbladder contractions.
D)Administer morphine, meperidine, or another opioid analgesic as ordered.
E)Place the patient in supine position to relieve abdominal pain.

Question 39

Which of the following lifestyle changes would most likely increase a client's risk for cholelithiasis?

A)Reducing intake of high-fat foods
B)Increasing intake of high-cholesterol foods
C)Beginning a regular exercise routine
D)Discontinuing use of hormonal birth control

Question 40

Which of the following lab results suggests that a client with gallbladder disease is experiencing obstructed bile flow in the biliary duct system?

A)Decreased WBC count
B)Elevated WBC count
C)Decreased direct bilirubin
D)Elevated direct bilirubin

Question 41

The nurse is caring for a client newly admitted to the medical-surgical unit with glomerulonephritis. Which classic manifestations of this disorder should the nurse expect to assess in this client? Select all that apply.

A)Edema
B)Weight loss
C)Hematuria
D)Acute flank pain
E)Proteinuria

Question 42

The nurse is assessing an older adult client with suspected acute interstitial nephritis. When gathering this client's health history, the nurse should be sure to ask the client which of the following questions?

A)"When is the last time you had a urinalysis?"
B)"Are you taking any medications for the treatment of indigestion?"
C)"Do you take any ACE inhibitors?"
D)"How much protein do you eat on an average day?"

Question 43

The nurse is planning a teaching session for older community members about the risks for peptic ulcer disease (PUD)in this age group. Which of the following pieces of information should the nurse include when teaching this group?

A)PUD causes less bleeding in older clients than in younger clients.
B)Older clients experience more severe abdominal pain than younger clients with PUD.
C)Older clients should undergo colonoscopy when diagnosed with PUD.
D)PUD is likely exacerbated by the bacterium Helicobacter pylori (H. pylori).

Question 44

A nurse caring for a pediatric client with inflammatory bowel disease (IBD)understands that there are variances in the presentation of IBD between children and adults. Which variances should the nurse anticipate for this pediatric client? Select all that apply.

A)Children suffer from Crohn disease more frequently than ulcerative colitis.
B)Pediatric clients often present with fistulizing or stricturing disease.
C)Pediatric clients usually have colonic involvement.
D)Pediatric clients more often present with left-sided colitis.
E)In the pediatric population, IBD is more common in females than males.

Question 45

The nurse is caring for an African American client with nephritis. When planning this client's care, the nurse should include interventions aimed at preventing which of the following long-term complications?

A)Congestive heart failure
B)Diabetes mellitus
C)End-stage renal disease
D)Hypertension

Question 46

A client is experiencing weight gain and foamy dark urine 4 weeks after being treated with antibiotics for a sore throat. Which client statement, made during the health history assessment, suggests that the nurse should provide the client with further instruction?

A)"I've been trying to get plenty of rest since I've been sick."
B)"I've started eating a more nutritious diet."
C)"I felt better after 1 week of the antibiotics, so I stopped taking them."
D)"I've gained a bit of weight over the last 2 weeks."

Question 47

A client is being scheduled for diagnostic tests to determine the presence of ulcerative colitis. For which diagnostic tests should the nurse plan to provide teaching? Select all that apply.

A)Barium enema
B)Intravenous pyelogram
C)Colonoscopy
D)Upper endoscopy
E)Barium swallow

Question 48

The nurse conducts an evaluation after completing a training session for community members on ways to prevent nephritis. When evaluating the success of this session, what responses from the community members would indicate that learning has been successful? Select all that apply.

A)"Practicing good hygiene can help prevent nephritis."
B)"One way to help avoid nephritis is by not smoking."
C)"Maintaining a healthy body weight helps promote kidney health."
D)"I should limit my alcohol intake to reduce the risk of nephritis."
E)"Controlling high blood pressure is important in the prevention of nephritis."

Question 49

The nurse has identified the diagnosis Excess Fluid Volume as appropriate for a client with acute glomerulonephritis. What should the nurse assess to obtain the most accurate indication of this client's fluid balance?

A)Vital signs
B)Intake and output records
C)Daily weight
D)Serum sodium levels

Question 50

Which of the following drugs used in the treatment of peptic ulcer disease (PUD)works by both binding to proteins in the ulcer base and stimulating the secretion of mucus?

A)Sucralfate
B)Omeprazole
C)Misoprostol
D)Bismuth

Question 51

A nurse is receiving a client from the emergency department who was diagnosed with an acute exacerbation of ulcerative colitis. The nurse anticipates that the client may present with which clinical characteristics? Select all that apply.

A)Between 5 and 30 diarrhea stools per day with blood and mucus
B)Steady right lower quadrant or periumbilical pain
C)Cramping in the left lower quadrant that is relieved by defecation
D)Tenderness and a mass in the right lower quadrant
E)Fever, malaise, and fatigue

Question 52

A client being discharged after treatment for nephritis is concerned about having adequate stamina to care for her children after discharge. Which statement made by the nurse would be most appropriate to address the client's concern?

A)"Tell your spouse he has to help you."
B)"You will be able to keep up with your family's needs once you return home."
C)"It sounds like you need some help, so I'll contact Social Services for support."
D)"Maybe your children should stay with a relative or neighbor for a few weeks."

Question 53

Which of the following lab values increases in the presence of renal impairment?

A)Creatinine clearance
B)Urine creatinine
C)Serum creatinine
D)Total urine output

Question 54

A child who is hospitalized with acute glomerulonephritis experiences blurred vision and headache while in the playroom. Which action by the nurse is the most appropriate?

A)Reassure the child and encourage bed rest until the headache improves.
B)Obtain the child's blood pressure and notify the physician.
C)Check the child's urine to see if hematuria has increased.
D)Obtain the child's serum electrolytes and send a urinalysis to the lab.

Question 55

A client being treated for nephrotic syndrome is a vegetarian and has recently experienced poor oral intake. Which action should the nurse take to meet this client's nutritional needs?

A)Request that the healthcare provider prescribe an appetite stimulant.
B)Request that a dietitian discuss dietary preferences with the client.
C)Encourage the client to eat the food provided on the meal trays.
D)Explain that the client will be returning home soon and can resume a preferred diet.

Question 56

The nurse is caring for a client who receives H?-receptor antagonists for the treatment of peptic ulcer disease. Based on the nursing diagnosis Risk for Bleeding, which assessment finding should the nurse report immediately to the healthcare provider?

A)The client reports pain after 24 hours of treatment.
B)The client reports episodes of melena.
C)The client reports that he is constipated.
D)The client reports that he took Tums antacids with his H?-receptor antagonist.

Question 57

Which of the following is the essential and most reliable diagnostic procedure for glomerular disorders?

A)Kidney scan
B)KUB abdominal x-ray
C)ASO titer
D)Biopsy

Question 58

A home health nurse is evaluating a client who had a colostomy placed 6 weeks ago for the treatment of ulcerative colitis. Which assessment would cause the nurse to conclude that teaching goals for this client have been met?

A)The client's colostomy pouch is clean and dry.
B)The client's vital signs reveal a normal temperature.
C)The client's stoma is pink and intact.
D)The client experiences pain with certain types of food.

Question 59

The healthcare provider prescribes misoprostol (Cytotec)for a female client for the treatment of peptic ulcer disease. What should the nurse ask the client prior to administration of this medication?

A)"Is there any chance that you are pregnant?"
B)"Are you currently sexually active?"
C)"Are your menstrual cycles irregular?"
D)"Do you plan on becoming pregnant in the next few months?"

Question 60

A client is being treated with blood transfusions for a large peptic ulcer in the duodenum. Which information in the client's history should the nurse suspect as a potential cause of this health problem?

A)Allergies to penicillin and morphine sulfate
B)History of chronic atrial fibrillation
C)Daily medications include naproxen sodium and aspirin
D)History of recent cataract extraction with lens implant

Question 61

A nurse is educating a client with peptic ulcer disease (PUD)about Helicobacter pylori (H. pylori)and its role in PUD. Which statements by the nurse are appropriate to include in the teaching session? Select all that apply.

A)"H. pylori produces enzymes that improve the efficacy of mucous gel in protecting the gastric mucosa."
B)"H. pylori infection is found in about 25% of individuals with PUD."
C)"Your inflammatory response to H. pylori contributes to gastric cell damage."
D)"H. pylori infection increases production of gastric acids."
E)"H. pylori infection is spread by droplets in the air."

Question 62

A client with Helicobacter pylori asks the nurse why bismuth (Pepto-Bismol)has been prescribed along with oral antibiotics for treatment. What should the nurse explain about the use of Pepto-Bismol for treatment of this health problem? Select all that apply.

A)"It helps prevent the side effects of antibiotics."
B)"It increases stomach acid to help kill bacteria."
C)"It helps relieve ulcer-related constipation."
D)"It is effective with inhibiting bacterial growth."
E)"It stimulates the production of substances that promote ulcer healing."

Question 63

The nurse is planning a teaching session regarding peptic ulcers for the residents of an assisted-living complex. Which concepts about peptic ulcer disease should the nurse include in the presentation to the residents? Select all that apply.

A)A colonoscopy is the most common test used to diagnose the presence of a gastric ulcer.
B)Gastric ulcers are more common than duodenal ulcers.
C)Many peptic ulcers are infected with Helicobacter pylori (H. pylori)and are treated with antibiotics.
D)The first sign of a peptic ulcer may be serious gastrointestinal bleeding.
E)An individual with a peptic ulcer will most likely experience pain when the stomach is empty.

Question 64

Which two areas are the most likely locations for a gastric ulcer to develop? Select all that apply.

A)Lesser curvature
B)Greater curvature
C)Distal to the pylorus
D)Proximal to the pylorus

Question 65

Why is steatorrhea a common manifestation of Zollinger-Ellison syndrome?

A)The high levels of hydrochloric acid associated with Zollinger-Ellison syndrome lead to impaired protein digestion.
B)The high levels of hydrochloric acid associated with Zollinger-Ellison syndrome lead to impaired fat digestion.
C)The large colonies of Helicobacter pylori (H. pylori)associated with Zollinger-Ellison syndrome lead to impaired protein digestion.
D)The large colonies of H. pylori associated with Zollinger-Ellison syndrome lead to impaired fat digestion.

Question 66

The nurse provides discharge teaching for a client with peptic ulcer disease (PUD). Which client statement indicates that teaching has been effective?

A)"I will drink more milk and limit spicy foods."
B)"I will take ibuprofen (Motrin)for my headaches."
C)"I will limit my intake of coffee."
D)"I will join a gym and increase my exercise."