NR283 Pathophysiology Week 2 DAPT Review — Inflammation, Immunity, Hypersensitivity, Wound
Healing, Skin Integrity & Infection | Chamberlain Nursing | Practice Q&A with Rationales
What are the signs of acute inflammation? Select Pain
all that apply. Heat
Rednes
Granulomas s
Swelling Swellin
Tissue g
destruction Pain RATIONALE: The pneumonic PRISH is used to recall the five signs of acute
Redness inflammation: pain, redness, immobility (if impacting a joint or pain is
Heat severe), swelling, and heat.
Tissue destruction and granuloma formation are characteristics of chronic
inflammation.
Which immune chemical mediators contribute to Leukotrienes
the swelling associated with acute inflammation? Histamine
Select all that apply. Prostaglandins
Kinins
Prostaglandins RATIONALE: During episodes of acute inflammation, swelling results in plasma
Histamine proteins and fluid entering the interstitial space at the area of injury. Chemical
Kinins mediators that alter capillary permeability, including histamine, kinins,
Chemotactic factors leukotrienes, and prostaglandins facilitate this process.
Leukotrienes Chemotactic factors are released by the cells to attract immune cells to the site of
injury.
Which item causes chronic inflammation? (SEE IMAGE) (SEE IMAGE)
Foreign material that remains in the body
RATIONALE: The three primary causes of chronic inflammation include
unresolved acute inflammation, pathogens that remain in tissues, and foreign
material that remains in the body.
Although topical anesthetic medication, moderate daily exercise, and
vaccinations may initiate acute inflammation, they are not considered causes of
chronic inflammation.
Acute vs. Chronic Inflammation (SEE IMAGE) (SEE IMAGE)
Although acute and chronic inflammation have
similar characteristics, the treatment options and
potential outcomes differ based on the underlying
processes occurring in the body. Match the
appropriate type of inflammation with the list of
associated characteristics by dragging the correct
answers into the boxes. You can also click the
correct answer, then the box where it should go.
Healing by intention occurs when a wound is Primary
clean, free of foreign material, and the edges are held RATIONALE: Healing by primary intention refers to the process involving a clean
close together. wound, no foreign or necrotic tissue, and a minimal gap between the edges,
which is common in surgical incisions.
Healing by secondary intention is more involved in a large break in the tissue that
has more inflammation, a longer healing period, and formation of scar tissue,
which is commonly seen in compound fractures.
A client is seen in the emergency clinic after Elevate the injured site
jumping off a ski lift and injuring their ankle. Which Rest the affected area
steps can the client take to reduce inflammation Wrap the ankle
and pain? Select all that apply. Apply an ice pack
RATIONALE: R-I-C-E is the correct option.
Wrap the ankle Rest the affected area, which will protect the area from additional injury.
Rest the affected Ice the ankle to reduce inflammation that is causing swelling or pain. Applying
area Apply heat to heat will not reduce inflammation and swelling.
the site Apply an ice Compression by wrapping the ankle can reduce the swelling.
pack Elevate the Elevate the ankle to reduce swelling.
injured site
,Which factor can delay tissue healing from inflammation Advanced age
and injury? RATIONALE: Advanced age can delay tissue healing from inflammation and
injury due to reduced mitosis.
Adequate hemoglobin Adequate hemoglobin, effective circulation, and an undisturbed wound promote
Effective circulation tissue healing from inflammation or injury.
Undisturbed wound
Advanced age
Scar tissue is and tends to over time, Nonelastic
which can result in Shrink
Complications
RATIONALE: Scar tissue is nonelastic and tends to shrink over time, which can
result in a client having complications such as contractures or loss of function.
A 72-year-old is recovering two days after having Primary intention
knee replacement surgery. The incision is going RATIONALE: Primary intention healing occurs when there is minimal tissue
through which type of healing? loss and the edges are close in proximity.
Secondary intention healing occurs in wounds with moderate to large tissue loss
Secondary and has edges that are not approximated or wounds that are infected and left
intention Scar open until the infection is treated. Scar tissue and granuloma formation result from
formation Primary chronic inflammation, not healing.
intention
Granuloma
formation
A client who has been experiencing stomach Chronic
pains for the past three months visits the RATIONALE: One outcome of acute inflammation with ulceration
healthcare provider to receive the results of their is chronic inflammation. This is particularly true when the inflammatory
diagnostic test. The client is informed the test process continues for weeks to months. Chronic inflammation is characterized
revealed an ulcer with fibrosis, fibroblasts, and by tissue destruction, mononuclear cell infiltration, and repair.
macrophages present. The client's treatment plan In acute inflammation, the healing process of fibrosis and angiogenesis has
should address the inflammation pathologic not begun.
process.
On post-op day one following abdominal surgery, a This is a normal inflammatory response.
client is experiencing pain, heat, and redness at the RATIONALE: The signs of acute inflammation include pain, redness, immobility,
incision. swelling, and heat (PRISH) and are normally seen at a fresh surgical site.
Based on these findings, what conclusion can be Enough information was provided to accurately assess the incision and no
made about the incision? evidence of infection is present based on cues provided. Not enough information
is available to determine if the individual is ready to go home.
The incision shows signs of infection.
No conclusions can be drawn from the cues
provided. This is a normal inflammatory
response.
The client is healing quickly and can go home today.
Which characteristics below are expected during The immediate response to tissue injury, which lasts from minutes to
an acute or chronic inflammatory episode? Mark days. ACUTE The repeated destruction and repair of tissue for weeks to
each characteristic under the appropriate type of years after the initial injury. CHRONIC
inflammation. Used to describe diseases characterized by long duration and slow
progression. CHRONIC
ACUTE Used to describe diseases characterized by sudden onset with a short,
CHRONIC relatively severe course. ACUTE
RATIONALE: Acute inflammation is the immediate response to tissue injury,
The immediate response to tissue injury, which which lasts from minutes to days, and is used to describe diseases characterized
lasts from minutes to days. by a sudden onset with a short, relatively severe course.
The repeated destruction and repair of tissue for Chronic inflammation is the repeated destruction and repair of tissue for weeks to
weeks to years after the initial injury. years after the initial injury and is used to describe diseases characterized by
Used to describe diseases characterized by long long duration and slow progression.
duration and slow progression.
Used to describe diseases characterized by sudden
onset with a short, relatively severe course.
A client is seen in the clinic with a wrist Client states, “I’m tired all the time and have no
injury. Which findings indicate clinical energy.” Client’s white blood cell count is elevated.
manifestations of systemic inflammation? Client’s temperature is 101.8F (38.8C).
Select all that apply. RATIONALE: Systemic manifestations of inflammatory response include elevated
temperature, leukocytosis, malaise, and fatigue.
Client complains of pain in the frontal and Purulent exudates and pain are both considered local manifestations of
maxillary sinuses. inflammation.
Client's temperature is 101.8F (38.8C).
Client states, "I'm tired all the time and have no
energy." Client's white blood cell count is
elevated.
Client is producing thick, green nasal discharge.
, The nurse reviews the client's complete blood count (CBC) Acute inflammatory response
results and notes that the neutrophil levels are elevated, RATIONALE: Elevated neutrophils and monocytes that are within normal limits
are
but the monocytes are still within normal limits. This indicative of an acute, not chronic inflammatory response.
indicates what type of inflammatory response? Neutrophils increase in just a few hours, which then causes the T cells to activate
to
release factors to attract monocytes, while it takes the body days to increase the
No inflammatory response exists monocyte levels. Chronic inflammation results in varying elevations in WBCs
Acute inflammatory response dependent on multiple issues. Elevated neutrophils are not indicative of
resolved The inflammatory response is resolved inflammation. Elevations in monocytes occur later in the inflammatory
response. Chronic inflammatory response
A college student comes to the health clinic with a “Avoid sharing personal items and wear non-skid shoes in the
bathroom.” complaint of red, painful, and itchy feet. During RATIONALE: Avoidance of sharing personal items and wearing
non-skid shoes assessment of the health history, the client tells the nurse suitable for water can decrease the spread of pathogens
that cause inflammation that they live in a dorm and share a bathroom with other and infection.
students. What teaching should the nurse provide to this Bloodwork monthly will not treat or prevent inflammation. Showers should be
client? disinfected before and after each use. Not showering as often is not a solution.
"Don't shower as often."
"Disinfect showers and bathroom floors monthly
after use." "Avoid sharing personal items and wear
non-skid shoes in the bathroom."
"Have bloodwork checked monthly."
A client with inflammation generally presents with one or
Swelling more of the classic signs. Identify the classic signs
that are Pain
clinical manifestations of inflammation. Select all that Redness
apply. Loss of function
Warmth
Fatigue RATIONALE: These are the classic signs of inflammation:
Pain pain
Redness swelling
Swelling redness
Warmth warmth
Loss of function loss of function
Fever Fever and fatigue are systemic clinical manifestations.
Which immune cells are activated first when suspicious B cells
cells are identified in the blood stream? RATIONALE: B cells, lymphocytes from human bone marrow, support humoral
immunity to identify cells that are non-self and are activated when they come into
Phagocytes contact with non-self substances. The B cells are responsible for alerting the rest
of
B cells the body to the presence of a foreign invader.
T
cells
Kinin
s
Match each element of the immune system to the correctANTIGENS: Any foreign substance that initiates an
immune response description of its action in the body.
ANTIBODIES: Proteins produced by a humoral response to bind with a
specific
Antibodies antigen
Antigens
Chemical mediators MACROPHAGES: Cells that present antigens to lymphocytes to initiate
specific
Complement system immune responses
Lymphocytes
Macrophage COMPLEMENT SYSTEM: A group of inactive chemical mediators
that, when activated, stimulate the release of other chemical
mediators
Any foreign substance that initiates an immune response
Proteins produced by a humoral response to bind with a LYMPHOCYTEZS: Cells that provide humoral (B lymphocytes) and cell-
mediated (T specific antigen lymphocytes) immunity
Cells that present antigens to lymphocytes to initiate
specific immune responses CHEMICAL MEDIATORS: Includes kinins, histamine,
prostaglandins, and A group of inactive chemical mediators that, when chemotactic factors
activated, stimulate the release of other
chemical mediators
Cells that provide humoral (B lymphocytes)
and cell-mediated (T lymphocytes) immunity
Includes kinins, histamine,
Healing, Skin Integrity & Infection | Chamberlain Nursing | Practice Q&A with Rationales
What are the signs of acute inflammation? Select Pain
all that apply. Heat
Rednes
Granulomas s
Swelling Swellin
Tissue g
destruction Pain RATIONALE: The pneumonic PRISH is used to recall the five signs of acute
Redness inflammation: pain, redness, immobility (if impacting a joint or pain is
Heat severe), swelling, and heat.
Tissue destruction and granuloma formation are characteristics of chronic
inflammation.
Which immune chemical mediators contribute to Leukotrienes
the swelling associated with acute inflammation? Histamine
Select all that apply. Prostaglandins
Kinins
Prostaglandins RATIONALE: During episodes of acute inflammation, swelling results in plasma
Histamine proteins and fluid entering the interstitial space at the area of injury. Chemical
Kinins mediators that alter capillary permeability, including histamine, kinins,
Chemotactic factors leukotrienes, and prostaglandins facilitate this process.
Leukotrienes Chemotactic factors are released by the cells to attract immune cells to the site of
injury.
Which item causes chronic inflammation? (SEE IMAGE) (SEE IMAGE)
Foreign material that remains in the body
RATIONALE: The three primary causes of chronic inflammation include
unresolved acute inflammation, pathogens that remain in tissues, and foreign
material that remains in the body.
Although topical anesthetic medication, moderate daily exercise, and
vaccinations may initiate acute inflammation, they are not considered causes of
chronic inflammation.
Acute vs. Chronic Inflammation (SEE IMAGE) (SEE IMAGE)
Although acute and chronic inflammation have
similar characteristics, the treatment options and
potential outcomes differ based on the underlying
processes occurring in the body. Match the
appropriate type of inflammation with the list of
associated characteristics by dragging the correct
answers into the boxes. You can also click the
correct answer, then the box where it should go.
Healing by intention occurs when a wound is Primary
clean, free of foreign material, and the edges are held RATIONALE: Healing by primary intention refers to the process involving a clean
close together. wound, no foreign or necrotic tissue, and a minimal gap between the edges,
which is common in surgical incisions.
Healing by secondary intention is more involved in a large break in the tissue that
has more inflammation, a longer healing period, and formation of scar tissue,
which is commonly seen in compound fractures.
A client is seen in the emergency clinic after Elevate the injured site
jumping off a ski lift and injuring their ankle. Which Rest the affected area
steps can the client take to reduce inflammation Wrap the ankle
and pain? Select all that apply. Apply an ice pack
RATIONALE: R-I-C-E is the correct option.
Wrap the ankle Rest the affected area, which will protect the area from additional injury.
Rest the affected Ice the ankle to reduce inflammation that is causing swelling or pain. Applying
area Apply heat to heat will not reduce inflammation and swelling.
the site Apply an ice Compression by wrapping the ankle can reduce the swelling.
pack Elevate the Elevate the ankle to reduce swelling.
injured site
,Which factor can delay tissue healing from inflammation Advanced age
and injury? RATIONALE: Advanced age can delay tissue healing from inflammation and
injury due to reduced mitosis.
Adequate hemoglobin Adequate hemoglobin, effective circulation, and an undisturbed wound promote
Effective circulation tissue healing from inflammation or injury.
Undisturbed wound
Advanced age
Scar tissue is and tends to over time, Nonelastic
which can result in Shrink
Complications
RATIONALE: Scar tissue is nonelastic and tends to shrink over time, which can
result in a client having complications such as contractures or loss of function.
A 72-year-old is recovering two days after having Primary intention
knee replacement surgery. The incision is going RATIONALE: Primary intention healing occurs when there is minimal tissue
through which type of healing? loss and the edges are close in proximity.
Secondary intention healing occurs in wounds with moderate to large tissue loss
Secondary and has edges that are not approximated or wounds that are infected and left
intention Scar open until the infection is treated. Scar tissue and granuloma formation result from
formation Primary chronic inflammation, not healing.
intention
Granuloma
formation
A client who has been experiencing stomach Chronic
pains for the past three months visits the RATIONALE: One outcome of acute inflammation with ulceration
healthcare provider to receive the results of their is chronic inflammation. This is particularly true when the inflammatory
diagnostic test. The client is informed the test process continues for weeks to months. Chronic inflammation is characterized
revealed an ulcer with fibrosis, fibroblasts, and by tissue destruction, mononuclear cell infiltration, and repair.
macrophages present. The client's treatment plan In acute inflammation, the healing process of fibrosis and angiogenesis has
should address the inflammation pathologic not begun.
process.
On post-op day one following abdominal surgery, a This is a normal inflammatory response.
client is experiencing pain, heat, and redness at the RATIONALE: The signs of acute inflammation include pain, redness, immobility,
incision. swelling, and heat (PRISH) and are normally seen at a fresh surgical site.
Based on these findings, what conclusion can be Enough information was provided to accurately assess the incision and no
made about the incision? evidence of infection is present based on cues provided. Not enough information
is available to determine if the individual is ready to go home.
The incision shows signs of infection.
No conclusions can be drawn from the cues
provided. This is a normal inflammatory
response.
The client is healing quickly and can go home today.
Which characteristics below are expected during The immediate response to tissue injury, which lasts from minutes to
an acute or chronic inflammatory episode? Mark days. ACUTE The repeated destruction and repair of tissue for weeks to
each characteristic under the appropriate type of years after the initial injury. CHRONIC
inflammation. Used to describe diseases characterized by long duration and slow
progression. CHRONIC
ACUTE Used to describe diseases characterized by sudden onset with a short,
CHRONIC relatively severe course. ACUTE
RATIONALE: Acute inflammation is the immediate response to tissue injury,
The immediate response to tissue injury, which which lasts from minutes to days, and is used to describe diseases characterized
lasts from minutes to days. by a sudden onset with a short, relatively severe course.
The repeated destruction and repair of tissue for Chronic inflammation is the repeated destruction and repair of tissue for weeks to
weeks to years after the initial injury. years after the initial injury and is used to describe diseases characterized by
Used to describe diseases characterized by long long duration and slow progression.
duration and slow progression.
Used to describe diseases characterized by sudden
onset with a short, relatively severe course.
A client is seen in the clinic with a wrist Client states, “I’m tired all the time and have no
injury. Which findings indicate clinical energy.” Client’s white blood cell count is elevated.
manifestations of systemic inflammation? Client’s temperature is 101.8F (38.8C).
Select all that apply. RATIONALE: Systemic manifestations of inflammatory response include elevated
temperature, leukocytosis, malaise, and fatigue.
Client complains of pain in the frontal and Purulent exudates and pain are both considered local manifestations of
maxillary sinuses. inflammation.
Client's temperature is 101.8F (38.8C).
Client states, "I'm tired all the time and have no
energy." Client's white blood cell count is
elevated.
Client is producing thick, green nasal discharge.
, The nurse reviews the client's complete blood count (CBC) Acute inflammatory response
results and notes that the neutrophil levels are elevated, RATIONALE: Elevated neutrophils and monocytes that are within normal limits
are
but the monocytes are still within normal limits. This indicative of an acute, not chronic inflammatory response.
indicates what type of inflammatory response? Neutrophils increase in just a few hours, which then causes the T cells to activate
to
release factors to attract monocytes, while it takes the body days to increase the
No inflammatory response exists monocyte levels. Chronic inflammation results in varying elevations in WBCs
Acute inflammatory response dependent on multiple issues. Elevated neutrophils are not indicative of
resolved The inflammatory response is resolved inflammation. Elevations in monocytes occur later in the inflammatory
response. Chronic inflammatory response
A college student comes to the health clinic with a “Avoid sharing personal items and wear non-skid shoes in the
bathroom.” complaint of red, painful, and itchy feet. During RATIONALE: Avoidance of sharing personal items and wearing
non-skid shoes assessment of the health history, the client tells the nurse suitable for water can decrease the spread of pathogens
that cause inflammation that they live in a dorm and share a bathroom with other and infection.
students. What teaching should the nurse provide to this Bloodwork monthly will not treat or prevent inflammation. Showers should be
client? disinfected before and after each use. Not showering as often is not a solution.
"Don't shower as often."
"Disinfect showers and bathroom floors monthly
after use." "Avoid sharing personal items and wear
non-skid shoes in the bathroom."
"Have bloodwork checked monthly."
A client with inflammation generally presents with one or
Swelling more of the classic signs. Identify the classic signs
that are Pain
clinical manifestations of inflammation. Select all that Redness
apply. Loss of function
Warmth
Fatigue RATIONALE: These are the classic signs of inflammation:
Pain pain
Redness swelling
Swelling redness
Warmth warmth
Loss of function loss of function
Fever Fever and fatigue are systemic clinical manifestations.
Which immune cells are activated first when suspicious B cells
cells are identified in the blood stream? RATIONALE: B cells, lymphocytes from human bone marrow, support humoral
immunity to identify cells that are non-self and are activated when they come into
Phagocytes contact with non-self substances. The B cells are responsible for alerting the rest
of
B cells the body to the presence of a foreign invader.
T
cells
Kinin
s
Match each element of the immune system to the correctANTIGENS: Any foreign substance that initiates an
immune response description of its action in the body.
ANTIBODIES: Proteins produced by a humoral response to bind with a
specific
Antibodies antigen
Antigens
Chemical mediators MACROPHAGES: Cells that present antigens to lymphocytes to initiate
specific
Complement system immune responses
Lymphocytes
Macrophage COMPLEMENT SYSTEM: A group of inactive chemical mediators
that, when activated, stimulate the release of other chemical
mediators
Any foreign substance that initiates an immune response
Proteins produced by a humoral response to bind with a LYMPHOCYTEZS: Cells that provide humoral (B lymphocytes) and cell-
mediated (T specific antigen lymphocytes) immunity
Cells that present antigens to lymphocytes to initiate
specific immune responses CHEMICAL MEDIATORS: Includes kinins, histamine,
prostaglandins, and A group of inactive chemical mediators that, when chemotactic factors
activated, stimulate the release of other
chemical mediators
Cells that provide humoral (B lymphocytes)
and cell-mediated (T lymphocytes) immunity
Includes kinins, histamine,
