Exam III - Final

Question 1

This is the initial response to injury that focuses on eradicating dead tissue and protecting against infection, an automatic response to tissue damage.

Answer 1

Acute inflammation

One of the components of the first (optimal) outcome to the inflammatory processes.

Question 2

This is when damaged tissue is replaced by identical tissue. The pathogen is removed and tissues are allowed to heal

Answer 2

Restitution (example: sprained ankle)

One of the components of the first (optimal) outcome to the inflammatory processes.

Question 3

The _____ outcome of the inflammatory process damaged cells are unable to be repaired and fibrous tissue replaces damaged tissue forming scar tissue

A. First outcome
B. Second outcome
C. Third outcome
D. Fourth outcome

Answer 3

B. Second outcome

Question 4

The ____ outcome of the inflammatory process involves the development of chronic inflammation. Pathologic agents remain active and tissue destruction continues. The immune system tries to resolve and fibrous tissue continues to form instead of new tissue.

A. First outcome
B. Second outcome
C. Third outcome
D. Fourth outcome

Answer 4

C. Third outcome

High outcome of morbidity and mortality

Question 5

The ____ outcome of the inflammatory process involves acute inflammation and restitution

A. First outcome
B. Second outcome
C. Third outcome
D. Fourth outcome

Answer 5

A. First outcome

Question 6

The ____ outcome of the inflammatory process involves the death of tissue and death of host

A. First outcome
B. Second outcome
C. Third outcome
D. Fourth outcome

Answer 6

D. Fourth outcome

Question 7

For the five classic signs of acute inflammation?

Answer 7

Redness, 
swelling, 
pain, 
heat, 
loss of function

This is an immediate, short lived response

Question 8

Increased blood flow,
Increased vascular permeability,
Migration of Leukocytes from the blood to the tissues, and
Movement of proteins, fluids, lymphocytes, monocytes, macrophages, and granulocytes to remove tissue debris and pathologic organisms are all physiologic changes to _____ _____

Answer 8

Acute inflammation

Question 9

_____ _____ continues for weeks to years and does not go away, however it can slow down or it can exacerbate. A granuloma is formed at the site of injury and an accumulation of macrophages, fibroblasts, and collagen form

Answer 9

Chronic inflammation

Examples are untreated tuberculosis, and inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease.

Question 10

What are the risk factors for inflammation?

Answer 10

Being very young: undeveloped immune system,
Being very old: weakened immune system,
Immune compromise: AIDS, chemo, radiation

Question 11

What triggers inflammation?

Answer 11

Allergens,
Exposure to infectious agents,
Age (very young, very old),
Physiological ability to respond (immune compromise)

Question 12

What determines the symptoms and duration of the inflammatory response?

Answer 12

Disease,
Patient condition,
Response to treatment

Question 13

What are the classic findings with inflammation if internal damage is present?

Answer 13

Fever,
Increased WBC,
Slowing/absence of tissue or organ function

Question 14

What laboratory tests are performed to determine inflammation/ infection?

Answer 14

WBC w/differential: increased indicates positive,
C-reactive protein (CRP): indicates presence of inflammation in cardiac patients,
ESR: increased shows inflammation

Question 15

A positive Epstein-Barr test indicates the presence of ______

Answer 15

Mononucleosis

Question 16

What are the primary preventions to reduce risk for inflammation?

Answer 16

Hand hygiene,
Keep wounds clean,
Ensure food/water safety,
Use safety equipment (helmet, knee pads, etc)

Question 17

What are the primary nursing interventions for inflammation?

Answer 17

RICE for sprains (rest, ice, compression, elevation),
Immobilization (splint),
Pharmacological agents:
Steroid-reduces swelling, pain
NSAIDS-reduces pain, fever, inflammation
Antipyretics-reduces fever (get blood cultures for fever 103+)
Analgesics-reduces pain
Antimicrobials-for prophylaxis or for identified microorganisms

Question 18

What types or research are found in primary literature?

Answer 18

Quantitative research,
Qualitative research,
Mixed design research

Question 19

This type of research uses objective observation and validation, random controlled trials, double blind studies, cohort studies, case-controlled studies, case studies and longitudinal studies

Answer 19

Quantitative research

Question 20

This type of research uses a person’s experiences, interviews, surveys, questionnaires, ethnography, phenomenology, grounded theory and case reports

Answer 20

Qualitative research

Question 21

This type of research uses a combination of quantitative and qualitative research, using a wholistic approach

Answer 21

Mixed design research

Question 22

What is a randomized control trial?

Answer 22

Uses test group and control group i.e. Drug trial

Question 23

What is a cohort study?

Answer 23

Research following one group of people

Question 24

What is a case controlled study?

Answer 24

A study of two groups with two different outcomes

Question 25

What is a case study?

Answer 25

A detailed analysis of members of groups making inferences

Question 26

What is a longitudinal study?

Answer 26

A study done over time

Question 27

_____ is the study of people and cultures

Answer 27

Ethnography

Question 28

_____ is the study of experiences and consciousness from the first person point of view

Answer 28

Phenomenology

Question 29

_____ _____ is the discovery of theory through the analysis of data

Answer 29

Grounded theory

Question 30

This organization is responsible for the standards of medical care in diabetes

Answer 30

American Diabetic Association

Question 31

This organization is responsible for lipid screening and cardiovascular health in childhood

Answer 31

American Academy of Pediatrics

Question 32

This organization is responsible for setting guidelines for HPV vaccinations used to prevent cervical cancer

Answer 32

American Cancer Society

Question 33

What types of research are found in secondary literature?

Answer 33

Evidence summaries, | Systematic reviews/Meta-analysis

Question 34

This type of research summarizes evidence from multiple studies and draws a conclusion

Answer 34

Systemic reviews/Meta-analysis This type of research is labor intensive

Question 35

This type of research summarizes original research studies and is not done first hand

Answer 35

Evidence summaries

Question 36

What are the attributes of evidence?

Answer 36

Replicability (can be repeated with same results), Reliability (is tool used for measurement reliable), Validity (did research answer the question being asked)

Question 37

The US Preventative Services Task Force issues this grade when they strongly recommend with high certainty that the net benefit of the intervention is substantial? ``` A. Grade A B. Grade B C. Grade C D. Grade D E. Grade E or IStatement ```

Answer 37

A. Grade A

Question 38

The US Preventative Services Task Force issues this grade when they recommends against with moderate to high certainty that the intervention has no net benefit or that the harms outweigh the benefits ``` A. Grade A B. Grade B C. Grade C D. Grade D E. Grade E or IStatement ```

Answer 38

D. Grade D

Question 39

The US Preventative Services Task Force issues this grade when they believe the current evidence is insufficient to assess the balance of benefits and harms of the service. Evidence may be lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined? ``` A. Grade A B. Grade B C. Grade C D. Grade D E. Grade E or IStatement ```

Answer 39

E. Grade E or IStatement

Question 40

The US Preventative Services Task Force issues this grade when there is a high certainty that the net benefit is moderate or there is a moderate certainty that the net benefit is moderate to substantial ``` A. Grade A B. Grade B C. Grade C D. Grade D E. Grade E or IStatement ```

Answer 40

B. Grade B

Question 41

The US Preventative Services Task Force issues this grade when there may be considerations that support providing the intervention in an individual patient, but not for the general population. There is at least moderate certainty that the net benefit is small (neutral)? ``` A. Grade A B. Grade B C. Grade C D. Grade D E. Grade E or IStatement ```

Answer 41

C. Grade C

Question 42

Whate does the initiative GRADE stand for?

Answer 42

Grading of Recommendations Assessment, Development, and Evaluation

Question 43

What are the three barriers to implementing evidence-based nursing?

Answer 43

Lack of knowledge, Overwhelming amounts of information, Time constraints

Question 44

What are the 5 steps to facilitate the use of evidence?

Answer 44

1. Develop an answerable question 2. Search the literature to uncover evidence to answer the question 3. Evaluate the evidence found 4. Apply the evidence to a practice situation 5. Evaluate the outcome

Question 45

Which type of cells are involved in the ingestion and phagocytosis of microorganisms and foreign protein? ``` A. Neutrophils B. Macrophages C. Eosinophils D. Basophils E. Lymphocytes ```

Answer 45

A. Neutrophils

Question 46

Which type of cells release histamine and heparin in areas of tissue damage and respond to allergens? ``` A. Neutrophils B. Macrophages C. Eosinophils D. Basophils E. Lymphocytes ```

Answer 46

D. Basophils

Question 47

Which type of cells release vasoactive amines during allergic reactions to limit inflammatory reaction? ``` A. Neutrophils B. Macrophages C. Eosinophils D. Basophils E. Lymphocytes ```

Answer 47

C. Eosinophils

Question 48

Which type of cells are involved in the recognition of foreign proteins and microorganisms, ingestion and phagocytosis? ``` A. Neutrophils B. Macrophages C. Eosinophils D. Basophils E. Lymphocytes ```

Answer 48

B. Macrophages Phagocytosis, repair, antigen presenting/processing and secretion of cytokines for immune system control

Question 49

Which type of cells become sensitized to foreign cells and proteins? ``` A. Neutrophils B. Macrophages C. Eosinophils D. Basophils E. Lymphocytes ```

Answer 49

E. Lymphocytes

Question 50

What is the classic sign of tuberculosis?

Answer 50

Night sweats Also: fever, cough, fatigue, chest pain, hemoptysis, weight loss, loss of appetite

Question 51

What is an unusual sign of acute pancreatitis?

Answer 51

Grey Turner's Sign | Bruising of flanks

Question 52

What is the hallmark sign of Crohn's Disease?

Answer 52

Rectal bleeding

Question 53

What happens when ammonia levels are increased in patients with cirrhosis of the liver?

Answer 53

Metabolic encephalopathy (profound confusion)

Question 54

Which pharmacological agent reduces swelling/inflammation and pain? ``` A. Steroids B. NSAIDS C. Antipyretics D. Analgesics E. Antimicrobials ```

Answer 54

A. Steroids

Question 55

Which pharmacological agent reduces fever? ``` A. Steroids B. NSAIDS C. Antipyretics D. Analgesics E. Antimicrobials ```

Answer 55

C. Antipyretics Get blood cultures for fever >103

Question 56

Which pharmacological agent reduces pain? ``` A. Steroids B. NSAIDS C. Antipyretics D. Analgesics E. Antimicrobials ```

Answer 56

D. Analgesics

Question 57

Which pharmacological agent reduces pain, fever, and inflammation? ``` A. Steroids B. NSAIDS C. Antipyretics D. Analgesics E. Antimicrobials ```

Answer 57

B. NSAIDs

Question 58

Which pharmacological agent is used as a prophylaxis or for identified microorganisms? ``` A. Steroids B. NSAIDS C. Antipyretics D. Analgesics E. Antimicrobials ```

Answer 58

E. Antimicrobials