Samuel Merritt University - MCA 1 (Cline)
Exam 1 Test Bank: Inflammation, Immune Response,
Infection, Fluid & Electrolytes, Diabetes, & Delegation
1. A nurse is caring for a patient who sustained a severe ankle sprain 2 hours ago. Which
localized vascular response accounts for the acute swelling and erythema at the injury
site?
A) Arteriolar constriction and decreased capillary permeability
B) Transient vasoconstriction followed by vasodilation and increased capillary
permeability
C) Migration of lymphocytes causing lymphatic obstruction
D) Rapid proliferation of fibroblasts producing extracellular collagen
Rationale: Acute inflammation begins with a momentary vasoconstriction followed
immediately by vasodilation and increased capillary permeability. This allows plasma fluid
and exudate to enter tissue spaces, creating localized edema and redness.
2. Which cellular component arrives first at the site of acute bacterial inflammation to
begin phagocytosis?
A) Neutrophils
B) Monocytes
C) Basophils
D) T-lymphocytes
Rationale: Neutrophils are the primary early responders in acute inflammatory reactions,
arriving within 6 to 12 hours to engulf bacteria and cellular debris.
3. A patient's laboratory results reveal a WBC count of 16,500/mm³ with a high proportion
of immature band neutrophils ("shift to the left"). The nurse interprets this as an indicator
of:
A) Resolving viral infection
B) Acute bacterial infection requiring rapid neutrophil release from bone marrow
C) Chronic autoimmune connective tissue disease
D) Type I immediate hypersensitivity reaction
Rationale: A "shift to the left" indicates that the bone marrow is releasing immature
neutrophils (bands) into circulation to meet the demands of an active, acute severe
, infection.
4. Which chemical mediator is primarily released by mast cells during acute tissue injury
to induce rapid vasodilation and increased vascular permeability?
A) Bradykinin
B) Histamine
C) Prostaglandin E2
D) Leukotriene D4
Rationale: Histamine is stored preformed in mast cell granules and basophils, serving as a
primary early mediator of acute vascular dilation and capillary leakiness.
5. What type of exudate is expected in a patient with a mild burn blister containing clear,
protein-light fluid?
A) Serous exudate
B) Purulent exudate
C) Fibrinous exudate
D) Sanguineous exudate
Rationale: Serous exudate is a low-protein, watery fluid commonly seen in early
inflammation or mild tissue injury such as skin blisters.
6. A patient with a surgical incision exhibits thick, yellow-green drainage with a foul odor.
The nurse documents this as:
A) Serosanguineous exudate
B) Purulent exudate
C) Catarrhal exudate
D) Fibrinous exudate
Rationale: Purulent exudate (pus) consists of dead white blood cells, cellular debris, and
bacteria, indicating active bacterial infection.
7. A postoperative patient has a temperature of 101.4°F (38.6°C). What central nervous
system structure controls this systemic febrile response?
A) Anterior pituitary gland
B) Hypothalamus
C) Medulla oblongata
D) Thalamus
Rationale: Endogenous pyrogens (IL-1, TNF-alpha) travel to the brain and stimulate the
, hypothalamus to raise the thermal set point.
8. Which systemic acute-phase protein produced by the liver serves as a primary marker
for active systemic inflammation?
A) Troponin I
B) C-Reactive Protein (CRP)
C) Alpha-fetoprotein
D) Serum Creatinine
Rationale: C-reactive protein (CRP) is an acute-phase reactant synthesized by the liver in
response to inflammatory cytokines.
9. Chronic inflammation differs pathologically from acute inflammation because chronic
inflammation involves higher concentrations of:
A) Neutrophils and eosinophils
B) Macrophages, lymphocytes, and tissue fibrosis
C) Histamine and mast cells
D) Erythrocytes and platelets
Rationale: Chronic inflammation is prolonged and characterized by mononuclear cells
(macrophages, lymphocytes), tissue destruction, and scarring/fibrosis.
10. An elderly patient taking long-term high-dose systemic corticosteroids is at risk for
delayed wound healing primarily because steroids:
A) Stimulate excessive fibroblast production
B) Suppress the inflammatory response, collagen synthesis, and epithelialization
C) Increase systemic vascular resistance
D) Enhance neutrophil margination
Rationale: Corticosteroids impair capillary permeability, suppress cytokine release, inhibit
fibroblast activity, and reduce collagen synthesis.
11. Primary intention healing is best exemplified by which clinical scenario?
A) A clean surgical incision closed with surgical staples
B) A stage 3 pressure injury healing from the base upward
C) An infected abdominal wound left open to drain before closure
D) A large avulsion wound requiring skin grafting
Rationale: Primary intention occurs when wound margins are well-approximated, clean,
and closed directly with minimal tissue loss.
Exam 1 Test Bank: Inflammation, Immune Response,
Infection, Fluid & Electrolytes, Diabetes, & Delegation
1. A nurse is caring for a patient who sustained a severe ankle sprain 2 hours ago. Which
localized vascular response accounts for the acute swelling and erythema at the injury
site?
A) Arteriolar constriction and decreased capillary permeability
B) Transient vasoconstriction followed by vasodilation and increased capillary
permeability
C) Migration of lymphocytes causing lymphatic obstruction
D) Rapid proliferation of fibroblasts producing extracellular collagen
Rationale: Acute inflammation begins with a momentary vasoconstriction followed
immediately by vasodilation and increased capillary permeability. This allows plasma fluid
and exudate to enter tissue spaces, creating localized edema and redness.
2. Which cellular component arrives first at the site of acute bacterial inflammation to
begin phagocytosis?
A) Neutrophils
B) Monocytes
C) Basophils
D) T-lymphocytes
Rationale: Neutrophils are the primary early responders in acute inflammatory reactions,
arriving within 6 to 12 hours to engulf bacteria and cellular debris.
3. A patient's laboratory results reveal a WBC count of 16,500/mm³ with a high proportion
of immature band neutrophils ("shift to the left"). The nurse interprets this as an indicator
of:
A) Resolving viral infection
B) Acute bacterial infection requiring rapid neutrophil release from bone marrow
C) Chronic autoimmune connective tissue disease
D) Type I immediate hypersensitivity reaction
Rationale: A "shift to the left" indicates that the bone marrow is releasing immature
neutrophils (bands) into circulation to meet the demands of an active, acute severe
, infection.
4. Which chemical mediator is primarily released by mast cells during acute tissue injury
to induce rapid vasodilation and increased vascular permeability?
A) Bradykinin
B) Histamine
C) Prostaglandin E2
D) Leukotriene D4
Rationale: Histamine is stored preformed in mast cell granules and basophils, serving as a
primary early mediator of acute vascular dilation and capillary leakiness.
5. What type of exudate is expected in a patient with a mild burn blister containing clear,
protein-light fluid?
A) Serous exudate
B) Purulent exudate
C) Fibrinous exudate
D) Sanguineous exudate
Rationale: Serous exudate is a low-protein, watery fluid commonly seen in early
inflammation or mild tissue injury such as skin blisters.
6. A patient with a surgical incision exhibits thick, yellow-green drainage with a foul odor.
The nurse documents this as:
A) Serosanguineous exudate
B) Purulent exudate
C) Catarrhal exudate
D) Fibrinous exudate
Rationale: Purulent exudate (pus) consists of dead white blood cells, cellular debris, and
bacteria, indicating active bacterial infection.
7. A postoperative patient has a temperature of 101.4°F (38.6°C). What central nervous
system structure controls this systemic febrile response?
A) Anterior pituitary gland
B) Hypothalamus
C) Medulla oblongata
D) Thalamus
Rationale: Endogenous pyrogens (IL-1, TNF-alpha) travel to the brain and stimulate the
, hypothalamus to raise the thermal set point.
8. Which systemic acute-phase protein produced by the liver serves as a primary marker
for active systemic inflammation?
A) Troponin I
B) C-Reactive Protein (CRP)
C) Alpha-fetoprotein
D) Serum Creatinine
Rationale: C-reactive protein (CRP) is an acute-phase reactant synthesized by the liver in
response to inflammatory cytokines.
9. Chronic inflammation differs pathologically from acute inflammation because chronic
inflammation involves higher concentrations of:
A) Neutrophils and eosinophils
B) Macrophages, lymphocytes, and tissue fibrosis
C) Histamine and mast cells
D) Erythrocytes and platelets
Rationale: Chronic inflammation is prolonged and characterized by mononuclear cells
(macrophages, lymphocytes), tissue destruction, and scarring/fibrosis.
10. An elderly patient taking long-term high-dose systemic corticosteroids is at risk for
delayed wound healing primarily because steroids:
A) Stimulate excessive fibroblast production
B) Suppress the inflammatory response, collagen synthesis, and epithelialization
C) Increase systemic vascular resistance
D) Enhance neutrophil margination
Rationale: Corticosteroids impair capillary permeability, suppress cytokine release, inhibit
fibroblast activity, and reduce collagen synthesis.
11. Primary intention healing is best exemplified by which clinical scenario?
A) A clean surgical incision closed with surgical staples
B) A stage 3 pressure injury healing from the base upward
C) An infected abdominal wound left open to drain before closure
D) A large avulsion wound requiring skin grafting
Rationale: Primary intention occurs when wound margins are well-approximated, clean,
and closed directly with minimal tissue loss.
