what is not an expected assessment finding in a client with inflammation

ATI RN

Multi Dimensional Care | Exam | Rasmusson

1. Which finding is not typically associated with inflammation in a client?

A. Pain
B. Heat
C. Polyuria
D. Erythema

Correct answer: C

Rationale: Polyuria is excessive urination and is not a typical assessment finding in inflammation. Inflammation commonly presents with pain (A), heat (B), and erythema (D) which are classic signs of an inflammatory response. Pain results from the release of inflammatory mediators, heat is due to increased blood flow, and erythema is caused by vasodilation and increased blood flow to the area. Polyuria is more likely associated with conditions such as diabetes or renal issues, rather than inflammation.

2. What phase of wound healing occurs at the time of injury and lasts about 3-5 days?

A. Maturation
B. Intentional
C. Inflammatory
D. Proliferative

Correct answer: C

Rationale:

3. What is the nurse's priority action for a client with compromised immunity?

A. Wash hands before entering the client's room
B. Take the client's vital signs every 4 hours
C. Determine whether it is temporary or permanent
D. Teach the family members to receive the flu shot annually

Correct answer: A

Rationale:

4. The nurse is caring for a client who develops compartment syndrome from a severely fractured arm. The client asks how this can happen. What is the best response by the nurse?

A. . "The fascia expands with injury, causing pressure on underlying nerves and muscles."?
B. "An injured artery causes impaired arterial perfusion through the compartment."?
C. "Bleeding and swelling cause increased pressure in an area that cannot expand."?
D. . "A bone fragment has injured the nerve supply in the area."?

Correct answer: C

Rationale: