WorksheetsInflammation (NCLEX-style Questions)
Total questions: 100
Worksheet time: 55mins
A client presents with redness, heat, swelling, and pain at a surgical incision site. Which finding indicates acute inflammation?
Presence of macrophages as the primary cell
Granulation tissue filling the wound
Neutrophil accumulation and pus formation
Collagen remodeling
The nurse observes an elevated WBC with an increased number of band neutrophils. What does this indicate?
Chronic inflammation
Viral infection
“Shift to the left” meaning acute bacterial inflammation
Bone marrow suppression
Which mediator is responsible for vasodilation and increased capillary permeability in inflammation?
Renin
Histamine
Serotonin
Dopamine
Which finding is a systemic manifestation of inflammation?
A neutropenic patient may have an infection without obvious inflammation because:
Neutrophils migrate too quickly
They mount an excessive immune response
They cannot form pus or typical inflammatory signs
Fever response is intensified
Which patient is at the highest risk for poor wound healing?
25-year-old with mild anemia
40-year-old taking vitamin C
70-year-old on chronic corticosteroids
35-year-old with healthy nutrition
The nurse recognizes which scenario as primary intention wound healing?
Surgical incision closed with sutures
Large traumatic wound left open
Wound packed and healing by granulation
Delayed closure after infection resolves
A client with fever of 103°F is shivering under blankets. What is the correct interpretation?
Fever is breaking
The set point is rising; body is generating heat to match new temperature
Patient is hypothermic
Patient has inadequate perfusion
The nurse caring for an inflamed ankle applies ice during the first 24 hours because cold:
Stimulates neutrophil production
Increases blood flow
Causes vasoconstriction reducing swelling and pain
Prevents scar tissue formation
Which is a correct teaching for NSAID use during inflammation?
NSAIDs increase prostaglandin production
NSAIDs raise the hypothalamic set point
NSAIDs block prostaglandin synthesis
NSAIDs must be taken with corticosteroids
A patient taking infliximab (Remicade) should be monitored for:
Hypoglycemia
Opportunistic infections
Severe dehydration
Hyperthyroidism
Which finding in Crohn’s disease is expected but NOT seen in ulcerative colitis?
Continuous inflammation starting at the rectum
Mucosal layer involvement only
Skip lesions and cobblestone appearance
20 bloody stools per day
A patient with UC reports 18 bloody stools/day and tachycardia. Which complication is the nurse concerned about?
Osteoporosis
Toxic megacolon
Fistula formation
Iron overload
Which drug is first-line maintenance therapy for ulcerative colitis?
Metronidazole
Sulfasalazine (5-ASA)
Infliximab
Ciprofloxacin
The nurse suspects peptic ulcer perforation when the patient reports:
Pain relieved by food
Burning pain 2–5 hours after meals
Which medication is part of triple therapy for H. pylori?
Amoxicillin
Famotidine
Sucralfate
Metronidazole alone
Which diagnostic test confirms ulcerative colitis?
Endoscopy of upper GI
Urodynamic testing
Colonoscopy
CT angiography
A client with hepatitis has clay-colored stools and dark urine. What lab is most important?
Lipase
Hepatitis panel
ESR
BNP
Which hepatitis transmission route is correct?
Hepatitis B is fecal-oral
Hepatitis C is transmitted through food
Hepatitis A is fecal-oral
Hepatitis A is transmitted by needles
A nurse caring for a patient with pancreatitis expects which intervention first?
Encourage walking
High-fat diet
NPO and pain control
Administer diuretics
The MOST concerning finding in a patient with pancreatitis is:
Nausea
Severe epigastric pain
Grey-Turner's sign (flank bruising)
Mild bloating
A patient receiving IV steroids for inflammation is at risk for:
Hypoglycemia
Bradycardia
Elevated glucose and immune suppression
Decreased appetite
A nurse suspects infection at a wound site when observing:
Clear serous drainage
Pink granulation tissue
Purulent drainage and fever
Scar contraction
A patient reports periumbilical pain, diarrhea, and low-grade fever. Which condition fits?
Gastric ulcer
Urolithiasis
Gastroenteritis/infectious diarrhea
Stress incontinence
After a cystoscopy, which finding must be reported immediately?
Light pink urine
Mild burning with urination
Bright red urine or clots
Frequency for 24 hours
Which patient statement indicates understanding of corticosteroid therapy?
I can stop taking this medication once I feel better.
This medication may raise my blood sugar.
I should avoid all foods with salt.
This medication prevents all types of infections.
Which assessment finding is most concerning in a patient with suspected sepsis?
Fever 101°F
Warm, flushed skin
Hypotension and altered mental status
Increased appetite
Which lab value supports acute inflammation?
Low CRP
Elevated ESR
Low WBC
High RBC
A nurse is caring for a newborn with infection. Which fact explains their higher risk?
Increased neutrophil production
Stronger skin barrier
Reduced inflammatory response
Faster immune memory development
Which lifestyle factor increases the risk of chronic inflammation?
High protein diet
Smoking
Low sodium intake
Moderate exercise
Which order should the nurse question for a patient with compartment syndrome?
Prepare for fasciotomy
Notify the provider
Ice the extremity
Keep extremity at heart level
Which finding suggests fat embolism syndrome?
Tingling in fingers
Bradycardia
Petechiae and hypoxemia
Hypertension
A patient with rheumatoid arthritis states, “My joints feel stiff for hours when I wake up.” The nurse interprets this as:
Osteoarthritis
Fibromyalgia
Classic RA stiffness pattern
Medication reaction
Which teaching is appropriate for osteoarthritis management?
Avoid exercise to reduce stress on joints.
Use heat before exercise and ice after.
Take NSAIDs only on an empty stomach.
Expect pain to fully resolve with medication.
Which medication requires infection screening (TB, hepatitis) before starting?
Famotidine
Sucralfate
Infliximab (Remicade)
Metoclopramide
A patient with Crohn’s is at greatest risk for which complication?
Toxic megacolon only
Fistula formation
Continuous rectal bleeding
No electrolyte imbalance
Which finding requires immediate intervention in a patient with ulcerative colitis?
Four loose stools/day
Mild cramping
Severe abdominal distention
Low-grade fever
A client receiving NSAIDs for inflammation should be monitored for:
Hyponatremia
Constipation
Gastric irritation and bleeding
Hypokalemia
In peptic ulcer disease, which statement indicates gastric ulcer symptoms?
My pain improves with eating.
I have pain 1–2 hours after meals.
Pain occurs late at night only.
Pain rarely returns.
A patient on sucralfate should take it:
With meals
After meals
On an empty stomach before meals
With antacids only
Which vital sign trend suggests developing septic shock?
HR 78 → 74
BP 128/78 → 110/70
HR 110 → 132 with dropping BP
Temp 98.9 → 99.2
Which intervention has priority for a patient with anaphylaxis?
Give warm blankets
Administer epinephrine IM
The nurse identifies which electrolyte imbalance as a risk during diarrhea?
Hypercalcemia
Hypernatremia
Hypokalemia
Hypermagnesemia
A patient with peritonitis from a perforated ulcer will MOST likely have:
Soft abdomen
Hyperactive bowel sounds
Rigid, board-like abdomen
Pain relieved by food
Which client should avoid live vaccines?
Patient taking antacids
Patient on infliximab (Remicade)
Patient taking sucralfate
Patient with constipation
Which sign indicates possible GI bleeding?
Clay-colored stool
Hard, lumpy stool
Black, tarry stool (melena)
Pale-yellow stool
Which is expected with chronic inflammation?
High numbers of neutrophils
Macrophage-dominated response
Rapid resolution
No tissue damage
A nurse caring for a patient with osteoarthritis expects which exam finding?
Symmetric joint swelling
Systemic fever
Heberden and Bouchard nodes
Weight loss
A client with acute pancreatitis develops decreased urine output and crackles. The nurse suspects:
Constipation
Hyperglycemia
Rhabdomyolysis
Fluid overload/AKI progression
Which intervention decreases risk of pressure ulcers during inflammation recovery?
Massage over bony areas
Turn every 2 hours
Keep heels flat on bed
Use cold packs continuously
Which finding differentiates Crohn’s disease from ulcerative colitis?
Continuous inflammation beginning in the rectum
Mucosal layer involvement only
Skip lesions throughout the GI tract
Large amounts of bloody diarrhea
A patient with ulcerative colitis has severe dehydration. Which symptom is the nurse MOST concerned about?
Tachycardia
Dry mouth
Poor skin turgor
Thirst
Which medication is contraindicated in a patient with peptic ulcer disease?
PPIs
Sucralfate
NSAIDs
Antibiotics for H. pylori
A nurse suspects a shift to the left when reviewing labs. What finding confirms this?
Elevated lymphocytes
Elevated eosinophils
Increased band neutrophils
Decreased monocytes
Which patient is at highest risk for gastritis or PUD?
Patient who drinks only water
Patient on long-term NSAIDs
Patient with high fiber diet
Patient who avoids caffeine
A client with rheumatoid arthritis is starting methotrexate. Which teaching is essential?
This drug works immediately.
You do not need lab monitoring.
Report any signs of infection promptly.
Take extra vitamin C for absorption.
Which assessment finding in pancreatitis requires priority action?
Mild abdominal pain
Nausea after eating
A patient with suspected UC undergoes colonoscopy. Which finding confirms severity?
Pale mucosa
Enlarged spleen
20+ bloody stools/day
Normal hemoglobin
The nurse caring for a patient with sepsis expects which acid–base imbalance?
Metabolic alkalosis
Respiratory alkalosis
Metabolic acidosis
Respiratory acidosis
A patient being treated for pyelonephritis is improving when which occurs?
Persistent flank pain
Fever returns
Pain improves and WBC trends down
Hematuria worsens
Which lab result is a priority for a patient with acute pancreatitis?
Sodium 138
Amylase elevated
Lipase critically elevated
Hemoglobin slightly low
A patient with Crohn’s disease is experiencing severe weight loss. What is the likely cause?
Hyperperistalsis
Malabsorption
Excess insulin
Increased appetite
Which finding differentiates gastric from duodenal ulcers?
Gastric ulcers improve with eating
Duodenal pain is relieved by vomiting
Gastric ulcer pain worsens 1–2 hrs after meals
Duodenal ulcers cause early satiety
The nurse knows that prednisone use increases the risk for which condition?
Hypoglycemia
Hypertension and infection
Low cortisol levels only
Urinary retention
A patient with acute diarrhea is at highest risk for:
Hypertension
Respiratory acidosis
Dehydration and electrolyte imbalance
High blood sugar
Which symptom suggests a complication of Crohn’s disease?
Joint pain
Fistula formation
Headache
Productive cough
A nurse receives report on four patients. Who should be seen first?
RA patient with morning stiffness
UC patient with mild cramping
PUD patient with rigid abdomen
Crohn’s patient with diarrhea
A priority teaching for patients on PPIs is to:
Avoid taking them with food
Report black, tarry stools
Increase sodium intake
Take only with caffeine
Which complication is more common in ulcerative colitis than Crohn’s?
Perianal fistulas
Cobblestoning
Toxic megacolon
Fistulas to bladder
A client states, “I’m taking acetaminophen for inflammation.” What is the correct response?
Acetaminophen reduces inflammation well.
Acetaminophen does not reduce inflammation.
You should double the dose.
Avoid using NSAIDs with it.
Which body system fails first in SIRS/sepsis progression?
Endocrine
Renal
Respiratory
Musculoskeletal
Which medication decreases stomach acid by blocking histamine receptors?
Omeprazole
Sucralfate
Famotidine (H2 blocker)
Metronidazole
A provider orders an NG tube for a patient with gastric outlet obstruction. The nurse knows its main purpose is:
Improve peristalsis
Remove intestinal gas
Decompress the stomach
Deliver medications
A patient receiving infliximab should report which symptom immediately?
(a)
A nurse suspects peritonitis in a patient with suspected ulcer perforation. Which finding supports this?
Hyperactive bowel sounds
Soft abdomen
Absent bowel sounds
Increased appetite
A patient with rheumatoid arthritis asks why morning movement helps their symptoms. The nurse responds:
Movement decreases synovial inflammation.
Movement prevents cartilage growth.
Movement stops immune activity.
Movement lowers WBC count.
Which assessment is PRIORITY for a patient with suspected pancreatitis?
Ability to tolerate oral fluids
Onset of diarrhea
Pain radiating to the back
Blurry vision
A client with gastric ulcer has coffee-ground emesis. What does this indicate?
Which of the following is most likely to be found in the vomitus of a patient with a gastric ulcer?
Undigested food
Partially digested blood from GI bleed
Normal stomach emptying
Bile reflux only
Which patient is most at risk for Crohn’s disease?
Older African American female
Young adult smoker with family history
Child with allergies
Patient who avoids fatty foods
Which symptom indicates possible toxic megacolon?
Soft abdomen
Mild bloating
Severe abdominal pain with distention
Watery diarrhea only
A patient with UC is prescribed sulfasalazine. Which teaching is correct?
Expect symptoms to improve immediately.
This medication decreases inflammation in the colon.
Take this only when symptoms occur.
You will not need labs while on this.
What is a key nursing priority when administering IV steroids?
Monitor for hypothermia
Monitor blood glucose
Reduce salt intake
Encourage potassium supplements
A patient with peptic ulcer perforation most likely has which finding?
Pain relieved by antacids
Bright red stool
Sudden severe pain and rigid abdomen
Burning pain after meals
Which assessment finding in Crohn’s is related to malabsorption?
Fever
Weight loss
Fluid retention
Headache
A patient receiving antibiotics for C. diff reports worsening diarrhea. What action is priority?
Administer antidiarrheals
Stop all fluids
Continue therapy and monitor hydration
Give opioids for pain
Which finding indicates effective treatment of sepsis after IV fluids and antibiotics?
HR 128 → 132
BP 84/40 → 92/48
HR 130 → 98 and improved mental status
Temp 100.5 → 100.7
Which nursing intervention helps prevent peptic ulcer rebleeding?
Avoiding all carbohydrates
Strict PPI therapy
Chewing peppermint gum
Drinking coffee daily
Which finding is expected in chronic pancreatitis?
Weight gain
Steatorrhea
Bradycardia
Jaundice relief
A nurse monitoring a patient with inflammation expects which lab to elevate FIRST?
ESR
CRP
Hemoglobin
Albumin
Which dietary choice is appropriate for ulcerative colitis during a flare?
Raw vegetables
Whole nuts
Low-residue foods
High-fat meals
Which action helps prevent urinary tract infections?
Hold urine to stretch bladder
Wipe back to front
Void after intercourse
Use bubble baths
A patient with Crohn’s develops a fever, abdominal pain, and purulent drainage near the anus. This suggests:
Gastritis
Toxic megacolon
Perianal fistula
Reflux
A nurse reviews meds for a patient with inflammation. Which increases ulcer risk?
PPIs
Corticosteroids
Sucralfate
Calcium supplements
Which finding is associated with peritonitis?
Bradycardia
Soft, non-tender abdomen
Rigid abdomen with rebound tenderness
Loud bowel sounds
A client taking PPIs long-term is at risk for:
Hypermagnesemia
Osteoporosis
The nurse identifies which lab abnormality in severe diarrhea?
Hyperkalemia
Hypokalemia
High chloride
Low sodium only
Which symptom is most indicative of appendicitis progressing toward rupture?
Pain relieved suddenly
Increased appetite
Persistent diarrhea
Fever decreases
In pancreatitis, the nurse monitors for tetany because:
Hypocalcemia is common
Hypernatremia is expected
Protein levels rise
Sodium increases
Which symptom suggests inflammation complication in older adults?
Fever first
Cognitive changes or confusion
Increased appetite
Tachypnea only
