A 79-year-old female resident of an assisted living facility ...

[eruditmonkey@yahoo.com]

A 79-year-old female resident of an assisted living facility receives care from a community nurse on a regular basis for treatment of a chronic venous leg ulcer.
 
  Which of the following factors would the nurse be most justified in ruling out as a contributing factor to the client's impaired wound healing?
  A)
  A lower skin collagen content than in younger adults
  B)
  Decreased fibroblast synthesis
  C)
  Slow reepithelialization
  D)
  Decreased antibody levels

Question 2

In the context of a workshop on rheumatoid arthritis, a clinical educator is teaching a group of nurses about autoimmune diseases. Which of the following statements by an attendee would the educator most likely want to follow up with further teaching?
 
  A)
  Introduction of a foreign antigen can sometimes induce a cascade of immune response that is not self-limiting
  B)
  Often the problem can be traced to antigens that sensitize T cells without the need for presentation.
  C)
  In some cases, the body attacks its own cells that are chemically similar to those of infectious organisms.
  D)
  Sometimes when the body's own cells are released after a long time, they are interpreted as being foreign.

[Chocorrol77]

Answer to Question 1

Ans:
D

Feedback:

Older adults do not normally have diminished antibody levels. Low collagen levels, decreased fibroblast activity, and slow reepithelialization are common impediments to wound healing in the elderly.

Answer to Question 2

Ans:
A

Feedback:

Autoimmune responses are not considered to be uncontrolled cascades of immune response that are catalyzed by introduction of an antigen. Superantigens are able to forego the normal antigen presentation process and directly stimulate T-cell response, resulting in overactivation of T cells. Molecular mimicry involves the misidentification of somatic cells as similar foreign cells, and self-antigens that have been sequestered for long periods can invoke an immune response.