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Exemplar 8.4: Systemic Lupus Erythematosus

Olivia McRitchie 14 questions

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Questions in this quiz (14)

  1. 1You have a young female nursing student just diagnosed with lupus. She's heard of this disorder, but knows very little about it and decides to ask you, the university nurse, about it. Which of the following statements made by the student nurse shows that teaching has been effective?
    1. A"My body is producing antibodies against itself because of hyperreactive T-cell function."
    2. B"The most characteristic autoantibodies in SLE are produced in response to nucleic acids."
    3. C"The autoantibodies react with their corresponding antigen to form immune complexes that deposit into the body's blood vessels."
    4. D"The coronary blood vessels are a frequent site of complex deposition and change."
  2. 2A 20-year-old female patient presents to you because she's had a 100.1 degree Fahrenheit fever, appetite loss, and pain in both elbows, wrists, shoulders, ankles. and knees for the past 2 weeks. She tells you she's lost about 6 pounds and she has had a hard time concentrating on schoolwork because hasn't "felt very good", though she can't identify why. She explains that this has been happening on and off for the past two years, but she hasn't gone to the doctor about it because her symptoms haven't been this troublesome before.

    What follow up question would you want to ask this patient?
    1. A"Have you had any fungal infections lately?"
    2. B"Are you on any antipsychotic medications?"
    3. C"Have you ever gotten a red rash on your cheeks and the bridge of your nose?"
    4. D"Have you had regular menses?"
  3. 3You are a nurse in a doctor's office about to see a male patient that has been taking procainamide for a little over a year. What questions might you ask this patient when he comes in?
    1. A"Have you been experiencing any new pain in your joints?"
    2. B"Have you been experiencing any new or increasing memory loss, disorientation, personality changes, depression, or psychoses?"
    3. C"Have you been noticing foamy urine, swelling in your abdomen and extremities, and weight gain?"
    4. D"Have you had diarrhea, abdominal pain, nausea, and decreased desire to eat?"
    5. E"Have you had any raised, scaly, circular lesions that has redness around them?"
    6. F"Have you been fatigued and experiencing bleeding gums, nosebleeds, or increased bruising?"
  4. 4Select the medications that have potential to cause drug-induced lupus.
    1. AProcainamide
    2. BHydralazine
    3. CIsoniazid
    4. DSertraline
    5. EHydroxychloroquinolone
    6. FPrednisolone
  5. 5Your female lupus patient is presenting with severe weakness, fatigue, dyspnea, and heart palpitations. She reports that her grades have been dropping because she's too exhausted to do anything and she can't concentrate. She is pale, her skin is cold, and the tips of her fingers are slightly cyanotic.

    Her heart rhythm is sinus rhythm; upon auscultation, S1 and S2 could clearly be heard, no extra sounds or murmurs identified. Her hematocrit is 22% and her hemoglobin is 7.5 g/dL.

    Which of the following orders should you place FIRST?
    1. AECG
    2. BRetake the CBC
    3. C50 units/kg epoetin alpha, subcutaneous
    4. D1 unit of blood of the appropriate blood type
  6. 6A patient with lupus is in the doctor's office during a flare up. She complaining about getting random nose bleeds, gum bleeds, and bruising. She is embarrassed to wear skirts and short sleeved shirts because of the extensive bruising and "bumpy, non-itchy rashes" (petechiae) on her skin. It is even interfering with her relationship with her fiance; due to the extensive bruising and the patient trying to cover it up, people will assume that her fiance is abusing her and act judgmentally.

    Which of the following orders will you suggest to the doctor for this patient?
    1. A5 mg prednisone, PO, BID.
    2. BHospital referral for IV platelet transfusion
    3. CHospital referral for IV IgG
    4. D1 mg/kg azathioprine IV BID for 6-8 wks
  7. 7A lupus patient presents with chest pain radiating to his back., dry cough, fever, and anxiety. He reports that he is very tired, but he can't lay down and rest because that makes the pain worse. He is pale and cold. Upon auscultation you hear a high-pitched grating sound, no crackles or rales in the lungs. Telemetry and ECG shows ST elevation and PR depression.

    Which of the following interventions should you order FIRST?
    1. APericardiocentesis
    2. B40 mg prednisone, PO, BID.
    3. C1,000 mg nafcillin PO, QID
    4. D1.2 mg colchicine PO, then 0.6 mg 1 hr later
  8. 8You are concerned that the patient you are caring for might have systemic lupus erythematosus. Which tests might you order?
    1. AAnti-DNA antibody testing.
    2. BErythrocyte sedimentation rate.
    3. CSerum complement levels.
    4. DComplete blood count
    5. EEnzyme-linked immunoabsorbent array.
    6. FWestern blot antibody testing
  9. 9You have a patient presenting to the hospital with anasarca, with increased edema in the hands, feet, and face; fatigue; anorexia; and foamy urine. This patient has been diagnosed with lupus in the past. What tests might you order?
    1. AUrinalysis
    2. BRenal function tests
    3. CAnti-DNA antibody testing
    4. DErythrocyte sedimentation rate
  10. 10Which of the following instructions is important to give to a female patient taking hydroxychloroquine?
    1. A"You should see an ophthalmologist every 6 months."
    2. B"Avoid large crowds and situations that increase exposure to infection."
    3. C"Refrain from taking aspirin or ibuprofen."
    4. D"Your menses may cease while taking the drug."

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Description
NCLEX Nursing (Medical-Surgical) Quiz on Exemplar 8.4: Systemic Lupus Erythematosus, created by Olivia McRitchie on 16/11/2018.
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