Chronic ch 13/64

A woman with systemic lupus erythematosus (SLE) who is one-month postpartum reports to the emergency room with fever, malaise, and severe pain for two days. She had been discharged from the hospital with similar symptoms one week ago. What is the most likely reason for readmission? 1 The patient is likely opioid-seeking. 2 The patient's SLE is poorly controlled. 3 SLE flares are common in the postpartum period. 4 The patient is exhausted from caring for a new baby

3

The nurse is administering tacrolimus to a patient. Which information about this medication would the nurse be sure to include during patient education? 1 Take this medication on an empty stomach. 2 This medication has very few side effects. 3 Avoid eating or drinking products with grapefruits while taking this medication. 4 Flu-like symptoms will develop in the first few days of treatment

3

The nurse is caring for a patient with systemic lupus erythematosus. To prevent an exacerbation of the condition, what should the nurse instruct the patient to avoid? 1 Dairy products 2 Animal dander 3 Becoming fatigued 4 Nonsteroidal drugs

3

Which patient should the nurse expect to be at the highest risk for systemic lupus erythematosus (SLE)? 1 A 24-year-old white female 2 A 55-year-old Hispanic male 3 A 28-year-old Asian American female 4 A 30-year-old African American male

3

The nurse is performing an assessment for a patient with suspected systemic lupus erythematosus (SLE). Which finding would the nurse determine is due to Raynaud's phenomenon? 1 Cyanosis of fingers 2 Swan neck deformity of the fingers 3 Persistent lesions and photosensitivity 4 Rashes over the cheeks and bridge of the nose

1

What integumentary change does the nurse expect to find in a patient with suspected systemic lupus erythematosus (SLE)? 1 Alopecia 2 Dysphagia 3 Splenomegaly 4 Cognitive impairment

1

A patient is suspected of having systemic lupus erythematosus (SLE). Which would be considered diagnostic for systemic lupus erythematosus? 1 Anti-Smith antibody 2 Lupus erythematosus 3 Swan-neck deformity 4 Raynaud's phenomenon

1

Survival in patients with systemic lupus erythematosus (SLE) is dependent on which factors? Select all that apply. 1 Age 2 Sex 3 Race 4 Comorbid conditions 5 Nonsteroidal antiinflammatory drug (NSAID) use

1, 2, 3, 4

A patient reports to the primary care clinic after being diagnosed with systemic lupus erythematosus (SLE). The patient's blood pressure is 175/90 mmHg. What does the nurse expect the healthcare provider to recommend? Select all that apply. 1 Low-sodium diet 2 Complete metabolic panel 3 Weight loss and high-intensity daily exercise 4 Aggressive antihypertensive therapy with oral medications 5 Referral to the emergency room for blood pressure managemen

1, 2, 4

The nurse is caring for a patient with systemic lupus erythematosus (SLE). Which cardiopulmonary manifestations should the nurse closely monitor for? Select all that apply. 1 Cough 2 Tachypnea 3 Hypotension 4 Dysrhythmias 5 Hypocholesterolemia

1, 2, 4

A patient is diagnosed with systemic lupus erythematosus (SLE). What neurologic manifestations should the nurse closely monitor for? Select all that apply. 1 Stroke 2 Seizures 3 Alopecia 4 Synovitis 5 Psychosis

1, 2, 5

Which nursing interventions should be implemented when caring for a patient who is taking immunosuppressive therapy? Select all that apply. 1 Place the patient in a private room 2 Advise the patient to avoid people who are sick 3 Encourage the patient to reduce daily fluid intake 4 Encourage consumption of fresh fruits and vegetables 5 Advise the patient to report any symptoms of acute illness

1, 2, 5

Which diagnostic laboratory studies are utilized in the evaluation of systemic lupus erythematosus (SLE)? Select all that apply. 1 Urinalysis 2 Chest x-ray 3 Serum complement 4 Electrocardiogram (ECG) 5 Complete blood cell count (CBC)

1, 3, 5

Which hematologic disorders are frequently associated with systemic lupus erythematosus (SLE)? Select all that apply. 1 Leukopenia 2 Leukocytosis 3 Erythrocytosis 4 Hemolytic anemia 5 Thrombocytopenia

1, 4, 5

Which body systems can be affected in patients with systemic lupus erythematosus (SLE) who become pregnant? Select all that apply. 1 Renal 2 Pulmonary 3 Integumentary 4 Cardiovascular 5 Central nervous system (CNS)

1,2,4,5

A nurse is caring for a patient who is undergoing plasmapheresis for glomerulonephritis. The nurse should be observant for which symptoms indicating citrate toxicity? 1 Sneezing 2 Headache 3 Hypertension 4 Conjunctivitis

2 When caring for a patient undergoing plasmapheresis, the nurse should be observant for headache. Citrate toxicity is a common complication of plasmapheresis because citrate is used as an anticoagulant and may cause hypocalcemia, which in turn manifests as headache, paresthesias, and dizziness

A nurse has just been asked by a friend to administer allergy shots at home to save money by avoiding office visits. Which response by the nurse is most appropriate? 1 "I would, but it is illegal for nurses to administer injections outside of a medical setting." 2 "These injections should only be administered in a setting where emergency equipment and drugs are available." 3 "Just make sure you have epinephrine in an injectable syringe provided along with the allergy injections." 4 "Allergy shots are not usually effective; it is safer and more effective to control allergies by avoiding allergens."

2

To diagnose a patient with systemic lupus erythematosus (SLE), the patient must meet how many of the distinct criteria either simultaneously or in sequential evaluation? 1 Three 2 Four 3 Five 4 Six

2

When caring for a patient with systemic lupus erythematosus, the nurse recognizes which major and serious complication of the disorder? 1 Dysphagia 2 Renal failure 3 Peripheral neuropathies 4 Multiple open skin lesions

2

Which action is most important when caring for a patient who is having a possible anaphylactic reaction? 1 Establish intravenous (IV) access. 2 Assess the patient's respiratory status. 3 Administer epinephrine to the patient. 4 Administer antihistamine to the patient

2

A patient was started on hydralazine for hypertension after a recent hospitalization. The patient is accompanied by a parent who has systemic lupus erythematosus (SLE). What is the best intervention by the nurse? 1 Alert the healthcare provider to screen for SLE. 2 Tell the patient to immediately discontinue taking the hydralazine. 3 Alert the healthcare provider to the medication and family history. 4 Educate the patient that family history of SLE does not increase risk for this disease.

3

A common diagnostic feature of systemic lupus erythematosus (SLE) is the malar rash, which is characterized by what features? 1 Painless oral ulcerations 2 Skin rash as an unusual reaction to light 3 Fixed erythema, flat or raised, usually in a butterfly pattern 4 Raised patches with scaling follicular plugging and scarring in older lesions

3

A parent brought his or her child to the allergist office for skin testing for suspected allergies. The child is crying, and the parent is fidgeting while trying to comfort the child. What is the most likely cause of anxiety in the parent? 1 The child is hungry. 2 The parent is late for work. 3 Concern about pain from the skin test. 4 The parent is concerned about the child disturbing others in the waiting room

3

A patient has begun immunotherapy for the treatment of intractable environmental allergies. When administering the patient's immunotherapy, what is the nurse's priority action? 1 Monitor the patient's fluid balance. 2 Assess the patient's need for analgesia. 3 Monitor for signs and symptoms of an adverse reaction. 4 Assess the patient for changes in level of consciousness

3

A patient has begun immunotherapy for the treatment of intractable environmental allergies. When administering the patient's immunotherapy, what is the nurse's priority action? 1 Monitor the patient's fluid balance. 2 Assess the patient's need for analgesia. 3 Monitor for signs and symptoms of an adverse reaction. 4 Assess the patient for changes in level of consciousness.

3

A patient informs the nurse that the appearance of a malar rash is concerning. What is the most appropriate response to this patient regarding treatment options? 1 "Intravenous (IV) corticosteroids will reverse this symptom." 2 "Oral corticosteroids will help treat the appearance of this rash." 3 "Topical immunomodulators can be used instead of corticosteroids to treat serious skin conditions." 4 "Nonsteroidal antiinflammatory drug (NSAID) medications will reduce the inflammation near the rash."

3

A patient reports to a rheumatology clinic with a swan neck deformity of the fingers of the left hand and is referred for laboratory testing for systemic lupus erythematosus (SLE). The patient calls back several days later saying, "The healthcare provider must be wrong. This has to be arthritis like my mother has." What is the nurse's best response? 1 Reassure the patient that SLE will not affect all the joints like arthritis. 2 Reassure the patient that SLE has a good prognosis in most patients. 3 Explain that arthritis is not the only medical condition that can cause joint deformities. 4 Reassure the patient that the inflammation in the hand is temporary and oral steroids will treat SLE and reverse the damage to the hand.

3

A patient voices concerns to the nurse about taking procainamide, stating that a friend was recently hospitalized for drug-induced systemic lupus erythematosus (SLE). What is the nurse's best response? 1 "Procainamide is not typically associated with drug-induced SLE." 2 "If this hasn't occurred yet, there is no continued risk of drug-induced SLE." 3 "Drug-induced SLE generally occurs months to year after continuous use of this drug." 4 "Drug-induced SLE is a common side effect of medication therapy, particularly this medication.

3

A woman with systemic lupus erythematosus (SLE) reports to the clinic that she has been attempting pregnancy for six months without success. What is the nurse's most appropriate response? 1 "Stillbirth is common in women with SLE." 2 "Women with SLE should never become pregnant." 3 "SLE causes many birth defects but should not affect fertility." 4 "Infertility can result from the SLE or from medications used to treat it."

4

Which is an immunosuppressive agent used to treat lupus nephritis in systemic lupus erythematosus (SLE) patients? 1 Allopurinol 2 Pilocarpine 3 Chloroquine 4 Cyclophosphamide

4