SLE NCLEX Practice Questions
The laboratory results of a client with systemic lupus erythematosus (SLE) indicates anemia. Which collaborative therapy should the nurse anticipate? Performing a splenectomy Treating the underlying cause Administering corticosteroids Administering erythropoietin
Administering erythropoietin For the client with anemia, medications such as erythropoietin may be given to stimulate red blood cell production. A splenectomy and the administration of corticosteroids are clinical therapies to treat thrombocytopenia. The underlying cause of the anemia is SLE. The disease cannot be cured, but the symptoms can be managed.
The nurse is caring for a client with systemic lupus erythematosus (SLE) who presents with pain and discomfort. Which treatment option should the nurse anticipate? (Select all that apply.) Corticosteroids Increasing sun exposure Moderate exercise Proper nutrition NSAIDs
Corticosteroids Moderate exercise NSAIDs NSAIDs are used to treat inflammation and pain in clients with SLE. A prescribed exercise plan can alleviate pain but must be balanced with adequate rest. Low-dose corticosteroids are used to reduce pain and inflammation in SLE. Improving nutrition promotes a well-balanced diet, improving overall health in clients, but does not specifically impact pain. Some medications that are used to treat SLE cause sun sensitivity; therefore, clients are advised to decrease the amount of time in the sun and to use sunscreen and other forms of sun protection when outdoors.
In a community setting, the nurse is providing care to a client who was recently diagnosed with systemic lupus erythematosus (SLE). Which is the goal of care for this client? (Select all that apply.) Maintaining skin integrity Reducing pain Limiting fluid intake Reducing inflammation Preventing infections
Maintaining skin integrity Reducing pain Reducing inflammation Preventing infections The treatment goals for clients with SLE are to reduce pain, reduce inflammation, prevent infections, maintain skin integrity, prevent exacerbations, and improve coping skills. Fluid and nutrition should be balanced while taking kidney function into consideration.
The nurse is assessing a client with systemic lupus erythematosus (SLE). Which manifestation should the nurse recognize as a result of inflammation? (Select all that apply.) Cough Malaise Maculopapular rash Joint pain Fever
Malaise Maculopapular rash Joint pain Fever In SLE, the immunocomplexes that are deposited in the connective tissue trigger an inflammatory response. Joint pain, fever, malaise, and maculopapular rash are all signs of the inflammation that result from local tissue damage. A cough is a sign of infection, not of inflammation resulting from tissue damage.
A client with a history of systemic lupus erythematosus (SLE) anxiously states, "My chest hurts when I lie down. I think it is from coughing so much. Please sit me up." Which condition should the nurse first suspect? Thrombocytopenia Pericarditis Myocardial infarction Anemia
Pericarditis A client diagnosed with SLE is at risk for pericarditis. Clinical manifestations of pericarditis include chest pain radiating to the back, relieved by sitting forward and worsening when lying down, and a dry cough. Electrocardiogram (ECG) findings in pericarditis are an ST elevation and PR depression. Although clients with SLE are prone to thrombocytopenia and anemia, the clinical presentation is not consistent with these conditions. While a myocardial infarction should be considered, the symptoms combined with the client's history should first lead the nurse to suspect pericarditis.
The nurse is assessing a client with systemic lupus erythematosus (SLE). Which clinical manifestation should the nurse expect to observe? (Select all that apply.) Red butterfly rash on the face Alopecia Psoriatic lesions Painful or swollen joints Leg and eye edema
Red butterfly rash on the face Alopecia Painful or swollen joints Leg and eye edema
The nurse is caring for a client with systemic lupus erythematosus (SLE). Which system should the nurse consider as being most affected by the formation of immune complexes and tissue damage? Cardiac Integumentary Respiratory Renal
Renal When the SLE autoantibodies react with their corresponding antigen, they form immune complexes, which are then deposited in the connective tissue of blood vessels, lymphatic vessels, and other tissues. These deposits trigger an inflammatory response that leads to local tissue damage. The kidneys are a frequent site of complex deposition and damage. The other systems include cardiac, respiratory, and integumentary.
The nurse is admitting a client with systemic lupus erythematosus (SLE) for an upper respiratory infection. Which nursing goal is the priority? The client can verbalize the importance of oral care. The client demonstrates proper hand hygiene. The client can verbalize skin care needs to reduce the risk of altered skin integrity. The client can verbalize the impact of the diagnosis to the healthcare provider.
The client demonstrates proper hand hygiene. The client demonstrating proper hand hygiene will reduce the risk of infection. Alterations in skin integrity, including those in the oral cavity, can increase the risk of acute exacerbation of SLE. It is important for the client diagnosed with SLE to be able to verbalize the impact of the disease to the healthcare provider in order to address the client's psychosocial well-being. Next Question
The nurse is providing teaching for a client diagnosed with systemic lupus erythematosus (SLE) experiencing alterations in skin integrity. Which client statement indicates effective teaching? "I will apply sunscreen immediately prior to going outdoors." "I will cover the lesions on my head with a wig." "I will use fluorescent lighting." "I will limit the use of cosmetics."
"I will limit the use of cosmetics." Cosmetics can irritate the skin and increase the risk of integumentary symptoms. It is important for the client's safety to use adequate lighting to prevent injury, and to specifically avoid fluorescent lighting. Fluorescent lighting has been linked to exacerbation of SLE. If the client experiences alopecia, it is important that a wig is avoided when skin integrity is impaired. The client should apply sunscreen 30 minutes prior to going out in the sun.
The nurse is teaching a client newly diagnosed with systemic lupus erythematosus (SLE). Which information should the nurse include in the client's teaching? Using high-dose birth control pills Using only acetaminophen for pain relief Avoiding large crowds Increasing daily sun exposure
Avoiding large crowds The client should be advised to avoid large crowds to decrease exposure to infection. Instruct the client to limit sun exposure and to use sunscreen with an SPF rating of 15 or higher when outdoors. The client should take aspirin or ibuprofen for pain, but should monitor for side effects of bleeding. The client should be encouraged to use contraception to prevent pregnancy, because the prescribed drugs for treatment may increase the risk for birth defects
The nurse is planning care for an adolescent client with systemic lupus erythematosus (SLE). Which nursing diagnosis is a special consideration for this client? Memory, Impaired Fluid Volume: Imbalanced, Risk for Body Image, Disturbed Infection, Risk for
Body Image, Disturbed The adolescent client with SLE needs special consideration for body image disturbance, such as hair loss and moon face, resulting from the effects of medication for treatment of SLE. A risk for infection and increased risk of fluid volume imbalance apply to all clients with SLE. Impaired memory is not a typical clinical manifestation of SLE. (NANDA-I ©2014)
The nurse is caring for a pregnant client with systemic lupus erythematosus (SLE). Which neonatal complication related to maternal lupus should the nurse anticipate the fetus to be tested for during the second trimester of pregnancy? Renal anomalies Congenital heart block (CHB) Anemia Liver involvement
Congenital heart block (CHB) Congenital heart block (CHB) may occur in the fetus of a mother diagnosed with SLE. Fetal echocardiography may be used to assess for CHB in the second trimester of pregnancy. The prognosis for CHB varies, depending on when the congenital heart defect is detected. With treatment, early CHB may be reversible. However, late CHB could require the insertion of a pacemaker at the time of delivery. Fetal anemia, renal anomalies, and liver involvement are not tested for in the second trimester of pregnancy.
A client diagnosed with systemic lupus erythematosus (SLE) presents with fatigue, joint pain, oral ulcers, and a red rash over the face and upper trunk. Which collaborative therapy should the nurse expect to implement? Corticosteroid therapy Antibiotic therapy Surgical drainage of affected joints Physical therapy to improve mobility
Corticosteroid therapy The nurse would expect corticosteroid therapy to be ordered. SLE is an autoimmune disorder, and corticosteroids and rest are the first-line treatment. It is a disorder of the muscles, so the nurse would not expect surgical drainage of the joints. It is autoimmune, not infective, in origin, so the nurse would not expect antibiotic therapy as a first-line treatment unless the client also has signs of infection. Also, a priority treatment is rest, so the nurse would not expect physical therapy to be ordered to improve mobility.
The nurse is preparing a presentation on systemic lupus erythematosus (SLE). Which statement should the nurse include? (Select all that apply.) The etiology is known to be linked to environmental factors. Manifestations can be mild to fatal, with remissions and exacerbations. The immune complex deposits trigger an inflammatory response. SLE is a result of deposition of antigen-antibody complexes in connective tissues. The inflammatory response leads to anaphylactic shock.
Manifestations can be mild to fatal, with remissions and exacerbations. The immune complex deposits trigger an inflammatory response. SLE is a result of deposition of antigen-antibody complexes in connective tissues. The pathophysiology of systemic lupus erythematosus is a result of the formation of antigen-antibody immunocomplexes that are deposited in the connective tissue and trigger an inflammatory response. The manifestations of the disease can be mild to fatal, and remissions are followed by exacerbations. The inflammatory response leads to tissue damage but not anaphylactic shock (allergic reaction). Although the exact etiology of SLE is unknown, genetic, ethnic, environmental, and hormonal factors play a role in its development.
The nurse is reviewing medications ordered for a newly admitted female client with systemic lupus erythematosus (SLE). Which medication order should the nurse question? Immunosuppressive Oral contraceptive Antineoplastic Corticosteroid
Oral contraceptive High-dose corticosteroids, immunosuppressants, and antineoplastic drugs are all used for the treatment of acute SLE. Caution needs to be taken with the use of oral contraceptives because estrogen triggers the symptoms of SLE.
An older adult client is experiencing an acute episode of systemic lupus erythematosus (SLE). Which primary concern should the nurse consider when administering newly prescribed medications? Renal function Cardiovascular function Respiratory function Neurological function
Renal function Treatment for the older adult client is the same regardless of the age at onset of the disease. In addition to taking into consideration that older adults may be taking multiple medications, these individuals may have decreased renal function. Pharmacokinetics and drug-to-drug interactions need to be considered prior to the initiation of medications commonly used to treat SLE. Respiratory, neurological, and cardiovascular function are important, but the renal system remains a primary concern.
A client diagnosed with systemic lupus erythematosus (SLE) is experiencing pulmonary interstitial fibrosis. Which classification of lupus should the nurse suspect? Systemic Drug-induced Discoid Cutaneous
Systemic The classification of lupus the client is experiencing is systemic. There are three major classifications of SLE: discoid or cutaneous, systemic, and drug-induced. Systemic lupus involves one or more of these systems: cardiovascular, central nervous, hematologic, kidneys, lungs, and musculoskeletal. Cutaneous or discoid lupus is limited to the skin. Many drugs can cause a syndrome that mimics lupus (drug-induced lupus).
Which laboratory test is used in the diagnosis of systemic lupus erythematosus (SLE)? (Select all that apply.) Urinalysis Anti-DNA antibody testing Erythrocyte sedimentation rate (ESR) Triglyceride levels Complete blood count (CBC)
Urinalysis Anti-DNA antibody testing Erythrocyte sedimentation rate (ESR) Complete blood count (CBC) The laboratory tests that are used in the diagnosis of SLE are anti-DNA antibody testing to detect antibodies that occur in SLE, erythrocyte sedimentation rate (ESR) to detect elevation related to SLE, serum complement levels to detect depletion by antigen-antibody complexes of SLE, complete blood count (CBC) to detect anemia and overall pancytopenia, and urinalysis for abnormal traces of blood and protein indicating kidney dysfunction related to SLE. Triglycerides are measured in the diagnosis of cardiovascular diseases like atherosclerosis.
The nurse is caring for a client with exacerbation of systemic lupus erythematosus (SLE). Which statement by the nurse is accurate? "The client is at risk for a micronutrient deficiency." "The client is at risk for weight gain." "The client is at risk for a macronutrient deficiency." "The client is at risk for weight loss."
"The client is at risk for weight gain." The client is at risk for weight gain associated with the treatment involving steroids and a decreased activity level during exacerbation of the disease. The client is not at risk for weight loss, micronutrient deficiency, or macronutrient deficiency unless the GI tract is compromised.
The nurse is teaching a new colleague the effects of drugs used for clients with systemic lupus erythematosus (SLE). Which statement by the colleague indicates the need for further teaching? "Thrombosis prevention is a positive side effect with aspirin therapy." "Corticosteroid therapy can cause cushingoid effects." "If a cytotoxic agent is prescribed, infection may occur." "When the client is on aspirin therapy, I should monitor for renal toxicity."
"When the client is on aspirin therapy, I should monitor for renal toxicity." Aspirin therapy may cause liver toxicity and hepatitis, not renal toxicity. Corticosteroid therapy can cause cushingoid effects. Aspirin is particularly beneficial for clients with SLE because its antiplatelet effects help to prevent thrombosis. Cytotoxic drugs can cause immunosuppression, placing the client at risk for infection, malignancy, and bone marrow depression.
