NUR 211 Quiz 5
- A Nurse is assessing a client who has systemic lupus erythematosus (SLE). Which of the
following findings should the nurse expect?
Facial rash Thickened skin Chronic back pain Iritis
Answer Facial rash
Rationale SLE causes a characteristic facial "butterfly" rash that is dry, scaly, red, and raised
- A nurse is providing discharge teaching to a client who has systemic lupus erythematosus
(SLE). Which of the following instructions should the nurse include?
Avoid using moisturizing lotions on the skin Wash the hair with a mild protein shampoo.Apply powder liberally to sensitive skin areas.
Use a sun-blocking agent with a sun protection of at least 15.
Answer Use a sun-blocking agent with a sun protection of at least 15.
Rationale Clients who have SLE are prone to hair loss. They should use a mild protein shampoo and ... avoid treatments that can damage the hair and scalp, such as dyes and permanents.Clients who have SLE should not use powder or other drying skin products on their skin. Clients who have SLE should apply non-perfumed moisturizing lotions liberally to the skin
- A nurse is caring for a client who has a new diagnosis of systemic lupus erythematosus
(SLE) and asks where this disease originates within the body. The nurse should tell the client that SLE originates in which of the following locations in the body?
Connective tissue Muscle tissue Peripheral vascular system 1 / 3
Answer Connective tissue
Rationale SLE originates in the connective tissues of the body and affects all organ systems.
- A nurse is assessing a client who has systemic lupus erythematosus (SLE). Which of the
following findings is the highest priority for the nurse to report to the provider?
Client reports mild feelings of depression Dry, raised rash on the face.Presence of sudden peripheral edema.Joint pain in hands and knees.
Answer Presence of sudden peripheral edema.
Rationale The client who has SLE is at greatest risk for death from lupus nephritis. Therefore, according to the safety and risk reduction priority setting framework, findings that indicate an impairment of renal function are the highest priority to report.Rationale The client who has SLE commonly reports joint pain and rash. However, according to Rationale The client who has SLE commonly reports feelings of depression. However, according to the safety and risk reduction priority setting framework, these other findings are not the highest priority.
- A nurse is assessing a client who is taking hydroxychloroquine. The nurse should report
which of the following adverse effects to the provider immediately?
Blurry vision Diarrhea Fatigue Pruritus
Answer Blurry Vision
Rationale When using the urgent vs non-urgent approach to client care, the nurse should determine that the priority finding to report to the provider is blurred vision, as this is a manifestation of hydroxychloroquine toxicity and can be an indication of retinal damage.
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- A nurse is teaching a female client who has a new diagnosis of systemic lupus
erythematosus (SLE). The nurse should recognize the need for further teaching when the client identifies which of the following as a factor that can exacerbate SLE?
Exercise Infection Pregnancy Sunlight
Answer Exercise
Rationale Deconditioning and muscle atrophy occurs as a result of lack of mobility. The nurse should encourage client to engage in conditioning exercises alternated with periods of rest.Rationale Exposure to sunlight and artificial ultraviolet light can cause for an exacerbation of SLE manifestations, especially the characteristic skin manifestations of lesions and butterfly rash.Rationale Pregnancy can cause an exacerbation of SLE, probably due to hormonal changes. The client should be advised of the risks and must be monitored closely for effects on the renal and cardiovascular systems if she decides to get pregnant.Rationale Infection is a major stressor on the body and can trigger an exacerbation of the SLE disease process. In addition, many clients who have SLE take steroid medications that place them at higher risk for infection.
- A nurse is reviewing laboratory values for a client who has systemic lupus erythematosus
(SLE). Which of the following values should give the nurse the best indication of the client's renal function?
Serum creatinine
Blood urea nitrogen (BUN) Serum sodium Urine-specific gravity
Answer Serum Creatinine
Rationale A renal function disorder reduces the excretion of creatinine, resulting in increased levels of blood creatinine. Creatinine is a specific and sensitive indicator of renal function. The BUN is used as a gross index of glomerular function and the production and excretion of urea. High-protein diets, rapid-protein catabolism, and dehydration are conditions that will
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