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CH 64 Systemic Lupus Erythematosus Final Exam Prediction Questions 2024. Which patient should the nurse expect to be at the highest risk for systemic lupus erythematosus (SLE)? a. A 24-year-old white female b. A 55-year-old Hispanic male c. A 28-year-old Asian American female d. A 30-year-ol...

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  • 29. april 2024
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CH 64 Systemic Lupus Erythematosus
Which patient should the nurse expect to be at the highest risk for systemic lupus erythematosus (SLE)?
a. A 24-year-old white female
b. A 55-year-old Hispanic male
c. A 28-year-old Asian American female
d. A 30-year-old African American male - correct answer ANS: C
SLE is a complex disorder affecting 250,000 people in the United States, with women 6 to 10 times more likely to develop this disorder than men. The Asian American female is at a higher risk for SLE than the African American and Hispanic males because she is female. She is also at a higher risk than the white female because white females are at a lower risk than Asian American females.
Survival in patients with systemic lupus erythematosus (SLE) is dependent on which factors? Select all that apply.
a. Age
b. Sex
c. Race
d. Comorbid conditions
e. Nonsteroidal antiinflammatory drug (NSAID) use - correct answer ANS: A B C D
A major challenge in SLE treatment is managing active disease while preventing complications. Survival appears to be influenced by several factors, including comorbid conditions, race, age, sex, and socioeconomic status. NSAID use is a mainstay of drug therapy in the treatment of arthritis associated with SLE, not an influencing factor for survival.
Which diagnostic laboratory studies are utilized in the evaluation of systemic lupus erythematosus (SLE)?
Select all that apply. a. Urinalysis
b. Chest x-ray
c. Serum complement
d. Electrocardiogram (ECG)
e. Complete blood cell count (CBC) - correct answer ANS: A C E
A CBC, serum complement, and urinalysis are all diagnostic laboratory studies used to evaluate SLE. A chest x-ray and an ECG are useful in diagnostic assessment of SLE, but these are not laboratory studies.
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?
a Three
b. Four
c. Five
d. Six - correct answer ANS: B
Patients are diagnosed with SLE if they have four of the criteria for the disease either simultaneously or in sequential observation since there is no specific diagnostic test for SLE. Meeting three is too few, and meeting five or six is subsumed in meeting four.
A common diagnostic feature of systemic lupus erythematosus (SLE) is the malar rash, which is characterized by what features?
a. Painless oral ulcerations
b. Skin rash as an unusual reaction to light
c. Fixed erythema, flat or raised, usually in a butterfly pattern d. Raised patches with scaling follicular plugging and scarring in older lesions - correct answer ANS: C
A malar rash is a fixed erythema that is either flat or raised, also known as a butterfly rash. Raised patches with scaling follicular plugging is associated with discoid rash, which is also found in SLE; Photosensitivity is a skin rash as an unusual reaction to light which can be found in SLE. Painless oral ulcerations are also a hallmark of SLE but are not a feature of the malar rash.
What marker is found in a majority of patients diagnosed with systemic lupus erythematosus (SLE)?
a. C-reactive protein (CRP)
b. Antinuclear antibody (ANA)
c. Carcinoembryonic antigen (CEA)
d. Erythrocyte sedimentation rate (ESR) - correct answer ANS: B
Of those diagnosed with SLE, 97% have ANA in their blood. ESR and CRP are markers of inflammation that may be used to monitor disease activity and effectiveness of therapy. CEA is a blood marker that is useful in diagnosing some cancers; it is unrelated to SLE.
What environmental factors are believed to contribute to the occurrence of systemic lupus erythematosus (SLE)? Select all that apply.
a. Stress
b. Hormones
c. Viral infections d. Ultraviolet (UV) light exposure
e. Exposure to chemicals and toxins - correct answer ANS: A C D E
Environmental exposure to some chemicals or toxins, UV light, viral infections, and stress can stimulate immune hyperactivity which may trigger SLE. Hormones are also known to play a role in the etiology of SLE, but they are not an environmental factor.
A patient with systemic lupus erythematosus has developed osteoporosis related to the disease process. Which drug therapy does the nurse anticipate the patient will be prescribed?
a. Tacrolimus
b. Prasterone
c. Azathioprine
d. Pimecrolimus - correct answer ANS: B
Prasterone is a hormone used to treat lupus-induced osteoporosis. Tacrolimus and pimecrolimus are used to treat integumentary symptoms of butterfly rash and discoid lesion in systemic lupus erythematosus (SLE). Azathioprine is used to reduce the need for long-term corticosteroid therapy in SLE
patients.
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?
a. "Procainamide is not typically associated with drug-induced SLE."
b. "If this hasn't occurred yet, there is no continued risk of drug-induced SLE."
c. "Drug-induced SLE generally occurs months to year after continuous use of this drug."
d. "Drug-induced SLE is a common side effect of medication therapy, particularly this medication." - correct answer ANS: C

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