Question 1

A patient asks the nurse if there are any conditions that can exacerbate systemic lupus erythematosus (SLE).Which response by the nurse is the most appropriate?

Accepted Answer

Pregnancy can often exacerbate SLE due to hormonal changes and increased stress on the body. Hypotension, GI upset, and fever may be symptoms of an SLE exacerbation, but they are not necessarily triggers or exacerbating factors.

Question 2

An Asian male accompanies his spouse to the clinic and states,"I want you to fix my wife and tell her that there is nothing wrong with her." The patient reports pain,sleep disorders,and stiffness.Which would be most appropriate for the nurse to include in a plan of care for this family?

Accepted Answer

Providing information and literature on fibromyalgia will help the family understand the condition better, which is crucial for managing symptoms and supporting the patient effectively.

Question 3

The nurse is collecting a health history for a patient in an outpatient clinic who reports joint pain and swelling for the last two months.The patient is diagnosed with rheumatoid arthritis (RA).When planning care for this patient,which statement supports the nursing diagnosis of Activity Intolerance?

Accepted Answer

The statement "I seem to get tired early in the day and require a nap" supports the nursing diagnosis of Activity Intolerance, as it indicates that the patient is experiencing fatigue that is impacting their ability to perform daily activities. Fatigue is a common symptom of RA and can contribute to activity intolerance. The other statements may be related to the patient's RA, but do not directly support the nursing diagnosis of Activity Intolerance.

Question 4

A patient with systemic lupus erythematosus (SLE)is being treated with immunosuppressant drugs and corticosteroids.Which patient statement indicates the need for further education after teaching?

Accepted Answer

Patients on immunosuppressants should avoid large crowds to reduce the risk of infections.

Question 5

The nurse is providing care for a newly married woman with systemic lupus erythematosus (SLE).Which patient statement indicates an appropriate understanding of the plan of care?

Accepted Answer

Patients with SLE taking cytotoxic medications should use birth control to prevent pregnancy due to potential harm to the fetus.

Question 6

The nurse is caring for a patient who was diagnosed with rheumatoid arthritis (RA)last year.The patient has recently been placed on prednisone for treatment.Which patient statement indicates that the medication teaching was successful?

Accepted Answer

Taking prednisone at the same time every day helps maintain consistent blood levels and effectiveness.

Question 7

An adult patient is diagnosed with fibromyalgia.The patient asks the nurse whether a recent of infection with the Coxsackie B virus could have caused fibromyalgia.Which response by the nurse is the most appropriate?

Accepted Answer

While the exact cause of fibromyalgia is unknown, there is some evidence that suggests viral or bacterial infections can trigger the condition. Therefore, it is appropriate for the nurse to suggest the Coxsackie B virus may have triggered the fibromyalgia. To claim that the virus definitely caused the fibromyalgia or that fibromyalgia is a psychiatric disorder would be inaccurate and inappropriate.

Question 8

The nurse identifies the nursing diagnosis of chronic pain as being appropriate for a patient with fibromyalgia.Which manifestation did the patient most likely report that caused the nurse to select this diagnosis?

Accepted Answer

Fibromyalgia is a chronic pain disorder characterized by tender points in specific locations throughout the body. Acute chest pain and pain from eyestrain are not typically associated with fibromyalgia. Pain from a severe skin rash may cause discomfort, but it is not a defining characteristic of fibromyalgia.

Question 9

A nurse is caring for a patient with systemic lupus erythematosus (SLE).The patient begins to cry stating,"I am afraid I will be disfigured because of all of these lesions." Which intervention does the nurse plan to teach this patient to minimize skin infections associated with SLE?

Accepted Answer

Using sunscreen with an SPF of 15 or greater can help protect the skin from damage and reduce the risk of skin infections associated with SLE. Remaining indoors on sunny days and avoiding swimming in a pool or the ocean are not necessary interventions, while decreasing sun exposure between 3:00 p.m. and 5:00 p.m. may not be practical or realistic for the patient.

Question 10

The nurse is caring for a patient who is hospitalized due to an exacerbation of systemic lupus erythematosus (SLE).The nurse is reviewing the patient's lab work and finds the white blood cell count (WBC)is shifted to the left.Based on this information,which is a priority nursing diagnosis for this patient?

Accepted Answer

A shift to the left in the WBC count indicates an infection or inflammation. Therefore, the priority nursing diagnosis for this patient should be Risk for Infection. The nurse should closely monitor the patient for signs of infection and implement appropriate infection prevention measures to prevent further complications. The other options may be relevant but are not the priority in this situation.

Question 11

A nurse is caring for a patient with systemic lupus erythematous (SLE)who is taking hydroxychloroquine (Plaquenil).When providing care for this patient,the nurse monitors for which adverse effect associated with the prescribed medication?

Accepted Answer

Retinal toxicity is a potential adverse effect of hydroxychloroquine, so the nurse should monitor the patient's vision and advise them to report any vision changes to the healthcare provider. Renal toxicity, Cushingoid effects, and pulmonary fibrosis are not common adverse effects of hydroxychloroquine.

Question 12

The patient enters the outpatient clinic and states to the triage nurse,"I think I have the flu.I'm so tired,I have no appetite,and everything hurts." The triage nurse assesses the patient and finds a butterfly rash over the bridge of nose and on the cheeks.Based on this data,which diagnosis does the nurse anticipate?

Accepted Answer

The butterfly rash over the bridge of nose and on the cheeks is a characteristic feature of systemic lupus erythematosus, along with the symptoms of fatigue, loss of appetite, and body aches. Gout is a type of arthritis caused by uric acid buildup, and Lyme disease is characterized by a skin rash (Erythema migrans), fever, and muscle and joint pain. Fibromyalgia is a chronic pain condition that causes widespread pain and tenderness throughout the body, but does not typically cause the butterfly rash or fever.

Question 13

A patient recently diagnosed with rheumatoid arthritis (RA)asks the nurse if the disease is caused by ethnicity.Which response by the nurse is the most appropriate?

Accepted Answer

Rheumatoid arthritis affects all races at the same rate. While certain genetic factors may increase one's risk for developing RA, ethnicity is not a known cause of the disease.

Question 14

A patient with rheumatoid arthritis (RA)is being seen in the outpatient clinic for a progress check-up.The nurse is reviewing the patient's plan of care and determines that the patient has met a goal of treatment when the patient makes which statement?

Accepted Answer

Delegating household chores indicates that the patient is managing their energy and joint stress, which is a goal in managing rheumatoid arthritis to prevent exacerbation and maintain function.

Question 15

The nurse is caring for a patient diagnosed with discoid lupus erythematosus.The nurse is collaborating with the patient to set goals for the nursing plan of care.Which is an appropriate goal for this patient?

Accepted Answer

Discoid lupus erythematosus is a chronic autoimmune disease that affects the skin, leading to sensitivity to sunlight. Sun protection is an essential part of managing this condition, and therefore, compliance with a sun protection plan is an appropriate goal. Working through the stages of death and dying is not directly related to this condition. Weight gain and pain management may be important goals for some patients, but they are not necessarily relevant to managing discoid lupus erythematosus.

Question 16

The nurse is completing a health screening for a school-age child with rheumatoid arthritis (RA).The parents ask the nurse to recommend activities that will promote exercise for their child.Which recommendation by the nurse is the most appropriate?

Accepted Answer

Swimming is a low-impact exercise that can be beneficial for children with rheumatoid arthritis. Running, softball, and football can be too strenuous and may exacerbate joint pain and inflammation.

Question 17

A nurse is caring for a patient who is newly diagnosed with rheumatoid arthritis (RA).The patient asks the nurse what the difference is between RA and osteoarthritis (OA).Which response by the nurse is most appropriate?

Accepted Answer

The onset of RA can be rapid and may cause systemic symptoms such as fatigue and fever, whereas OA typically has a more gradual onset and is limited to specific joints. The other options are not accurate descriptions of the differences between RA and OA.

Question 18

The nurse is planning care for an adolescent patient who has systemic lupus erythematosus (SLE).Which action by the patient indicates the implemented plan of care is appropriate?

Accepted Answer

Discussing skin changes with a good friend indicates that the patient is coping with the condition and is comfortable sharing and managing their symptoms, which is a positive outcome of the care plan.

Question 19

The nurse is providing health education to a diverse group at a neighborhood community center.Why does the nurse plan to include signs and symptoms of systemic lupus erythematosus (SLE)?

Accepted Answer

Systemic lupus erythematosus (SLE) is more prevalent in females of Asian, African, and Native American descent. Therefore, it is important for the nurse to provide education on the signs and symptoms of SLE to a diverse group of females from Asian-American descent.

Question 20

A nurse is caring for a pregnant patient who has rheumatoid arthritis (RA).Based on this data,which does the nurse anticipate when providing care to this patient?

Accepted Answer

Pregnant patients with rheumatoid arthritis often experience a remission of symptoms during pregnancy, so an acute exacerbation is less likely. However, they may still have a continued risk for anemia due to both the pregnancy and the chronic inflammatory nature of RA.

Quiz 19: Coordinating Care for Patients With Connective Tissue Disorders

A patient asks the nurse if there are any conditions that can exacerbate systemic lupus erythematosus (SLE) .Which response by the nurse is the most appropriate?

An Asian male accompanies his spouse to the clinic and states,"I want you to fix my wife and tell her that there is nothing wrong with her." The patient reports pain,sleep disorders,and stiffness.Which would be most appropriate for the nurse to include in a plan of care for this family?

A patient with systemic lupus erythematosus (SLE) is being treated with immunosuppressant drugs and corticosteroids.Which patient statement indicates the need for further education after teaching?

The nurse is providing care for a newly married woman with systemic lupus erythematosus (SLE) .Which patient statement indicates an appropriate understanding of the plan of care?

The nurse is caring for a patient who was diagnosed with rheumatoid arthritis (RA) last year.The patient has recently been placed on prednisone for treatment.Which patient statement indicates that the medication teaching was successful?

An adult patient is diagnosed with fibromyalgia.The patient asks the nurse whether a recent of infection with the Coxsackie B virus could have caused fibromyalgia.Which response by the nurse is the most appropriate?

The nurse identifies the nursing diagnosis of chronic pain as being appropriate for a patient with fibromyalgia.Which manifestation did the patient most likely report that caused the nurse to select this diagnosis?

A nurse is caring for a patient with systemic lupus erythematosus (SLE) .The patient begins to cry stating,"I am afraid I will be disfigured because of all of these lesions." Which intervention does the nurse plan to teach this patient to minimize skin infections associated with SLE?

A nurse is caring for a patient with systemic lupus erythematous (SLE) who is taking hydroxychloroquine (Plaquenil) .When providing care for this patient,the nurse monitors for which adverse effect associated with the prescribed medication?

A patient recently diagnosed with rheumatoid arthritis (RA) asks the nurse if the disease is caused by ethnicity.Which response by the nurse is the most appropriate?

A patient with rheumatoid arthritis (RA) is being seen in the outpatient clinic for a progress check-up.The nurse is reviewing the patient's plan of care and determines that the patient has met a goal of treatment when the patient makes which statement?

The nurse is caring for a patient diagnosed with discoid lupus erythematosus.The nurse is collaborating with the patient to set goals for the nursing plan of care.Which is an appropriate goal for this patient?

The nurse is completing a health screening for a school-age child with rheumatoid arthritis (RA) .The parents ask the nurse to recommend activities that will promote exercise for their child.Which recommendation by the nurse is the most appropriate?

A nurse is caring for a patient who is newly diagnosed with rheumatoid arthritis (RA) .The patient asks the nurse what the difference is between RA and osteoarthritis (OA) .Which response by the nurse is most appropriate?

The nurse is planning care for an adolescent patient who has systemic lupus erythematosus (SLE) .Which action by the patient indicates the implemented plan of care is appropriate?

The nurse is providing health education to a diverse group at a neighborhood community center.Why does the nurse plan to include signs and symptoms of systemic lupus erythematosus (SLE) ?

A nurse is caring for a pregnant patient who has rheumatoid arthritis (RA) .Based on this data,which does the nurse anticipate when providing care to this patient?