Question 1

Why is kidney damage often observed in clients with systemic lupus erythematosus (SLE)?
A)SLE involves unusually high levels of circulating antigens. Because the kidneys play a critical role in filtering these antigens from the blood, they are under excess stress in clients with SLE.
B)SLE is commonly treated with nonsteroidal anti-inflammatory drugs (NSAIDs). Because these medications carry a high risk of nephrotoxicity, their use often leads to kidney damage in clients with SLE.
C)SLE involves deposition of immune complexes in the body's connective tissues. Because connective tissue makes up a significant portion of the kidneys, these organs are a frequent site of damage in SLE.
D)SLE involves unusually high levels of circulating antibodies. Because the kidneys play a critical role in filtering these antibodies from the blood, they are under excess stress in clients with SLE.

Accepted Answer

A)SLE involves deposition of antigen-antibody complexes, also known as immune complexes, in the body's connective tissues. Because connective tissues makes up a large portion of the kidneys, these organs are frequently damaged in SLE. Note that the kidneys do not filter either antigens or antibodies from the blood. Also, even though NSAIDs are commonly used in the treatment of SLE and may exert nephrotoxic effects, use of NSAIDs is not the primary reason why kidney damage is often observed in clients with SLE.
B)SLE involves deposition of antigen-antibody complexes, also known as immune complexes, in the body's connective tissues. Because connective tissues makes up a large portion of the kidneys, these organs are frequently damaged in SLE. Note that the kidneys do not filter either antigens or antibodies from the blood. Also, even though NSAIDs are commonly used in the treatment of SLE and may exert nephrotoxic effects, use of NSAIDs is not the primary reason why kidney damage is often observed in clients with SLE.
C)SLE involves deposition of antigen-antibody complexes, also known as immune complexes, in the body's connective tissues. Because connective tissues makes up a large portion of the kidneys, these organs are frequently damaged in SLE. Note that the kidneys do not filter either antigens or antibodies from the blood. Also, even though NSAIDs are commonly used in the treatment of SLE and may exert nephrotoxic effects, use of NSAIDs is not the primary reason why kidney damage is often observed in clients with SLE.
D)SLE involves deposition of antigen-antibody complexes, also known as immune complexes, in the body's connective tissues. Because connective tissues makes up a large portion of the kidneys, these organs are frequently damaged in SLE. Note that the kidneys do not filter either antigens or antibodies from the blood. Also, even though NSAIDs are commonly used in the treatment of SLE and may exert nephrotoxic effects, use of NSAIDs is not the primary reason why kidney damage is often observed in clients with SLE.

Question 2

A nurse is caring for a client with systemic lupus erythematosus (SLE)who is taking hydroxychloroquine (Plaquenil). When providing care for this client, the nurse should monitor for which adverse effect associated with this medication?
A)Pulmonary fibrosis
B)Cushingoid effects
C)Retinal toxicity
D)Renal toxicity

Accepted Answer

A)Hydroxychloroquine (Plaquenil)is an antimalarial drug that is also used to reduce the frequency of acute episodes of SLE. The primary concern with Plaquenil is retinal toxicity and possible irreversible blindness. Cushingoid effects are a concern with corticosteroid therapy. Pulmonary fibrosis is a potential adverse effect of cyclophosphamide, not Plaquenil. Renal toxicity is not the primary concern with Plaquenil.
B)Hydroxychloroquine (Plaquenil)is an antimalarial drug that is also used to reduce the frequency of acute episodes of SLE. The primary concern with Plaquenil is retinal toxicity and possible irreversible blindness. Cushingoid effects are a concern with corticosteroid therapy. Pulmonary fibrosis is a potential adverse effect of cyclophosphamide, not Plaquenil. Renal toxicity is not the primary concern with Plaquenil.
C)Hydroxychloroquine (Plaquenil)is an antimalarial drug that is also used to reduce the frequency of acute episodes of SLE. The primary concern with Plaquenil is retinal toxicity and possible irreversible blindness. Cushingoid effects are a concern with corticosteroid therapy. Pulmonary fibrosis is a potential adverse effect of cyclophosphamide, not Plaquenil. Renal toxicity is not the primary concern with Plaquenil.
D)Hydroxychloroquine (Plaquenil)is an antimalarial drug that is also used to reduce the frequency of acute episodes of SLE. The primary concern with Plaquenil is retinal toxicity and possible irreversible blindness. Cushingoid effects are a concern with corticosteroid therapy. Pulmonary fibrosis is a potential adverse effect of cyclophosphamide, not Plaquenil. Renal toxicity is not the primary concern with Plaquenil.

Question 3

A nurse is caring for a client with systemic lupus erythematosus (SLE)who is prescribed immunosuppressive therapy. When providing teaching for this client, which statements are appropriate for the nurse to include? Select all that apply.
A)"Avoid large crowds and situations that increase your exposure to infection."
B)"Report any cough or difficulty breathing to the physician if you are taking cyclophosphamide."
C)"Use aspirin instead of acetaminophen if you develop a fever."
D)"Heavy menstrual bleeding may occur during therapy."
E)"Be sure to drink plenty of liquids."

Accepted Answer

A)Clients who are on immunosuppressant therapy for SLE should be advised to avoid large crowds and situations that increase their exposure to infection; to report difficulty breathing or a cough; and to maintain adequate oral hydration. The client should report a fever if it develops, but aspirin should not be used, as this may increase the risk for bleeding. Also, women may have an absence of menstruation, not heavy bleeding, during therapy.
B)Clients who are on immunosuppressant therapy for SLE should be advised to avoid large crowds and situations that increase their exposure to infection; to report difficulty breathing or a cough; and to maintain adequate oral hydration. The client should report a fever if it develops, but aspirin should not be used, as this may increase the risk for bleeding. Also, women may have an absence of menstruation, not heavy bleeding, during therapy.
C)Clients who are on immunosuppressant therapy for SLE should be advised to avoid large crowds and situations that increase their exposure to infection; to report difficulty breathing or a cough; and to maintain adequate oral hydration. The client should report a fever if it develops, but aspirin should not be used, as this may increase the risk for bleeding. Also, women may have an absence of menstruation, not heavy bleeding, during therapy.
D)Clients who are on immunosuppressant therapy for SLE should be advised to avoid large crowds and situations that increase their exposure to infection; to report difficulty breathing or a cough; and to maintain adequate oral hydration. The client should report a fever if it develops, but aspirin should not be used, as this may increase the risk for bleeding. Also, women may have an absence of menstruation, not heavy bleeding, during therapy.
E)Clients who are on immunosuppressant therapy for SLE should be advised to avoid large crowds and situations that increase their exposure to infection; to report difficulty breathing or a cough; and to maintain adequate oral hydration. The client should report a fever if it develops, but aspirin should not be used, as this may increase the risk for bleeding. Also, women may have an absence of menstruation, not heavy bleeding, during therapy.

Question 4

A nurse is caring for a client diagnosed with discoid lupus erythematosus. The nurse is collaborating with this client to set goals for the nursing plan of care. Based on the information given here, which of the following would be an appropriate goal for this client?
A)Learn strategies to cope with death and the dying process.
B)Remain compliant with a sun protection plan.
C)Gain weight to within 10 pounds of normal for height.
D)Report pain no higher than 4 on a scale of 0 to 10.

Accepted Answer

A)Discoid lupus erythematosus is an autoimmune disorder of the skin, so clients must protect their skin against the sun to avoid exacerbations. The other goals are not appropriate because discoid lupus erythematosus is not fatal, is not related to weight, and is rarely painful unless complications arise.
B)Discoid lupus erythematosus is an autoimmune disorder of the skin, so clients must protect their skin against the sun to avoid exacerbations. The other goals are not appropriate because discoid lupus erythematosus is not fatal, is not related to weight, and is rarely painful unless complications arise.
C)Discoid lupus erythematosus is an autoimmune disorder of the skin, so clients must protect their skin against the sun to avoid exacerbations. The other goals are not appropriate because discoid lupus erythematosus is not fatal, is not related to weight, and is rarely painful unless complications arise.
D)Discoid lupus erythematosus is an autoimmune disorder of the skin, so clients must protect their skin against the sun to avoid exacerbations. The other goals are not appropriate because discoid lupus erythematosus is not fatal, is not related to weight, and is rarely painful unless complications arise.

Question 5

The nurse is providing care for a newly married woman with systemic lupus erythematosus (SLE). Which statement on the part of the client indicates an appropriate understanding of the plan of care?
A)"I will take birth control pills while I am taking cytotoxic medications."
B)"I do not need to contact the doctor if I develop a fever or rash."
C)"I plan to go to a concert this weekend so that I get out of the house."
D)"I can take aspirin as indicated for pain."

Accepted Answer

A)Treatment for SLE may include cytotoxic drugs. Because these drugs can cause birth defects, women who take them should be advised to avoid pregnancy by using contraceptives. Clients with SLE should also be taught to avoid crowds, because they are potential sources of infection. Aspirin can cause bleeding, so it should be taken only with extreme care. Also, clients with SLE should contact their primary care provider whenever signs of infection occur, because it means their immune system is compromised.
B)Treatment for SLE may include cytotoxic drugs. Because these drugs can cause birth defects, women who take them should be advised to avoid pregnancy by using contraceptives. Clients with SLE should also be taught to avoid crowds, because they are potential sources of infection. Aspirin can cause bleeding, so it should be taken only with extreme care. Also, clients with SLE should contact their primary care provider whenever signs of infection occur, because it means their immune system is compromised.
C)Treatment for SLE may include cytotoxic drugs. Because these drugs can cause birth defects, women who take them should be advised to avoid pregnancy by using contraceptives. Clients with SLE should also be taught to avoid crowds, because they are potential sources of infection. Aspirin can cause bleeding, so it should be taken only with extreme care. Also, clients with SLE should contact their primary care provider whenever signs of infection occur, because it means their immune system is compromised.
D)Treatment for SLE may include cytotoxic drugs. Because these drugs can cause birth defects, women who take them should be advised to avoid pregnancy by using contraceptives. Clients with SLE should also be taught to avoid crowds, because they are potential sources of infection. Aspirin can cause bleeding, so it should be taken only with extreme care. Also, clients with SLE should contact their primary care provider whenever signs of infection occur, because it means their immune system is compromised.

Question 6

Which of the following hormonal changes would most likely result in an exacerbation of systemic lupus erythematosus (SLE)?
A)Increase in testosterone levels
B)Increase in estrogen levels
C)Increase in overall androgen levels
D)Increase in serotonin levels

Accepted Answer

A)Sex hormones are thought to influence the development of SLE. In particular, increased estrogen levels and reduced androgen levels are shown to enhance antibody responses and have an adverse effect in clients with SLE. Testosterone is an androgen, so increased testosterone levels likely would not exacerbate SLE. Serotonin is a neurotransmitter and typically not considered a hormone, and it does not play a direct role in the exacerbation of SLE.
B)Sex hormones are thought to influence the development of SLE. In particular, increased estrogen levels and reduced androgen levels are shown to enhance antibody responses and have an adverse effect in clients with SLE. Testosterone is an androgen, so increased testosterone levels likely would not exacerbate SLE. Serotonin is a neurotransmitter and typically not considered a hormone, and it does not play a direct role in the exacerbation of SLE.
C)Sex hormones are thought to influence the development of SLE. In particular, increased estrogen levels and reduced androgen levels are shown to enhance antibody responses and have an adverse effect in clients with SLE. Testosterone is an androgen, so increased testosterone levels likely would not exacerbate SLE. Serotonin is a neurotransmitter and typically not considered a hormone, and it does not play a direct role in the exacerbation of SLE.
D)Sex hormones are thought to influence the development of SLE. In particular, increased estrogen levels and reduced androgen levels are shown to enhance antibody responses and have an adverse effect in clients with SLE. Testosterone is an androgen, so increased testosterone levels likely would not exacerbate SLE. Serotonin is a neurotransmitter and typically not considered a hormone, and it does not play a direct role in the exacerbation of SLE.

Question 7

The nurse is planning care for an adolescent client who has systemic lupus erythematosus (SLE). Which action by the client indicates the implemented plan of care is appropriate?
A)Refusing to attend school
B)Refraining from attending social functions
C)Discussing skin changes with the healthcare provider
D)Discussing skin changes with a good friend

Accepted Answer

A)Peer interaction is important to teens. Being able to discuss the physical changes related to SLE with a friend indicates acceptance of the change in body image. Refusing to go to school or attend social functions indicates nonacceptance of the changes to body image. Discussing changes only with healthcare personnel does not indicate the teen has adjusted to the body image changes.
B)Peer interaction is important to teens. Being able to discuss the physical changes related to SLE with a friend indicates acceptance of the change in body image. Refusing to go to school or attend social functions indicates nonacceptance of the changes to body image. Discussing changes only with healthcare personnel does not indicate the teen has adjusted to the body image changes.
C)Peer interaction is important to teens. Being able to discuss the physical changes related to SLE with a friend indicates acceptance of the change in body image. Refusing to go to school or attend social functions indicates nonacceptance of the changes to body image. Discussing changes only with healthcare personnel does not indicate the teen has adjusted to the body image changes.
D)Peer interaction is important to teens. Being able to discuss the physical changes related to SLE with a friend indicates acceptance of the change in body image. Refusing to go to school or attend social functions indicates nonacceptance of the changes to body image. Discussing changes only with healthcare personnel does not indicate the teen has adjusted to the body image changes.

Question 8

Which of the following manifestations is not associated with systemic lupus erythematosus (SLE)?
A)Symmetric polyarthritis
B)Excess hair growth
C)Thrombocytopenia
D)Pleural effusions

Accepted Answer

A)Common manifestations of SLE include symmetric polyarthritis, thrombocytopenia, and pleural effusions. Alopecia (hair loss)is also associated with SLE; excess hair growth is not.
B)Common manifestations of SLE include symmetric polyarthritis, thrombocytopenia, and pleural effusions. Alopecia (hair loss)is also associated with SLE; excess hair growth is not.
C)Common manifestations of SLE include symmetric polyarthritis, thrombocytopenia, and pleural effusions. Alopecia (hair loss)is also associated with SLE; excess hair growth is not.
D)Common manifestations of SLE include symmetric polyarthritis, thrombocytopenia, and pleural effusions. Alopecia (hair loss)is also associated with SLE; excess hair growth is not.

Quiz 8: Immunity

Why is kidney damage often observed in clients with systemic lupus erythematosus (SLE) ?

A nurse is caring for a client with systemic lupus erythematosus (SLE) who is taking hydroxychloroquine (Plaquenil) . When providing care for this client, the nurse should monitor for which adverse effect associated with this medication?

A nurse is caring for a client with systemic lupus erythematosus (SLE) who is prescribed immunosuppressive therapy. When providing teaching for this client, which statements are appropriate for the nurse to include? Select all that apply.

A nurse is caring for a client diagnosed with discoid lupus erythematosus. The nurse is collaborating with this client to set goals for the nursing plan of care. Based on the information given here, which of the following would be an appropriate goal for this client?

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

Which of the following hormonal changes would most likely result in an exacerbation of systemic lupus erythematosus (SLE) ?

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

Which of the following manifestations is not associated with systemic lupus erythematosus (SLE) ?