A 49-year-old woman is diagnosed with Sjogren syndrome following complaints of a foreign body sensation in her eyes and a dry mouth. Which one of the following is NOT characteristic of Sjogren syndrome?
Increased risk for beta cell non-Hodgkin's lymphoma
The female: male incidence is approximately 9:1
White people in North America are affected at much higher rates than in other parts of the world
Biopsy of the minor salivary glands is the ideal test to confirm the diagnosis of Sjogren syndrome
The Correct Answer is C
Choice A reason: Sjogren syndrome is associated with an increased risk of developing non-Hodgkin’s lymphoma, particularly B-cell lymphomas, due to chronic autoimmune stimulation of lymphoid tissue. This is a recognized characteristic of the disease.
Choice B reason: The condition disproportionately affects females, with a female-to-male ratio of approximately 9:1. This is a well-established epidemiologic feature of Sjogren syndrome.
Choice C reason: Sjogren syndrome occurs worldwide and is not significantly more prevalent in White populations in North America compared to other regions. Suggesting a strong racial or geographic predilection is inaccurate, making this the correct answer to the question.
Choice D reason: Minor salivary gland biopsy is the gold standard diagnostic test for confirming Sjogren syndrome. The presence of focal lymphocytic sialadenitis supports the diagnosis and is considered an essential diagnostic tool.
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Related Questions
Correct Answer is D
Explanation
Choice A reason: Referral to an oncologist is premature without diagnostic confirmation of malignancy.
Choice B reason: CA-125 is mainly used for ovarian cancer, which is unlikely after bilateral oophorectomy.
Choice C reason: Pap smear screens for cervical cancer and is not indicated for evaluating postmenopausal or post-oophorectomy bleeding.
Choice D reason: Correct. Endometrial biopsy or transvaginal ultrasound helps evaluate uterine pathology, including endometrial cancer, and is the most appropriate initial diagnostic step.
Correct Answer is B
Explanation
Choice A reason: Fluoxetine is an SSRI that may be used off-label for PTSD, but it is not specifically FDA-approved for this condition.
Choice B reason: This is correct. Sertraline is an SSRI and one of the first-line medications approved by the FDA for PTSD treatment, demonstrating efficacy in reducing core PTSD symptoms.
Choice C reason: Mirtazapine is not FDA-approved for PTSD but may be used off-label to target sleep disturbances or depressive symptoms.
Choice D reason: Lamotrigine is a mood stabilizer used primarily for bipolar disorder and not FDA-approved for PTSD management.
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