A clinic nurse is performing a physical assessment on a patient who has systemic lupus erythematosus (SLE). Which of the following findings should the nurse expect?
A grey colored, non-purpuric papular rash.
Subcutaneous nodules on the ulnar side of the arm.
A dry, red rash across the bridge of the nose and on the cheeks.
Pitting edema of the hands and fingers.
The Correct Answer is C
Choice A rationale
A grey colored, non-purpuric papular rash is not a typical dermatological manifestation of systemic lupus erythematosus. SLE is often associated with erythematous rashes due to inflammation and immune complex deposition in the skin. Purpura indicates bleeding under the skin, which is not characteristic of the lupus rash.
Choice B rationale
Subcutaneous nodules on the ulnar side of the arm are more commonly associated with rheumatoid arthritis or gout, not systemic lupus erythematosus. SLE primarily affects connective tissues and can cause various skin manifestations, but subcutaneous nodules are not a hallmark finding.
Choice C rationale
A dry, red rash across the bridge of the nose and on the cheeks, often described as a "butterfly rash" or malar rash, is a classic and highly specific finding in patients with systemic lupus erythematosus. This rash is caused by photosensitivity and inflammation in the facial skin.
Choice D rationale
Pitting edema of the hands and fingers is not a primary finding directly associated with systemic lupus erythematosus. While SLE can cause renal involvement leading to fluid retention and edema, localized pitting edema in the hands and fingers is less typical and might suggest other underlying conditions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit the production of prostaglandins, which play a protective role in the gastric mucosa by promoting mucus and bicarbonate secretion, maintaining mucosal blood flow, and inhibiting acid secretion. Chronic NSAID use can disrupt these protective mechanisms, leading to mucosal damage and increasing the risk of peptic ulcer formation.
Choice B rationale
Bulimia nervosa is an eating disorder characterized by cycles of binge eating followed by compensatory behaviors such as vomiting. While vomiting can cause esophageal damage and dental erosion due to stomach acid exposure, it is not a direct risk factor for peptic ulcer disease.
Choice C rationale
Moderate alcohol consumption, such as a glass of wine with dinner, has not been consistently shown to be a significant risk factor for peptic ulcer disease. While excessive alcohol intake can irritate the gastric mucosa, moderate consumption is generally not considered a primary cause.
Choice D rationale
Green tea contains antioxidants and has some anti-inflammatory properties. Studies have not shown a link between green tea consumption and an increased risk of peptic ulcer disease; in fact, some research suggests potential protective effects on the gastric mucosa. .
Correct Answer is B
Explanation
Choice A rationale
Limiting fluid intake to 1L each day is generally not recommended for individuals with irritable bowel syndrome (IBS) unless specifically indicated due to other co-existing conditions. Adequate hydration is important for overall health and can help prevent constipation, a common symptom of IBS. General recommendations for fluid intake are around 2-3 liters per day, depending on individual needs and activity levels.
Choice B rationale
Keeping a food diary is a valuable strategy for individuals with irritable bowel syndrome (IBS) to identify specific food triggers that exacerbate their symptoms such as abdominal pain, bloating, diarrhea, or constipation. By meticulously recording food intake and associated symptoms, patients can often discern patterns and work with healthcare providers to develop an individualized dietary management plan.
Choice C rationale
Planning three moderate to large meals per day might not be suitable for all individuals with irritable bowel syndrome (IBS). Some people with IBS find that smaller, more frequent meals are better tolerated as large meals can distend the bowel and trigger symptoms. Individual responses to meal size and frequency can vary significantly.
Choice D rationale
While fiber is generally beneficial for bowel regularity, a blanket recommendation of 12 to 20g of fiber daily might not be appropriate for all individuals with irritable bowel syndrome (IBS). For some individuals, particularly those with diarrhea-predominant IBS, increasing fiber intake too quickly or consuming certain types of high-fiber foods can worsen their symptoms. Fiber intake should be individualized and often increased gradually.
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