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
Prednisone, a corticosteroid, can decrease calcium absorption in the gut and increase calcium excretion by the kidneys. Long-term use can lead to bone demineralization and osteoporosis. Vitamin D is essential for calcium absorption, so supplementation helps mitigate these effects and maintain bone health. Normal serum calcium levels range from 8.5 to 10.5 mg/dL.
Choice B rationale
Pantothenic acid (vitamin B5) is involved in various metabolic processes, and vitamin B6 is crucial for protein metabolism and nerve function. While important for overall health, there is no direct established link requiring their supplementation specifically due to prednisone therapy.
Choice C rationale
Biotin (vitamin B7) is involved in carbohydrate and fat metabolism, and vitamin B12 is essential for red blood cell formation and nerve function. There is no strong scientific evidence indicating a specific need for biotin and vitamin B12 supplementation during long-term prednisone treatment.
Choice D rationale
Folic acid (vitamin B9) is important for cell growth and DNA synthesis, and vitamin C (ascorbic acid) is an antioxidant involved in immune function and collagen synthesis. While beneficial for overall health, their supplementation is not specifically indicated to counteract the side effects of long-term prednisone therapy.
Correct Answer is D
Explanation
Choice A rationale
Stretching exercises primarily improve flexibility and range of motion by elongating muscles and connective tissues. While beneficial for overall fitness, they do not directly address bone density loss, which is the primary concern in osteoporosis. Osteoporosis requires weight-bearing activities to stimulate bone formation.
Choice B rationale
Riding a bicycle is a low-impact aerobic exercise that improves cardiovascular health and muscle strength. However, because it is non-weight-bearing, it does not provide the mechanical stress necessary to promote bone density and is therefore not the most effective exercise for osteoporosis management.
Choice C rationale
High-impact aerobics, such as jumping and running, can increase the risk of fractures in individuals with osteoporosis due to the stress placed on weakened bones. These types of exercises should generally be avoided to prevent injury.
Choice D rationale
Walking briskly is a weight-bearing exercise that applies moderate stress to the bones, stimulating osteoblast activity and promoting bone density. Regular brisk walking can help slow bone loss and reduce the risk of fractures in older adults with osteoporosis.
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