A nurse is assessing a patient who has systemic lupus erythematosus (SLE). Which of the following findings is the highest priority for the nurse to report to the provider?
Presence of peripheral edema.
Joint pain in hands and knees.
Dry, raised rash on the face.
Patient reports feelings of depression.
The Correct Answer is C
Choice A rationale
Peripheral edema can occur in systemic lupus erythematosus (SLE) due to various factors like kidney involvement or heart issues. While it should be monitored, it is not typically the highest priority finding compared to signs of acute organ involvement.
Choice B rationale
Joint pain is a common symptom of SLE due to inflammation in the joints. While it affects the patient's quality of life, it is usually a chronic manifestation rather than an acute, life-threatening concern.
Choice C rationale
A dry, raised rash on the face, particularly a butterfly-shaped rash across the cheeks and bridge of the nose, is a classic and specific sign of an SLE flare. This rash can indicate active disease and potential systemic involvement, making it a high priority for the provider to assess and manage.
Choice D rationale
Feelings of depression are common in patients with chronic illnesses like SLE and should be addressed for the patient's mental well-being. However, a new or worsening physical symptom indicative of active disease, such as the characteristic rash, takes higher priority in terms of immediate medical assessment and intervention. .
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 D
Explanation
Choice A rationale
Patient-controlled analgesia is designed to allow patients to manage their pain proactively. Waiting until the pain is severe before using the device can lead to inadequate pain control and increased discomfort. The goal of PCA is to maintain a consistent level of analgesia by allowing the patient to self-administer small doses as needed.
Choice B rationale
PCA devices are programmed with safety limits, including lockout intervals and maximum doses, to prevent accidental overdosing. While the patient should understand how to use the button, the primary responsibility for preventing overdose lies with the device's safety mechanisms and the healthcare team's programming.
Choice C rationale
Allowing family members to push the PCA button bypasses the safety mechanisms built into the device, which are based on the patient's demand for pain relief. This practice can lead to over-sedation and respiratory depression if the patient is not the one experiencing the pain and needing the medication. The patient must be the only one to activate the PCA device.
Choice D rationale
If the PCA device is not effectively controlling the patient's pain, it indicates a need for reassessment of the medication, dosage, or delivery method. The nurse can then collaborate with the provider to make necessary adjustments to ensure adequate pain management. This statement demonstrates the client's understanding of the importance of communicating their pain level.
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