A nurse is completing an assessment on a client who reports severe fatigue, hair loss, and trouble remembering things. The nurse notes a butterfly-shaped rash on the client's face. Which of the following conditions is the client likely experiencing?

Systemic lupus erythematosus

Acute HIV

Chronic HIV

Discoid lupus erythematosus

Answer and Explanation

The Correct Answer is A

A. Systemic lupus erythematosus: The butterfly-shaped rash, along with symptoms like fatigue, hair loss, and memory issues, is characteristic of systemic lupus erythematosus (SLE), an autoimmune disease. The rash typically appears across the cheeks and nose and is a hallmark sign of SLE, often triggered by sunlight exposure.
B. Acute HIV: Acute HIV infection may cause symptoms like fatigue, but it typically does not present with the specific butterfly-shaped rash seen in SLE. The rash associated with HIV is generally more generalized and not localized like the characteristic lupus rash.
C. Chronic HIV: Chronic HIV can present with fatigue and other symptoms, but it does not cause the butterfly-shaped rash seen in lupus. HIV-related rashes are more often generalized or occur due to secondary infections, not the distinct butterfly pattern seen in lupus.
D. Discoid lupus erythematosus: Discoid lupus erythematosus (DLE) can cause skin lesions, including facial rashes, but it does not present with the same systemic symptoms (like fatigue, hair loss, and memory issues) as systemic lupus erythematosus. DLE affects only the skin, whereas SLE affects multiple organs.

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Correct Answer is A

Explanation

A. 3% sodium chloride: A serum sodium level of 115 mEq/L is dangerously low, indicating severe hyponatremia. The nurse should anticipate that a hypertonic saline solution such as 3% sodium chloride will be prescribed to rapidly increase the sodium concentration in the blood and treat the underlying SIADH.
B. Dextrose 5% in 0.99% sodium chloride: This is an isotonic solution and would not be suitable for treating severe hyponatremia in SIADH, as it would not significantly increase sodium levels. Hypertonic saline solutions are more appropriate for severe cases of hyponatremia.
C. Dextrose 5% in 0.45% sodium chloride: This solution is hypotonic and could worsen hyponatremia by diluting the sodium further. It should not be used to treat SIADH with severely low sodium levels.
D. 0.9% sodium chloride: Normal saline (0.9% sodium chloride) is isotonic and would not correct the low sodium levels as effectively as hypertonic saline. While it is used in less severe cases, 3% sodium chloride is necessary in cases of severe hyponatremia.

A. Tachycardia B. Chest pain C. Agonal breathing D. Brainstem ischemia

Correct Answer is D

Explanation

A. Tachycardia: Tachycardia is typically a compensatory response to low blood pressure, but it is not directly prevented by Cushing’s triad. Cushing's triad is a group of symptoms that suggests increased intracranial pressure (ICP) and is more closely related to brainstem ischemia.
B. Chest pain: Chest pain is usually associated with cardiac issues or other systemic problems. Cushing's triad, which includes bradycardia, irregular respirations, and hypertension, does not specifically address chest pain.
C. Agonal breathing: Agonal breathing, characterized by irregular, labored breathing, is a result of brainstem dysfunction but is not the direct cause of Cushing's triad. Cushing’s triad is more indicative of impending brainstem ischemia due to increased ICP.
D. Brainstem ischemia: Cushing's triad is a physiological response to increased intracranial pressure, often caused by brainstem ischemia or compression. The symptoms of Cushing's triad (hypertension, bradycardia, and irregular respirations) are indicative of the body attempting to protect vital brainstem function from ischemic damage.

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A nurse is completing an assessment on a client who reports severe fatigue, hair loss, and trouble remembering things. The nurse notes a butterfly-shaped rash on the client's face. Which of the following conditions is the client likely experiencing?

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to provide care for a client in the emergency department who has syndrome of inappropriate antidiuretic hormone (SIADH). The client has a serum sodium of 115 mEq/L (136-145 mEq/L). Which of the following IV solutions should the nurse anticipate will be prescribed?

Correct Answer is A

Explanation

A nurse is collecting neurologic data on a client who has a neurological injury and notes changes suggestive of Cushing's Triad. The nurse understands that Cushing's Triad is a nervous system response that might prevent which of the following conditions?

Correct Answer is D

Explanation

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