A nurse is reviewing the laboratory results of a client who has systemic lupus erythematosus. Which of the following results should the nurse expect to find? (Select all that apply.)

Increased D-dimer

Elevated brain natriuretic peptide

Elevated erythrocyte sedimentation rate

Positive rheumatoid factor

Elevated troponin I

Answer and Explanation

Correct Answer : A,C,D

Rationale:

A. Increased D-dimer: Clients with systemic lupus erythematosus (SLE) are at increased risk for thromboembolic events due to antiphospholipid antibodies. A D-dimer may be elevated due to ongoing coagulation and fibrinolysis activity, especially during active disease or clot formation.

B. Elevated brain natriuretic peptide: BNP is primarily used to assess heart failure. While pericarditis or myocarditis can occur in SLE, an elevated BNP is not a typical finding unless there is coexisting heart dysfunction.

C. Elevated erythrocyte sedimentation rate: ESR is commonly elevated in SLE due to systemic inflammation. It serves as a nonspecific marker of disease activity and is frequently used to monitor flares or response to therapy.

D. Positive rheumatoid factor: Although most commonly associated with rheumatoid arthritis, RF can also be positive in SLE. It reflects an overlap of autoimmune markers seen in various connective tissue disorders.

E. Elevated troponin I: Troponin I is a marker of myocardial injury. While SLE can involve the heart, elevated troponin I would only be expected in cases of active cardiac involvement, such as myocarditis or infarction, and is not a routine finding in all SLE patients.

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Correct Answer is A

Explanation

Rationale:

A. Identify an industry performance standard: The first step in a quality control audit is to establish a benchmark or standard to measure against. By identifying an industry standard, the nurse can determine what constitutes acceptable rates of healthcare-associated infections and use this as a reference for evaluating the facility’s performance.

B. Compare collected data to industry data: This step occurs later in the audit process after data has been gathered. It helps determine how the facility measures up, but it is not the initial step in planning the audit.

C. Gather facility information for analysis: While essential, data collection comes after the audit’s objectives and standards are clearly defined. Without knowing what to measure or compare against, collecting data may be misdirected or ineffective.

D. Establish methods to collect necessary data: Creating a structured data collection process is important, but it must be guided by the specific performance standards and metrics established in the initial step.

A. Fluid resuscitation B. Psychological support C. Wound debridement D. Infection prevention

Correct Answer is A

Explanation

Rationale:

A. Fluid resuscitation: In the initial phase of a major burn injury, massive fluid shifts occur due to increased capillary permeability, leading to hypovolemia and shock. Prompt fluid resuscitation is the top priority to restore circulating volume, support organ perfusion, and prevent life-threatening complications.

B. Psychological support: While essential for long-term recovery and emotional well-being, psychological support is not the first priority during the emergency phase. Stabilizing the client's physiological status takes precedence in acute care.

C. Wound debridement: Debridement is part of burn wound management but is not an immediate priority. It is typically performed after the client has been stabilized with fluids and vital signs are maintained within a safe range.

D. Infection prevention: Infection control is critical in burn care but is addressed after the initial resuscitation phase. Without immediate fluid replacement, the client is at high risk for hypovolemic shock and organ failure, which must be treated first.

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A nurse is reviewing the laboratory results of a client who has systemic lupus erythematosus. Which of the following results should the nurse expect to find? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning a quality control audit to measure the occurrence of health care-associated infections at an outpatient facility. Which of the following steps should the nurse plan to take first?

Correct Answer is A

Explanation

A nurse is caring for a client who is being admitted to the emergency department with an extensive burn injury. Which of the following actions is the priority for the nurse to take?

Correct Answer is A

Explanation

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