What is an ominous sign of advanced SLE?
Cognitive dysfunction from immune complex deposit in the brain
Proteinuria from early glomerulonephritis
Dysrhythmias from fibrosis of the atrioventricular node
Anemia from antibodies against blood cells
The Correct Answer is A
Choice A reason: Cognitive dysfunction in advanced systemic lupus erythematosus (SLE) results from immune complex deposition in cerebral vessels, causing neuropsychiatric symptoms like confusion or memory loss. This is an ominous sign, indicating central nervous system involvement, which is severe and potentially life-threatening due to its impact on brain function and difficulty in management.
Choice B reason: Proteinuria from early glomerulonephritis is common in SLE but indicates renal involvement, not necessarily advanced disease. It is manageable with immunosuppressants and less immediately life-threatening than cerebral involvement. While significant, it is not as ominous as cognitive dysfunction, which signals severe systemic progression.
Choice C reason: Dysrhythmias from atrioventricular node fibrosis are rare in SLE and typically occur in congenital lupus or late cardiac complications. They are not a hallmark of advanced disease compared to neuropsychiatric manifestations. This sign is less ominous, as it is less common and not indicative of widespread systemic damage.
Choice D reason: Anemia from autoantibodies against red blood cells is frequent in SLE, reflecting autoimmune activity. It is manageable with corticosteroids and not uniquely indicative of advanced disease. Cognitive dysfunction is more ominous, as it suggests severe, multisystem involvement with poor prognosis due to central nervous system damage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Equal weights on each side are appropriate in skeletal traction, ensuring balanced force to maintain bone alignment. This finding supports the traction’s purpose of stabilizing the fracture without causing uneven stress on the bone or soft tissues. No correction is needed, as this is a correct setup.
Choice B reason: Securely attached ropes to pins are essential in skeletal traction to transmit consistent force to the bone. Loose attachments could disrupt alignment or cause pin site complications like infection. This finding is correct and does not require correction, as it ensures effective traction and patient safety.
Choice C reason: Weights resting against the bed negate the traction’s pulling force, failing to maintain bone alignment. Weights must hang freely to apply continuous tension, counteracting muscle spasms and stabilizing the fracture. This finding requires correction to restore effective traction and prevent malunion or delayed healing.
Choice D reason: Ropes centered in wheel grooves ensure smooth movement and consistent traction force without fraying or misalignment. This is a correct setup, as misaligned ropes could reduce traction effectiveness or cause mechanical issues. No correction is needed, as this supports proper traction mechanics.
Correct Answer is B
Explanation
Choice A reason: Complications of immobility, like muscle atrophy or thromboembolism, occur with both ORIF and closed reduction, as both may require immobilization post-procedure. ORIF involves surgery, but modern protocols emphasize early mobilization, similar to closed reduction. This disadvantage is not unique to ORIF, making it an incorrect choice.
Choice B reason: ORIF involves surgical incision and hardware placement, increasing infection risk at the surgical site or deep tissues (osteomyelitis). Closed reduction is non-invasive, avoiding this risk. Infections can delay healing, require antibiotics, or necessitate hardware removal, making this a significant disadvantage of ORIF compared to closed reduction.
Choice C reason: Skin irritation can occur with both ORIF (from incisions or hardware) and closed reduction (from casts or splints). It is not a distinct disadvantage of ORIF, as both methods involve external or internal devices that may irritate skin. This choice is incorrect, as it is not unique to ORIF.
Choice D reason: Nerve impairment risks exist in both ORIF (from surgical manipulation) and closed reduction (from fracture displacement or cast pressure). Neither method uniquely predisposes to nerve damage, and careful technique minimizes this risk. This disadvantage is not specific to ORIF, making it an incorrect choice.
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