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

Answer and Explanation

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.

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Correct Answer is A

Explanation

Choice A reason: Morning stiffness lasting 60 minutes or more is a hallmark of rheumatoid arthritis (RA) due to synovial inflammation in affected joints. This prolonged stiffness, worse after inactivity, reflects autoimmune-mediated synovitis, distinguishing RA from osteoarthritis. Recognizing this guides diagnosis and treatment with disease-modifying antirheumatic drugs (DMARDs) to reduce joint damage.

Choice B reason: Bamboo-shaped fingers are characteristic of psoriatic arthritis, not RA. RA causes joint deformities like swan-neck or boutonnière due to synovial destruction, not a bamboo appearance. Expecting this finding risks misdiagnosis, delaying RA-specific therapies like methotrexate, which target inflammation and prevent progressive joint erosion.

Choice C reason: Asymmetric small joint involvement is typical of osteoarthritis or psoriatic arthritis, not RA. RA features symmetric involvement of small joints, like metacarpophalangeal joints, due to systemic autoimmune inflammation. Assuming asymmetry misguides assessment, potentially overlooking RA’s bilateral pattern critical for early diagnosis and effective immunosuppressive treatment.

Choice D reason: Noninflammatory pain in large joints is not typical of RA, which involves inflammatory pain in small joints due to synovitis. Large joint pain may occur in osteoarthritis or gout. Expecting noninflammatory pain misdirects RA diagnosis, delaying interventions like corticosteroids or biologics to manage inflammation and joint destruction.

A. The weights are equal on each side. B. The ropes are securely attached to the pins. C. The weights rest against the foot of the bed. D. The ropes are in the center of the wheel grooves.

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.

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What is an ominous sign of advanced SLE?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Assessment findings that the nurse would expect in a patient with rheumatoid arthritis who has articular involvement include

Correct Answer is A

Explanation

A nurse is assessing a client who is in skeletal traction. The nurse should correct which of the following findings?

Correct Answer is C

Explanation

What would the nurse check when assessing the patient with early to moderate rheumatoid arthritis?

A nurse is caring for a client who has acute osteomyelitis. Which of the following interventions is the nurse’s priority?

A nurse is teaching an older adult client who has an intracapsular fracture of the right hip following a fall about the purpose of Buck’s extension traction. The nurse should include which of the following information in the teaching?

A patient is admitted with an open fracture of the tibia after a bicycle accident. What information would the nurse obtain when assessing the patient?

A nurse is caring for a client who has developed gout. Which of the following medications should the nurse prepare to administer?

Which description is most characteristic of osteoarthritis (OA) when compared to rheumatoid arthritis (RA)?

A nurse is caring for a female client who has rheumatoid arthritis and asks the nurse if it is safe for her to take aspirin. The nurse should recognize which of the following findings in the client’s history is a contraindication to this medication?

A nurse is educating coworkers about how to minimize back strain and avoid repeated episodes of low back pain. Which of the following strategies should the nurse include? (Select all that apply)