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NUR265 Advanced Concepts of Medical-Surgical
Nursing Exam 4 2026/2027 | Galen College Actual
Exam Questions & Verified Answers | Med Surg
Grade A Study Guide
1. The nurse is assessing a client with suspected lupus. Which of the following is the
hallmark sign of this condition?
A. Malar (butterfly) rash on the face
B. Discoid rash on the trunk
C. Oral ulcers
D. Alopecia
CORRECT ANSWER: A. Malar (butterfly) rash on the face.
Rationale: The hallmark sign of lupus is a butterfly-shaped rash across the cheeks and
nose. This is a classic manifestation of systemic lupus erythematosus (SLE).
2. The nurse is monitoring a client with lupus for indications of a flare. Which of the
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following findings should the nurse identify as indicating an exacerbation? (Select All
That Apply)
A. Fever
B. Fatigue
C. Increased appetite
D. Improved energy levels
E. Decreased joint pain
CORRECT ANSWER: A, B. Fever and Fatigue.
Rationale: Fever and fatigue are common indicators of a lupus flare. Clients should be
taught to report these symptoms immediately. BUN and creatinine should also be
monitored for renal involvement.
3. The nurse is planning care for a client with lupus. Which of the following
interventions should be included? (Select All That Apply)
A. Implement fall precautions
B. Treat pain with acetaminophen or NSAIDs
C. Instruct client to avoid sunlight exposure
D. Clean skin with mild soap and pat dry, then apply lotion
E. Report signs of flare immediately
CORRECT ANSWER: A, B, C, D, E. All of the above.
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Rationale: Lupus management includes fall precautions (due to fatigue/weakness), pain
management with acetaminophen/NSAIDs (monitor kidney function), sun avoidance,
gentle skin care, and prompt reporting of flares.
4. The nurse is administering medications to a client with lupus. Which of the
following medications should the nurse anticipate?
A. Methotrexate
B. Hydroxychloroquine (Plaquenil)
C. Cyclophosphamide
D. Prednisone
CORRECT ANSWER: B. Hydroxychloroquine (Plaquenil).
Rationale: Hydroxychloroquine is an anti-malarial medication commonly used in lupus
to decrease UV light absorption and manage symptoms.
5. The nurse is assessing a client with scleroderma. Which of the following best
describes this condition?
A. Chronic pain disorder with tender points
B. Inflammatory, autoimmune connective tissue disease
C. Acute inflammatory disorder of the skin
D. Viral infection causing skin lesions
CORRECT ANSWER: B. Inflammatory, autoimmune connective tissue disease.
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Rationale: Scleroderma is an autoimmune connective tissue disease characterized by
hardening and tightening of the skin and connective tissues.
6. The nurse is assessing a client with scleroderma. Which of the following is the
hallmark sign of this condition?
A. Butterfly rash on the face
B. Hard, leather-like, edematous skin
C. Bull's eye rash
D. Painless testicular swelling
CORRECT ANSWER: B. Hard, leather-like, edematous skin.
Rationale: Scleroderma causes hardening and tightening of the skin, which becomes
leather-like and edematous. Late manifestations include esophageal dysmotility.
7. The nurse is assessing a client with scleroderma for complications. Which of the
following is a priority assessment?
A. Visual acuity
B. Swallow safety due to esophageal dysmotility (aspiration risk)
C. Hearing loss
D. Urinary output
CORRECT ANSWER: B. Swallow safety due to esophageal dysmotility (aspiration
risk).
NUR265 Advanced Concepts of Medical-Surgical
Nursing Exam 4 2026/2027 | Galen College Actual
Exam Questions & Verified Answers | Med Surg
Grade A Study Guide
1. The nurse is assessing a client with suspected lupus. Which of the following is the
hallmark sign of this condition?
A. Malar (butterfly) rash on the face
B. Discoid rash on the trunk
C. Oral ulcers
D. Alopecia
CORRECT ANSWER: A. Malar (butterfly) rash on the face.
Rationale: The hallmark sign of lupus is a butterfly-shaped rash across the cheeks and
nose. This is a classic manifestation of systemic lupus erythematosus (SLE).
2. The nurse is monitoring a client with lupus for indications of a flare. Which of the
,2|Page
following findings should the nurse identify as indicating an exacerbation? (Select All
That Apply)
A. Fever
B. Fatigue
C. Increased appetite
D. Improved energy levels
E. Decreased joint pain
CORRECT ANSWER: A, B. Fever and Fatigue.
Rationale: Fever and fatigue are common indicators of a lupus flare. Clients should be
taught to report these symptoms immediately. BUN and creatinine should also be
monitored for renal involvement.
3. The nurse is planning care for a client with lupus. Which of the following
interventions should be included? (Select All That Apply)
A. Implement fall precautions
B. Treat pain with acetaminophen or NSAIDs
C. Instruct client to avoid sunlight exposure
D. Clean skin with mild soap and pat dry, then apply lotion
E. Report signs of flare immediately
CORRECT ANSWER: A, B, C, D, E. All of the above.
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Rationale: Lupus management includes fall precautions (due to fatigue/weakness), pain
management with acetaminophen/NSAIDs (monitor kidney function), sun avoidance,
gentle skin care, and prompt reporting of flares.
4. The nurse is administering medications to a client with lupus. Which of the
following medications should the nurse anticipate?
A. Methotrexate
B. Hydroxychloroquine (Plaquenil)
C. Cyclophosphamide
D. Prednisone
CORRECT ANSWER: B. Hydroxychloroquine (Plaquenil).
Rationale: Hydroxychloroquine is an anti-malarial medication commonly used in lupus
to decrease UV light absorption and manage symptoms.
5. The nurse is assessing a client with scleroderma. Which of the following best
describes this condition?
A. Chronic pain disorder with tender points
B. Inflammatory, autoimmune connective tissue disease
C. Acute inflammatory disorder of the skin
D. Viral infection causing skin lesions
CORRECT ANSWER: B. Inflammatory, autoimmune connective tissue disease.
, 4|Page
Rationale: Scleroderma is an autoimmune connective tissue disease characterized by
hardening and tightening of the skin and connective tissues.
6. The nurse is assessing a client with scleroderma. Which of the following is the
hallmark sign of this condition?
A. Butterfly rash on the face
B. Hard, leather-like, edematous skin
C. Bull's eye rash
D. Painless testicular swelling
CORRECT ANSWER: B. Hard, leather-like, edematous skin.
Rationale: Scleroderma causes hardening and tightening of the skin, which becomes
leather-like and edematous. Late manifestations include esophageal dysmotility.
7. The nurse is assessing a client with scleroderma for complications. Which of the
following is a priority assessment?
A. Visual acuity
B. Swallow safety due to esophageal dysmotility (aspiration risk)
C. Hearing loss
D. Urinary output
CORRECT ANSWER: B. Swallow safety due to esophageal dysmotility (aspiration
risk).
