1. A 26-year-old woman has been diagnosed taking corticosteroids, it is especially important to
with early systemic lupus erythematosus (SLE) monitor renal function. There is no indication that
involving her joints. In teaching the patient about the patient is experiencing any nervous system or
the disease, the nurse includes the information cardiac problems with the SLE.
that SLE is a(n):
A. Hereditary disorder of women but usually does
not show clinical symptoms unless a woman
becomes pregnant. 3. A patient with systemic lupus erythematosus
B. Autoimmune disease of women in which (SLE) who has a facial rash and alopecia tells the
antibodies are formed that destroy all nucleated nurse, "I hate the way I look! I never go anyplace
cells in the body. except here to the health clinic." An appropriate
C. Disorder of immune function, but it is nursing diagnosis for the patient is:
extremely variable in its course, and there is no
way to predict its progression. A. Activity intolerance related to fatigue and
D. Disease that causes production of antibodies inactivity.
that bind with cellular estrogen receptors, B. Impaired skin integrity related to itching and
causing an inflammatory response. - -1. skin sloughing.
Answer: C C. Social isolation related to embarrassment
Rationale: SLE has an unpredictable course, about the effects of SLE.
even with appropriate treatment. Women are D. Impaired social interaction related to lack of
more at risk for SLE, but it is not confined social skills. - -3. Answer: C
exclusively to women. Clinical symptoms may Rationale: The patient's statement about not
worsen during pregnancy but are not confined to going anyplace because of hating the way he or
pregnancy or the perinatal period. All nucleated she looks supports the diagnosis of social
cells are not destroyed by the antinuclear isolation because of embarrassment about the
antibodies. The inflammation in SLE is not effects of the SLE. Activity intolerance is a
caused by antibody binding to cellular estrogen possible problem for patients with SLE, but the
receptors. information about this patient does not support
this as a diagnosis. The rash with SLE is
nonpruritic. There is no evidence of lack of social
skills for this patient.
2. A patient with an acute exacerbation of
systemic lupus erythematosus (SLE) is
hospitalized with incapacitating fatigue, acute
hand and wrist pain, and proteinuria. The health 4. A patient with polyarthralgia with joint swelling
care provider prescribes prednisone (Deltasone) and pain is being evaluated for systemic lupus
40 mg twice daily. Which nursing action should erythematosus (SLE). The nurse knows that the
be included in the plan of care? serum test result that is the most specific for SLE
is the presence of:
A. Institute seizure precautions.
B. Reorient to time and place PRN. A. Rheumatoid factor.
C. Monitor intake and output. B. Anti-Smith antibody (Anti-Sm).
D. Place on cardiac monitor. - -2. Answer: C. Antinuclear antibody (ANA).
C D. Lupus erythematosus (LE) cell prep. - -
Rationale: Lupus nephritis is a common 4. Answer: B
complication of SLE, and when the patient is Rationale: The anti-Sm is antibody found almost
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, Lupus NCLEX Questions with Verified Answers Graded A+
exclusively in SLE. The other blood tests are also D. Famotidine (Pepcid) 20 mg daily - -6.
used in screening but are not as specific to SLE. Answer: B
Rationale: Live virus vaccines, such as rubella,
are contraindicated in a patient taking
immunosuppressive drugs. The other orders are
5. Following instruction for a patient with newly appropriate for the patient.
diagnosed systemic lupus erythematosus (SLE),
the nurse determines that teaching about the
disease has been effective when the patient
says: 7. A client is suspected of having systemic lupus
erythematous. The nurse monitors the client,
A. "I should expect to have a low fever all the knowing that which of the following is one of the
time with this disease." initial characteristic sign of systemic lupus
B. "I need to restrict my exposure to sunlight to erythematous?
prevent an acute onset of symptoms."
C. "I should try to ignore my symptoms as much A. Weight gain
as possible and have a positive outlook." B. Subnormal temperature
D. "I can expect a temporary improvement in my C. Elevated red blood cell count
symptoms if I become pregnant." - -5. D. Rash on the face across the bridge of the
Answer: B nose - -7. Answer: D
Rationale: Sun exposure is associated with SLE Rationale: Skin lesions or rash on the face across
exacerbation, and patients should use sunscreen the bridge of the nose and on the cheeks is an
with an SPF of at least 15 and stay out of the sun initial characteristic sign of systemic lupus
between 11:00 AM and 3:00 PM. Low-grade erythematosus (SLE). Fever and weight loss may
fever may occur with an exacerbation but should also occur. Anemia is most likely to occur later in
not be expected all the time. A positive attitude SLE.
may decrease the incidence of SLE
exacerbations, but patients are taught to self-
monitor for symptoms that might indicate
changes in the disease process. Symptoms may 8. The nurse is assigned to care for a client with
worsen during pregnancy and especially during systemic lupus erythematosus (SLE). The nurse
the postpartum period. plans care knowing that this disorder is:
A. A local rash that occurs as a result of allergy
B. A disease caused by overexposure to sunlight
6. A 19-year-old patient who is taking C. An inflammatory disease of collagen contained
azathioprine (Imuran) for systemic lupus in connective tissue
erythematosus has a check-up before leaving D. A disease caused by the continuous release of
home for college. The health care provider writes histamine in the body - -8. Answer: C
all of these orders. Which one should the nurse An inflammatory disease of collagen contained in
question? connective tissue
Test-Taking Strategy:
A. Naproxen (Aleve) 200 mg BID Use the process of elimination. Eliminate option 1
B. Give measles-mumps-rubella (MMR) because SLE is a systemic disorder, not a local
immunization one. Next eliminate option 2 because of its
C. Draw anti-DNA titer similarity to option 1. From the remaining options,
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