NCLEX RN Immune Disorders Practice
Exam 100 Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026
1. A client with systemic lupus erythematosus (SLE) reports increasing
fatigue and joint pain. Which laboratory finding is most specific for SLE?
A. Rheumatoid factor
B. Anti–double-stranded DNA antibodies
C. C-reactive protein
D. Antistreptolysin O
Answer: Anti–double-stranded DNA antibodies
Rationale: Anti-dsDNA antibodies are strongly associated with SLE and
correlate with disease activity, particularly lupus nephritis.
2. A nurse is assessing a client with SLE. Which finding requires the most
immediate follow-up?
A. Photosensitivity
B. Butterfly-shaped facial rash
C. 2+ proteinuria
D. Mild joint stiffness
Answer: 2+ proteinuria
Rationale: Proteinuria may indicate renal involvement from lupus nephritis,
which can progress to significant kidney dysfunction.
3. Which instruction should the nurse provide to a client with SLE who is
prescribed hydroxychloroquine?
,A. Avoid all dairy products
B. Have regular ophthalmologic examinations
C. Take the medication only when joint pain occurs
D. Stop the medication when the rash disappears
Answer: Have regular ophthalmologic examinations
Rationale: Hydroxychloroquine can cause retinal toxicity. Baseline and
periodic eye examinations are important during long-term therapy.
4. A client with rheumatoid arthritis (RA) reports morning joint stiffness.
Which characteristic is most typical of RA?
A. Stiffness lasting only a few minutes
B. Symmetric inflammatory joint involvement
C. Pain limited to one weight-bearing joint
D. Joint pain that improves with prolonged inactivity
Answer: Symmetric inflammatory joint involvement
Rationale: RA commonly causes symmetric inflammation of multiple joints,
particularly the small joints of the hands and feet, with prolonged morning
stiffness.
5. Which medication is commonly used as a disease-modifying
antirheumatic drug for rheumatoid arthritis?
A. Methotrexate
B. Acetaminophen
C. Furosemide
D. Diphenhydramine
Answer: Methotrexate
Rationale: Methotrexate is a commonly prescribed DMARD that slows
disease progression and reduces inflammatory activity in RA.
6. A client taking methotrexate for rheumatoid arthritis should report
which finding immediately?
A. Mild thirst
B. Increased appetite
,C. Fever and sore throat
D. Occasional fatigue
Answer: Fever and sore throat
Rationale: Methotrexate can cause bone marrow suppression and
immunosuppression. Fever or sore throat may indicate infection or
neutropenia.
7. Which assessment finding is characteristic of systemic sclerosis
(scleroderma)?
A. Soft, hypermobile joints
B. Tight, thickened skin
C. Severe thrombocytopenia
D. Increased skin elasticity
Answer: Tight, thickened skin
Rationale: Systemic sclerosis causes excessive collagen deposition, producing
thickened, tight skin and potentially affecting internal organs.
8. A client with systemic sclerosis has Raynaud phenomenon. Which
instruction is most appropriate?
A. Apply ice packs to the hands
B. Avoid exposure to cold temperatures
C. Smoke cigarettes to improve circulation
D. Keep the hands uncovered in cold weather
Answer: Avoid exposure to cold temperatures
Rationale: Cold can trigger vasospasm and worsen Raynaud symptoms.
Keeping the extremities warm helps prevent attacks.
9. Which manifestation is commonly associated with Sjögren syndrome?
A. Excessive salivation
B. Dry eyes and dry mouth
C. Severe hearing loss
D. Increased sweating
Answer: Dry eyes and dry mouth
, Rationale: Sjögren syndrome primarily affects exocrine glands, causing
decreased tear and saliva production.
10.Which intervention is appropriate for a client with Sjögren syndrome?
A. Encourage artificial tears
B. Restrict oral fluids
C. Avoid dental care
D. Encourage caffeinated beverages
Answer: Encourage artificial tears
Rationale: Artificial tears help relieve ocular dryness and protect the cornea
in clients with Sjögren syndrome.
11.A client with HIV has a CD4 count of 180 cells/mm³. What does this
finding indicate?
A. Normal immune function
B. Significant immunosuppression
C. Immunity to opportunistic infections
D. Successful elimination of HIV
Answer: Significant immunosuppression
Rationale: A CD4 count below 200 cells/mm³ indicates severe
immunosuppression and increased risk for opportunistic infections.
12.Which laboratory test is primarily used to monitor the amount of HIV
circulating in the blood?
A. Viral load
B. Hemoglobin
C. Serum sodium
D. Prothrombin time
Answer: Viral load
Rationale: HIV viral load measures the amount of HIV RNA in the blood and is
used to assess treatment response and disease activity.
13.Which statement by a client taking antiretroviral therapy indicates a
need for further teaching?
Exam 100 Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026
1. A client with systemic lupus erythematosus (SLE) reports increasing
fatigue and joint pain. Which laboratory finding is most specific for SLE?
A. Rheumatoid factor
B. Anti–double-stranded DNA antibodies
C. C-reactive protein
D. Antistreptolysin O
Answer: Anti–double-stranded DNA antibodies
Rationale: Anti-dsDNA antibodies are strongly associated with SLE and
correlate with disease activity, particularly lupus nephritis.
2. A nurse is assessing a client with SLE. Which finding requires the most
immediate follow-up?
A. Photosensitivity
B. Butterfly-shaped facial rash
C. 2+ proteinuria
D. Mild joint stiffness
Answer: 2+ proteinuria
Rationale: Proteinuria may indicate renal involvement from lupus nephritis,
which can progress to significant kidney dysfunction.
3. Which instruction should the nurse provide to a client with SLE who is
prescribed hydroxychloroquine?
,A. Avoid all dairy products
B. Have regular ophthalmologic examinations
C. Take the medication only when joint pain occurs
D. Stop the medication when the rash disappears
Answer: Have regular ophthalmologic examinations
Rationale: Hydroxychloroquine can cause retinal toxicity. Baseline and
periodic eye examinations are important during long-term therapy.
4. A client with rheumatoid arthritis (RA) reports morning joint stiffness.
Which characteristic is most typical of RA?
A. Stiffness lasting only a few minutes
B. Symmetric inflammatory joint involvement
C. Pain limited to one weight-bearing joint
D. Joint pain that improves with prolonged inactivity
Answer: Symmetric inflammatory joint involvement
Rationale: RA commonly causes symmetric inflammation of multiple joints,
particularly the small joints of the hands and feet, with prolonged morning
stiffness.
5. Which medication is commonly used as a disease-modifying
antirheumatic drug for rheumatoid arthritis?
A. Methotrexate
B. Acetaminophen
C. Furosemide
D. Diphenhydramine
Answer: Methotrexate
Rationale: Methotrexate is a commonly prescribed DMARD that slows
disease progression and reduces inflammatory activity in RA.
6. A client taking methotrexate for rheumatoid arthritis should report
which finding immediately?
A. Mild thirst
B. Increased appetite
,C. Fever and sore throat
D. Occasional fatigue
Answer: Fever and sore throat
Rationale: Methotrexate can cause bone marrow suppression and
immunosuppression. Fever or sore throat may indicate infection or
neutropenia.
7. Which assessment finding is characteristic of systemic sclerosis
(scleroderma)?
A. Soft, hypermobile joints
B. Tight, thickened skin
C. Severe thrombocytopenia
D. Increased skin elasticity
Answer: Tight, thickened skin
Rationale: Systemic sclerosis causes excessive collagen deposition, producing
thickened, tight skin and potentially affecting internal organs.
8. A client with systemic sclerosis has Raynaud phenomenon. Which
instruction is most appropriate?
A. Apply ice packs to the hands
B. Avoid exposure to cold temperatures
C. Smoke cigarettes to improve circulation
D. Keep the hands uncovered in cold weather
Answer: Avoid exposure to cold temperatures
Rationale: Cold can trigger vasospasm and worsen Raynaud symptoms.
Keeping the extremities warm helps prevent attacks.
9. Which manifestation is commonly associated with Sjögren syndrome?
A. Excessive salivation
B. Dry eyes and dry mouth
C. Severe hearing loss
D. Increased sweating
Answer: Dry eyes and dry mouth
, Rationale: Sjögren syndrome primarily affects exocrine glands, causing
decreased tear and saliva production.
10.Which intervention is appropriate for a client with Sjögren syndrome?
A. Encourage artificial tears
B. Restrict oral fluids
C. Avoid dental care
D. Encourage caffeinated beverages
Answer: Encourage artificial tears
Rationale: Artificial tears help relieve ocular dryness and protect the cornea
in clients with Sjögren syndrome.
11.A client with HIV has a CD4 count of 180 cells/mm³. What does this
finding indicate?
A. Normal immune function
B. Significant immunosuppression
C. Immunity to opportunistic infections
D. Successful elimination of HIV
Answer: Significant immunosuppression
Rationale: A CD4 count below 200 cells/mm³ indicates severe
immunosuppression and increased risk for opportunistic infections.
12.Which laboratory test is primarily used to monitor the amount of HIV
circulating in the blood?
A. Viral load
B. Hemoglobin
C. Serum sodium
D. Prothrombin time
Answer: Viral load
Rationale: HIV viral load measures the amount of HIV RNA in the blood and is
used to assess treatment response and disease activity.
13.Which statement by a client taking antiretroviral therapy indicates a
need for further teaching?
