Chapter 22: SLE Flashcards
Which population is most likely to experience higher morbidity and mortality associated with systemic lupus erythematosus (SLE)?
A. Hispanic males diagnosed in adulthood
B. Caucasian females diagnosed in adulthood
C. African American females diagnosed in childhood
D. Asian males diagnosed in childhood
C. African American females diagnosed in childhood
Rationale: The text highlights that African Americans experience more severe disease and higher morbidity and mortality related to SLE. Females are disproportionately affected, and childhood diagnoses make up 15% to 20% of cases, further increasing their risk for complications.
Which factors contribute to the development of systemic lupus erythematosus (SLE) according to the text? (SATA)
A. Genetic predisposition
B. Environmental triggers
C. Overuse of antibiotics
D. Abnormal immune response
E. Accumulation of immune complexes
A. Genetic predisposition
B. Environmental triggers
D. Abnormal immune response
E. Accumulation of immune complexes
Rationale: The text indicates that SLE may involve genetic predisposition, an environmental trigger, and an abnormal immune response. This leads to the production of autoantibodies and the formation of immune complexes, which deposit in connective tissues. Overuse of antibiotics is not related to the development of SLE.
A nurse is caring for a 10-year-old boy with systemic lupus erythematosus (SLE). The child has proteinuria and joint pain. The nurse understands that the connective tissue damage in SLE is caused by:
A. Immune complex deposition in small blood vessels and glomeruli.
B. A direct attack on red blood cells by autoantibodies.
C. Overproduction of cortisol in response to chronic stress.
D. Blockage of lymphatic vessels by immune complexes.
A. Immune complex deposition in small blood vessels and glomeruli.
Rationale: In SLE, immune complexes are deposited in connective tissues, particularly in small blood vessels and glomeruli, leading to inflammation and tissue damage. Autoantibodies target various tissues, not just red blood cells. Cortisol overproduction and lymphatic blockage are not part of the pathophysiology of SLE.
Which of the following best explains the pathophysiology of systemic lupus erythematosus (SLE)?
A. A bacterial infection directly destroys connective tissue, leading to organ damage.
B. An autoimmune response causes the body to produce antibodies that attack foreign pathogens.
C. Immune complexes form and deposit in connective tissue, triggering inflammation and tissue destruction.
D. Environmental toxins accumulate in the bloodstream, damaging small blood vessels and glomeruli.
C. Immune complexes form and deposit in connective tissue, triggering inflammation and tissue destruction.
Rationale: In SLE, the body produces autoantibodies that combine with antigens to form immune complexes. These complexes deposit in connective tissue, leading to chronic inflammation and tissue destruction. This process primarily affects small blood vessels, glomeruli, joints, spleen, and heart valves. The etiology is autoimmune rather than bacterial or toxin-related.
Which of the following best describes the role of antigen-antibody complexes in systemic lupus erythematosus (SLE)?
A. They neutralize harmful pathogens, reducing inflammation.
B. They block blood flow in major arteries, causing ischemia in vital organs.
C. They form in response to a bacterial infection, causing organ-specific damage.
D. They are deposited in connective tissues, leading to inflammation and tissue destruction.
D. They are deposited in connective tissues, leading to inflammation and tissue destruction.
Rationale: In SLE, antigen-antibody complexes are deposited in connective tissues, triggering chronic inflammation and tissue destruction. They do not neutralize pathogens, block major arteries, or directly result from bacterial infections.
A nurse is reviewing the pathophysiology of systemic lupus erythematosus (SLE) with a colleague. Which statements about the condition are accurate? (SATA)
A. “A genetic predisposition may increase the likelihood of developing SLE.”
B. “Immune complexes deposit in connective tissue, leading to inflammation.”
C. “Organ damage occurs primarily in the pancreas and liver.”
D. “Multisystem failure may occur due to widespread organ involvement.”
E. “An environmental trigger may initiate an abnormal immune response in genetically predisposed individuals.”
A. “A genetic predisposition may increase the likelihood of developing SLE.”
B. “Immune complexes deposit in connective tissue, leading to inflammation.”
D. “Multisystem failure may occur due to widespread organ involvement.”
E. “An environmental trigger may initiate an abnormal immune response in genetically predisposed individuals.”
Rationale: SLE is believed to involve genetic predisposition, with an environmental trigger causing an abnormal immune response. Immune complexes deposit in connective tissue, causing inflammation and tissue destruction. Multisystem failure can result from widespread organ damage. The pancreas and liver are not the primary organs affected in SLE.
The nurse is teaching a student about organ damage caused by systemic lupus erythematosus (SLE). Which tissues and organs are most likely to be affected? (SATA)
A. Heart valves
B. Spleen
C. Pancreas
D. Glomeruli
E. Joints
A. Heart valves
B. Spleen
D. Glomeruli
E. Joints
Rationale: According to the text, the tissues most affected by SLE are the small blood vessels, glomeruli, joints, spleen, and heart valves. The pancreas is not listed as one of the tissues commonly affected by SLE.
A 15-year-old patient with systemic lupus erythematosus (SLE) presents with dyspnea, chest pain, and edema. Lab results show proteinuria and hematuria. Which complications are likely contributing to these symptoms?
A. Pulmonary embolism and renal involvement
B. Seizures and cognitive disorders
C. Abdominal pain and photosensitivity
D. Psychosis and mood disorders
A. Pulmonary embolism and renal involvement
Rationale: Dyspnea and chest pain suggest pulmonary complications, such as pulmonary embolism, while proteinuria, hematuria, and edema indicate renal involvement. These findings are consistent with common complications of SLE affecting the pulmonary and renal systems.
A nurse is assessing a patient with systemic lupus erythematosus (SLE) who reports alopecia. Which additional integumentary symptoms should the nurse monitor for? (SATA)
A. Butterfly rash
B. Mouth or nose ulcers
C. Photosensitivity
D. Edema
E. Easy bruising
A. Butterfly rash
B. Mouth or nose ulcers
C. Photosensitivity
Rationale: Integumentary manifestations of SLE include butterfly rash, photosensitivity, alopecia, and mouth or nose ulcers. Edema is a renal symptom, and easy bruising is hematologic.
A patient with systemic lupus erythematosus (SLE) is admitted with hematuria, proteinuria, and hypertension. These findings indicate involvement of which organ system?
A. Musculoskeletal
B. Cardiac
C. Renal
D. Pulmonary
C. Renal
Rationale: Renal manifestations of SLE include hematuria, proteinuria, edema, and hypertension. These symptoms indicate damage to the kidneys.
The nurse is reviewing the cardiac manifestations of systemic lupus erythematosus (SLE). Which findings should be included in the assessment? (SATA)
A. Arrhythmias
B. Friction rub
C. Raynaud phenomenon
D. Butterfly rash
E. Pulmonary embolism
A. Arrhythmias
B. Friction rub
C. Raynaud phenomenon
Rationale: Cardiac manifestations of SLE include arrhythmias, friction rub, and Raynaud phenomenon. Butterfly rash is an integumentary symptom, and pulmonary embolism is a pulmonary complication.
A patient with systemic lupus erythematosus (SLE) reports severe headaches and mood changes. Which of the following systems is likely affected?
A. Neurologic
B. Pulmonary
C. Gastrointestinal
D. Integumentary
A. Neurologic
Rationale: Neurological manifestations of SLE include headaches, mood disorders, cognitive disorders, seizures, stroke, and peripheral neuropathy. These symptoms indicate involvement of the nervous system.
A 16-year-old patient with systemic lupus erythematosus (SLE) is admitted with abdominal pain radiating to the shoulder, diarrhea, and fatigue. Which organ systems are most likely involved in this scenario?
A. Renal and neurologic
B. Gastrointestinal and hematologic
C. Pulmonary and integumentary
D. Musculoskeletal and cardiac
B. Gastrointestinal and hematologic
Rationale: Gastrointestinal symptoms of SLE include abdominal pain (which may radiate to the shoulder) and diarrhea, while fatigue is a hematologic manifestation.
A 13-year-old girl presents to the clinic with fatigue, fever, joint pain, and a pink rash over the bridge of her nose and cheeks. Laboratory results reveal anemia and thrombocytopenia. The nurse suspects systemic lupus erythematosus (SLE). Which finding is most characteristic of this condition?
A. Fatigue
B. Arthritis
C. Butterfly rash on the face
D. Weight loss
C. Butterfly rash on the face
Rationale: While fatigue, arthritis, and weight loss are common symptoms of SLE, the butterfly rash on the face (a pink or red rash over the bridge of the nose extending to the cheeks) is a hallmark clinical manifestation of the disease.
What is the leading cause of morbidity and mortality in children diagnosed with systemic lupus erythematosus (SLE)?
A. Cardiovascular disease
B. Central nervous system disorders
C. Vasculitis
D. Renal disease
D. Renal disease
Rationale: Renal disease is the leading cause of morbidity and mortality in children with SLE. It is evident at diagnosis in 50% of children and develops in 80% to 90% within the first year of diagnosis.
The nurse is reviewing the clinical manifestations of systemic lupus erythematosus (SLE) with a colleague. Which symptoms should the nurse identify as possible signs of SLE?
A. Fever
B. Malaise
C. Cerebrovascular disease
D. Leukopenia
E. Hyperkalemia
A. Fever
B. Malaise
C. Cerebrovascular disease
D. Leukopenia
Rationale: Fever, malaise, cerebrovascular disease, and leukopenia are all potential manifestations of SLE. Hyperkalemia is not mentioned as a clinical manifestation of SLE in the text.
Which of the following symptoms is most likely to indicate central nervous system (CNS) involvement in a child with systemic lupus erythematosus (SLE)?
A. Seizures
B. Butterfly rash
C. Arthritis
D. Weight loss
A. Seizures
Rationale: CNS disorders in children with SLE include headaches, mood disorders, seizure disorders, and cerebrovascular disease. Seizures are a direct indication of CNS involvement.
A 10-year-old child with a history of systemic lupus erythematosus (SLE) is hospitalized with complaints of severe fatigue and joint pain. Lab results reveal leukopenia and thrombocytopenia. Which additional manifestation should the nurse monitor for based on this diagnosis?
A. Hyperglycemia
B. Butterfly rash
C. Polycythemia
D. Hypercalcemia
B. Butterfly rash
Rationale: The butterfly rash is a common and characteristic finding in SLE. Other common findings include anemia, leukopenia, and thrombocytopenia. Hyperglycemia, polycythemia, and hypercalcemia are not associated with SLE.
The nurse is educating the parents of a child newly diagnosed with systemic lupus erythematosus (SLE). Which clinical manifestations should the parents watch for as signs of disease progression? (SATA)
A. Rash
B. Headaches
C. Nephritis
D. Mood disorders
E. Elevated blood pressure
A. Rash
B. Headaches
C. Nephritis
D. Mood disorders
Rationale: Rash, headaches, nephritis, and mood disorders are all possible clinical manifestations of SLE. While elevated blood pressure may occur secondary to renal involvement, it is not listed as a primary clinical manifestation of SLE in the text.
A nurse is assessing a child with systemic lupus erythematosus (SLE). Which symptom would most likely indicate the development of nephritis?
A. Fatigue
B. Proteinuria
C. Rash on the cheeks
D. Weight loss
B. Proteinuria
Rationale: Proteinuria is a key indicator of nephritis, which is a leading cause of morbidity and mortality in children with SLE. While fatigue, rash, and weight loss are common symptoms, proteinuria specifically indicates renal involvement.
A 14-year-old patient with systemic lupus erythematosus (SLE) presents with chest pain and dyspnea. Which of the following pulmonary complications should the nurse suspect?
A. Pulmonary embolism
B. Stroke
C. Abdominal pain radiating to the shoulder
D. Cognitive disorder
A. Pulmonary embolism
Rationale: Pulmonary manifestations of SLE include pulmonary embolism, pulmonary hypertension, chest pain, and dyspnea. Stroke and cognitive disorders are neurological complications, while abdominal pain radiating to the shoulder is gastrointestinal.
The nurse is educating a patient with systemic lupus erythematosus (SLE) about potential hematologic symptoms. Which symptoms should the patient be advised to report? (SATA)
A. Easy bruising
B. Nosebleeds
C. Alopecia
D. Fever
E. Peripheral neuropathy
A. Easy bruising
B. Nosebleeds
D. Fever
Rationale: Hematologic manifestations of SLE include easy bruising, nosebleeds, fatigue, and fever. Alopecia is an integumentary symptom, and peripheral neuropathy is a neurological manifestation.
A 12-year-old patient with systemic lupus erythematosus (SLE) reports severe joint pain, muscle weakness, and swollen joints. Which organ system is primarily affected in this scenario?
A. Neurologic
B. Renal
C. Integumentary
D. Musculoskeletal
D. Musculoskeletal
Rationale: Musculoskeletal symptoms of SLE include joint pain, swollen inflamed joints, muscle weakness, and myalgias. These findings indicate the musculoskeletal system is primarily affected in this case.
Which neurological manifestation of systemic lupus erythematosus (SLE) is characterized by changes in mental function and emotional stability?
A. Seizures
B. Raynaud phenomenon
C. Hematuria
D. Psychosis
D. Psychosis
Rationale: Neurological symptoms of SLE include psychosis, mood disorders, cognitive disorders, seizures, stroke, and peripheral neuropathy. Psychosis is specifically associated with altered mental function and emotional instability.
A nurse is preparing a teaching plan for a patient with SLE who is at risk for osteopenia. Which interventions should be included to improve bone health?
A. Encourage weight-bearing exercise and increase dietary protein.
B. Prescribe vitamin D supplements and calcium carbonate.
C. Restrict fluid intake and administer NSAIDs.
D. Recommend corticosteroids and a high-sodium diet.
B. Prescribe vitamin D supplements and calcium carbonate.
Rationale: Vitamin D supplements and calcium carbonate are recommended for patients with SLE at risk for osteopenia due to corticosteroid use. Weight-bearing exercise may also be beneficial but was not an option. High sodium is contraindicated.
What are the primary goals of medical management for systemic lupus erythematosus (SLE)? (SATA)
A. Create remission of symptoms
B. Prevent complications
C. Repair connective tissue damage
D. Avoid dietary restrictions
E. Prolong survival rates
A. Create remission of symptoms
B. Prevent complications
E. Prolong survival rates
Rationale: The goals of SLE management include creating remission of symptoms, preventing complications, and improving survival rates. Connective tissue damage is managed, but repair is not always possible. Dietary restrictions may be necessary for certain patients.
A child with SLE has excessive weight gain and fluid retention. What dietary modification should the nurse recommend?
A. Increased calcium intake
B. High-protein diet
C. Low-sodium diet
D. Fluid restriction
C. Low-sodium diet
Rationale: A low-sodium diet is recommended to manage fluid retention and excessive weight gain caused by corticosteroid use or renal damage in SLE.
A patient with SLE is diagnosed with lupus nephritis. What is the most definitive treatment for kidney failure secondary to lupus nephritis?
A. Corticosteroids
B. Renal transplantation
C. Hemodialysis
D. Cyclophosphamide
B. Renal transplantation
Rationale: Renal transplantation is the most definitive treatment for kidney failure caused by lupus nephritis. Hemodialysis is a temporary management strategy, and medications like corticosteroids and cyclophosphamide help control inflammation.
Which statement best explains the role of antimalarial drugs like hydroxychloroquine in the treatment of SLE?
A. They directly target autoantibody production.
B. They treat inflammation in the kidneys.
C. They reduce skin and joint symptoms and maintain remission.
D. They prevent clot formation in blood vessels.
C. They reduce skin and joint symptoms and maintain remission.
Rationale: Antimalarial drugs, such as hydroxychloroquine, are effective in treating skin lesions, arthritis, and maintaining remission in SLE. Their exact mechanism of action on SLE is unknown.
Which medications may be used to control systemic lupus erythematosus (SLE)? (SATA)
A. Prednisone
B. Methotrexate
C. Hydroxychloroquine
D. Ibuprofen
E. Vitamin B12
A. Prednisone
B. Methotrexate
C. Hydroxychloroquine
D. Ibuprofen
Rationale: Prednisone (a corticosteroid), methotrexate (an immunosuppressant), hydroxychloroquine (an antimalarial), and ibuprofen (an NSAID) are commonly used in managing SLE. Vitamin B12 is not indicated for SLE.
A 14-year-old patient with SLE is prescribed corticosteroids for inflammation control. The nurse is educating the patient about potential side effects. What long-term complication should the nurse discuss related to corticosteroid use?
A. Osteopenia
B. Hematuria
C. Peripheral neuropathy
D. Pulmonary embolism
A. Osteopenia
Rationale: Patients with SLE on corticosteroids are at increased risk for osteopenia. Vitamin D and calcium carbonate are recommended to improve bone health. Hematuria is related to lupus nephritis, not corticosteroid use.
