Systemic Lupus Erythematosus NCLEX questions nursing review quiz!
Lupus (SLE) is an autoimmune condition that causes damage to vital organs, tissues, and joints. It can affect any area of the body and signs and symptoms vary among patients (depending on the structure affected by the condition). The nurse plays a vital role with patient education, treatment, and monitoring for complications.
Take the free systemic lupus erythematosus quiz below to practice for NCLEX or nursing school exams. Before taking the quiz, you might want to review our systemic lupus erythematosus notes, or watch our systemic lupus erythematosus lecture.
Systemic Lupus Erythematosus NCLEX Questions Quiz
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Systemic Lupus Erythematosus (Nursing) NCLEX Questions Quiz
1. Which statements below are INCORRECT about Systemic Lupus Erythematosus? Select all that apply:
A. Lupus mainly affects Black, Asian, and Hispanic men.
B. Lupus is a chronic condition that has periods of flare-ups and remission.
C. The joints and skin are rarely affected in lupus.
D. Systemic Lupus Erythematosus (SLE) is the most common form of lupus.
The answers are A and C. Options B and D are correct statements about lupus. Option A is wrong because lupus mainly affects Black, Asian, and Hispanic WOMEN (not men). Option C is wrong because lupus DOES affect the joints and skin along with many other systems of the body (heart, lungs, kidneys, blood system, brain etc.).
2. What is the name of the process in the body that is responsible for the death of a cell?
The answer is C: Apoptosis. In lupus, this process is not occurring effectively, specifically the phagocytosis of the apoptotic bodies.
3. During the death process of a cell, which immune system cell is responsible for ingesting the fragments of the dying cell?
The answer is C. Macrophages (also known as phagocytes) digest the tiny fragments of the dying cell called apoptotic bodies. In lupus, this process is either occurring too slowly or not performed correctly (but either way the immune system sees the nuclear material from these bodies as foreign “antinuclear antigens” and forms autoantibodies against them and this causes immune complexes to form…and inflammation of body systems).
4. Which statements are true about the pathogenesis of Systemic Lupus Erythematosus? Select all that apply:
A. The phagocytosis process is not occurring properly, which causes the nuclear material inside the dying cell to be seen as a foreign invader and antinuclear antibodies are created.
B. During cell death the nucleus of the cell fails to condense, which leads to the development of autoantibodies.
C. Immune complexes form and attach within the structures of important organs, joints, and tissues, and this causes inflammation.
D. Neutrophil activity is decreased and this causes B-cells to attack phagocytes and nuclear material within the cells, which leads to the activation of the complement cascade system and inflammation.
The answers are A and C. These are correct statements about the pathogenesis of SLE. In a nutshell, apoptosis is ineffective (specifically how the macrophages/phagocytes consume the fragmented parts of the dying cell during apoptosis). These fragmented parts of the dying cell are not consumed (either the consumption by the macrophages is too slow or they are not consumed), and the nuclear material inside the small bodies spill into the extracellular space. The immune system recognizes this as an antigen “antinuclear antigens” and forms antinuclear antibodies to attack them. The antibodies attack the antigens and form immune complexes. These immune complexes now start to “float” around in the body and get stuck in various organs, joints, and tissues. This leads to the activation of the complement system and causes inflammation. This inflammation damages the structure (hence the organs/tissues/joint)s.
5. A patient is diagnosed with Systemic Lupus Erythematous (SLE). You note the patient has a red rash that starts on the nose and expands onto the cheeks of the face. This is known as what type of rash?
The answer is B: Malar (it’s also called a butterfly rash).
6. A patient with Systemic Lupus Erythematous (SLE) takes the medication Azathioprine. Which statement by the patient requires re-education?
A. “I’ve made sure all my vaccines are up-to-date, and I’m getting the Shingles vaccine next week.”
B. “This medication can increase my chances for developing infection.”
C. “This medication is “steroid-sparing” meaning it may help lower the amount of steroids I may need to manage my lupus.”
D. “This medication lowers my immune system.”
The answer is A. Azathioprine is an immunosuppressant. Patients can have vaccines while taking this medication but NOT live vaccines…like shingles, MMR etc.
7. A patient is undergoing testing for the evaluation of Systemic Lupus Erythematous. What lab findings below are associated with this condition? Select all that apply:
A. Decreased ESR and CRP
B. Positive ANA
C. Positive Anti-dsDNA
D. Negative Anti-Sm
E. Low C3 and C4
The answers are B, C, and E. A positive ANA (anti-nuclear antibodies) demonstrates there are autoantibodies the body created against the nuclei of the dying cells (almost all patient with lupus will have a positive ANA), but these anti-nuclear antibodies can also be present with other autoimmune disorders. A positive anti-dsDNA (anti-double stranded DNA anti-body) is a particular anti-nuclear antibody found in some patients with lupus and is not typically present in patients who don’t have lupus. An INCREASE in ESR and CRP would be found in a patient with lupus (especially during a flare) along with a POSITIVE Anti-Sm antibody (which is a particular antibody found in the nucleus that is present in lupus).
8. A patient with Systemic Lupus Erythematosus is experiencing a complication called Lupus Nephritis. What are some signs and symptoms that correlate with this complication of SLE? Select all that apply:
A. Decreased Creatinine
B. Increased BUN
C. 48 hour urinary output of 720 mL
E. Weight loss
F. Edema in upper and lower extremities
The answers are B, C D, and F. Lupus nephritis is a serious complication of SLE. It is a condition that affects the functional units of the kidneys called the nephrons. In severe cases, renal failure develops which leads to an INCREASED BUN/Creatinine, low UOP (<30 mL/hr), proteinuria, weightGAIN, and swelling in the upper and lower extremities.
9. Which medication below used to treat Systemic Lupus Erythematosus decreases inflammation quickly, is not for long-term usage, and can lead to weight gain, susceptibility to infection, diabetes, and osteoporosis?
The answer is B. The question above is describing steroids. Prednisone is a steroid medication. These are medications used to treat lupus. They decrease inflammation quickly, are not for long-term usage, and can lead to weight gain, susceptibility to infection, diabetes, and osteoporosis.
10. A patient with Systemic Lupus Erythematosus is prescribed Hydroxychloroquine. Select all the educational points you will include in the patient’s education about this medication:
A. Hydroxychloroquine is considered a Biologic medication.
B. It is used long-term to help prevent flares.
C. This medication doesn’t produce results immediately. Therefore, the patient may not see results for a couple of months.
D. This medication binds with a protein that supports the activity of B-cells, which decreases the activity of B-cells.
E. The patient must have their eyes checked regularly to monitor the retina while taking this medication.
The answers are B, C, and E. Hydroxychloroquine is an antimalarial medication. It decreases antibodies attacking the body (option D describes a biologic like Belimumab). If used long-term it can damage the retinas of the eyes (the patient needs a minimum of 1 eye exam per year while taking this med). It also takes a couple of months to start working.
11. A patient is prescribed Belimumab for treatment of lupus. The patient has been taking the medication for one month. Which finding below during a patient assessment requires further evaluation?
A. The patient reports trouble sleeping and loss of energy.
B. The patient declines a flu shot via the intranasal route.
C. The patient says they have not noticed a change in symptoms.
D. The patient administers the medication in the subcutaneous tissue on the abdomen.
The answer is A. Belimumab is a Biologic that binds with a protein that supports the activity of B-cells to decrease the activity of B-cells, which decreases antibody attacks and decreases inflammation. Depression and suicide are serious side effects of this medication. Option A demonstrates the patient may be experiencing depression and further evaluation is needed. Option B is correct because the patient should avoid LIVE vaccines like the flu vaccine via the intranasal route, Option C is correct because this medication can take up to 6 months to start working, and Option D is correct because this medication can be given via injection (subq fat of the upper legs or abdomen) or infusion.
12. A 26-year-old female with Systemic Lupus Erythematosus has been hospitalized with a flare-up. The patient is now recovered and is about to be discharged. The patient expresses that she wants to have a baby soon. How long should the woman be advised to be in remission of this condition before trying to conceive a baby?
A. 2 months
B. 2 years
C. 6 months
D. 1 year
The answer is C. Women with lupus, who want to become pregnant, need to make sure their lupus has been in control (hence remission….no flare-ups) for at least 6 months before conceiving. This is because there is a risk of miscarriage and clotting issues. Pregnancy and the post-partum period can cause flares.
13. You’re providing education to a Systemic Lupus Erythematosus support group about preventing flares. Which statement by a participant requires re-education about this topic?
A. “Emotional stress and illness are triggers for a flare-up.”
B.”I always wear large-brimmed hats and long sleeves when I’m outside.”
C. “Exercise should be avoided due to the physical stress it causes on the body.”
D. “I will make it priority to receive my yearly influenza vaccine.
The answer is C. Exercise is a very important step in preventing lupus flares. It helps maintain joint stability and manages weight. Exercise should not be limited but encouraged to as much as the patient can tolerate. Remember LESS for less flares: Lower stress (avoid overworking, emotional, illness, and use techniques to have prevent stress), Exercise (helps joints and manages weight), Sleep (need more than 8 hours to prevent the body from getting too exhausted), Sun Protection (sunscreen and large-brimmed hats…sunlight can activate a flare).
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