A nurse is assessing a client who has a new diagnosis of SLE (Lupus). Which of the following findings should the nurse expect?

Weight gain

Systolic murmur

Alopecia

Petechiae on thighs

Answer and Explanation

The Correct Answer is C

A.   Weight gain is not a typical finding associated with SLE. Patients often experience weight loss due to decreased appetite, fatigue, or increased metabolism. Therefore, this choice is less likely to be expected.
B.   While some patients with SLE may develop cardiac complications, such as pericarditis or valvular disease, a systolic murmur is not a common or characteristic finding of the disease itself. This choice is not specifically indicative of SLE.
C.   Alopecia, or hair loss, is a common finding in patients with SLE. It can occur due to the disease itself or as a side effect of certain medications used in treatment. This choice is a typical manifestation of SLE.
D.   Petechiae can occur in SLE, particularly when there is thrombocytopenia (low platelet count) or vasculitis associated with the condition. While it is not as common as alopecia, it can still be an expected finding in some cases of SLE.

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Correct Answer is ["A","B","D","E"]

Explanation

A. Using a filtered IV line helps remove any particulate matter that could be present in the TPN solution, reducing the risk of complications such as phlebitis or embolism.
B. TPN should have its own dedicated line to prevent incompatibilities and ensure the TPN solution is delivered without interference. Infusing other medications through the same line can lead to complications and reduce the effectiveness of TPN.
C. If TPN gets stopped or runs out, a bag of 5% dextrose in water (D5W) should be hung to prevent hypoglycemia. D10% is too concentrated and can cause hyperglycemia.
D. To minimize the risk of infection and maintain sterility, TPN bags and tubing should be replaced every 24 hours. This helps prevent bacterial growth in the TPN solution.
E. TPN is typically administered through a central line because it allows for the infusion of hypertonic solutions that can irritate peripheral veins. Central lines provide better access to larger blood vessels, reducing the risk of complications.

A. The MTX will stop the pain but not the progression of your disease, so we also give you NSAIDS and steroids B. You have good insurance so we like to prescribe you a whole bunch of medications just in case C. The MTX helps treat the nausea associated with the other meds that actually treat your disease D. The MTX takes several weeks or months to reach full effect, so the other meds are started now to help your symptoms

Correct Answer is D

Explanation

A. Methotrexate (MTX) is a disease-modifying antirheumatic drug (DMARD) that helps slow disease progression but does not provide immediate pain relief. NSAIDs and steroids may be used for symptomatic relief, but MTX alone can manage both pain and disease progression over time.
B. This response is unprofessional and dismissive. It implies that the medication regimen is based solely on the patient's insurance coverage rather than their medical needs. It does not address the patient’s question and could undermine trust in the healthcare team.
C. Methotrexate does not primarily treat nausea; rather, it is used to manage rheumatoid arthritis. While some patients may experience nausea as a side effect of MTX or other medications, this is not its primary purpose.
D. Methotrexate is indeed a DMARD that can take weeks to months to show its full benefits in controlling inflammation and slowing disease progression. Meanwhile, NSAIDs or corticosteroids may be prescribed to provide quicker relief from symptoms such as pain and swelling.

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A nurse is assessing a client who has a new diagnosis of SLE (Lupus). Which of the following findings should the nurse expect?

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Naxlex Comprehensive Predictor Exams

Which of the following is are appropriate nursing interventions to ensure the safety of a patient who is receiving Total Parenteral Nutrition (TPN)? (Select all that apply)

Correct Answer is ["A","B","D","E"]

Explanation

Your patient has just received a new diagnosis of Rheumatoid Arthritis. They are confused about their prescriptions, however. They ask you "Why am I receiving so many medications? I thought this 'MTX' drug was the one that would treat my arthritis?". What is your BEST response?

Correct Answer is D

Explanation

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