A nurse is caring for a female client who has toxic shock syndrome. Which of the following findings should the nurse expect?

Generalized rash

Elevated platelet count

Decreased total bilirubin

Hypertension

Answer and Explanation

The Correct Answer is A

A. Generalized rash is a common finding in toxic shock syndrome (TSS). The rash often appears as a sunburn-like rash and can progress to desquamation (peeling of the skin).

B. Elevated platelet count is not typically associated with toxic shock syndrome. In fact, thrombocytopenia (low platelet count) is more commonly seen in TSS.

C. Decreased total bilirubin is not associated with toxic shock syndrome. Bilirubin levels may be affected in cases of liver dysfunction, but TSS does not typically cause a decrease in bilirubin.

D. Hypertension is not a common finding in toxic shock syndrome. TSS often causes hypotension (low blood pressure) due to the systemic inflammatory response and shock.

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Correct Answer is B

Explanation

A. Pedal edema is more commonly associated with right-sided heart failure due to fluid retention in the lower extremities.

B. In left-sided heart failure, fluid backs up into the lungs, leading to pulmonary congestion and reduced renal perfusion. This can result in daytime oliguria (decreased urine output) as the kidneys receive less blood flow.

C. Neck vein distention is a hallmark of right-sided heart failure, not left-sided heart failure. It occurs due to increased venous pressure.

D. An enlarged liver is more commonly seen in right-sided heart failure due to congestion of the liver, but it is not a typical manifestation of left-sided heart failure.

Correct Answer is []

Explanation

Rationale:

The client exhibits hallmark symptoms of Systemic Lupus Erythematosus (SLE), including a butterfly rash on the cheeks, alopecia, joint tenderness, and elevated ANA and ESR levels. These findings, combined with anemia and thrombocytopenia, are consistent with SLE, an autoimmune disorder characterized by systemic inflammation and tissue damage.

Multiple sclerosis is primarily a neurological condition and does not align with the client’s dermatological and hematological findings. Celiac disease is associated with gastrointestinal symptoms and gluten sensitivity, which the client denies. Type 1 diabetes mellitus involves hyperglycemia and insulin deficiency, which are not relevant to the presented symptoms.

Helping the client identify aggravating factors (e.g., sunlight exposure, stress) is crucial for managing SLE. Recommending low-impact exercises can help maintain joint mobility and reduce inflammation.

Monitoring adherence to corticosteroid therapy is essential since these medications are often used to control inflammation in SLE. Assessing for depression related to body image is important due to the physical manifestations of SLE, such as alopecia and hyperpigmentation, which may affect the client’s mental health.

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A nurse is caring for a female client who has toxic shock syndrome. Which of the following findings should the nurse expect?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has left-sided heart failure. Which of the following manifestations should the nurse expect?

Correct Answer is B

Explanation

Correct Answer is []

Explanation

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