A nurse is providing care for a client who is experiencing an acute exacerbation of systemic lupus erythematosus. Which of the following findings should the nurse anticipate?

Diplopia

Fever

Esophagitis

Bradykinesia

Answer and Explanation

The Correct Answer is B

A. Diplopia. Double vision (diplopia) is more commonly associated with neurological or ophthalmic disorders such as multiple sclerosis or cranial nerve dysfunction. It is not a typical manifestation of lupus exacerbations.
B. Fever. Fever is a common and expected finding during an acute exacerbation of systemic lupus erythematosus (SLE). It results from systemic inflammation and immune system activation, often indicating disease flare-up or potential infection.
C. Esophagitis. Esophagitis is more often linked to gastroesophageal reflux disease or infections, not systemic lupus. Although lupus can affect many organs, the esophagus is not a typical site of acute involvement in SLE exacerbations.
D. Bradykinesia. Bradykinesia, or slowness of movement, is a hallmark feature of Parkinson’s disease. It is not associated with SLE and would not be expected during a lupus flare.

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Correct Answer is A

Explanation

A. Palms of the hands. In clients with dark skin, assessing for cyanosis is best done in areas where skin is lighter and blood vessels are more visible, such as the palms, soles, lips, mucous membranes, and conjunctiva. These sites provide clearer visual cues of decreased oxygenation.
B. Area of trauma. This area may show signs of bruising or inflammation, but it is not ideal for assessing cyanosis. Local changes in color may be due to injury, not systemic oxygenation.
C. Sacrum. The sacrum is typically assessed for pressure injuries, not for cyanosis. Its location and frequent pressure make it a less reliable site for detecting systemic color changes.
D. Shoulders. The shoulders are not reliable sites for detecting cyanosis, especially in individuals with darker skin, as color changes may be less apparent in more heavily pigmented or sun-exposed areas.

A. Temperature 38.2° C (100.8° F) B. Heart rate 104/min C. Client reports feeling unwell D. Lung sounds clear but diminished in the bases E. Fundus boggy but firmed with massage F. Moderate amount of dark brown, foul-smelling lochia noted G. No bowel movement since birth, hypoactive bowel sounds H. WBC count 33,000/mm3 (5,000 to 10,000/mm)

Correct Answer is ["A","B","C","D","E","F","G","H"]

Explanation

Client reports feeling unwell: This is clinically significant when combined with fever, foul-smelling lochia, and elevated WBCs; it could indicate systemic infection such as endometritis.
Fundus boggy but firms with massage: Indicates uterine atony, a risk factor for postpartum hemorrhage. Even if it responds to massage, repeated bogginess suggests the need for uterotonic medications and close monitoring.
Foul-smelling, dark brown lochia: These findings are highly suggestive of uterine infection (endometritis), especially when paired with uterine tenderness, fever, and elevated WBCs.
WBC count 33,000/mm³: Severely elevated — well above normal postpartum leukocytosis (typically up to 20,000/mm³). A level of 33,000 strongly suggests an ongoing infectious process.
Temperature 38.2°C (100.8°F): Slightly elevated, and while low-grade fever is common postpartum, when associated with uterine tenderness and abnormal lochia, it raises concern for infection and should be monitored and managed appropriately.
Lung sounds diminished in the bases: Could be due to post-surgical hypoventilation, immobility, or atelectasis. Should prompt encouragement of deep breathing, incentive spirometry, and ambulation.
No bowel movement since birth, hypoactive bowel sounds: This is a common post-cesarean finding due to anesthesia and immobility, but it still indicates delayed return of GI function and should be monitored for signs of ileus.

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A nurse is providing care for a client who is experiencing an acute exacerbation of systemic lupus erythematosus. Which of the following findings should the nurse anticipate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is performing a skin assessment on a client who has dark skin. Which of the following locations on the client's body should the nurse observe to assess for cyanosis?

Correct Answer is A

Explanation

Correct Answer is ["A","B","C","D","E","F","G","H"]

Explanation

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