The nurse is assessing a client for signs and symptoms of systemic lupus erythematosus (SLE). Which of the following would be consistent with this disorder? (Select one that does not apply.)
Correct Answer: A
Rationale: The correct answer is A: Discoid rash on skin exposed to sunlight. Systemic lupus erythematosus (SLE) commonly presents with a characteristic butterfly-shaped rash on the face, especially over the cheeks and nose, that worsens with sunlight exposure. The rash is not limited to skin exposed to sunlight. Choices B, C, and D are inconsistent with SLE. B: Urinalysis negative for casts and protein is not indicative of SLE, as renal involvement in SLE often presents with the presence of casts and protein in the urine. C: Painful, deformed small joints is more typical of rheumatoid arthritis, not SLE. D: Pain on inspiration is a symptom of pleurisy, which can occur in SLE but is not a defining feature.