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What is the pathophysiology of systemic lupus erythematosus (SLE) characterized by?
- A. Destruction of nucleic acids and other self-proteins by autoantibodies
- B. Overproduction of collagen that disrupts the functioning of internal organs
- C. Formation of abnormal IgG that attaches to cellular antigens, activating complement
- D. Increased activity of T suppressor cells with B-cell hypoactivity, resulting in an immunodeficiency
Correct Answer: A
Rationale: Autoantibodies attack self-proteins in SLE.
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What is the major focus for care today for a patient who is 1 day post-operative after a left below-the-knee amputation?
- A. To attain pain control for phantom pain.
- B. To monitor for signs of sufficient tissue perfusion.
- C. To assist the patient to ambulate as soon as possible.
- D. To elevate the residual limb when the patient is supine.
Correct Answer: B
Rationale: Ensuring adequate tissue perfusion is critical in the immediate post-operative period to prevent complications.
A person who experiences an aura as part of his/her seizure pattern should be instructed to
- A. lie down in a safe place
- B. take additional anticonvulsant medication
- C. call an ambulance
- D. exercise vigorously
Correct Answer: A
Rationale: Lying down in a safe place can prevent injury during a seizure.
Laboratory findings that the nurse would expect to be present in the patient with RA include
- A. polycythemia.
- B. increased immunoglobulin G (IgG).
- C. decreased white blood cell (WBC) count.
- D. anti-citrullinated protein antibody (ACPA).
Correct Answer: D
Rationale: ACPA is specific to RA.
An elderly patient presents with a right-sided headache and acute loss of vision on the same side. Tenderness is noted to the right temporal region as well as to the scalp. To obtain a definitive diagnosis, the nurse practitioner will order:
- A. Erythrocyte sedimentation rate (ESR)
- B. C-reactive protein (CRP)
- C. Temporal artery biopsy
- D. CT scan of the head
Correct Answer: C
Rationale: The correct answer is C: Temporal artery biopsy. This is the gold standard for diagnosing giant cell arteritis, which presents with symptoms such as headache, vision loss, and tenderness to the temporal region and scalp. The biopsy will show characteristic inflammatory changes in the artery wall.
A: ESR and B: CRP are nonspecific markers of inflammation and can be elevated in various conditions, including giant cell arteritis, but they do not provide a definitive diagnosis.
D: CT scan of the head may show signs of inflammation in the temporal artery, but it is less sensitive than a biopsy for diagnosing giant cell arteritis.
A college student observes a roommate going out wearing uncharacteristically seductive clothing, returning 12 to 24 hours later, and then sleeping for 8 to 12 hours. At other times, the roommate sits on the floor speaking like a young child. Which health problem should be considered?
- A. Functional neurological (conversion) disorder
- B. Dissociative identity disorder
- C. Dissociative amnesia
- D. Body dysmorphic disorder
Correct Answer: B
Rationale: The correct answer is B: Dissociative identity disorder. The roommate displaying different behaviors indicates potential dissociation, where different identities or states of consciousness take control. Seductive clothing and extended absence may indicate a different identity, while childlike speech may suggest another identity. This pattern aligns with the criteria for dissociative identity disorder. Functional neurological disorder (Choice A) involves physical symptoms without a clear organic cause. Dissociative amnesia (Choice C) pertains to memory loss due to psychological trauma. Body dysmorphic disorder (Choice D) involves obsession with perceived flaws in physical appearance. These options do not align with the diverse behaviors and identity shifts observed in the roommate.