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NUR 265 / NUR265 Exam 4 Galen
Advanced Concepts of Medical
Surgical Nursing | Questions &
Answers with Rationales | Grade A
Exam Structure:
Subject: Nursing / Advanced Medical-Surgical Nursing, Autoimmune Disorders,
Infectious Diseases, Oncology, Emergency/Triage
Source: NUR 265 Galen
Format: Key Concept Questions with Answers and Rationales
Autoimmune and Connective Tissue Disorders
1. What is the hallmark sign of Lupus (Systemic Lupus
Erythematosus)?
Answer: Butterfly rash on the face.
Rationale:
1. The malar (butterfly) rash across the cheeks and nose is a classic
cutaneous manifestation of SLE.
2. It is photosensitive and appears in approximately 50% of patients.
2. What indicates a Lupus flare?
Answer: Fever and fatigue.
Rationale:
1. Systemic symptoms like fever and fatigue often precede or
accompany disease exacerbations.
2. Patients should be educated to report these early signs promptly.
3. What are nursing interventions for a patient with Lupus?
Answer: Falls precautions; treat pain with Tylenol and NSAIDs (monitor
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kidney function); AVOID SUNLIGHT; REPORT FLARE IMMEDIATELY; clean
skin with mild soap, pat dry, and apply lotion.
Rationale:
1. Photosensitivity is common; sun exposure triggers flares.
2. NSAIDs require renal monitoring due to potential nephritis.
3. Skin care prevents breakdown from rashes.
4. What is the medical management for Lupus?
Answer: Hydroxychloroquine (anti-malarial) decreases absorption of UV
light.
Rationale:
1. Hydroxychloroquine is first-line for mild-moderate SLE, reducing
skin and joint symptoms.
2. It modulates the immune response and has photoprotective effects.
5. What is Scleroderma?
Answer: An inflammatory, autoimmune connective tissue disease.
Rationale:
1. Characterized by fibrosis of skin and internal organs.
2. Results from excessive collagen deposition.
6. What is the hallmark sign of Scleroderma?
Answer: Hard, leather-like edematous skin. Late: esophageal dysmotility.
Rationale:
1. Skin becomes thickened, tight, and shiny.
2. Esophageal involvement causes dysphagia and reflux.
7. What should the nurse assess in a patient with Scleroderma?
Answer: Swallow safety (esophageal dysmotility → aspiration risk); O2
circulation; skin.
Rationale:
1. Aspiration pneumonia is a major risk due to dysphagia.
2. Skin assessment monitors progression and breakdown.
8. What are interventions for Scleroderma?
Answer: Aspiration precautions (keep HOB at 60 degrees during and after
meals); skin protection measures; small frequent meals; avoid caffeine,
alcohol, spices, and pepper.
Rationale:
1. Upright positioning reduces reflux and aspiration.
2. Dietary modifications decrease esophageal irritation.
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Chronic Pain Disorders
9. What are signs and symptoms of Fibromyalgia?
Answer: Extreme fatigue, GI symptoms, dysuria, blurred vision,
forgetfulness.
Rationale:
1. Fibromyalgia is characterized by widespread pain and associated
multisystem symptoms.
2. Cognitive dysfunction ("fibro fog") is common.
10. What should the nurse assess in a patient with Fibromyalgia?
Answer: Pain level, extreme fatigue, GI symptoms.
Rationale:
1. Pain assessment guides treatment effectiveness.
2. Fatigue and GI symptoms impact quality of life and require
management.
11. What are interventions for Fibromyalgia?
Answer: NSAIDs; Neurontin (gabapentin); Lyrica (pregabalin); SNRIs and
tricyclic antidepressants (amitriptyline); promote sleep and low-impact
exercise (stretching, walking, swimming, rowing, water exercise).
Rationale:
1. Pharmacologic management targets neuropathic pain and sleep
disturbance.
2. Low-impact exercise maintains function without exacerbating pain.
Tick-Borne Illnesses
12. What is the hallmark sign of Lyme Disease?
Answer: Stage 1: "Bulls eye rash" and flu-like symptoms. Stage 2: facial
paralysis, carditis, meningitis.
Rationale:
1. Erythema migrans rash is pathognomonic for early Lyme.
2. Disseminated disease affects neurological and cardiac systems.
13. What should the nurse assess in a patient with suspected Lyme
Disease?
Answer: Skin; history of tick bites.
Rationale:
1. Rash identification is key to early diagnosis.
2. Exposure history supports clinical suspicion.
NUR 265 / NUR265 Exam 4 Galen
Advanced Concepts of Medical
Surgical Nursing | Questions &
Answers with Rationales | Grade A
Exam Structure:
Subject: Nursing / Advanced Medical-Surgical Nursing, Autoimmune Disorders,
Infectious Diseases, Oncology, Emergency/Triage
Source: NUR 265 Galen
Format: Key Concept Questions with Answers and Rationales
Autoimmune and Connective Tissue Disorders
1. What is the hallmark sign of Lupus (Systemic Lupus
Erythematosus)?
Answer: Butterfly rash on the face.
Rationale:
1. The malar (butterfly) rash across the cheeks and nose is a classic
cutaneous manifestation of SLE.
2. It is photosensitive and appears in approximately 50% of patients.
2. What indicates a Lupus flare?
Answer: Fever and fatigue.
Rationale:
1. Systemic symptoms like fever and fatigue often precede or
accompany disease exacerbations.
2. Patients should be educated to report these early signs promptly.
3. What are nursing interventions for a patient with Lupus?
Answer: Falls precautions; treat pain with Tylenol and NSAIDs (monitor
, 2|Page
kidney function); AVOID SUNLIGHT; REPORT FLARE IMMEDIATELY; clean
skin with mild soap, pat dry, and apply lotion.
Rationale:
1. Photosensitivity is common; sun exposure triggers flares.
2. NSAIDs require renal monitoring due to potential nephritis.
3. Skin care prevents breakdown from rashes.
4. What is the medical management for Lupus?
Answer: Hydroxychloroquine (anti-malarial) decreases absorption of UV
light.
Rationale:
1. Hydroxychloroquine is first-line for mild-moderate SLE, reducing
skin and joint symptoms.
2. It modulates the immune response and has photoprotective effects.
5. What is Scleroderma?
Answer: An inflammatory, autoimmune connective tissue disease.
Rationale:
1. Characterized by fibrosis of skin and internal organs.
2. Results from excessive collagen deposition.
6. What is the hallmark sign of Scleroderma?
Answer: Hard, leather-like edematous skin. Late: esophageal dysmotility.
Rationale:
1. Skin becomes thickened, tight, and shiny.
2. Esophageal involvement causes dysphagia and reflux.
7. What should the nurse assess in a patient with Scleroderma?
Answer: Swallow safety (esophageal dysmotility → aspiration risk); O2
circulation; skin.
Rationale:
1. Aspiration pneumonia is a major risk due to dysphagia.
2. Skin assessment monitors progression and breakdown.
8. What are interventions for Scleroderma?
Answer: Aspiration precautions (keep HOB at 60 degrees during and after
meals); skin protection measures; small frequent meals; avoid caffeine,
alcohol, spices, and pepper.
Rationale:
1. Upright positioning reduces reflux and aspiration.
2. Dietary modifications decrease esophageal irritation.
, 3|Page
Chronic Pain Disorders
9. What are signs and symptoms of Fibromyalgia?
Answer: Extreme fatigue, GI symptoms, dysuria, blurred vision,
forgetfulness.
Rationale:
1. Fibromyalgia is characterized by widespread pain and associated
multisystem symptoms.
2. Cognitive dysfunction ("fibro fog") is common.
10. What should the nurse assess in a patient with Fibromyalgia?
Answer: Pain level, extreme fatigue, GI symptoms.
Rationale:
1. Pain assessment guides treatment effectiveness.
2. Fatigue and GI symptoms impact quality of life and require
management.
11. What are interventions for Fibromyalgia?
Answer: NSAIDs; Neurontin (gabapentin); Lyrica (pregabalin); SNRIs and
tricyclic antidepressants (amitriptyline); promote sleep and low-impact
exercise (stretching, walking, swimming, rowing, water exercise).
Rationale:
1. Pharmacologic management targets neuropathic pain and sleep
disturbance.
2. Low-impact exercise maintains function without exacerbating pain.
Tick-Borne Illnesses
12. What is the hallmark sign of Lyme Disease?
Answer: Stage 1: "Bulls eye rash" and flu-like symptoms. Stage 2: facial
paralysis, carditis, meningitis.
Rationale:
1. Erythema migrans rash is pathognomonic for early Lyme.
2. Disseminated disease affects neurological and cardiac systems.
13. What should the nurse assess in a patient with suspected Lyme
Disease?
Answer: Skin; history of tick bites.
Rationale:
1. Rash identification is key to early diagnosis.
2. Exposure history supports clinical suspicion.
