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SYSTEMIC LUPUS ERYTHEMATOSUS (NURSING) NCLEX
QUESTIONS 2026 EXAM
- Which statements below are INCORRECT about Systemic Lupus Erythematosus? Select all that apply: A. Lupus mainly affects Black, Asian, and Hispanic men. B. Lupus is a chronic condition that has periods of flare-ups and remission. C. The joints and skin are rarely affected in lupus. D. Systemic Lupus Erythematosus (SLE) is the most common form of lupus. The answers are A and C. Options B and D are correct statements about lupus. Option A is wrong because lupus mainly affects Black, Asian, and Hispanic WOMEN (not men). Option C is wrong because lupus DOES affect the joints and
skin along with many other systems of the body (heart, lungs, kidneys, blood system, brain etc.).
- What is the name of the process in the body that is responsible for the death of a cell? A. Mitosis B. Osmosis C. Apoptosis D. Meiosis The answer is C: Apoptosis. In lupus, this process is not occurring effectively, specifically the phagocytosis of the apoptotic bodies.
- During the death process of a cell, which immune system cell is responsible for ingesting the fragments of the dying cell?
A. The phagocytosis process is not occurring properly, which causes the nuclear material inside the dying cell to be seen as a foreign invader and antinuclear antibodies are created. B. During cell death the nucleus of the cell fails to condense, which leads to the development of autoantibodies. C. Immune complexes form and attach within the structures of important organs, joints, and tissues, and this causes inflammation. D. Neutrophil activity is decreased and this causes B-cells to attack phagocytes and nuclear material within the cells, which leads to the activation of the complement cascade system and inflammation. The answers are A and C. These are correct statements about the pathogenesis of SLE. In a nutshell, apoptosis is ineffective (specifically how the macrophages/phagocytes consume the fragmented parts of the dying cell during apoptosis). These fragmented parts of the dying cell are not consumed (either the consumption by the macrophages is too slow or they are not consumed), and the nuclear material inside the small bodies spill into the extracellular space. The immune system recognizes this as an antigen “antinuclear antigens” and forms antinuclear antibodies to attack them. The antibodies attack the antigens and form immune complexes. These immune complexes now start to “float” around
in the body and get stuck in various organs, joints, and tissues. This leads to the activation of the complement system and causes inflammation. This inflammation damages the structure (hence the organs/tissues/joint)s.
- A patient is diagnosed with Systemic Lupus Erythematous (SLE). You note the patient has a red rash that starts on the nose and expands onto the cheeks of the face. This is known as what type of rash? A. Discoid B. Malar C. Miliaria D. Eczema The answer is B: Malar (it’s also called a butterfly rash).
- A patient with Systemic Lupus Erythematous (SLE) takes the medication Azathioprine. Which statement by the patient requires re-education?
- A patient is undergoing testing for the evaluation of Systemic Lupus Erythematous. What lab findings below are associated with this condition? Select all that apply: A. Decreased ESR and CRP B. Positive ANA C. Positive Anti-dsDNA D. Negative Anti-Sm E. Low C3 and C The answers are B, C, and E. A positive ANA (anti-nuclear antibodies) demonstrates there are autoantibodies the body created against the nuclei of the dying cells (almost all patient with lupus will have a positive ANA), but these anti- nuclear antibodies can also be present with other autoimmune disorders. A positive anti-dsDNA (anti-double stranded DNA anti-body) is a particular anti- nuclear antibody found in some patients with lupus and is not typically present in patients who don’t have lupus. An INCREASE in ESR and CRP would be found in a
patient with lupus (especially during a flare) along with a POSITIVE Anti-Sm antibody (which is a particular antibody found in the nucleus that is present in lupus).
- A patient with Systemic Lupus Erythematosus is experiencing a complication called Lupus Nephritis. What are some signs and symptoms that correlate with this complication of SLE? Select all that apply: A. Decreased Creatinine B. Increased BUN C. 48 hour urinary output of 720 mL D. Proteinuria E. Weight loss F. Edema in upper and lower extremities
inflammation quickly, are not for long-term usage, and can lead to weight gain, susceptibility to infection, diabetes, and osteoporosis.
- A patient with Systemic Lupus Erythematosus is prescribed Hydroxychloroquine. Select all the educational points you will include in the patient’s education about this medication: Discover more Blood Pressure Monitors Nursing care plan templates Medical equipment rentals A. Hydroxychloroquine is considered a Biologic medication. B. It is used long-term to help prevent flares. C. This medication doesn’t produce results immediately. Therefore, the patient may not see results for a couple of months. D. This medication binds with a protein that supports the activity of B-cells, which decreases the activity of B-cells.
E. The patient must have their eyes checked regularly to monitor the retina while taking this medication. The answers are B, C, and E. Hydroxychloroquine is an antimalarial medication. It decreases antibodies attacking the body (option D describes a biologic like Belimumab). If used long-term it can damage the retinas of the eyes (the patient needs a minimum of 1 eye exam per year while taking this med). It also takes a couple of months to start working.
- A patient is prescribed Belimumab for treatment of lupus. The patient has been taking the medication for one month. Which finding below during a patient assessment requires further evaluation? A. The patient reports trouble sleeping and loss of energy. B. The patient declines a flu shot via the intranasal route. C. The patient says they have not noticed a change in symptoms.
C. 6 months D. 1 year The answer is C. Women with lupus, who want to become pregnant, need to make sure their lupus has been in control (hence remission….no flare-ups) for at least 6 months before conceiving. This is because there is a risk of miscarriage and clotting issues. Pregnancy and the post-partum period can cause flares.
- You’re providing education to a Systemic Lupus Erythematosus support group about preventing flares. Which statement by a participant requires re-education about this topic? A. “Emotional stress and illness are triggers for a flare-up.” B.”I always wear large-brimmed hats and long sleeves when I’m outside.” C. “Exercise should be avoided due to the physical stress it causes on the body.”
D. “I will make it priority to receive my yearly influenza vaccine. The answer is C. Exercise is a very important step in preventing lupus flares. It helps maintain joint stability and manages weight. Exercise should not be limited but encouraged to as much as the patient can tolerate. Remember LESS for less flares: Lower stress (avoid overworking, emotional, illness, and use techniques to have prevent stress), Exercise (helps joints and manages weight), Sleep (need more than 8 hours to prevent the body from getting too exhausted), Sun Protection (sunscreen and large-brimmed hats…sunlight can activate a flare).
