EAQ Multiple Sclerosis

Which statement by the patient diagnosed with multiple sclerosis indicates a need for further teaching? "I will try to use stress-management techniques." "I will stay away from people who have infections." "If my muscles are feeling tired, I will take a hot bath." "I will alternate an eye patch from side to side when I have diplopia."

"If my muscles are feeling tired, I will take a hot bath."

Which statement by the patient newly diagnosed with multiple sclerosis (MS) indicates a correct understandings of the pathophysiology of the disease? "I can expect to die at an early age." "Parts of my nervous system have plaques." "I will have gradual deterioration with no healthy times." "This was caused by getting too many x-rays as a child."

"Parts of my nervous system have plaques." Rationale: The patient with MS has no decrease in life expectancy. Frequent times of remission are common in patients with MS. There is no known cause for MS.

The nurse is teaching a patient about multiple sclerosis. Which statement by the patient indicates a need for further teaching? "There's a good chance multiple sclerosis is related to viruses." "People in colder climates are more prone to developing multiple sclerosis." "People with Asian ancestry are more likely to get multiple sclerosis." "I am at higher risk for developing multiple sclerosis if my mother had it."

"People with Asian ancestry are more likely to get multiple sclerosis."

A patient diagnosed with multiple sclerosis is getting ready to be discharged home. Which action would the nurse ensure is completed before the patient is discharged? Suggest referral to a rehabilitation center. Ensure that the patient has home adaptive equipment. Assess the patient's home for hazards. Ask the patient's family what assistance they can provide.

Assess the patient's home for hazards.

Which treatment would the nurse recommend to relieve diplopia in a patient diagnosed with multiple sclerosis? Use corrective lenses as prescribed. Ensure adequate sleep and rest periods. Alternate an eye patch from eye to eye every few hours. Use scanning techniques by moving the head from side to side.

Alternate an eye patch from eye to eye every few hours.

A patient diagnosed with multiple sclerosis is having difficulty emptying the bladder. Which action would the nurse take first? Assess the patient for urinary infection. Encourage bladder training methods. Discuss the use of a bladder pacemaker. Teach the patient straight catheterization.

Asses the patient for urinary infection.

Which information would the nurse provide to a patient receiving interferon-beta? Avoid crowds. Rotate the injection sites. Report signs of facial flushing. Stop taking the drug if seizures occur. Check pulse within 6 hours of taking medication

Avoid crowds. Rotate the injection sites.

The nurse reviews the health history of a patient diagnosed with multiple sclerosis. Which assessment finding would be consistent with the report of the patient developing scotomas? Double vision Intention tremors Decreased peripheral vision Involuntary eye movements

Decreased Peripheral Vision

A patient diagnosed with multiple sclerosis is having issues with bowel and bladder. Which complication would the nurse suspect is causing the issues? Cerebellar inhibition Disruption of the cranial nerves Demyelination of the spinal cord Excitability of the white fiber tracks

Demyelination of the Spinal Cord

Which ocular or vision-related finding is a complication of multiple sclerosis (MS)? Diplopia Scotomas Glaucoma Nystagmus Dry eye

Diplopia Scotomas Nystagmus

A patient with multiple sclerosis who is receiving drug therapy develops severe disability. A cerebrospinal fluid examination and MRI indicate progressive multifocal leukoencephalopathy (PML). Which change in therapy would the nurse anticipate for this patient? Administering natalizumab orally Co-administering fingolimod with natalizumab Co-administering mitoxantrone with natalizumab Discontinuing natalizumab administration

Discontinuing Natalizumab administration

A patient diagnosed with multiple sclerosis has slurred speech. Which term would the nurse use for this speech pattern? Scanning Dysmetria Dysarthria Scotomas

Dysarthria

Which laboratory finding is consistent with a diagnosis of multiple sclerosis? Positive protein in the urine Elevated protein in the cerebrospinal fluid Immunoglobulins in the cerebrospinal fluid Elevated albumin levels in the peripheral blood sample Decreased white blood cell count in peripheral blood sample

Elevated protein in the cerebrospinal fluid Immunoglobulins in the cerebrospinal fluid

For which finding would the nurse when a patient is taking teriflunomide? Diplopia Dysarthria Tachycardia Facial flushing GI disturbances

Facial Flushing GI disturbances

Which assessment finding would the nurse anticipate for a patient with an acute exacerbation of multiple sclerosis? Fatigue Hypertension Double vision Muscle spasms Negative Babinski reflex

Fatigue Double Vision Muscle Spasms

Which finding is an early indicator of multiple sclerosis? Impaired memory Hypoalgesia Inattentiveness Decreased visual acuity Stiffness of the extremities

Hypoalgesia Decreased visual acuity Stiffness of the extremities Rationale: Changes in cognition are seen later in multiple sclerosis.

Which type of drug would the nurse expect to administer as part of the treatment plan for a patient with relapsing multiple sclerosis (MS)? Antispasmotic Immunomodulator Calcium channel blocker Penicillin-based antibiotc

Immunomodulator

Which type of medication would the nurse expect will be prescribed for an adult male patient who has multiple sclerosis (MS)? Antibiotic Immunomodulator Stool softener Muscle relaxant Prostaglandin-5 inhibitor

Immunomodulator Stool softener Muscle relaxant Prostaglandin-5 inhibitor

Which immunomodulator drug is used in the treatment of multiple sclerosis? Cyclosporine Methotrexate Methylprednisone Interferon beta-1b

Interferon beta-1b Rationale: Cyclosporine and methotrexate are immunosuppressants. Methylprednisone is a corticosteroid with antivirus properties that is used in the treatment of multiple sclerosis.

Which recommendation would the nurse make for decreasing fatigue in a patient with multiple sclerosis (MS)? Avoid aerobic exercise. Have group activities together. Take hot showers daily. Keep frequently used items accessible.

Keep frequently used items accessible Rationale: Aerobic exercise in moderation is useful in decreasing fatigue because it will help maintain conditioning. Avoiding it altogether promotes deconditioning and can worsen fatigue. Activities should be spaced apart, not grouped together. Hot showers or baths should be avoided because they may exacerbate symptoms.

Which diagnostic tool would the nurse expect to be used to confirm a patient's diagnosis of multiple sclerosis (MS)? Recent blood tests Physical assessment Abnormal cerebrospinal fluid MRI

MRI

Which statement about multiple sclerosis (MS) is accurate? MS affects more men than women. MS usually occurs in people older than 50 years. MS is seen more often in warmer climates. MS occurs more frequently among whites than other races.

MS occurs more frequently among whites than other races. Rationale: Women are affected twice as often as men. Though MS may occur in people over 50 years, it usually affects people between 20 and 40 years of age. There is a higher incidence in the colder climates of the Northeastern states, the Great Lakes, Pacific Northwestern states, and Canada.

Which antineoplastic drug has been shown to effectively reduce neurologic disability in patients with multiple sclerosis? Fingolimob Cyclosporine Mitoxantrone Methootrexate

Mitoxantrone Rationale: Fingolimod was the first oral immunomodulator. Cyclosporine and methotrexate are immunosuppressants.

A patient with multiple sclerosis will begin therapy with fingolimod. Which instruction would the nurse give the patient about this drug? Monitor the pulse daily. Report symptoms of vertigo. Report symptoms of flushing. Monitor daily fingerstick blood sugar.

Monitor the pulse daily. Rationale: The medication can cause bradycardia, especially within the first 6 hours of taking it.

Which disease is characterized by remissions and exacerbations of symptoms causing neurological disability? Spinal shock Multiple sclerosis Spinal cord tumor Amyotrophic lateral sclerosis (ALS)

Multiple Sclerosis

For which complication would the nurse evaluate the patient with multiple sclerosis? Ulcerations at the ends of the fingers and toes Cyanosis in extremities Muscle stiffness or spasms Paralysis, typically in the legs Problems with bladder, bowel, or sexual functioning

Muscle stiffness or spasms Paralysis, typically in the legs Problems with bladder, bowel, or sexual functioning

The patient reports progressive fatigue, muscle weakness, and diplopia that has worsened during the past 6 months. An MRI reveals the presence of plaques on the brain and spinal cord. Which diagnosis would the nurse anticipate? Primary progressive multiple sclerosis Relapsing-remitting multiple sclerosis Secondary progressive multiple sclerosis Progressive-relapsing multiple sclerosis

Primary Progressive Multiple Sclerosis Rationale: Involves a steady, gradual neurological deterioration with plaques on the brain and spinal cord.

Which type of multiple sclerosis (MS) involves steady and gradual neurological deterioration with remission of the symptoms? Relapsing-remitting multiple sclerosis (RRMS) Primary progressive multiple sclerosis (PPMS) Progressive relapsing multiple sclerosis (PRMS) Secondary progressive multiple sclerosis (SPMS)

Primary Progressive Multiple Sclerosis (PPMS) Rationale: Relapsing-Remitting Multiple Sclerosis (development and resolution of symptoms within the span of a few weeks to a few months. Progressive Relapsing Multiple Sclerosis (frequent relapses with partial recovery without the patient returning to the baseline) Secondary Progressing Multiple Sclerosis (relapsing remitting course that later becomes steadily progressive

The nurse teaches a patient with multiple sclerosis (MS) how to reduce fatigue. Which recommendation would the nurse provide? Take a hot bath. Avoid naps during the day. Rest in a cool room. Increase the dose of muscle relaxants.

Rest in a cool room.

A patient diagnosed with relapsing-remitting multiple sclerosis (MS) now reports that symptoms have become steadily progressive with no return to baseline. Which form of MS would the nurse suspect that the patient is experiencing? Primary progressive MS Secondary progressive MS Progressive-relapsing MS Relapsing-remitting MS Relapsing-remitting MS exacerbation

Secondary Progressive MS Rationale: Secondary progressive MS begins with relapsing-remitting MS and later becomes steadily progressive.

Which medication may be prescribed for a patient with multiple sclerosis who is experiencing erectile dysfunction? Sildenafil Methotrexate Magnesium oxide Methylprednisone

Sildenafil

Which health care team member referral would the nurse recommend for a patient experiencing dysarthria? Urologist Physical therapist Occupational therapist Speech-language pathologist (SLP)

Speech-Language Pathologist (SLP)

Which recommendation would the nurse give to a patient diagnosed with multiple sclerosis who is trying to manage fatigue? Taking rest periods Keeping frequently used items nearby Taking mitoxantrone Engaging in aerobic exercise Grouping all daily activities together

Taking rest periods Keeping frequently used items nearby Engaging in aerobic exercise

Which finding is consistent with a diagnosis of multiple sclerosis? Vertigo Tinnitus Dysmetria Intention tremor Dysarthria

Vertigo Tinnitus Dysmetria Intention tremor Dysarthria

Which finding would the nurse expect when assessing a 30-year-old patient diagnosed with multiple sclerosis (MS)? Vision changes Flaccid muscles Tremors at rest Absent deep tendon reflexes

Vision Changes Rationale: Vision changes such as diplopia, nystagmus, and blurred vision are symptoms of MS.

Which findings would the nurse expect when assessing a patient admitting with multiple sclerosis (MS)? Vision changes Difficulty walking Generalized seizures Numbness in extremities Urinary bladder dysfunction

Vision changes Difficulty walking Numbness in extremities Urinary bladder dysfunction

Which lab value would the nurse monitor in patients taking oral immunomodulating drugs? Platelets Potassium Hemoglobin White blood cells

White Blood Cells

The daughter of a patient diagnosed with multiple sclerosis expresses concern over the patient's inappropriate behavior in social situations. Which response would the nurse provide? "It may be important to avoid taking your parent into social situations." "We can talk about medication to help with the behavior." "Unfortunately, this is part of the disease process and will likely get worse." "You can develop a cue to alert your parent to modify actions."

"You can develop a cue to alert your parent to modify actions."

The patient with multiple sclerosis is experiencing cognitive impairment. Which intervention would the nurse recommend for home care? Teaching the patient how to self-catheterize Referring the patient to a speech pathologist Educating the patient to keep medications in a familiar place Suggesting that the patient place a monthly calendar in a visible location.

Educating the patient to keep medications in a familiar place

Which intervention would the nurse plan for a patient diagnosed with multiple sclerosis who is experiencing cognitive impairment? Encourage the use of written lists. Teach the use of a monthly calendar. Teach about the use of antidepressants. Discourage the use of electronic devices.

Encourage the use of written lists. Rationale: Cognitive impairment is a late sign of multiple sclerosis. The use of written lists can help reorient a patient. Monthly calendars are not recommended; daily calendars are. Antidepressants may be used to treat paresthesias in early multiple sclerosis. Patients can use electronic devices for cues and reminders.

Which treatment can provide relief from tremors in a patient with multiple sclerosis? Exercise program Thalamotomy Carbamazepine Cyclophosphamide Amantadine hydrochloride

Exercise Program Thalamotomy Rationale: Carbamazepine is used to treat paresthesia. Cyclophosphamide is immunosuppressant therapy. Amantadine hydrochloride is used to treat fatigue.

The nurse teaches a patient who is newly diagnosed with multiple sclerosis (MS) about the disease. Which characteristic of MS would the nurse explain to the patient? Drooping eyelids Problems chewing Exacerbation and remissions Demineralization of the neurons Breakdown in communication between nerves and muscles Chronic degenerative disease of the central nervous system

Problems chewing Exacerbation and remissions Demineralization of the neurons Chronic degenerative disease of the central nervous system Rationale: Drooping eyelids and the breakdown in communication between nerves and muscles are characteristic of myasthenia gravis, not MS.