WK 5 FONTAINE PREPU

Which of the following is the most common clinical manifestation of multiple sclerosis? a) Ataxia b) Fatigue c) Pain d) Spasticity

b) Fatigue

A nurse is assessing a client diagnosed with multiple sclerosis (MS). Which symptom does the nurse expect to find? a) Vision changes b) Flaccid muscles c) Tremors at rest d) Absent deep tendon reflexes

a) Vision changes

The nurse is caring for a patient with myasthenia gravis. The nurse generates a plan of care for the patient based on which of the following types of hypersensitivity reaction? a) Immune complex b) Delayed c) Anaphylactic d) Cytotoxic

d) Cytotoxic

A patient diagnosed with multiple sclerosis (MS) has ataxia. Which of the following medications could be used to treat this clinical manifestation? a) Neurontin b) Baclofen c) Valium d) Dantrium

a) Neurontin Ataxia is a chronic problem most resistant to treatment. Medications used to treat ataxia include beta-adrenergic blockers (Inderal), antiseizure agents (Neurontin), and benzodiazepines (Klonopin).

The nurse is advising a client with multiple sclerosis on methods to minimize spasticity and contractures. Which of the following techniques would the nurse instruct the client to perform? a) Avoid swimming and any weight-bearing activity. b) Exercise following a circuit training regimen. c) Apply warm packs to the affected area. d) Relax in a hot bath.

c) Apply warm packs to the affected area.

The diagnosis of multiple sclerosis is based on which of the following tests? a) Cerebrospinal fluid (CSF) electrophoresis b) Evoked potential studies c) Magnetic resonance imaging (MRI) d) Neuropsychological testing

c) Magnetic resonance imaging (MRI) The diagnosis of MS is based on the presence of multiple plaques in the CNS observed with MRI.

A nurse is teaching a client who was recently diagnosed with myasthenia gravis. Which statement should the nurse include in her teaching? a) "You'll continue to experience progressive muscle weakness and sensory deficits." b) "You'll need to take edrophonium (Tensilon) to treat the disease." c) "The disease is a disorder of motor and sensory dysfunction." d) "This disease doesn't cause sensory impairment."

d) "This disease doesn't cause sensory impairment."

The nurse is caring for a client hospitalized with a severe exacerbation of myasthenia gravis. When administering medications to this client, what is a priority nursing action? a) Assess client's reaction to new medication schedule. b) Document medication given and dose. c) Give client plenty of fluids with medications. d) Administer medications at exact intervals ordered.

d) Administer medications at exact intervals ordered.

The nurse is caring for a patient with multiple sclerosis (MS). The patient tells the nurse the hardest thing to deal with is the fatigue. When teaching the patient how to reduce fatigue, what action should the nurse suggest? a) Taking a hot bath at least once daily b) Increasing the dose of muscle relaxants c) Resting in an air-conditioned room whenever possible d) Avoiding naps during the day

c) Resting in an air-conditioned room whenever possible

A nurse is caring for a client with multiple sclerosis. Client education about the disease process includes which of the following explanations about the cause of the disorder? a) The immune system recognizes one's own tissues as "foreign." b) Excess cytokines cause tissue damage. c) The immune system recognizes one's own tissues as "self." d) Regulatory mechanisms fail to halt the immune response.

a) The immune system recognizes one's own tissues as "foreign."

Which is a chronic, degenerative, progressive disease of the central nervous system characterized by the occurrence of demyelination in the brain and spinal cord? a) Huntington disease b) Parkinson's disease c) Creutzfeldt-Jakob disease d) Multiple sclerosis (MS)

d) Multiple sclerosis (MS)

A patient has a diagnosis of multiple sclerosis. The nurse is aware that neuromuscular disorders such as multiple sclerosis may lead to a decreased vital capacity. What does vital capacity measure? a) The volume of air inhaled and exhaled with each breath b) The volume of air in the lungs after a maximal inspiration c) The maximal volume of air inhaled after normal expiration d) The maximal volume of air exhaled from the point of maximal inspiration

d) The maximal volume of air exhaled from the point of maximal inspiration

The nurse is assessing a client newly diagnosed with myasthenia gravis. Which of the following signs would the nurse most likely observe? a) Diplopia and ptosis b) Numbness c) Patchy blindness d) Loss of proprioception

a) Diplopia and ptosis

A client is experiencing muscle weakness and an ataxic gait. The client has a diagnosis of multiple sclerosis (MS). Based on these symptoms, the nurse formulates "Impaired physical mobility" as one of the nursing diagnoses applicable to the client. What nursing intervention should be most appropriate to address the nursing diagnosis? a) Help the client perform range-of-motion (ROM) exercises every 8 hours. b) Use pressure-relieving devices when the client is in bed or in a wheelchair. c) Change body position every 2 hours. d) Use a footboard and trochanter rolls.

a) Help the client perform range-of-motion (ROM) exercises every 8 hours.

Which of the following diseases is a chronic, progressive, hereditary disease of the nervous system that results in progressive involuntary dancelike movements and dementia? a) Huntington disease b) Creutzfeldt-Jakob disease c) Multiple sclerosis d) Parkinson's disease

a) Huntington disease

The nurse is completing an assessment on a client with myasthenia gravis. Which of the following historical recounting provides the most significant evidence regarding when the disorder began? a) Muscle spasms b) Shortness of breath c) Sensitivity to bright light d) Drooping eyelids

d) Drooping eyelids

A client with multiple sclerosis is being discharged. The nurse understands that living with chronic conditions imposes many challenges, including the need to accomplish the following. Choose all that apply. a) Validate family functioning b) Validate individual self-worth c) Die without comfort d) Ignore threats to identity e) Alleviate and manage symptoms

• Alleviate and manage symptoms • Validate family functioning • Validate individual self-worth

Which of the following are the most commonly reported clinical manifestations of multiple sclerosis? Select all that apply. a) Aphasia b) Numbness c) Fatigue d) Spasticity e) Depression f) Pain

• Numbness • Pain • Spasticity • Fatigue • Depression

The nursing instructor is teaching the senior nursing class about neuromuscular disorders. When talking about Multiple Sclerosis (MS) what diagnostic finding would the instructor list as being confirmatory of a diagnosis of MS? a) An elevated acetylcholine receptor antibody titer b) Episodes of muscle fasciculations c) Oligoclonal bands d) IV administration of edrophonium

c) Oligoclonal bands

Which of the following is considered a central nervous system (CNS) disorder? a) Myasthenia gravis b) Guillain-Barré c) Bell's palsy d) Multiple sclerosis

d) Multiple sclerosis

A client with multiple sclerosis is learning to perform intermittent self-catherizations of the urinary bladder. The nurse obtains the following equipment for teaching. Select all that apply. a) Syringe with sterile water b) Forceps c) Foley bag d) 16-French catheters e) Anatomically correct model

• Anatomically correct model • 16-French catheters

A nurse is explaining treatment options to a patient diagnosed with an immune dysfunction. Which of the following statements made by the patient accurately reflects the teaching about current stem cell research? a) "Stem cell transplantation has been discontinued based on concerns about safety, efficacy, resource allocation, and human cloning." b) "Currently stem cell transplantation has only been performed in the laboratory, but future research with embryonic stem cell transplants for humans with immune dysfunction has been promising." c) "Stem cell clinical trials have only been attempted in patients with acquired immune deficiencies but plans are underway to begin human cloning using embryonic stem cells." d) "Stem cell transplantation has been carried out in humans with certain types of immune dysfunction and clinical trials using stem cells are underway in patients with a variety of disorders having an autoimmune component."

d) "Stem cell transplantation has been carried out in humans with certain types of immune dysfunction and clinical trials using stem cells are underway in patients with a variety of disorders having an autoimmune component."

A client with respiratory complications of multiple sclerosis (MS) is admitted to the medical-surgical unit. Which equipment is most important for the nurse to keep at the client's bedside? a) Padded tongue blade b) Nasal cannula and oxygen c) Sphygmomanometer d) Suction machine with catheters

d) Suction machine with catheters

The nurse is preparing to provide care for a patient diagnosed with myasthenia gravis. The nurse should know that the signs and symptoms of the disease are the result of what? a) A lower motor neuron lesion b) Genetic dysfunction c) Decreased conduction of impulses in an upper motor neuron lesion d) Upper and lower motor neuron lesions

a) A lower motor neuron lesion

Which of the following is the first-line therapy for myasthenia gravis (MG)? a) Deltasone (Prednisone) b) Pyridostigmine bromide (Mestinon) c) Lioresal (Baclofen) d) Azathioprine (Imuran)

b) Pyridostigmine bromide (Mestinon) (Mestinon, an anticholinesterase medication, is the first-line therapy in MG. It provides symptomatic relief by inhibiting the breakdown of acetylcholine and increasing the relative concentration of available acetylcholine at the neuromuscular junction)

A client with multiple sclerosis is being seen by a neuroophthalmologist for her routine eye exam. The nurse explains to the client that during the examination, she will be asked to fix her gaze on a stationary point while an object is moved from a point on the side, where it can't be seen, toward the center. The client will indicate when she can see the object. The nurse further explains that the test being performed is called a ________. a) retinal angiography b) perimetry test c) slit-lamp examination d) color vision test

b) perimetry test