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A 73-year-old man comes to the clinic complaining of weakness and loss of sensation in his feet and legs. Assessment of the patient shows decreased reflexes bilaterally. Why would it be a challenge to diagnose a peripheral neuropathy in this patient?
- A. Older adults are often vague historians.
- B. The elderly have fewer peripheral nerves than younger adults.
- C. Many older adults are hesitant to admit that their body is changing.
- D. Many symptoms can be the result of normal aging process.
Correct Answer: D
Rationale: Symptoms like decreased reflexes in peripheral neuropathy can mimic normal aging, complicating diagnosis. Older adults do not necessarily have fewer nerves or withhold information.
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A patient diagnosed with MS has been admitted to the medical unit for treatment of an MS exacerbation. Included in the admission orders is baclofen (Lioresal). What should the nurse identify as an expected outcome of this treatment?
- A. Reduction in the appearance of new lesions on the MRI
- B. Decreased muscle spasms in the lower extremities
- C. Increased muscle strength in the upper extremities
- D. Decreased severity and duration of exacerbations
Correct Answer: B
Rationale: Baclofen reduces muscle spasms in MS by acting as a GABA agonist. It does not affect MRI lesions, upper extremity strength, or exacerbation duration.
The nurse is working with a patient who is newly diagnosed with MS. What basic information should the nurse provide to the patient?
- A. MS is a progressive demyelinating disease of the nervous system.
- B. MS usually occurs more frequently in men.
- C. MS typically has an acute onset.
- D. MS is sometimes caused by a bacterial infection.
Correct Answer: A
Rationale: MS is a chronic, progressive demyelinating disease of the central nervous system. It affects women more than men, has a gradual onset, and is not caused by bacterial infection.
You are the clinic nurse caring for a patient with a recent diagnosis of myasthenia gravis. The patient has begun treatment with pyridostigmine bromide (Mestinon). What change in status would most clearly suggest a therapeutic benefit of this medication?
- A. Increased muscle strength
- B. Decreased pain
- C. Improved GI function
- D. Improved cognition
Correct Answer: A
Rationale: Pyridostigmine enhances muscle strength in myasthenia gravis by inhibiting acetylcholine breakdown. It does not target pain, GI function, or cognition.
A middle-aged woman has sought care from her primary care provider and undergone diagnostic testing that has resulted in a diagnosis of MS. What sign or symptom is most likely to have prompted the woman to seek care?
- A. Cognitive declines
- B. Personality changes
- C. Contractures
- D. Difficulty in coordination
Correct Answer: D
Rationale: Difficulty in coordination, along with fatigue and weakness, is a common early symptom of MS prompting medical evaluation. Cognitive declines and contractures occur later, and personality changes are not typical.
The nurse is discharging a patient home after surgery for trigeminal neuralgia. What advice should the nurse provide to this patient in order to reduce the risk of injury?
- A. Avoid watching television or using a computer for more than 1 hour at a time.
- B. Use OTC antibiotic eye drops for at least 14 days.
- C. Avoid rubbing the eye on the affected side of the face.
- D. Rinse the eye on the affected side with normal saline daily for 1 week.
Correct Answer: C
Rationale: Surgery may cause sensory loss, making eye rubbing dangerous as pain from injury may not be felt. TV use, antibiotic drops, and saline rinses are not relevant to injury prevention.