Nokea
A client diagnosed with multiple sclerosis has an acute onset of visual changes, fatigue, and leg weakness. The client says that the last time this happened, recovery occurred in a few weeks. Which classification of multiple sclerosis is the client experiencing?
- A. Progressive-relapsing
- B. Secondary-progressive
- C. Relapsing-remitting
- D. Primary-progressive
Correct Answer: C
Rationale: Relapsing-remitting MS is characterized by periods of exacerbation followed by partial or complete recovery. This pattern matches the client's description of their symptoms.
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Why does a nurse position a patient with an above-the-knee amputation with a delayed prosthetic fitting prone several times a day?
- A. To prevent flexion contractures
- B. To assess the posterior skin flap
- C. To reduce edema in the residual limb
- D. To relieve pressure on the incision site
Correct Answer: A
Rationale: Prone positioning prevents contractures.
The patient who has right homonymous hemianopia and right hemiparesthesia would indicate his awareness of his safety self-promotion by
- A. keeping frequently used objects on his left side
- B. asking his visitors to approach him from his affected side
- C. frequently checking the position of the affected extremities in space
- D. adhering to one-handed activities
Correct Answer: A
Rationale: Placing objects on the unaffected side ensures visibility.
With regard to nystagmus:
- A. caloric nystagmus occurs when iced water is poured into the ear
- B. vestibular nystagmus occurs as a consequence of head rotation
- C. optokinetic nystagmus occurs as a consequence of the relative motion of the visual field
- D. all above
Correct Answer: D
Rationale: Caloric, vestibular, and optokinetic nystagmus are all types of nystagmus caused by specific stimuli, such as temperature changes, head rotation, or visual field motion.
The 45-year-old client is diagnosed with primary progressive multiple sclerosis and the nurse writes the nursing diagnosis 'anticipatory grieving related to progressive loss.' Which intervention should be implemented?
- A. Consult the physical therapist for assistive devices for mobility.
- B. Determine if the client has a legal power of attorney.
- C. Ask if the client would like to talk to the hospital chaplain.
- D. Discuss the client's wishes regarding end-of-life care.
Correct Answer: D
Rationale: Discussing end-of-life care is crucial for clients with progressive diseases like MS, as it helps them plan for the future and express their wishes.
Which of the following organisms causes epidemic meningitis cases at college campuses?
- A. Haemophilus influenzae type b
- B. Neisseria meningitidis
- C. Streptococcus pneumoniae
- D. Listeria monocytogenes
Correct Answer: B
Rationale: The correct answer is B: Neisseria meningitidis. This bacterium is a common cause of epidemic meningitis in college campuses due to person-to-person transmission, especially in crowded living spaces. It has a polysaccharide capsule that helps evade the immune system, leading to severe infections. Haemophilus influenzae type b, Streptococcus pneumoniae, and Listeria monocytogenes can also cause meningitis but are not typically associated with college campus epidemics.