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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.
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A patient with Guillain-Barr?© syndrome has experienced a sharp decline in vital capacity. What is the nurse's most appropriate action?
- A. Administer bronchodilators as ordered.
- B. Remind the patient of the importance of deep breathing and coughing exercises.
- C. Prepare to assist with intubation.
- D. Administer supplementary oxygen by nasal cannula.
Correct Answer: C
Rationale: A sharp decline in vital capacity in Guillain-Barr?© syndrome indicates respiratory muscle weakness, necessitating preparation for intubation to ensure adequate oxygenation. Bronchodilators and oxygen are insufficient, and breathing exercises may be impossible.
A patient diagnosed with myasthenia gravis has been hospitalized to receive plasmapheresis for a myasthenic exacerbation. The nurse knows that the course of treatment for plasmapheresis in a patient with myasthenia gravis is what?
- A. Every day for 1 week
- B. Determined by the patient's response
- C. Alternate days for 10 days
- D. Determined by the patient's weight
Correct Answer: B
Rationale: Plasmapheresis frequency in myasthenia gravis depends on clinical response, typically daily or alternate days until improvement. Fixed schedules or weight-based dosing are not standard.
A nurse is planning the care of a 28-year-old woman hospitalized with a diagnosis of myasthenia gravis. What approach would be most appropriate for the care and scheduling of diagnostic procedures for this patient?
- A. All at one time, to provide a longer rest period
- B. Before meals, to stimulate her appetite
- C. In the morning, with frequent rest periods
- D. Before bedtime, to promote rest
Correct Answer: C
Rationale: Scheduling procedures in the morning with rest periods minimizes fatigue in myasthenia gravis, where muscle weakness worsens with activity. Other timings risk exhaustion or poor appetite.
The nurse is caring for a patient who is hospitalized with an exacerbation of MS. To ensure the patient's safety, what nursing action should be performed?
- A. Ensure that suction apparatus is set up at the bedside.
- B. Pad the patient's bed rails.
- C. Maintain bed rest whenever possible.
- D. Provide several small meals each day.
Correct Answer: A
Rationale: MS exacerbations increase aspiration risk due to dysphagia, so suction apparatus at the bedside is critical for safety. Bed rest should be minimized, and padding or small meals are not priority.
A patient with MS has developed dysphagia as a result of cranial nerve dysfunction. What nursing action should the nurse consequently perform?
- A. Arrange for the patient to receive a low residue diet.
- B. Position the patient upright during feeding.
- C. Suction the patient following each meal.
- D. Withhold liquids until the patient has finished eating.
Correct Answer: B
Rationale: Upright positioning during feeding reduces aspiration risk in MS-related dysphagia. Low-residue diets, routine suctioning, and withholding liquids are not indicated.