Nokea
The 30-year-old female client is admitted with complaints of numbness, tingling, a crawling sensation affecting the extremities, and double vision which has occurred two(2) times in the month. Which question is most important for the nurse to ask the client?
- A. Have you experienced any difficulty with your menstrual cycle?
- B. Have you noticed a rash across the bridge of your nose?
- C. Do you get tired easily and sometimes have problems swallowing?
- D. Are you taking birth control pills to prevent conception?
Correct Answer: C
Rationale: Fatigue and swallowing difficulties are common symptoms of MS and can indicate disease progression or exacerbation.
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How many distinct types of multiple sclerosis (MS) are there?
- A. 6
- B. 5
- C. 4
- D. 3
Correct Answer: C
Rationale: Multiple sclerosis (MS) is classified into four main types: relapsing-remitting MS (RRMS), secondary-progressive MS (SPMS), primary-progressive MS (PPMS), and progressive-relapsing MS (PRMS). Each type has distinct patterns of disease progression and symptom presentation.
You are instructing a patient who has multiple sclerosis about how dantrolene (Dantrium) will help control spasticity. Through which of the following pharmacologic actions is this drug effective in treating this manifestation?
- A. Blocks acetylcholine at the neuromuscular junction
- B. Interrupts nerve signals from the spinal cord to the muscles
- C. Inhibits destruction of acetylcholine by acetylcholinesterase
- D. Alters intracellular calcium exchange at the muscles
Correct Answer: D
Rationale: Dantrolene, a peripherally acting muscle relaxant, acts directly on spastic muscles and inhibits muscle contraction by preventing the release of calcium in skeletal muscles. Anticholinergic drugs or muscarinic antagonist block acetylcholine at the neuromuscular junction. Baclofen, a centrally acting muscle relaxant, relieves spasticity by interrupting nerve signals from the spinal cord. Most drugs used to treat myasthenia gravis act by preventing the destruction of acetylcholine at the neuromuscular junction.
Which type of seizure occurs in children, is also known as a petit mal seizure, and consists of a staring spell that lasts for a few seconds?
- A. Atonic
- B. Simple focal
- C. Typical absence
- D. Atypical absence
Correct Answer: C
Rationale: Absence seizures are brief staring spells common in children
When caring for the patient with CREST syndrome (calcinosis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia) associated with scleroderma, what should the nurse teach the patient to do?
- A. Maintain a fluid intake of at least 3000 mL/day.
- B. Avoid exposure to the sun or other ultraviolet light.
- C. Monitor and keep a log of daily blood pressure (BP).
- D. Protect the hands and feet from cold exposure and injury.
Correct Answer: D
Rationale: Cold protection prevents Raynaud's episodes.
Which of the following is a sign of urinary retention in older adults with neurologic deficit?
- A. Amnesia
- B. Hypotension
- C. Hypertension
- D. A behavior change
Correct Answer: D
Rationale: Behavior changes, such as confusion, can indicate urinary retention.