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The nurse is caring for a 77-year-old woman with MS. She states that she is very concerned about the progress of her disease and what the future holds. The nurse should know that elderly patients with MS are known to be particularly concerned about what variables? Select all that apply.
- A. Possible nursing home placement
- B. Pain associated with physical therapy
- C. Increasing disability
- D. Becoming a burden on the family
- E. Loss of appetite
Correct Answer: A,C,D
Rationale: Elderly MS patients worry about increasing disability, family burden, and potential nursing home placement due to progressive loss of function. Pain from therapy and appetite loss are not primary concerns.
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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.
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 male patient presents to the clinic complaining of a headache. The nurse notes that the patient is guarding his neck and tells the nurse that he has stiffness in the neck area. The nurse suspects the patient may have meningitis. What is another well-recognized sign of this infection?
- A. Negative Brudzinski's sign
- B. Positive Kernig's sign
- C. Hyperpatellar reflex
- D. Sluggish pupil reaction
Correct Answer: B
Rationale: A positive Kernig's sign, where leg extension causes pain due to meningeal irritation, is a classic sign of meningitis. Brudzinski's sign is positive, not negative, and reflexes or pupil reactions are not typical signs.
A patient presents at the clinic complaining of pain and weakness in her hands. On assessment, the nurse notes diminished reflexes in the upper extremities bilaterally and bilateral loss of sensation. The nurse knows that these findings are indicative of what?
- A. Guillain-Barr?© syndrome
- B. Myasthenia gravis
- C. Trigeminal neuralgia
- D. Peripheral nerve disorder
Correct Answer: D
Rationale: Pain, weakness, diminished reflexes, and sensory loss in the extremities indicate a peripheral nerve disorder. Guillain-Barr?© involves ascending paralysis, myasthenia gravis affects voluntary muscles, and trigeminal neuralgia causes facial pain.
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.