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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.
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The critical care nurse is caring for a 25-year-old man admitted to the ICU with a brain abscess. What is a priority nursing responsibility in the care of this patient?
- A. Maintaining the patient's functional independence
- B. Providing health education
- C. Monitoring neurologic status closely
- D. Promoting mobility
Correct Answer: C
Rationale: Close neurologic monitoring is critical for brain abscess patients to detect changes like increased intracranial pressure. Independence, education, and mobility are secondary in acute care.
The nurse caring for a patient diagnosed with Guillain-Barr?© syndrome is planning care with regard to the clinical manifestations associated with this syndrome. The nurse's communication with the patient should reflect the possibility of what sign or symptom of the disease?
- A. Intermittent hearing loss
- B. Tinnitus
- C. Tongue enlargement
- D. Vocal paralysis
Correct Answer: D
Rationale: Guillain-Barr?© syndrome affects the vagus nerve (X), potentially causing vocal paralysis or dysphagia. Hearing loss, tinnitus, and tongue enlargement are not associated.
The nurse is teaching a patient with Guillain-Barr?© syndrome about the disease. The patient asks how he can ever recover if demyelination of his nerves is occurring. What would be the nurse's best response?
- A. Guillain-Barr?© spares the Schwann cell, which allows for remyelination in the recovery phase of the disease.
- B. In Guillain-Barr?©, Schwann cells replicate themselves before the disease destroys them, so remyelination is possible.
- C. I know you understand that nerve cells do not remyelinate, so the physician is the best one to answer your question.
- D. For some reason, in Guillain-Barr?©, Schwann cells become activated and take over the remyelination process.
Correct Answer: A
Rationale: Guillain-Barr?© spares Schwann cells, enabling remyelination during recovery. Schwann cells do not replicate preemptively or take over uniquely, and deferring entirely to the physician dismisses the nurse's role.
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 patient diagnosed with Bell's palsy is being cared for on an outpatient basis. During health education, the nurse should promote which of the following actions?
- A. Applying a protective eye shield at night
- B. Chewing on the affected side to prevent unilateral neglect
- C. Avoiding the use of analgesics whenever possible
- D. Avoiding brushing the teeth
Correct Answer: A
Rationale: Bell's palsy can impair eye closure, risking corneal damage, so a protective eye shield at night is essential. Chewing on the affected side is difficult, analgesics may be needed, and oral hygiene should continue.