Multiple Sclerosis NCLEX Review

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4.Dysphagia is a common problem of clients diagnosed with mul-
The nurse is assessing a 48-year-old client diagnosed with mul- tiple sclerosis,and this places the client at risk for aspiration pneu-
tiple sclerosis. Which clinical manifestation warrants immediate monia. Some clients diagnosed with multiple sclerosis eventually
intervention? become immobile and are at risk for pneumonia.

1. The client has scanning speech and diplopia.

2. The client has dysarthria and scotomas. 1. These are clinical manifestations of multiple sclerosis and are
3. The client has muscle weakness and spasticity. expected.
4. The client has a congested cough and dysphagia. 2. These are expected clinical manifestations of multiple sclerosis.
3. These are expected clinical manifestations of multiple sclerosis.
The client newly diagnosed with multiple sclerosis (MS) states, "I
1.The exact cause of MS is not known,but there is a theory
don't understand how I got multiple sclerosis. Is it genetic?" On
stating a slow virus is partially responsible. A failure of apart of
which statement should the nurse base the response?
the immune system may also beat fault. A genetic predisposition
involving chromosomes 2, 3, 7, 11, 17, 19, and X may be involved.
1. Genetics may play a role in susceptibility to MS, but the disease
may be caused by a virus.
2. There is no evidence suggesting there is any chromosomal
2. There is some evidence supporting a genetic component in-
involvement in developing MS.
volved in developing MS.
3. Multiple sclerosis is caused by a recessive gene, so both
3. A specific gene has not been identified to know if the gene is
parents had to have the gene for the client to get MS.
recessive or dominant.
4. Multiple sclerosis is caused by an autosomal dominant gene on
4. The X chromosome, not the Y chromosome,may be involved.
the Y chromosome,so only fathers can pass it on.
The 30-year-old female client is admitted with complaints of 3.These are clinical manifestation of MS and can go un diagnosed
numbness, tingling, a crawling sensation affecting the extremities, for years be-cause of the remitting-relapsing nature of the disease.
and double vision which has occurred two(2) times in the month. Fatigue and difficulty swallowing are other symptoms of MS.
Which question is most important for the nurse to ask the client?

1. "Have you experienced any difficulty with your menstrual cy-

cle?" 1. MS does not affect the menstrual cycle.
2. "Have you noticed a rash across the bridge of your nose?" 2. A rash across the bridge of the nose suggests systemic lupus
3. "Do you get tired easily and sometimes have problems swal- erythematosus
lowing?" 4. Taking birth control medications should not produce these
4. "Are you taking birth control pills to prevent conception?" symptoms or the pattern of occurrence.
2.This is stating a fact and offering self. Both are therapeutic
The nurse enters the room of a client diagnosed with acute ex- techniques for conversations.
acerbation of multiple sclerosis and finds the client crying. Which
statement is the most therapeutic response for the nurse to make?

1. "Why are you crying?The medication will help the disease." 1. "Why" is requesting an explanation, and the client does not owe
2. "You seem upset. I will sit down and we can talk for awhile." the nurse an explanation.
3. "Multiple sclerosis is a disease that has good times and bad 3. The client did not ask about the nature of MS. The client needs
times." to be able to verbalize feelings.
4. "I will have the chaplain come and stay with you for a while." 4. This is "passing the buck." Therapeutic communication is an
integral part of nursing.
The client diagnosed with multiple sclerosis is scheduled for a
magnetic resonanceimaging (MRI) scan of the head. Which in-
2.MRI scans require the client to lie stilland not move the body; the
formation should the nurse teach the client about the test?
clientshould be warned about the loud noise
1. The client will have wires attached to the scalp and lights will
flash off and on.
1. This describes an evoked potential electroencephalogram
2. The machine will be loud and the client must not move the head
(EEG).
during the test.
3. The client does not drink any contrast medium. If contrast is
3. The client will drink a contrast medium 30 minutes to one (1)
used, it will be given IVP for a CT scan.
hour before the test.
4. The test is performed at one time
4. The test will be repeated at intervals during a five (5)- to six
(6)-hour period.
4.The client should make personal choices about end-of-life is-
The 45-year-old client is diagnosed with primary progressive mul- sues while it is possible to do so. This client is progressing toward
tiple sclerosis and the nurse writes the nursing diagnosis "antic- immobility and all the complications related to it.
ipatory grieving related to progressive loss." Which intervention

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 Multiple Sclerosis NCLEX Review
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1. The problem is grieving R/T loss of functioning. Assistive de-
should be implemented? vices will not prevent loss of functioning and do not address
grieving.
1. Consult the physical therapist for assistive devices for mobility. 2. A legal power of attorney is for personal property and control of
2. Determine if the client has a legal power of attorney. financial issues,which is not the focus of the nurse's care. A legal
3. Ask if the client would like to talk to the hospital chaplain. 4. power of attorney for health care maybe appropriate.
Discuss the client's wishes regarding end-of-life care. 3. The nurse should and must discuss end-of-life issues with the
client and does not need to contact the hospital chaplain.
The home health nurse is caring for the client newly diagnosed
with multiple sclerosis. Which client issue is of most importance?
3.A potential suicide statement is priority for the nurse when caring
1. The client refuses to have a gastrostomy feeding.
for the client with MS.
2. The client wants to discuss if she should tell her fiancé.
3. The client tells the nurse life is not worth living anymore
.4. The client needs the flu and pneumonia vaccines.
The nurse and a licensed practical nurse (LPN) are caring for a
group of clients.Which nursing task should not be assigned to the
LPN?

1. Administer a skeletal muscle relaxant to a client diagnosed with

4.The nurse should not assign assessing,teaching, or evaluation
low back pain.
to the LPN. Evaluating the client's ability to per-form self-catheter-
2. Discuss bowel regimen medications with the HCP for the client
ization should not beassigned to the LPN
on strict bed rest.
3. Draw morning blood work on the client diagnosed with bacterial
meningitis.
4. Teach self-catheterization to the client diagnosed with multiple
sclerosis.
The male client diagnosed with multiple sclerosis states he has
been investigating alternative therapies to treat his disease. Which
intervention is most appropriate by the nurse?
1.The nurse should listen without being judgmental about any
1. Encourage the therapy if it is not contraindicated by the medical
alternative therapy the client is considering. Alternative therapies,
regimen.
such as massage and relaxation, are frequently beneficial and
2. Tell the client only the health-care provider should discuss this
enhance the medical regimen.
with him.
3. Ask how his significant other feels about this deviation from the
medical regimen.
4. Suggest the client research an investigational therapy instead.
3.Steroids interfere with glucose metabolism by blocking the ac-
The client diagnosed with an acute exacerbation of multiple scle- tion of insulin;therefore, the blood glucose levels should be mon-
rosis is placed on high-dose intravenous injections of corticos- itored.
teroid medication. Which nursing intervention should be imple-
mented?
1. Steroid medications increase gastric acid;therefore, a proton
1. Discuss discontinuing the proton pump inhibitor with the HCP. pump inhibitor is an appropriate medication for the client.
2. Hold the medication until after all cultures have been obtained. 2. Cultures are ordered prior to administer-ing antibiotics, not
3. Monitor the client's serum blood glucose levels frequently steroids.
.4. Provide supplemental dietary sodium with the client's meals. 4. Steroid medications cause the client to retain sodium; therefore,
a low-sodiumdiet should be encouraged
The nurse writes the client problem of "altered sexual functioning"
for a male client diagnosed with multiple sclerosis (MS). Which
intervention should be implemented?
1.This will assist the client and significant other to maintain a close
relation-ship without putting undue pressure on the client.
1. Encourage the couple to explore alternative ways of maintaining
intimacy.
2. This is a real physical problem, not a psychological one.
2. Make an appointment with a psychotherapist to counsel the
3. The problem is impotence, not libido
couple.
4. The problem is not psychosocial. It is aphysical problem, and
3. Explain daily exercise will help increase libido and sexual
staying calm willnot hel
arousal.
4. Discuss the importance of keeping physically calm during sex-
ual intercourse.
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 Multiple Sclerosis NCLEX Review
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1.Muscle flaccidity is a hallmark symptom of MS.
The nurse is admitting a client diagnosed with multiple sclerosis.
3.Dysmetria is the inability to control muscular action character-
Which clinical manifestation should the nurse assess?Select all
ized by overestimating or under estimating range of movement.
that apply.
4.Fatigue is a symptom of MS.
1. Muscle flaccidity.
5.Dysphagia, or difficulty swallowing, is associated with MS.
2. Lethargy.
3. Dysmetria.
4. Fatigue.
2. Lethargy is the state of prolonged sleepiness or serious drowsi-
5. Dysphagia.
ness and is not associated with MS.

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