A client is diagnosed with amyotrophic lateral sclerosis (ALS). Which pathophysiological process should the nurse use when providing the client with information about this disease prognosis?
It occurs as a complication of a spinal cord injury.
Muscle weakness is progressive, degenerative, and fatal.
Mental status changes occur late in the disease.
Autonomic nervous system and sensory changes occur.
The Correct Answer is B
Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, is a progressive neurodegenerative disorder affecting motor neurons in the brain and spinal cord. Understanding the pathophysiological process of ALS is crucial for providing accurate information about the disease prognosis to the client. Here's why option B is the correct choice:
A) It occurs as a complication of a spinal cord injury:
This statement is incorrect. ALS is not a complication of a spinal cord injury. While both conditions involve motor neuron dysfunction, they have different etiologies and pathophysiological processes. ALS is characterized by the degeneration of motor neurons in the brain and spinal cord, leading to muscle weakness and atrophy, whereas spinal cord injury results from trauma to the spinal cord.
B) Muscle weakness is progressive, degenerative, and fatal:
Correct. ALS is characterized by progressive degeneration of motor neurons, leading to muscle weakness, atrophy, and eventual paralysis. The disease is relentless and fatal, typically within 2 to 5 years of diagnosis, although survival can vary widely among individuals. As motor neurons degenerate, voluntary muscle control is lost, eventually affecting the ability to speak, swallow, breathe, and move. Respiratory failure is the most common cause of death in ALS patients.
C) Mental status changes occur late in the disease:
While cognitive and behavioral changes can occur in some individuals with ALS, particularly in the later stages of the disease, they are not universal. ALS primarily affects motor neurons, leading to progressive muscle weakness and paralysis. However, some individuals may experience frontotemporal dementia (FTD), a type of cognitive impairment characterized by changes in behavior, personality, and language.
D) Autonomic nervous system and sensory changes occur:
ALS primarily affects motor neurons rather than sensory neurons or the autonomic nervous system. Sensory symptoms such as numbness, tingling, or loss of sensation are not typical features of ALS. Autonomic dysfunction, including changes in heart rate, blood pressure, or bowel and bladder function, is not a prominent feature of ALS.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Histamine-mediated vascular permeability leading to fluid transudation:
Correct. Ankle edema following an ankle sprain is often due to inflammation and increased vascular permeability. Histamine, released from mast cells and basophils during the inflammatory response, causes vasodilation and increases vascular permeability. This leads to the leakage of fluid from the blood vessels into the surrounding tissues, resulting in edema.
B) Bradykinin cascade resulting in the accumulation of substance P:
While bradykinin is involved in the inflammatory response and can contribute to pain and vasodilation, it does not directly cause fluid transudation leading to edema in the context of an ankle sprain.
C) Thromboxane A activation of chemical mediators:
Thromboxane A is involved in platelet aggregation and vasoconstriction rather than increasing vascular permeability and edema formation.
D) Neutrophil migration secondary to chemotaxis:
Neutrophil migration is part of the inflammatory response and can contribute to tissue damage and inflammation, but it is not the primary mechanism responsible for the development of edema following an ankle sprain.
Correct Answer is A,D,C,E,B
Explanation
This sequence starts with an injury to the arterial endothelium, leading to inflammation. Macrophages then consume LDL, forming foam cells. These foam cells release growth factors that stimulate the growth of smooth muscle cells. The smooth muscle cells grow over the fatty streaks, creating fibrous plaques. Finally, as these plaques grow, they narrow the vessel, which can result in ischemia. This is a simplified explanation of a complex process that involves many other factors and steps. It’s also important to note that this process can take many years to develop.
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