A client presents to the emergency department with complaints of numbness and weakness which began in the feet and has progressed symmetrically in an ascending pattern through the bilateral lower extremities. The nurse understands that this pattern most closely fits which neurological disorder?
Multiple sclerosis
Guillain Barre Syndrome
Myasthenia gravis
Parkinson's disease
The Correct Answer is B
A. MS is a chronic autoimmune disorder affecting the central nervous system (CNS), specifically the brain and spinal cord. It typically presents with a wide range of neurological symptoms such as blurred vision, sensory disturbances, weakness, and difficulties with coordination and balance. However, MS does not typically present with a sudden onset of ascending numbness and weakness starting in the feet and moving upwards.
B. GBS is an acute autoimmune disorder where the immune system attacks the peripheral nervous system. It often starts with numbness, tingling, and weakness in the feet and legs, which then
progresses symmetrically upwards to involve the upper limbs and potentially affect respiratory muscles. This ascending pattern of weakness is characteristic of GBS, making it the most likely diagnosis in this scenario.
C. Myasthenia gravis is a chronic autoimmune disorder affecting neuromuscular junctions, leading to muscle weakness and fatigue, especially with repetitive use. It typically presents with fluctuating muscle weakness that worsens with activity and improves with rest. The pattern of ascending numbness and weakness seen in the scenario does not align with the typical presentation of myasthenia gravis.
D. Parkinson's disease is a progressive neurological disorder primarily affecting movement. It presents with symptoms such as tremors, bradykinesia (slowness of movement), rigidity, and postural instability. It does not typically cause numbness or a symmetrical ascending pattern of weakness as described in the scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. This statement refers to medications like statins (e.g., rosuvastatin, atorvastatin) which are used to lower cholesterol levels and reduce the risk of atherosclerosis progression. Docusate sodium does not treat hyperlipidemia or affect plaque formation directly.
B. This refers to anticoagulant medications (e.g., heparin, warfarin, direct oral anticoagulants) which are used to prevent clot formation and reduce the risk of thromboembolic events such as stroke. Docusate sodium does not have anticoagulant properties.
C. After a myocardial infarction (MI), especially in the early recovery phase, vagal stimulation can exacerbate bradycardia or contribute to dysrhythmias. Stool softeners like docusate sodium help prevent constipation, which can stimulate the vagus nerve during straining, potentially leading to vagally mediated dysrhythmias such as bradycardia or atrioventricular blocks.
D. Diuretics (e.g., furosemide, hydrochlorothiazide) are used to reduce fluid retention and lower blood pressure by increasing urine output. Docusate sodium does not remove excess sodium or affect blood pressure regulation.
Correct Answer is A
Explanation
A. Retropulsion is a classic manifestation of postural instability in Parkinson's disease. It refers to a tendency to lose balance and fall backward, especially when attempting to initiate walking or when challenged with external forces.
B. Impaired handwriting, also known as micrographia, is associated with bradykinesia (slowness of movement) in Parkinson's disease. It manifests as progressively smaller and more cramped handwriting.
C. Muscle soreness and pain can occur in Parkinson's disease, but they are not typically directly associated with postural instability. They may occur due to rigidity (muscle stiffness) or abnormal postures maintained over time.
D. Slow movements, or bradykinesia, are a hallmark feature of Parkinson's disease and are characterized by a gradual reduction in the speed and fluidity of voluntary movements. While related to motor symptoms in Parkinson's disease, slow movements are not specific to postural instability.
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