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 B
Explanation
A. Atrial flutter typically presents with a regular atrial rate (usually around 250-350 beats per minute) and a characteristic "sawtooth" pattern of flutter waves (F-waves) on the ECG. This condition would not present with irregular ventricular rates and is less likely based on the ECG findings described.
B. Atrial fibrillation is identified by an irregularly irregular rhythm and the absence of P-waves on the ECG, which is replaced by erratic activity.
C. Unstable angina presents with chest pain or discomfort due to reduced blood flow to the heart muscles, usually related to atherosclerotic plaque rupture or erosion. It does not cause the ECG findings described (absence of P-waves and irregular ventricular rate).
D. PACs are early atrial depolarizations that can cause palpitations but do not typically result in the absence of P-waves or irregular ventricular rates as described in the scenario.
Correct Answer is C
Explanation
A. Most individuals with Bell's palsy experience gradual improvement within weeks to months, and the majority recover completely. Permanent facial paralysis is rare, but some individuals may have residual mild weakness or asymmetry.
B. This statement is not typically true for Bell's palsy. Antibiotic eye drops are not routinely prescribed unless there is evidence of corneal exposure due to incomplete eyelid closure (lagophthalmos). Instead, artificial tears and lubricating ointments are often recommended to prevent dryness and protect the cornea.
C. In Bell's palsy, weakness or paralysis of the facial muscles can lead to inability to fully close the eyelid on the affected side. Taping the eyelid closed at night helps prevent corneal damage from exposure and dryness.
D. This statement is not recommended. It is important to avoid stressing the affected facial muscles excessively during recovery from Bell's palsy. Chewing evenly on both sides of the mouth is generally recommended to prevent strain and promote balanced muscle function.
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