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

Answer and Explanation

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.

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Correct Answer is B

Explanation

A. Carbidopa itself does not cross the blood-brain barrier. Its primary role in Sinemet is to inhibit the peripheral breakdown of levodopa (the precursor of dopamine) into dopamine before it reaches the brain.
B. It is true that it may take a few weeks to see the full effects of this medication, as the body needs time to adjust to it.
C. Parkinson's disease is progressive, and as the disease advances, the dosage and frequency of levodopa with carbidopa may need to be adjusted to maintain symptom control. Over time, higher doses or additional medications may be required to manage symptoms effectively.
D. Levodopa does not protect Carbidopa; rather, Carbidopa protects Levodopa from early conversion to dopamine outside the brain, which would make it less effective.

A. To control the heart rate and reduce the oxygen demand of the heart. B. To prevent platelet aggregation in order to prevent thrombus formation. C. To reduce LDL cholesterol to prevent the formation of additional plaques. D. To relieve acute episodes of angina when they occur.

Correct Answer is C

Explanation

A. This function is typically managed by medications such as beta-blockers or calcium channel blockers, which help reduce heart rate and myocardial oxygen demand. Rosuvastatin does not directly affect heart rate or myocardial oxygen demand.
B. Medications like aspirin or other antiplatelet agents are used to inhibit platelet aggregation and reduce the risk of thrombus formation. Rosuvastatin is not primarily indicated for this purpose.
C. This is the correct rationale for prescribing rosuvastatin in a client with chronic stable angina. High LDL cholesterol levels contribute to the development and progression of atherosclerosis, which narrows coronary arteries and leads to angina. By lowering LDL cholesterol levels, rosuvastatin helps slow down the progression of atherosclerosis and reduces the risk of cardiovascular events, including angina.
D. Acute episodes of angina are typically managed with short-acting nitrates or other medications that dilate coronary arteries to improve blood flow to the heart muscle. Rosuvastatin does not provide immediate relief of angina symptoms.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with Parkinson's disease is started on Levodopa with Carbidopa (Sinemet). What should the nurse include in the patient teaching?

Correct Answer is B

Explanation

A client who has been diagnosed with chronic stable angina is placed on multiple medications to manage the condition. The nurse understands that the client is receiving rosuvastatin for which reason?

Correct Answer is C

Explanation

A nurse manager is discussing social services for older adults during a staff meeting in a long- term acute care (LTAC) facility. Which statement about Medicare made by one of the employees requires correction by the nurse manager?

A client on a medical-surgical unit has been diagnosed with Guillain-Barre Syndrome. The nurse understands that in addition to supportive care, which treatment can be used within the first 2 weeks of symptom onset?

A nurse is caring for a client who has myasthenia gravis which has not responded to medication treatments. Which of the following surgeries can treat myasthenia gravis?

The nurse is performing an admission assessment on a client who is being admitted for right- sided heart failure. Which statement made by the patient would be consistent with right-sided heart failure?

A female client with multiple sclerosis is being treated with prednisone and the immunomodulator drug interferon B-1a to manage the condition. Which finding is the most important for the nurse to report to the provider?

The nurse is reviewing the results of the client's echocardiogram and notes that the ejection fraction is 35%. The nurse anticipates that which of the following medications will be ordered to increase the client's cardiac output?

Which type of elder mistreatment is demonstrated by a caregiver leaving a nursing home resident alone in his room for long periods at a time with no opportunity for social stimulation?