A client with multiple complaints has been referred to a neurologist for further evaluation. Which of the following complaints are common manifestations of amyotrophic lateral sclerosis? (Select all that apply.)

Muscle hypertrophy

Tinnitus

Tripping

Confusion

Dropping objects

Answer and Explanation

Correct Answer : C,E

Muscle hypertrophy (increase in muscle size) is not a typical manifestation of ALS. In fact, ALS leads to muscle atrophy (wasting) rather than hypertrophy. As motor neurons degenerate, muscles become weaker and smaller because they are no longer receiving adequate nerve signals to maintain strength.
B.A Tinnitus (ringing in the ears) is not a common manifestation of ALS. ALS primarily affects motor neurons and does not usually cause auditory symptoms. Tinnitus is more related to other conditions such as ear infections, exposure to loud noises, or certain neurological conditions, but it is not associated with ALS.
C.   Tripping or stumbling is a common manifestation of ALS. As the disease progresses, it causes weakness in the muscles responsible for maintaining balance and coordination. This can lead to difficulties with walking and increased risk of tripping or falling.
D.   Confusion is not a typical symptom of ALS. ALS primarily affects motor neurons, leading to muscle weakness and atrophy, but it does not usually affect cognitive function. However, in rare cases, some patients with ALS may develop cognitive or behavioral changes, but these are not the primary symptoms and are less common.
E.   Dropping objects is a common manifestation of ALS. Muscle weakness and loss of fine motor control in the hands and arms can make it difficult to hold or manipulate objects, leading to frequent dropping.

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Correct Answer is C

Explanation

A. Elevated potassium levels (hyperkalemia) can occur in chronic kidney disease, as the kidneys struggle to excrete potassium. However, hyperkalemia does not typically cause visible crystals on the skin. It is more associated with cardiac arrhythmias and muscle weakness rather than skin manifestations.
B. Sodium imbalance is common in chronic kidney disease, often leading to fluid retention and hypertension. However, excess sodium does not result in crystal formation on the skin. Sodium issues are more related to fluid balance and blood pressure, not external crystalline deposits.
C. Urea is a waste product formed from the breakdown of proteins and is normally excreted by the kidneys. In chronic kidney disease, urea accumulates in the blood (uremia) because the kidneys cannot effectively filter it out. Urea can be deposited on the skin and form crystals, leading to a condition known as "uremic frost." This is often observed on the forehead or other areas of the skin and is a direct result of excess urea in the body.

D. Creatinine is another waste product filtered by the kidneys. Elevated levels indicate impaired kidney function, but creatinine itself does not form visible crystals on the skin. Elevated creatinine levels are primarily used as an indicator of kidney function rather than a cause of external skin manifestations.

A. Client's response to nitroglycerin therapy B. Client's initial report of manifestations C. 12 Lead EKG report D. Troponin results

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B"},"C":{"answers":"A"},"D":{"answers":"B"}}

Explanation

Client's Response to Nitroglycerin Therapy

• Unstable Angina:
o Typically, unstable angina responds well to nitroglycerin. The relief of discomfort after nitroglycerin administration suggests that the chest pain was likely related to unstable angina, as it indicates a reduction in coronary artery spasm or temporary ischemia.
• Myocardial Infarction:
o In an MI, nitroglycerin may help alleviate pain, but it does not address the underlying cause of myocardial injury. The pain relief in an MI is generally more variable and may not be as effective if there is significant myocardial damage.

2. Client's Initial Report of Manifestations

• Unstable Angina:
o The symptoms described (shortness of breath, dizziness, and discomfort in the jaw, neck, and left arm) are consistent with unstable angina, which is characterized by episodes of chest pain or discomfort at rest or with minimal exertion, often associated with transient ischemia.
• Myocardial Infarction:
o These symptoms can also be consistent with MI, especially if they are severe or persistent. However, MI often presents with more intense and prolonged pain, and the discomfort might not always resolve with rest.

3. 12 Lead EKG Report

• Unstable Angina:
o ST depression on an EKG is more commonly associated with unstable angina, which indicates transient ischemia rather than a sustained myocardial injury.
• Myocardial Infarction:
o ST depression indicates ischemia commonly in angina.

4. Troponin Results

• Unstable Angina:
o Troponin levels are typically normal in unstable angina. The client’s troponin I (0.01 ng/mL) and troponin T (0.03 ng/mL) are within the normal range, suggesting no significant myocardial injury. This is consistent with unstable angina.
• Myocardial Infarction:
o Elevated troponin levels are a key marker of myocardial injury. The normal troponin results in this case do not support an MI diagnosis, as elevated troponin levels would be expected in MI.

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A client with multiple complaints has been referred to a neurologist for further evaluation. Which of the following complaints are common manifestations of amyotrophic lateral sclerosis? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has chronic kidney disease and notes that the client has small crystals on his forehead. The nurse understands that this manifestation is a result of an excess of which substance in the body?

Correct Answer is C

Explanation

A nurse in the emergency department is admitting a client. Exhibits For each of the following findings in the client's medical record, click to specify if they are consistent with unstable angina or a myocardial infarction (MI). Each finding may support more than one disease process.

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B"},"C":{"answers":"A"},"D":{"answers":"B"}}

Explanation

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