A nurse is assessing a client who has multiple sclerosis. The client reports that, since the onset of the disease, there are times when their symptoms are active and then followed by a period with no symptoms. Which of the following types of multiple sclerosis does this pattern indicate?

Primary progressive multiple sclerosis

Relapsing-remitting multiple sclerosis

Clinically isolating syndrome

Secondary progressive multiple sclerosis

Answer and Explanation

The Correct Answer is B

Primary progressive multiple sclerosis (PPMS) is false. This subtype of MS is characterized by a gradual worsening of symptoms from the onset of the disease, without distinct relapses or remissions. It typically leads to a progressive accumulation of disability over time, without periods of remission. The pattern described by the client, with alternating periods of active symptoms and symptom-free periods, does not align with the continuous progression seen in PPMS.

Choice B Reason:

Relapsing-remitting multiple sclerosis (RRMS) is true. RRMS is characterized by distinct relapses, during which new symptoms may appear or existing symptoms may worsen, followed by periods of partial or complete recovery (remissions), during which the symptoms improve or may even disappear entirely. This pattern matches the description provided by the client, indicating RRMS as the likely subtype.

Choice C Reason:

Clinically isolating syndrome (CIS) is false. CIS refers to a single episode of neurological symptoms caused by inflammation or demyelination in the central nervous system, which may or may not progress to MS. However, CIS does not involve the characteristic pattern of relapses and remissions seen in RRMS.

Choice D Reason:

Secondary progressive multiple sclerosis (SPMS) is false. SPMS is characterized by a gradual worsening of symptoms and disability over time, following an initial period of relapsing-remitting disease. It may or may not involve distinct relapses and remissions, depending on the individual's disease course. While SPMS can involve periods of symptom exacerbation, it typically lacks the clear pattern of relapses followed by remissions seen in RRMS.

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Correct Answer is A

Explanation

Choice A Reason:

COPD is a chronic lung condition characterized by airflow limitation that is not fully reversible. Individuals with COPD often have underlying structural lung changes, such as emphysematous bullae or blebs. These areas of weakened lung tissue are prone to rupture, leading to the development of pneumothorax. Additionally, the chronic inflammation and damage to the airways and lung parenchyma in COPD contribute to the development of pneumothorax.

Choice B Reason:

Sarcoidosis is incorrect. Sarcoidosis is a granulomatous disease that primarily affects the lungs and lymph nodes. While it can cause lung damage and lead to pneumothorax, it is less common than COPD as a comorbidity associated with SSP.

Choice C Reason:

Lung cancer is incorrect. Lung cancer can lead to pneumothorax, especially if the tumor erodes into the pleural space. However, SSP is more commonly associated with underlying lung diseases like COPD rather than lung cancer.

Choice D Reason:

Cystic fibrosis is incorrect. Cystic fibrosis is a genetic disorder characterized by abnormal mucus production and impaired clearance in various organs, including the lungs. While individuals with cystic fibrosis are at increased risk of pneumothorax due to underlying lung disease, SSP is less commonly seen in this population compared to COPD.

A. Metoprolol B. Lactated Ringers intravenous fluid C. Furosemide D. Dopamine E. Epinephrine

Correct Answer is ["B","D","E"]

Explanation

Choice A Reason:

Metoprolol is incorrect. Metoprolol is a beta-blocker medication commonly used to treat conditions such as hypertension, angina, and heart failure. However, in the context of neurogenic shock following a spinal cord injury, the use of beta-blockers such as metoprolol is generally contraindicated. Beta-blockers antagonize the effects of sympathetic activation, leading to a reduction in heart rate and myocardial contractility, which can exacerbate hypotension and bradycardia, the hallmarks of neurogenic shock. Therefore, the nurse would not anticipate a prescription for metoprolol in the management of neurogenic shock.

Choice B Reason:

Lactated Ringers intravenous fluid is correct. Fluid resuscitation with isotonic crystalloid solutions such as lactated Ringers is essential to restore intravascular volume and improve perfusion.

Choice C Reason:

Furosemide is incorrect. Furosemide is a loop diuretic medication commonly used to treat conditions such as heart failure, edema, and hypertension by promoting diuresis and reducing fluid volume. However, in the context of neurogenic shock, the use of diuretics such as furosemide is generally not indicated unless there is concurrent volume overload. Neurogenic shock is characterized by hypotension due to vasodilation and decreased systemic vascular resistance, often leading to relative hypovolemia rather than volume overload. Therefore, administering furosemide could further decrease intravascular volume, exacerbating hypotension and compromising perfusion. As a result, the nurse would not anticipate a prescription for furosemide in the management of neurogenic shock.:

Choice D Reason:

Dopamine is correct. Dopamine is a vasopressor medication that acts to increase vascular tone and blood pressure by stimulating alpha-adrenergic receptors. It is commonly used in the management of neurogenic shock to augment blood pressure.

Choice E Reason:

Epinephrine is correct. Epinephrine is a potent vasopressor that acts on both alpha and beta-adrenergic receptors, leading to vasoconstriction and increased cardiac output. It is used in the treatment of refractory hypotension in neurogenic shock.

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A nurse is assessing a client who has multiple sclerosis. The client reports that, since the onset of the disease, there are times when their symptoms are active and then followed by a period with no symptoms. Which of the following types of multiple sclerosis does this pattern indicate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following is the most common comorbidity of a secondary spontaneous pneumothorax (SSP)?

Correct Answer is A

Explanation

A nurse is planning care for a client who has neurogenic shock following a spinal cord injury. Which of the following provider prescriptions should the nurse anticipate? (Select all that apply.) (Select All that Apply.)

Correct Answer is ["B","D","E"]

Explanation

A nurse in the emergency department is assessing a client who was brought in by a neighbor after falling down suddenly while walking. Which of the following assessments are the priority for the nurse to complete?(Select All that Apply.)

A nurse is teaching a client who has a spinal cord injury about prevention of atelectasis. Which of the following statements should the nurse include in the teaching?

A nurse is planning care for a client who has multiple sclerosis and is receiving methylprednisolone. Which of the following adverse effects should the nurse anticipate? (Select all that apply.)

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A nurse is caring for a client who has a pulmonary embolism. The nurse should identify that the release of inflammatory mediators leads to which of the following pathologic findings?

A nurse is assessing a client who has a spinal cord injury. Which of the following assessment findings should the nurse expect with neurogenic shock? (Select all that apply.) (Select All that Apply.)

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