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","B","C","E"]

Explanation

Choice A Reason:

"It will be necessary to take a stool softener to keep you from becoming constipated." This instruction is correct. Individuals with spinal cord injuries often experience bowel dysfunction, including constipation, due to decreased mobility and impaired bowel function. Stool softeners can help soften the stool and facilitate easier bowel movements, reducing the risk of constipation and associated complications such as fecal impaction.

Choice B Reason:

"Suprapubic catheterization might have to be done if you are unable to catheterize yourself." This instruction is correct. Suprapubic catheterization involves the insertion of a catheter through the abdominal wall directly into the bladder to drain urine. It may be necessary if the client is unable to perform intermittent catheterization independently or if other methods of bladder management are ineffective or contraindicated.

Choice C Reason:

"You will need to learn how to do self-intermittent catheterization to drain your bladder." This instruction is correct. Self-intermittent catheterization involves inserting a catheter into the bladder to drain urine at regular intervals. It is a commonly used method of bladder management for individuals with spinal cord injuries to prevent urinary retention and bladder distention.

Choice D Reason:

"Do not drink fluids excessively as this may cause diarrhea," is not typically included in bowel and bladder management instructions for individuals with spinal cord injuries. Hydration is important for overall health and may help prevent complications such as urinary tract infections, kidney stones, and constipation. Therefore, option D is not appropriate for inclusion in the teaching for a client with a complete spinal cord injury.

Choice E Reason:

"To achieve a bowel movement, daily digital stimulation will need to be done." This instruction is incorrect. Digital stimulation involves gently stimulating the rectum with a lubricated gloved finger to initiate a bowel movement. It can help individuals with spinal cord injuries who have neurogenic bowel dysfunction to stimulate bowel motility and facilitate bowel evacuation.

A. Asthma flare-ups during exercise B. Nasal inflammation C. No hypersensitivity to allergens D. Asthma flare-ups with NSAID administration E. Persistence of manifestations F. Positive response to corticosteroids

Correct Answer is ["A","C","D","E","F"]

Explanation

Choice A Reason:

Asthma flare-ups during exercise is correct . Exercise-induced asthma is a common feature of nonallergic asthma. Physical activity can trigger bronchoconstriction and asthma symptoms in individuals with this type of asthma.

Choice B Reason:

Nasal inflammation is incorrect. Nasal inflammation is not typically a characteristic feature of nonallergic asthma. While nasal symptoms such as congestion, rhinorrhea (runny nose), and sneezing are common in allergic asthma due to the involvement of allergic rhinitis (hay fever), they are not typically prominent in nonallergic asthma. Nonallergic asthma primarily affects the lower airways (bronchi and bronchioles) rather than the upper airways (nose and throat). Therefore, nasal inflammation is not commonly associated with nonallergic asthma.

Choice C Reason:

No hypersensitivity to allergens is correct. Unlike allergic asthma, where exposure to allergens triggers asthma symptoms, individuals with nonallergic asthma do not have a hypersensitivity to allergens.

Choice D Reason:

Asthma flare-ups with NSAID administration is correct. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen can trigger asthma symptoms in some individuals with nonallergic asthma.

Choice E Reason:

Persistence of manifestations is correct. Nonallergic asthma tends to have persistent symptoms even in the absence of allergen exposure. Symptoms may occur regularly and may not have a clear seasonal pattern like allergic asthma.

Choice F Reason:

Positive response to corticosteroids is correct. Corticosteroids are often effective in managing nonallergic asthma. Individuals with this type of asthma typically respond well to corticosteroid treatment as part of their asthma management plan.

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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

A nurse is teaching a client who has a complete spinal cord injury about bowel and bladder management. Which of the following instructions should the nurse include in the teaching? (Select all that apply.) (Select All that Apply.)

Correct Answer is ["A","B","C","E"]

Explanation

Which of the following common characteristics of nonallergic asthma can the nurse expect to find when assessing an adult client? (Select all that appl (Select All that Apply.)

Correct Answer is ["A","C","D","E","F"]

Explanation

A nurse is providing care to a client who has Parkinson's disease and is having difficulty swallowing. Which of the following departments should the nurse plan to contact for a consultation?

A nurse is teaching a group of student nurses about populations at higher risk for multiple sclerosis. Which of the following demographics should be included in the teaching? (Select All that Apply.)

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A nurse is assessing a client who has acute respiratory distress syndrome (ARDS). Which of the following findings should the nurse expect?

A nurse is caring for a client who was involved in a motor vehicle accident. The client is alert and oriented and reports a loss of consciousness immediately after the accident. Which of the following additional manifestations should the nurse assess the client for? (Select All that Apply.)

A nurse is caring for a client who has a spinal cord injury at the fourth cervical level. Which of the following mobility options should the nurse anticipate for this client?

A nurse is assessing a client who has a spinal cord injury with heterotopic ossifications. Which of the following findings should the nurse expect?