A nurse is caring for a client at an outpatient clinic.

For each assessment finding, click to specify if the finding is consistent with amyotrophic lateral sclerosis (ALS) or multiple sclerosis (MS). Each finding may support more than 1 disease process or none at all. There must be at least 1 selection in every column. There does not need to be a selection in every row.

Genitourinary findings

Report about gait

Vision disturbance

Energy level

Answer and Explanation

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

Rationale

• Genitourinary findings: Intermittent sensations of "squeezing or spasm" in the bladder or urinary tract are typical in multiple sclerosis due to autonomic nervous system involvement and demyelination affecting bladder control. These symptoms are less common in ALS, which primarily affects motor neurons without early autonomic involvement.

• Report about gait: Episodes of leg weakness and balance issues can occur in both ALS and MS. ALS causes progressive motor weakness affecting gait due to upper and lower motor neuron degeneration. MS can cause intermittent gait disturbances from demyelination in the central nervous system, often with exacerbations and remissions.

• Vision disturbance: Intermittent double vision is consistent with MS, reflecting demyelination of cranial nerves or the optic pathways. Visual symptoms, including diplopia or optic neuritis, are hallmark early signs of MS. ALS typically does not involve vision, making this symptom specific to MS.

• Energy level: Fatigue lasting more than 4 months aligns with MS, which frequently causes persistent fatigue due to both neurological dysfunction and immune-mediated inflammation. ALS may lead to fatigue later in disease progression, but early chronic fatigue is more characteristic of MS.

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

Explanation

Rationale:

• Deep tendon patellar reflex: The client’s patellar reflex decreased from 4+ on day 1 to 2+ on day 2, indicating reduced hyperreflexia. This suggests a positive response to antihypertensive and preeclampsia management, lowering the risk for complications such as eclampsia or seizures.

• Heart rate: The client’s heart rate increased slightly from 84/min on day 1 to 90/min on day 2, which falls within a normal physiologic range and does not indicate significant improvement or deterioration. This shows that cardiovascular status has remained relatively stable.

• Blood pressure: Blood pressure decreased from severely elevated readings (162/112 mm Hg and 166/110 mm Hg) to 152/90 mm Hg, reflecting a partial response to antihypertensive therapy. Although still above normal, the downward trend indicates some improvement in maternal hemodynamic status.

• Edema: The client continues to have +3 pitting edema in bilateral lower extremities, which has not improved since the previous day. Persistent edema suggests that fluid balance and vascular permeability issues related to preeclampsia remain a concern and require ongoing monitoring.

A. A B. B C. C

Correct Answer is C

Explanation

A. The infant is swaddled but there is a blanket and a stuffed toy in the crib. Loose items increase the risk of suffocation and SUID, so this does not demonstrate safe sleep practices.

B. The infant is placed on their back, but there is a blanket and a stuffed toy in the crib. These items pose a suffocation risk and do not follow safe sleep guidelines.

C. The infant is placed on their back in a swaddle with no loose blankets or toys in the crib. This position aligns with American Academy of Pediatrics (AAP) recommendations for safe sleep to reduce the risk of SUID, demonstrating proper understanding of safe sleep practices.

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Naxlex Comprehensive Predictor Exams

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

Explanation

A nurse is teaching about preventing sudden unexpected infant death (SUID) to a parent of a 1-month-old infant. Which of the following ling indicates that the parent understands how to place the infant in the crib at bedtime?

Correct Answer is C

Explanation

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