A nurse is caring for a client who has a new diagnosis of amyotrophic lateral sclerosis (ALS), and a new prescription for riluzole. The nurse understands that this medication works in which of the following ways?

It suppresses the virus which is responsible for causing the inflammation of the nerve.

It prevents the breakdown of acetylcholine to increase the amount available at the neuromuscular junction.

It reduces inflammation in the CNS to prevent further demyelination of nerves in the central nervous system.

It slows the progression of the disease by decreasing the release of glutamate in the brain.

Answer and Explanation

The Correct Answer is D

A.   ALS is not caused by a virus or inflammation of the nerves. It is a progressive neurodegenerative disease affecting the motor neurons in the brain and spinal cord.
B.   While acetylcholine breakdown is involved in other neurological conditions (such as myasthenia gravis), ALS primarily affects motor neurons and does not directly involve acetylcholine metabolism at the neuromuscular junction.
C.   ALS does not typically involve significant inflammation or demyelination (which is more characteristic of conditions like multiple sclerosis). Therefore, reducing CNS inflammation is not a therapeutic target in ALS.
D.   Riluzole, the medication prescribed for ALS, works by decreasing the release of glutamate, which is a neurotransmitter that can be toxic to nerve cells in high amounts. In ALS, excessive glutamate release is believed to contribute to motor neuron degeneration. By reducing glutamate release, riluzole may help protect motor neurons and slow the progression of the disease.

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Correct Answer is A

Explanation

A. By surrounding themselves with familiar items, such as photos, favorite objects, or comforting decor from their previous home, the resident can feel more at ease and connected to their past. This approach helps in creating a more homelike atmosphere and reducing feelings of disorientation and stress associated with the move.
B. Isolating the resident and encouraging avoidance of social interactions can exacerbate feelings of loneliness, isolation, and anxiety. Avoiding social interactions may prolong feelings of stress and hinder adaptation to the new living situation.
C. While it's important to manage the frequency and timing of visits to ensure the resident is not overwhelmed, outright restricting visitation hours can be counterproductive. Restricting visitation could increase feelings of isolation and loneliness, which are already common in new residents of long-term care facilities.
D. Using sedative medications should be reserved for situations where non-pharmacological interventions have been unsuccessful and the resident's anxiety or distress is severe and persistent. Sedatives can have side effects, especially in older adults, and should not be the first-line approach for managing relocation stress syndrome.

A. The client has developed moon face. B. The client complains of muscle spasticity. C. The client drinks alcohol several days per week. D. The client is taking birth control pills.

Correct Answer is C

Explanation

A. Moon face is a common side effect of prednisone, a corticosteroid medication. It results from fluid retention and redistribution of fat in the face. While moon face is a cosmetic concern, it is not typically an urgent or critical finding that requires immediate reporting.
B. Muscle spasticity may develop but does not pose an immediate risk that requires urgent attention.
C. Alcohol consumption can interact with both prednisone and interferon B-1a, potentially leading to increased drug levels in the bloodstream and intensifying side effects. This interaction can also increase the risk of liver problems, which is particularly concerning given that interferon B-1a may cause liver issues.
D. Birth control pills have been a subject of debate regarding their effect on multiple sclerosis but a study found that oral hormonal contraceptives did not appear to be associated with an increased chance of MS relapses.

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A nurse is caring for a client who has a new diagnosis of amyotrophic lateral sclerosis (ALS), and a new prescription for riluzole. The nurse understands that this medication works in which of the following ways?

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Naxlex Comprehensive Predictor Exams

Which nursing intervention is the most appropriate for managing relocation stress syndrome in an older adult in addition to supportive long-term care facility?

Correct Answer is A

Explanation

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?

Correct Answer is C

Explanation

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