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 D

Explanation

A. This symptom is consistent with orthopnea, which is common in left-sided heart failure rather than right-sided heart failure. In orthopnea, patients experience shortness of breath when lying flat because fluid accumulates in the lungs due to impaired left ventricular function.
B. Pink-tinged or blood-tinged sputum, known as hemoptysis, can occur in left-sided heart failure due to pulmonary congestion and elevated pressures in the pulmonary circulation. This symptom is not typically associated with right-sided heart failure.
C. This finding suggests pulmonary congestion, which is more indicative of left-sided heart failure. In left- sided heart failure, fluid backs up into the lungs, leading to crackles or rales on auscultation.
D. This statement is consistent with right-sided heart failure. In right-sided heart failure, the right ventricle fails to effectively pump blood into the pulmonary circulation, causing fluid to back up into the venous system. This can lead to peripheral edema (such as in the legs and abdomen) and abdominal distension due to ascites (fluid accumulation in the peritoneal cavity).

A. The client has a harmful gene mutation which puts him at a higher risk for cancer in the future. B. The client will need additional testing to determine if he has cancer. C. The client has prostate cancer. D. The client has benign prostatic hyperplasia (BPH).

Correct Answer is B

Explanation

A. PSA levels themselves do not indicate a gene mutation. Elevated PSA levels are primarily associated with prostate conditions rather than genetic mutations. While certain genetic mutations can predispose individuals to prostate cancer, PSA alone does not diagnose genetic mutations.
B. Elevated PSA levels can indicate the possibility of prostate cancer, but further testing is necessary to confirm the diagnosis. Additional tests may include a digital rectal exam (DRE), imaging studies (such as ultrasound or MRI), and a prostate biopsy.
C. Elevated PSA levels can suggest prostate cancer, but they do not definitively diagnose it. Prostate cancer can only be confirmed through a biopsy that identifies cancerous cells in the prostate tissue.
D. BPH is a non-cancerous enlargement of the prostate gland that commonly occurs in older men. While BPH can cause urinary symptoms similar to prostate cancer, elevated PSA levels are not typically associated with BPH alone. PSA elevation is more specific to prostate cancer but can also occur with other prostate conditions.

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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

The nurse is performing an admission assessment on a client who is being admitted for right- sided heart failure. Which statement made by the patient would be consistent with right-sided heart failure?

Correct Answer is D

Explanation

An older adult client who is having difficulty passing urine is found to have elevated levels of prostate-specific antigen (PSA). The nurse understands that this finding indicates which of the following?

Correct Answer is B

Explanation

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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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