A nurse is caring for a client who has chronic respiratory acidosis due to chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse expect with this client?

Choice A Reason:

Myelogram is not appropriate. This imaging test involves injecting contrast dye into the spinal canal to visualize the spinal cord and nerve roots. While it may help identify certain spinal cord abnormalities, it is not typically used as a primary diagnostic tool for multiple sclerosis.

Choice B Reason:

Brain natriuretic peptide (BNP) is not appropriate. This blood test measures the level of BNP, a hormone produced by the heart, which can be elevated in conditions such as heart failure. It is not used in the diagnosis of multiple sclerosis.

Choice C Reason:

Troponin level is not appropriate. Troponin is a protein released into the bloodstream during a heart attack or other heart-related conditions. This test is used to diagnose heart muscle damage and is not relevant to the diagnosis of multiple sclerosis.

Choice D Reason:

Lumbar puncture is appropriate. Also known as a spinal tap, a lumbar puncture involves collecting cerebrospinal fluid (CSF) from the spinal canal for analysis. In the diagnosis of multiple sclerosis, analysis of CSF can help identify certain abnormalities, such as an elevated level of immunoglobulin G (IgG) or the presence of oligoclonal bands, which are often indicative of inflammation in the central nervous system. Therefore, a lumbar puncture is commonly ordered to assist with the diagnosis of multiple sclerosis.

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.