A nurse is caring for a client who is newly diagnosed with Parkinson's disease. The client states, "I have no idea why I got this." Which of the following is the most important question the nurse should ask this client while performing the assessment?

Choice A Reason:

Paresthesia is appropriate. Paresthesia, or abnormal sensations such as tingling, numbness, or burning, is a common neurological symptom in individuals with multiple sclerosis. It results from damage to the nerves or disruption of nerve signals in the central nervous system.

Choice B Reason:

Nausea and vomiting is inappropriate. While nausea and vomiting can occur in individuals with multiple sclerosis, they are not considered hallmark symptoms of the disease. These symptoms may be associated with other factors such as medications, autonomic dysfunction, or complications such as urinary tract infections.

Choice C Reason:

Dysphagia is appropriate. Dysphagia, or difficulty swallowing, is a common symptom in individuals with multiple sclerosis, particularly as the disease progresses. It can result from damage to the nerves that control swallowing muscles or from impaired coordination of swallowing reflexes.

Choice D Reason:

Spasticity is appropriate. Spasticity, or muscle stiffness and involuntary muscle contractions, is a common symptom in individuals with multiple sclerosis. It occurs due to damage to the nerve fibers that control muscle movement and can lead to difficulty with movement, walking, and muscle control.

Choice E Reason:

Vertigo is appropriate. Vertigo, or the sensation of spinning or dizziness, can occur in individuals with multiple sclerosis, particularly if lesions develop in areas of the brain involved in balance and coordination.

Choice A Reason:

Pregabalin is incorrect. Pregabalin is a medication used to treat neuropathic pain, seizures, and generalized anxiety disorder. It is not associated with an increased risk of PML.

Choice B Reason:

Natalizumab is correct.: Natalizumab is a monoclonal antibody used to treat relapsing forms of MS. It is associated with an increased risk of developing PML, particularly in individuals who are JC virus antibody positive. Regular monitoring of JC virus antibody status and clinical vigilance is required when using natalizumab to reduce the risk of PML.

Choice C Reason:

Furosemide: Furosemide is a loop diuretic used to treat edema and hypertension. It is not associated with an increased risk of PML.

Choice D Reason:

Metoprolol is incorrect .Metoprolol is a beta-blocker used to treat hypertension, angina, and heart failure. It is not associated with an increased risk of PML.