A nurse is teaching a client who has multiple sclerosis. Which of the following instructions should the nurse include in the teaching?

"Schedule rest periods during the day."

"Soak in a hot bath."

"Perform aerobic activities three times per week."

"Have your partner complete activities of daily living for you."

Answer and Explanation

The Correct Answer is A

Rationale:
A. "Schedule rest periods during the day.": Fatigue is a common symptom of multiple sclerosis. Scheduling rest periods helps conserve energy, prevent exacerbation of symptoms, and improve overall functioning without overtaxing the client.

B. "Soak in a hot bath.": Heat can worsen multiple sclerosis symptoms by temporarily increasing nerve conduction delays. Hot baths may trigger fatigue or weakness and are generally discouraged.

C. "Perform aerobic activities three times per week.": While gentle exercise is beneficial, intense aerobic activity can exacerbate fatigue and heat sensitivity in clients with multiple sclerosis. Exercise should be balanced with rest periods.

D. "Have your partner complete activities of daily living for you.": Encouraging total dependence can reduce independence and self-efficacy. Clients should perform activities within their capacity to maintain function while pacing themselves appropriately.

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Correct Answer is A

Explanation

Rationale:
A. 0.45% sodium chloride: This is a hypotonic solution that helps lower elevated serum sodium levels by promoting water movement into the intracellular space. It is appropriate for correcting hypernatremia gradually while preventing cerebral edema.

B. Lactated Ringer's: Lactated Ringer’s is an isotonic solution containing sodium, potassium, and calcium. It is not ideal for hypernatremia because its sodium content can maintain or worsen elevated serum sodium levels.

C. 0.9% sodium chloride: Normal saline is isotonic and contains a high concentration of sodium, which would not reduce hypernatremia and could exacerbate the condition if used for correction.

D. 3% sodium chloride: This hypertonic solution increases serum sodium levels and is used to treat hyponatremia, not hypernatremia. Administering it to a client with hypernatremia would worsen the electrolyte imbalance.

A. Initiate fibrinolytic therapy. B. Place the client in a supine position. C. Prepare the client for a chest x-ray. D. Insert an indwelling urinary catheter.

Correct Answer is A

Explanation

Rationale:
A. Initiate fibrinolytic therapy: Fibrinolytic therapy, such as tissue plasminogen activator (tPA), is most effective when administered within a 3- to 4.5-hour window from the onset of ischemic stroke symptoms. Early administration can dissolve the clot, restore cerebral blood flow, and improve neurological outcomes.

B. Place the client in a supine position: Clients with ischemic stroke are usually positioned with the head of the bed elevated 15–30 degrees unless contraindicated. Supine positioning can increase intracranial pressure and risk aspiration, which may worsen neurological status.

C. Prepare the client for a chest x-ray: A chest x-ray is not a priority in acute ischemic stroke management. Immediate neuroimaging, typically a CT scan, is required to differentiate ischemic from hemorrhagic stroke before initiating fibrinolytic therapy.

D. Insert an indwelling urinary catheter: Inserting a catheter is not indicated as an initial intervention for acute stroke unless the client is unable to void or requires strict output monitoring. Priority actions focus on neuroprotection and reperfusion therapy.

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A nurse is teaching a client who has multiple sclerosis. Which of the following instructions should the nurse include in the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

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