The nurse is assessing a patient who has been diagnosed with multiple sclerosis (MS).
Which of the following findings is most consistent with this condition?
Muscle atrophy and fasciculations.
Intention tremors and nystagmus.
Flaccid paralysis and areflexia.
Hyperactive reflexes and spasticity.
The Correct Answer is B
Intention tremors and nystagmus. These are some of the common symptoms of multiple sclerosis (MS), a condition that affects the central nervous system and causes communication problems between the brain and the rest of the body. Intention tremors are involuntary shaking movements that occur when a person tries to perform a precise action, such as reaching for an object or writing. Nystagmus is a condition where the eyes make repetitive, uncontrolled movements, often resulting in reduced vision and depth perception.
Choice A is wrong because muscle atrophy and fasciculations are more typical of motor neuron diseases, such as amyotrophic lateral sclerosis (ALS), which affect the nerve cells that control voluntary muscle movements.
Choice C is wrong because flaccid paralysis and areflexia are signs of lower motor neuron lesions, which can be caused by spinal cord injuries, peripheral nerve disorders, or Guillain-Barré syndrome.
Choice D is wrong because hyperactive reflexes and spasticity are signs of upper motor neuron lesions, which can be caused by stroke, traumatic brain injury, or cerebral palsy.
Normal ranges for some of the symptoms mentioned are:.
• Intention tremors: none or minimal.
• Nystagmus: none or minimal.
• Muscle atrophy: none or minimal.
• Fasciculations: none or minimal.
• Flaccid paralysis: none or minimal.
• Areflexia: absent or reduced reflexes.
• Hyperactive reflexes: normal or slightly increased reflexes.
• Spasticity: normal or slightly increased muscle tone.
A. Muscle atrophy and fasciculations B.
Intention tremors and nystagmus C.
Flaccid paralysis and areflexia D.
Hyperactive reflexes and spasticity
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","E"]
Explanation
The correct answer isA, B, C and E.These interventions are consistent with the best practices for optimizing functional status in the elderly.
Some explanations for the choices are:.
• Choice A is correct because physical activity and exercise can help maintain muscle strength, joint mobility, balance and coordination, which are essential for functional independence and quality of life.
• Choice B is correct because adequate nutrition and hydration can prevent malnutrition, dehydration and electrolyte imbalance, which can impair physical and cognitive function and increase the risk of complications.
• Choice C is correct because managing chronic diseases and medications can prevent complications, adverse effects and polypharmacy, which can affect functional status and increase the need for health care services.
• Choice D is wrong because providing assistive devices and adaptive equipment is not an intervention to improve functional status, but rather to enhance mobility, safety and independence for patients who already have functional limitations.
The question asks for interventions to improve functional status, not to compensate for it.
• Choice E is correct because modifying the environment can reduce hazards, improve accessibility and facilitate self-care, which can promote functional independence and prevent injuries or falls.
The normal ranges for blood glucose and blood pressure for older adults with diabetes and hypertension are:.
• Blood glucose: 80-130 mg/dL before meals and less than 180 mg/dL after meals.
• Blood pressure: less than 140/90 mmHg or individualized based on comorbidities and risk factors.
Correct Answer is ["A","B","C"]
Explanation
The correct answer is A, B and C.
These are the factors that increase the risk of respiratory infections in elderly patients:.
• Decreased immune response: Elderly patients have a weaker immune system that makes them more susceptible to viral and bacterial infections.They also have a poor response to respiratory vaccines.
• Decreased chest wall compliance: Elderly patients have reduced elasticity of the lungs and chest wall, which makes it harder for them to breathe and expel mucus.
• Decreased alveolar surface area: Elderly patients have fewer and larger alveoli, which reduces the gas exchange area and oxygen diffusion capacity.
Choice D is wrong because decreased oxygen saturation is not a risk factor, but a consequence of respiratory infections.
Choice E is wrong because decreased bronchial dilation is not a specific factor for elderly patients, but a common feature of obstructive lung diseases.
Normal ranges for oxygen saturation are 95-100% and for bronchial dilation are variable depending on the type and severity of the disease.
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