The nurse is caring for a patient who has multiple sclerosis. The patient is experiencing an acute attack. Which drug does the nurse anticipate the provider will order?

Interferon-B (IFN-B)

Mitoxantrone

Glatiramer acetate (Copaxone)

Methylprednisolone (Solu-Medrol)

Answer and Explanation

The Correct Answer is D

A) Interferon-B (IFN-B): Interferon-beta is a disease-modifying therapy (DMT) used for multiple sclerosis (MS) to reduce the frequency and severity of attacks and slow disease progression. However, it is not typically used during an acute exacerbation of MS. It is more commonly prescribed for long-term management of the disease.
B) Mitoxantrone: Mitoxantrone is an immunosuppressive agent that is used as a disease-modifying therapy for patients with more aggressive forms of MS. While it can be helpful in reducing the frequency of attacks, it is not the first-line treatment during an acute relapse. Mitoxantrone is often considered for long-term use when other therapies are not effective.
C) Glatiramer acetate (Copaxone): Glatiramer acetate is another disease-modifying therapy for MS. It works by altering the immune response to protect the myelin sheath. Like interferon-beta, it is used for long-term management, not for acute attacks. It is not typically used during an exacerbation of MS.
D) Methylprednisolone (Solu-Medrol): Methylprednisolone, a corticosteroid, is the standard treatment for acute exacerbations of multiple sclerosis. It works by reducing inflammation, which helps to decrease the severity of symptoms during an MS relapse. The nurse would anticipate this drug being prescribed to manage the acute inflammatory episode and speed recovery from the attack. This medication is often administered intravenously in high doses and then tapered as the patient stabilizes.

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Correct Answer is D

Explanation

A) Decreased sweating, decreased BP, and increased heart rate: This combination does not reflect a typical stress response. In stressful or threatening situations, the body activates the sympathetic nervous system, leading to increased sweating, elevated blood pressure, and other physiological changes, rather than a decrease in blood pressure.
B) Increased sweating, decreased respiratory rate, and increased BP: In a stressful situation, sweating would indeed increase due to the activation of the sympathetic nervous system. However, the respiratory rate would typically increase, not decrease, as the body prepares for the "fight or flight" response. Increased blood pressure is expected, but decreased respiratory rate does not align with this response.
C) Pupil constriction, increased respiratory rate, and decreased heart rate: Pupil constriction is not characteristic of the "fight or flight" response; instead, pupil dilation occurs as part of the body's preparation to react to a threat. Increased respiratory rate and heart rate are typically seen during stress, but decreased heart rate would not be expected in such a situation.
D) Increased blood pressure, increased heart rate, and pupil dilation: This is the correct response. When faced with a threatening situation, the body activates the sympathetic nervous system, triggering the "fight or flight" response. This includes increased blood pressure and heart rate to prepare the body for action, as well as pupil dilation (mydriasis) to enhance vision and perception of the environment. These changes help the body respond quickly to a perceived danger.

A. The blood cells will migrate to the bone marrow B. the red cells will precipitate out of circulation C. They will swell and eventually rupture D. The cells will shrink and shrivel, decreasing their oxygen-carrying ability

Correct Answer is D

Explanation

A) The blood cells will migrate to the bone marrow:
While the bone marrow is responsible for producing red blood cells, dehydration and hypertonicity of the blood would not cause the red blood cells to migrate to the bone marrow. Migration of blood cells typically refers to white blood cells moving toward sites of infection or inflammation, not a response to dehydration.

B) The red cells will precipitate out of circulation:
Red blood cells do not precipitate out of circulation due to dehydration or hypertonic conditions. Instead, dehydration causes a shift in water balance that leads to changes in the shape and function of the red blood cells. Precipitation of cells is not a physiological response in this context.

C) They will swell and eventually rupture:
In conditions of hypertonicity, where the concentration of solutes (such as sodium) in the blood is higher than normal, red blood cells actually shrink, not swell. When blood is hypertonic, water moves out of the red blood cells into the extracellular space to balance the osmotic pressure, leading to cell shrinkage. Cells only swell in hypotonic conditions, when water moves into the cell.

D) The cells will shrink and shrivel, decreasing their oxygen-carrying ability:
When the body becomes dehydrated, the blood becomes hypertonic (more concentrated), leading to a shift of water out of the red blood cells to try to balance the osmotic gradient. As a result, the red blood cells shrink and shrivel. This shrinkage can impair their ability to carry oxygen effectively, as the cells may become more rigid and less flexible, making it difficult for them to navigate through small blood vessels and perform gas exchange in the lungs and tissues.

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The nurse is caring for a patient who has multiple sclerosis. The patient is experiencing an acute attack. Which drug does the nurse anticipate the provider will order?

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Explanation

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