The nurse provides care for a client diagnosed with multiple sclerosis. The client has bilateral muscle weakness, frequent muscle spasms, and urinary retention. Which best describes the cause of these manifestations?

Ischemia of the motor and sensory neurons in the brain

Damage and scarring of the white matter in the brain

Infection of the parietal and temporal lobes of the brain

Increased amounts of epinephrine and acetylcholine in the brain

Answer and Explanation

The Correct Answer is B

Choice A reason: Ischemia of the motor and sensory neurons in the brain is not the cause of multiple sclerosis, but a possible consequence of it. Ischemia is a lack of blood supply to the tissues, which may result from inflammation, thrombosis, or embolism. It may cause neuronal death, stroke, or dementia.

Choice B reason: Damage and scarring of the white matter in the brain is the best description of the cause of multiple sclerosis. Multiple sclerosis is an autoimmune disorder that causes the immune system to attack the myelin sheath, which is a protective layer that covers the nerve fibers. The damage and scarring of the myelin sheath, also called demyelination, disrupts the transmission of nerve impulses and causes various neurological symptoms.

Choice C reason: Infection of the parietal and temporal lobes of the brain is not the cause of multiple sclerosis, but a rare complication of it. Infection of the brain, also called encephalitis, may occur due to viral, bacterial, or fungal agents. It may cause fever, headache, confusion, seizures, or coma.

Choice D reason: Increased amounts of epinephrine and acetylcholine in the brain are not the cause of multiple sclerosis, but a possible effect of it. Epinephrine and acetylcholine are neurotransmitters that regulate the sympathetic and parasympathetic nervous systems, respectively. They may be affected by the demyelination of the nerve fibers, which may alter the autonomic functions such as heart rate, blood pressure, digestion, or bladder control.

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Correct Answer is D

Explanation

Choice A reason: The thyroid gland is cancerous is not a correct description of a goiter. A goiter is a non-specific term that refers to any enlargement of the thyroid gland, which may have various causes and may or may not be associated with thyroid cancer.

Choice B reason: The client has a low serum calcium level is not a correct description of a goiter. A low serum calcium level is a sign of hypoparathyroidism, which is a condition that affects the parathyroid glands, not the thyroid gland. The parathyroid glands are located behind the thyroid gland and regulate the calcium and phosphorus levels in the blood.

Choice C reason: The thyroid gland has been surgically removed is not a correct description of a goiter. A goiter is a condition that involves the presence of an enlarged thyroid gland, not the absence of it. A surgical removal of the thyroid gland is called a thyroidectomy, which may be done for various reasons such as thyroid cancer, hyperthyroidism, or large goiters.

Choice D reason: The thyroid gland is enlarged is the best description of a goiter. A goiter is a condition that involves the enlargement of the thyroid gland, which may be due to iodine deficiency, autoimmune disease, inflammation, infection, benign nodules, or thyroid hormone imbalance. A goiter may cause symptoms such as difficulty swallowing, breathing, or speaking, hoarseness, cough, or neck discomfort.

A. Blood flow is diverted from the abdominal muscles to the liver due to increased intravascular pressure B. Vasodilation of the mesenteric blood vessels promotes movement of sodium into the peritoneum C. Fluid moves from the intravascular space to the interstitial space due to decreased serum albumin levels D. The liver metabolizes increased amounts of antidiuretic hormone and aldosterone

Correct Answer is C

Explanation

Choice A reason: Blood flow is diverted from the abdominal muscles to the liver due to increased intravascular pressure is not the best description because it is a condition that affects the distribution of blood in the body, not the accumulation of fluid in the abdomen. Intravascular pressure is the pressure exerted by the blood on the walls of the blood vessels, which can be affected by various factors, such as blood volume, cardiac output, or vascular resistance. Increased intravascular pressure can cause blood flow to be diverted from the peripheral areas, such as the abdominal muscles, to the central areas, such as the liver, which can result in symptoms such as portal hypertension, which is a high blood pressure in the vein that carries blood from the digestive organs to the liver.

Choice B reason: Vasodilation of the mesenteric blood vessels promotes movement of sodium into the peritoneum is not the best description because it is a condition that affects the diameter of the blood vessels in the abdomen, not the accumulation of fluid in the abdomen. Vasodilation is the widening of the blood vessels, which can be caused by various factors, such as nitric oxide, prostaglandins, or histamine. Vasodilation of the mesenteric blood vessels, which are the blood vessels that supply the intestines, can increase the blood flow and the permeability of the capillaries, which are the smallest blood vessels, allowing sodium and water to move from the blood to the peritoneum, which is the membrane that covers the abdominal organs and the abdominal wall. However, this is not the main mechanism for ascites development in this client, because the amount of sodium and water that moves through the capillaries is normally balanced by the lymphatic system, which is a network of vessels that drains the excess fluid and returns it to the blood.

Choice C reason: Fluid moves from the intravascular space to the interstitial space due to decreased serum albumin levels is the best description because it is a condition that affects the osmotic pressure of the blood, which is the main mechanism for ascites development in this client. Osmotic pressure is the pressure that is exerted by the solutes, such as proteins, in a solution, which determines the movement of water across a semipermeable membrane, such as the capillary wall. Albumin is the most abundant protein in the blood, which is produced by the liver and helps to maintain the osmotic pressure of the blood. Decreased serum albumin levels can be caused by various factors, such as liver failure, malnutrition, or inflammation. Decreased serum albumin levels can reduce the osmotic pressure of the blood, which means that the blood cannot retain enough water, causing fluid to move from the intravascular space, which is the space within the blood vessels, to the interstitial space, which is the space between the cells and the blood vessels. This can result in edema, which is the swelling of the tissues due to fluid accumulation, especially in the abdomen, which is called ascites.

Choice D reason: The liver metabolizes increased amounts of antidiuretic hormone and aldosterone is not the best description because it is a condition that affects the hormonal regulation of water and sodium balance, not the accumulation of fluid in the abdomen. Antidiuretic hormone and aldosterone are hormones that help the kidneys retain water and sodium, respectively, and regulate the fluid and electrolyte balance in the body. Antidiuretic hormone is produced by the hypothalamus and secreted by the pituitary gland, while aldosterone is produced by the adrenal glands. The liver is involved in the metabolism and clearance of these hormones, which means that it breaks them down and removes them from the blood. Increased amounts of antidiuretic hormone and aldosterone can be caused by various factors, such as dehydration, heart failure, or renal failure. Increased amounts of antidiuretic hormone and aldosterone can cause the kidneys to reabsorb more water and sodium, which can increase the blood volume and the blood pressure, but this is not the main mechanism for ascites development in this client, because the fluid that accumulates in the abdomen is not from the kidneys, but from the capillaries.

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The nurse provides care for a client diagnosed with multiple sclerosis. The client has bilateral muscle weakness, frequent muscle spasms, and urinary retention. Which best describes the cause of these manifestations?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During review of a client's history, the nurse notes that a goiter is present. Which statement best describes a goiter?

Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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