Which reason explains why a patient with amyotrophic lateral sclerosis (ALS) is uniquely prone to depression?

Intellectual capacity is not affected.

Communication is altered.

Mobility is limited.

Nutritional intake is poor.

Answer and Explanation

The Correct Answer is B

A. Intellectual capacity is not affected:

This statement refers to the fact that ALS primarily affects motor neurons, leading to muscle weakness and paralysis, but it typically does not directly impact cognitive function or intellectual capacity. While cognitive impairment is not a hallmark feature of ALS, some individuals may experience changes in cognitive function or behavior, such as executive dysfunction or frontotemporal dementia, in later stages of the disease. However, depression in ALS is not primarily linked to changes in intellectual capacity but rather to other factors such as altered communication, physical limitations, and loss of autonomy.

B. Communication is altered:

ALS can affect the muscles involved in speech and swallowing, leading to difficulties in communicationAs the disease progresses, patients may experience dysarthria (difficulty speaking clearly) and dysphagia (difficulty swallowing), which can impair their ability to communicate effectively with others. Altered communication can result in frustration, social isolation, and feelings of being misunderstood, all of which are risk factors for depression.

C. Mobility is limited:

ALS causes progressive muscle weakness and paralysis, which can significantly impair mobility over time. As the disease advances, individuals with ALS may become increasingly dependent on mobility aids such as wheelchairs or may require assistance with mobility tasks. Limited mobility can lead to feelings of loss of independence, decreased participation in activities, and increased dependence on caregivers, all of which can contribute to depression.

D. Nutritional intake is poor:

ALS can affect the muscles involved in swallowing and chewing, leading to difficulties with eating and drinking. Dysphagia, or difficulty swallowing, is a common symptom in ALS and can result in poor nutritional intake and weight loss. Malnutrition and weight loss are associated with increased morbidity and mortality in ALS, and they can also contribute to feelings of weakness, fatigue, and overall decline in quality of life, which may exacerbate depression.

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Correct Answer is A

Explanation

A. 4 hours:

This option indicates that tissue plasminogen activator (tPA) must be administered within 4 hours of the onset of stroke symptoms to be considered as a drug therapy option. tPA is a thrombolytic medication used to dissolve blood clots in ischemic stroke, and its effectiveness is highest when administered promptly after the onset of symptoms.

B. 1 hour:

Administering tPA within 1 hour of stroke onset would be extremely challenging and impractical. It typically takes time for patients to recognize stroke symptoms, seek medical attention, and undergo diagnostic evaluations before tPA administration. While time is of the essence in stroke treatment, 1 hour is too short of a timeframe for most patients to receive tPA.

C. 24 hours:

Administering tPA beyond 4.5 hours of stroke onset is generally contraindicated due to the increased risk of complications, including hemorrhagic transformation of the stroke. While there may be some extended time windows considered for certain patients under specific circumstances, such as those meeting eligibility criteria for extended thrombolytic therapy, 24 hours is outside the standard timeframe for tPA administration.

D. 8 hours:

While tPA administration within 8 hours of stroke onset may be feasible for some patients, it is beyond the standard recommended time window for optimal effectiveness. As mentioned earlier, tPA is most effective when administered within the first 3 to 4.5 hours after the onset of symptoms, with earlier administration associated with better outcomes.

A. The client should maintain systolic BP between 120 and 129 mm Hg. B. The client should maintain systolic BP between 130 and 135 mm Hg. C. The client should maintain systolic BP between 136 and 140 mm Hg. D. The client should maintain systolic BP between 141 and 145 mm Hg. E. Note the time the seizure started

Correct Answer is A

Explanation

A. The client should maintain systolic BP between 120 and 129 mm Hg.

This is an appropriate recommendation. The American Heart Association (AHA) guidelines recommend maintaining systolic BP below 130 mm Hg to reduce the risk of stroke and other cardiovascular events in individuals with a history of stroke or TIA.

B. The client should maintain systolic BP between 130 and 135 mm Hg.

This is slightly above the recommended range. While systolic BP below 135 mm Hg is generally recommended for individuals with a history of stroke or TIA, a range of 130-135 mm Hg may still be acceptable based on individual patient factors and risk assessments.

C. The client should maintain systolic BP between 136 and 140 mm Hg.

This is above the recommended range. Systolic BP between 136 and 140 mm Hg may be considered elevated and should be managed to lower levels to reduce the risk of recurrent TIA or stroke.

D. The client should maintain systolic BP between 141 and 145 mm Hg.

This is above the recommended range. Systolic BP above 140 mm Hg is generally considered elevated and should be managed to lower levels to reduce the risk of recurrent TIA or stroke.

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Which reason explains why a patient with amyotrophic lateral sclerosis (ALS) is uniquely prone to depression?

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Naxlex Comprehensive Predictor Exams

A few days after a Cerebral Vascular Accident, the patient's family asks the nurse if tissue plasminogen activator (tPA) is a drug therapy option now. The nurse's response based on the knowledge that this drug must be used within:

Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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