Review Neuroinflammation: Multiple sclerosis; Meningitis; Guillain-BarrÃ© syndrome

Pathophysiology of the Nervous System > Pathophysiology

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Neuroinflammation: Multiple sclerosis; Meningitis; Guillain-BarrÃ© syndrome

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Total Questions : 4

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Question 1:

A nurse is caring for a client who has multiple sclerosis (MS). The client reports blurred vision, eye pain, and loss of color perception. Which of the following terms should the nurse use to document this finding?

A. Nystagmus B. Diplopia C. Optic neuritis D. Papilledema

Answer and Explanation

Choice A:

This is an incorrect answer. Nystagmus is a condition that causes involuntary and rhythmic eye movements, which can affect vision and balance. Nystagmus can occur in some clients who have MS due to damage to the brainstem or cerebellum, but it does not cause eye pain or loss of color perception.

Choice B:

This is an incorrect answer. Diplopia is a condition that causes double vision, which can affect depth perception and coordination. Diplopia can occur in some clients who have MS due to damage to the cranial nerves or ocular muscles, but it does not cause eye pain or loss of color perception.

Choice C:

This is a correct answer. Optic neuritis is a condition that causes inflammation and demyelination of the optic nerve, which can affect visual acuity and color perception. Optic neuritis can occur in some clients who have MS due to damage to the optic nerve or chiasm, and it often causes blurred vision, eye pain, and loss of color perception.

Choice D:

This is an incorrect answer. Papilledema is a condition that causes swelling of the optic disc, which can affect peripheral vision and cause headaches. Papilledema can occur in some clients who have increased intracranial pressure (ICP) due to various causes, such as brain tumors, meningitis, or hydrocephalus, but it is not a common finding in MS.

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Question 2:

A nurse is assessing a client who has meningitis. Which of the following findings should the nurse expect? (Select all that apply.)

A. Fever B. Photophobia C. Nuchal rigidity D. Positive Babinski sign E. Positive Brudzinski sign

Answer and Explanation

Choice A:

This is a correct answer. Fever is a common symptom of meningitis, which is an inflammation of the meninges or the membranes that cover the brain and spinal cord. Fever occurs due to the infection or immune response that causes meningitis, which can be bacterial, viral, fungal, or parasitic.

Choice B:

This is a correct answer. Photophobia is another common symptom of meningitis, which is an intolerance or sensitivity to light that causes eye pain or discomfort. Photophobia occurs due to the irritation of the optic nerve or cranial nerves that control the pupillary reflex by the inflamed meninges.

Choice C:

This is a correct answer. Nuchal rigidity is another common symptom of meningitis, which is stiffness or pain in the neck when flexing or extending it. Nuchal rigidity occurs due to the inflammation or spasm of the neck muscles by the inflamed meninges.

Choice D:

This is an incorrect answer. Positive Babinski sign is not a common symptom of meningitis, but rather a sign of upper motor neuron lesion or damage to the corticospinal tract that controls voluntary movement. Positive Babinski sign occurs when the big toe extends upward and the other toes fan out when stroking the sole of the foot with a blunt object.

Choice E:

This is a correct answer. Positive Brudzinski sign is another common symptom of meningitis, which is flexion of the hips and knees when flexing the neck forward. Positive Brudzinski sign occurs due to the irritation of the spinal nerve roots by the inflamed meninges.

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Question 3:

A nurse is educating a client who has Guillain-Barré syndrome (GBS). The client says to the nurse, "I don't understand why I have this condition." How should the nurse respond?

A. "You have this condition because your immune system mistakenly attacks your peripheral nerves." B. "You have this condition because your body produces antibodies against your myelin sheath." C. "You have this condition because you have a genetic mutation that affects your nerve function." D. "You have this condition because you have been exposed to a virus that infects your nerve cells."

Answer and Explanation

Choice A:

This is a correct answer. The nurse should explain to the client that GBS is an autoimmune disorder that causes inflammation and demyelination of the peripheral nerves, which can affect sensation, movement, and autonomic function. GBS occurs when the immune system mistakenly attacks the peripheral nerves, often after an infection or vaccination.

Choice B:

This is an incorrect answer. The nurse should not tell the client that they have GBS because their body produces antibodies against their myelin sheath. This is not the mechanism of GBS, but rather multiple sclerosis (MS), which is another autoimmune disorder that causes inflammation and demyelination of the central nervous system (CNS).

Choice C:

This is an incorrect answer. The nurse should not tell the client that they have GBS because they have a genetic mutation that affects their nerve function. This is not the cause of GBS, but rather Charcot-Marie-Tooth disease (CMT), which is a hereditary disorder that affects the structure and function of the peripheral nerves.

Choice D:

This is an incorrect answer. The nurse should not tell the client that they have GBS because they have been exposed to a virus that infects their nerve cells. This is not the cause of GBS, but rather encephalitis, which is an acute inflammatory condition of the brain that can be caused by various viruses or bacteria.

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Question 4:

A nurse is caring for a client who has meningitis. The client reports severe headache, nausea, and vomiting. Which of the following interventions should the nurse implement to relieve the client's symptoms?

A. Administer analgesics and antiemetics as prescribed B. Elevate the head of the bed to 45 degrees C. Apply a cold compress to the forehead D. Dim the lights and reduce noise in the room

Answer and Explanation

Choice A:

This is an incorrect answer. Administering analgesics and antiemetics as prescribed is not an effective intervention to relieve the client's symptoms of headache, nausea, and vomiting due to meningitis. Analgesics and antiemetics can have adverse effects such as sedation, hypotension, or constipation, which can worsen the client's condition or mask signs of increased intracranial pressure (ICP). The nurse should use non-pharmacological methods to relieve the client's symptoms and monitor their vital signs and neurological status.

Choice B:

This is an incorrect answer. Elevating the head of the bed to 45 degrees is not an effective intervention to relieve the client's symptoms of headache, nausea, and vomiting due to meningitis. Elevating the head of the bed can increase ICP by reducing venous drainage from the brain, which can worsen the client's condition or cause complications such as herniation or hydrocephalus. The nurse should keep the head of the bed flat or slightly elevated and avoid neck flexion or rotation.

Choice C:

This is an incorrect answer. Applying a cold compress to the forehead is not an effective intervention to relieve the client's symptoms of headache, nausea, and vomiting due to meningitis. A cold compress can cause vasoconstriction and reduce blood flow and oxygen delivery to the brain, which can worsen the client's condition or cause ischemia or infarction. The nurse should avoid applying cold or heat to the head and maintain a normal body temperature for the client.

Choice D:

This is a correct answer. Dimming the lights and reducing noise in the room is an effective intervention to relieve the client's symptoms of headache, nausea, and vomiting due to meningitis. Dimming the lights and reducing noise can decrease sensory stimulation and irritation of the optic nerve or cranial nerves that control the pupillary reflex by the inflamed meninges. The nurse should also provide a quiet and calm environment for the client and limit visitors and activities.

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Neuroinflammation: Multiple sclerosis; Meningitis; Guillain-BarrÃ© syndrome

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