When obtaining a health history and physical assessment for a
36-year-old female patient with possible
multiple sclerosis (MS), the nurse should
a. assess for the presence of chest pain.
b. inquire about urinary tract problems.
c. inspect the skin for rashes or discoloration.
d. ask the patient about any increase in libido. Correct Answers
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ANS: B
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Urinary tract problems with incontinence or retention are
common symptoms of MS. Chest pain and skin
rashes are not symptoms of MS. A decrease in libido is common
with MS.
A 31-year-old woman who has multiple sclerosis (MS) asks the
nurse about risks associated with pregnancy. Which response by
the nurse is accurate?
a. MS symptoms may be worse after the pregnancy.
b. Women with MS frequently have premature labor.
c. MS is associated with an increased risk for congenital defects.
d. Symptoms of MS are likely to become worse during
pregnancy. Correct Answers ANS: A
hh hh
During the postpartum period, women with MS are at greater
risk for exacerbation of symptoms. There is no
increased risk for congenital defects in infants born of mothers
with MS. Symptoms of MS may improve
during pregnancy. Onset of labor is not affected by MS.
,A 49-year-old patient with multiple sclerosis (MS) is to begin
treatment with glatiramer acetate (Copaxone). Which
information will the nurse include in patient teaching?
a. Recommendation to drink at least 4 L of fluid daily
b. Need to avoid driving or operating heavy machinery
c. How to draw up and administer injections of the medication
d. Use of contraceptive methods other than oral contraceptives
Correct Answers ANS: C
hh hh
Copaxone is administered by self-injection. Oral contraceptives
are an appropriate choice for birth control. There is no need to
avoid driving or drink large fluid volumes when taking
glatiramer.
Which information about a 60-year-old patient with MS
indicates that the nurse should consult with the health care
provider before giving the prescribed dose of dalfampridine
(Ampyra)?
a. The patient has relapsing-remitting MS.
b. The patient walks a mile a day for exercise.
c. The patient complains of pain with neck flexion.
d. The patient has an increased serum creatinine level. Correct
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Answers ANS: D
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Dalfampridine should not be given to patients with impaired
renal function. The other information will not
impact whether the dalfampridine should be administered.
Which action will the nurse plan to take for a 40-year-old patient
with multiple sclerosis (MS) who has urinary retention caused
by a flaccid bladder?
,a. Decrease the patients evening fluid intake.
b. Teach the patient how to use the Cred method.
c. Suggest the use of adult incontinence briefs for nighttime
only.
d. Assist the patient to the commode every 2 hours during the
day Correct Answers ANS: B
hh hh
The Cred method can be used to improve bladder emptying.
Decreasing fluid intake will not improve bladder emptying and
may increase risk for urinary tract infection (UTI) and
dehydration. The use of incontinence briefs and frequent
toileting will not improve bladder emptying.
A 73-year-old patient with Parkinsons disease has a nursing
diagnosis of impaired physical mobility related to bradykinesia.
Which action will the nurse include in the plan of care?
a. Instruct the patient in activities that can be done while lying or
sitting.
b. Suggest that the patient rock from side to side to initiate leg
movement.
c. Have the patient take small steps in a straight line directly in
front of the feet.
d. Teach the patient to keep the feet in contact with the floor and
slide them forward. Correct Answers ANS: B
hh hh
Rocking the body from side to side stimulates balance and
improves mobility. The patient will be encouraged
to continue exercising because this will maintain functional
abilities. Maintaining a wide base of support will help with
balance. The patient should lift the feet and avoid a shuffling
gait.
, A 62-year-old patient who has Parkinsons disease is taking
bromocriptine (Parlodel). Which information obtained by the
nurse may indicate a need for a decrease in the dose?
a. The patient has a chronic dry cough.
b. The patient has four loose stools in a day.
c. The patient develops a deep vein thrombosis.
d. The patients blood pressure is 92/52 mm Hg. Correct
hh
Answers ANS: D
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Hypotension is an adverse effect of bromocriptine, and the nurse
should check with the health care provider
before giving the medication. Diarrhea, cough, and deep vein
thrombosis are not associated with bromocriptine use.
The nurse advises a patient with myasthenia gravis (MG) to
a. perform physically demanding activities early in the day.
b. anticipate the need for weekly plasmapheresis treatments.
c. do frequent weight-bearing exercise to prevent muscle
atrophy.
d. protect the extremities from injury due to poor sensory
perception. Correct Answers ANS: A
hh hh
Muscles are generally strongest in the morning, and activities
involving muscle activity should be scheduled
then. Plasmapheresis is not routinely scheduled, but is used for
myasthenia crisis or for situations in which
corticosteroid therapy must be avoided. There is no decrease in
sensation with MG, and muscle atrophy does not occur because
although there is muscle weakness, they are still used.
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