A client is newly diagnosed with relapsing-remitting multiple sclerosis (RRMS). What instruction should the nurse provide?

You will have a steady and gradual decline in function.

You must avoid stress and extreme fatigue because it can trigger a relapse.

Your type of multiple sclerosis is the least common, making it difficult to manage.

You should take your medications only during times of relapse.

Answer and Explanation

The Correct Answer is B

Choice A rationale
This statement is not accurate. Relapsing-remitting multiple sclerosis (RRMS) is characterized by periods of new symptoms or relapses that develop over days or weeks and usually improve partially or completely. These episodes are followed by periods of remission, where the disease does not progress. Therefore, RRMS does not cause a steady and gradual decline in function.
Choice B rationale
This is the correct answer. Stress and extreme fatigue can trigger a relapse in RRMS1. Therefore, it is important for patients to avoid these triggers to manage their symptoms effectively.
Choice C rationale
This statement is incorrect. RRMS is the most common disease course at the time of diagnosis. It is not the least common type of multiple sclerosis.
Choice D rationale
This statement is not accurate. Medications for RRMS, known as disease-modifying treatments (DMT), are designed to reduce the frequency and severity of relapses. They are not intended to be taken only during times of relapse, but rather on an ongoing basis to manage the disease.

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Correct Answer is C

Explanation

Choice A rationale
Sensorineural hearing loss is a type of hearing loss in which the root cause lies in the inner ear or sensory organ (cochlea and associated structures) or the vestibulocochlear nerve (cranial nerve VIII). Sensorineural hearing loss can be mild, moderate, severe, or profound, and it affects the ability to hear faint sounds or understand speech. However, in the Rinne test, if the air-conducted sound is louder than the bone-conducted sound, it indicates that the patient’s hearing is likely normal.
Choice B rationale
Tinnitus is the perception of noise or ringing in the ears. It is a common problem that affects about 15 to 20 percent of people and is especially common in older adults. However, the Rinne test is not used to diagnose tinnitus. It is used to compare air and bone conduction of sound.
Choice C rationale
In a normal Rinne test, air conduction (AC) is better than bone conduction (BC). This is referred to as a positive Rinne test. If a patient reports that air-conducted sound is louder than bone-conducted sound, it suggests that the patient’s hearing is likely normal.
Choice D rationale
Otosclerosis is a condition that affects the bones in the middle ear, causing hearing loss. It is a common cause of conductive hearing loss, particularly in young adults. However, in otosclerosis, bone conduction (BC) is better than air conduction (AC), which is referred to as a negative Rinne test.

A. Ask the patient to demonstrate the instillation of the medications. B. Assess the patient for any previous inability to self-manage medications. C. The patient accurately describes the directions for administering the medications. D. Assess the patient’s functional status.

Correct Answer is A

Explanation

Choice A rationale
The best way to determine if a patient can safely and effectively self-administer medications is to ask the patient to demonstrate the instillation of the medications. This allows the nurse to directly observe the patient’s technique, identify any errors, and provide immediate feedback and instruction. It also gives the patient an opportunity to ask questions and clarify any misunderstandings. This method is often referred to as the “show-back” or “teach-back” method and is widely used in patient education to confirm understanding and competency.
Choice B rationale
While assessing the patient for any previous inability to self-manage medications can provide useful information, it does not directly assess the patient’s ability to self-administer the new eye medications. Previous difficulties may be due to factors that do not apply to the current situation, such as complex medication regimens, cognitive impairment, or lack of resources.
Choice C rationale
Although the patient accurately describing the directions for administering the medications indicates that the patient understands the instructions, it does not necessarily mean that the patient can perform the task correctly. Physical limitations, dexterity issues, or misunderstanding of the instructions can still result in incorrect administration.
Choice D rationale

Assessing the patient’s functional status can provide valuable information about the patient’s overall ability to perform activities of daily living, including medication management.
However, it does not specifically assess the patient’s ability to self-administer eye medications.

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A client is newly diagnosed with relapsing-remitting multiple sclerosis (RRMS). What instruction should the nurse provide?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An advanced practice nurse has performed a Rinne test on a new patient. During the test, the patient reports that air-conducted sound is louder than bone-conducted sound. How should the nurse interpret this assessment finding?

Correct Answer is C

Explanation

The nurse is educating a patient who has been newly prescribed eye medications to treat glaucoma. How can the nurse best determine if the patient can safely and effectively self-administer the medications?

Correct Answer is A

Explanation

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