A nurse in a provider’s office is assessing a client who has wrist pain. Which of the following findings is a manifestation of carpal tunnel syndrome?

Choice A reason: Wearing an eye patch at all times for diplopia in multiple sclerosis is inappropriate, as it may not address the underlying demyelination causing visual disturbances. Alternating eye patches or consulting a neurologist is preferred, as constant patching could strain vision or mask worsening symptoms, reducing quality of life.

Choice B reason: Relaxing in a hot tub daily is not advisable for multiple sclerosis, as heat can exacerbate symptoms (Uhthoff’s phenomenon) by slowing nerve conduction in demyelinated areas. This could worsen fatigue, sensory changes, or motor symptoms, making it an unsafe recommendation for managing MS symptoms.

Choice C reason: Implementing a rest schedule is appropriate for multiple sclerosis, as fatigue is a common symptom due to immune-mediated demyelination and central nervous system dysfunction. Rest periods help conserve energy, reduce symptom exacerbation, and improve daily functioning, making this a critical strategy for managing MS effectively.

Choice D reason: A vigorous exercise program is inappropriate for MS clients with active symptoms like diplopia and sensory changes, as overexertion can worsen fatigue and neurological symptoms. Gentle, tailored exercise may be beneficial, but vigorous activity risks exacerbating demyelination-related impairments, making this an unsuitable recommendation.

Choice A reason: Inserting a padded tongue blade during a seizure is outdated and dangerous, as it can cause injury or obstruct the airway. Seizures involve uncontrolled neuronal firing, and forcing objects into the mouth risks trauma or aspiration, contrary to current epilepsy management guidelines focusing on airway protection and safety.

Choice B reason: Placing the client on their back during a seizure increases the risk of aspiration, as secretions or vomit may obstruct the airway. Seizures cause loss of motor control, and the side-lying position is preferred to maintain airway patency, making this an incorrect and unsafe instruction.

Choice C reason: Moving objects away from the client during a seizure is critical to prevent injury from uncontrolled movements caused by synchronized neuronal discharges in the brain. This ensures a safe environment, reducing the risk of trauma from striking objects, aligning with standard seizure management protocols to prioritize safety.

Choice D reason: Restraining a client during a seizure can cause injury, as forceful movements from epileptiform activity are involuntary. Restraints may increase muscle strain or fractures and heighten agitation, potentially worsening the seizure or causing psychological harm, making this an inappropriate and unsafe action.