A nurse is assessing a client who has multiple sclerosis. The client reports that, since the onset of the disease, there are times when their symptoms are active and then followed by a period with no symptoms. Which of the following types of multiple sclerosis does this pattern indicate?

Primary progressive multiple sclerosis

Relapsing-remitting multiple sclerosis

Clinically isolating syndrome

Secondary progressive multiple sclerosis

Answer and Explanation

The Correct Answer is B

Primary progressive multiple sclerosis (PPMS) is false. This subtype of MS is characterized by a gradual worsening of symptoms from the onset of the disease, without distinct relapses or remissions. It typically leads to a progressive accumulation of disability over time, without periods of remission. The pattern described by the client, with alternating periods of active symptoms and symptom-free periods, does not align with the continuous progression seen in PPMS.

Choice B Reason:

Relapsing-remitting multiple sclerosis (RRMS) is true. RRMS is characterized by distinct relapses, during which new symptoms may appear or existing symptoms may worsen, followed by periods of partial or complete recovery (remissions), during which the symptoms improve or may even disappear entirely. This pattern matches the description provided by the client, indicating RRMS as the likely subtype.

Choice C Reason:

Clinically isolating syndrome (CIS) is false. CIS refers to a single episode of neurological symptoms caused by inflammation or demyelination in the central nervous system, which may or may not progress to MS. However, CIS does not involve the characteristic pattern of relapses and remissions seen in RRMS.

Choice D Reason:

Secondary progressive multiple sclerosis (SPMS) is false. SPMS is characterized by a gradual worsening of symptoms and disability over time, following an initial period of relapsing-remitting disease. It may or may not involve distinct relapses and remissions, depending on the individual's disease course. While SPMS can involve periods of symptom exacerbation, it typically lacks the clear pattern of relapses followed by remissions seen in RRMS.

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Correct Answer is ["A","C","D","E"]

Explanation

Choice A Reason:

Decreased visual acuity is correct. Yes, decreased visual acuity, including issues such as poor depth perception, reduced peripheral vision, and difficulty with contrast sensitivity, can contribute to falls and head injuries in older adults.

Choice B Reason:

Motor vehicle crashes is incorrect. While motor vehicle crashes can cause head injuries in individuals of all ages, they are less common among older adults compared to younger age groups.

Choice C Reason:

Polypharmacy is correct. Yes, polypharmacy, which refers to the use of multiple medications concurrently, is a common risk factor for falls and head injuries in older adults. Certain medications, especially those with sedative or psychotropic effects, can increase the risk of falls and accidents.

Choice D Reason:

Weakness is correct. Yes, weakness, frailty, and decreased muscle strength are common age-related changes that can increase the risk of falls and subsequent head injuries in older adults.

Choice E Reason:

Chronic hypertension, particularly when poorly controlled, can contribute to an increased risk of falls in older adults through various mechanisms:Hypertension medications or the condition itself can lead to orthostatic hypotension. This can cause dizziness or lightheadedness, increasing the risk of falls.Chronic hypertension is a major risk factor for cerebrovascular disease, including strokes. These events can lead to neurological deficits such as weakness, numbness, or impaired balance, predisposing individuals to falls.

Choice F Reason:

Previous military experience is incorrect. While previous military experience may contribute to certain health conditions or injuries in older adults, it is not a common reason for head injuries specifically related to falls or accidents in this population.

A. Client responds to name B. Eyes open to painful stimuli C. Client states day of the week D. Client is confused E. Client mumbles inappropriate words F. Eyes do not open to name

Correct Answer is ["B","D","E","F"]

Explanation

Choice A Reason:

Client responds to name is incorrect. Responding to one's name is a positive sign indicating consciousness and orientation. It suggests that the client's level of consciousness is relatively intact.

Choice B Reason:

Eyes open to painful stimuli is correct. Opening the eyes in response to painful stimuli is a concerning sign, indicating a decrease in consciousness and potentially worsening neurological status. It suggests that the client's level of arousal is diminishing and may indicate a decline in condition.

Choice C Reason:

Client states day of the week is correct. Oriented behavior, such as knowing the day of the week, is a positive sign indicating intact cognition and orientation. It suggests that the client's mental status is relatively preserved.

Choice D Reason:

Client is confused is correct. Confusion is a concerning sign, indicating altered mental status and potentially worsening neurological function. It suggests that the client's cognition is impaired, which may be indicative of a decline in condition.

Choice E Reason:

Client mumbles inappropriate words is correct. Mumbling inappropriate words suggests disorientation and altered mental status, which are concerning signs indicating a decline in neurological function.

Choice F Reason:

Eyes do not open to name is incorrect. Failure to open the eyes in response to verbal stimuli, such as one's name, is a concerning sign indicating a decrease in consciousness and potentially worsening neurological status. It suggests that the client's level of arousal is diminished and may indicate a decline in condition.

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A nurse is assessing a client who has multiple sclerosis. The client reports that, since the onset of the disease, there are times when their symptoms are active and then followed by a period with no symptoms. Which of the following types of multiple sclerosis does this pattern indicate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for an older adult client in the emergency department who sustained a head injury due to a fall. Which of the following are common reasons for head injuries in older adults? (Select All that Apply.)

Correct Answer is ["A","C","D","E"]

Explanation

Correct Answer is ["B","D","E","F"]

Explanation

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