A nurse is caring for a client who has a new diagnosis of amyotrophic lateral sclerosis (ALS), and a new prescription for riluzole. The nurse understands that this medication works in which of the following ways?
It suppresses the virus which is responsible for causing the inflammation of the nerve.
It prevents the breakdown of acetylcholine to increase the amount available at the neuromuscular junction.
It reduces inflammation in the CNS to prevent further demyelination of nerves in the central nervous system.
It slows the progression of the disease by decreasing the release of glutamate in the brain.
The Correct Answer is D
A. ALS is not caused by a virus or inflammation of the nerves. It is a progressive neurodegenerative disease affecting the motor neurons in the brain and spinal cord.
B. While acetylcholine breakdown is involved in other neurological conditions (such as myasthenia gravis), ALS primarily affects motor neurons and does not directly involve acetylcholine metabolism at the neuromuscular junction.
C. ALS does not typically involve significant inflammation or demyelination (which is more characteristic of conditions like multiple sclerosis). Therefore, reducing CNS inflammation is not a therapeutic target in ALS.
D. Riluzole, the medication prescribed for ALS, works by decreasing the release of glutamate, which is a neurotransmitter that can be toxic to nerve cells in high amounts. In ALS, excessive glutamate release is believed to contribute to motor neuron degeneration. By reducing glutamate release, riluzole may help protect motor neurons and slow the progression of the disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Most individuals with Bell's palsy experience gradual improvement within weeks to months, and the majority recover completely. Permanent facial paralysis is rare, but some individuals may have residual mild weakness or asymmetry.
B. This statement is not typically true for Bell's palsy. Antibiotic eye drops are not routinely prescribed unless there is evidence of corneal exposure due to incomplete eyelid closure (lagophthalmos). Instead, artificial tears and lubricating ointments are often recommended to prevent dryness and protect the cornea.
C. In Bell's palsy, weakness or paralysis of the facial muscles can lead to inability to fully close the eyelid on the affected side. Taping the eyelid closed at night helps prevent corneal damage from exposure and dryness.
D. This statement is not recommended. It is important to avoid stressing the affected facial muscles excessively during recovery from Bell's palsy. Chewing evenly on both sides of the mouth is generally recommended to prevent strain and promote balanced muscle function.
Correct Answer is C
Explanation
A. Moon face is a common side effect of prednisone, a corticosteroid medication. It results from fluid retention and redistribution of fat in the face. While moon face is a cosmetic concern, it is not typically an urgent or critical finding that requires immediate reporting.
B. Muscle spasticity may develop but does not pose an immediate risk that requires urgent attention.
C. Alcohol consumption can interact with both prednisone and interferon B-1a, potentially leading to increased drug levels in the bloodstream and intensifying side effects. This interaction can also increase the risk of liver problems, which is particularly concerning given that interferon B-1a may cause liver issues.
D. Birth control pills have been a subject of debate regarding their effect on multiple sclerosis but a study found that oral hormonal contraceptives did not appear to be associated with an increased chance of MS relapses.
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