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.

Answer and Explanation

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.

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Correct Answer is D

Explanation

A. Barrel chest is a physical finding commonly associated with COPD due to hyperinflation of the lungs. It results from chronic air trapping and enlargement of the chest. While barrel chest is not directly caused by cor pulmonale, it is a characteristic feature of advanced COPD.
B. Clubbing of the fingers is not directly caused by cor pulmonale. It is typically associated with chronic hypoxia, which can occur in advanced lung diseases like COPD. Clubbing involves changes in the shape and texture of the nails and fingertips due to chronic lack of oxygen in the blood.
C. Destruction of the alveoli is a hallmark of emphysema, which is a type of COPD. Emphysema leads to loss of lung tissue elasticity and surface area, contributing to chronic airflow limitation. While emphysema is a risk factor for developing cor pulmonale, destruction of alveoli itself does not directly cause cor pulmonale.
D. Peripheral edema is a manifestation caused by cor pulmonale. When the right side of the heart fails (cor pulmonale), it leads to increased pressure in the pulmonary circulation, which can eventually cause fluid to leak out into the tissues, resulting in peripheral edema. This is a consequence of the right heart's inability to effectively pump blood forward due to pulmonary hypertension and subsequent right ventricular failure.

A. Soles of the feet B. Palms of the hands C. Oral mucosa D. Nail beds

Correct Answer is C

Explanation

A. The soles of the feet are not typically assessed for cyanosis because they are not a reliable indicator of central cyanosis. Cyanosis is best evaluated in areas where mucous membranes are visible.
B. Similar to the soles of the feet, the palms of the hands are not a reliable indicator of central cyanosis. Cyanosis is not typically visible on the palms unless there are severe systemic circulation issues.
C. The oral mucosa (inside the mouth) is a reliable area to assess for central cyanosis. The nurse can inspect the lips, tongue, and buccal mucosa for a bluish discoloration, which indicates decreased arterial oxygen saturation.
D. The nail beds are also a reliable indicator of central cyanosis. The nurse can assess the color of the nail beds and look for bluish discoloration, which can be more apparent in darker-skinned individuals compared to the lips and oral mucosa.

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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?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has developed cor pulmonale secondary to an acute exacerbation of chronic obstructive pulmonary disease (COPD). Which of the following manifestations is caused by corpulmonale?

Correct Answer is D

Explanation

A nurse is assessing a client who has asthma. Which of the following areas should the nurse evaluate as the most reliable indicator of central cyanosis?

Correct Answer is C

Explanation

The nurse is reviewing the results of the client's echocardiogram and notes that the ejection fraction is 35%. The nurse anticipates that which of the following medications will be ordered to increase the client's cardiac output?

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A nurse is caring for a client who has myasthenia gravis which has not responded to medication treatments. Which of the following surgeries can treat myasthenia gravis?

A nurse manager is discussing social services for older adults during a staff meeting in a long- term acute care (LTAC) facility. Which statement about Medicare made by one of the employees requires correction by the nurse manager?

The nurse is performing an admission assessment on a client who is being admitted for right- sided heart failure. Which statement made by the patient would be consistent with right-sided heart failure?