A nurse is caring for a client who has multiple sclerosis and is being evaluated for progressive multifocal leukoencephalopathy (PML). Which of the following findings should the nurse recognize as manifestations of this condition?
(Select All that Apply.)

Memory loss

Clumsiness

Tardive dyskinesia

Seizures

Vision difficulty

Answer and Explanation

Correct Answer : A,B,D,E

Choice A Reason:

Memory loss is correct. Memory loss can occur in individuals with PML due to damage to the white matter of the brain caused by the JC virus infection. This damage can affect cognitive function, including memory.

Choice B Reason:

Clumsiness is correct. Clumsiness or lack of coordination is a common neurological symptom of PML. It can result from damage to areas of the brain responsible for motor function and coordination.

Choice C Reason:

Tardive dyskinesia is incorrect. Tardive dyskinesia is a movement disorder characterized by involuntary, repetitive movements, often involving the face, lips, tongue, and limbs. While tardive dyskinesia can occur as a side effect of certain medications, it is not typically associated with PML.

Choice D Reason:

Seizures is correct. Seizures can occur in individuals with PML due to the involvement of the brain's white matter by the JC virus infection. Seizures may present as sudden, uncontrolled movements, altered consciousness, or other neurological symptoms.

Choice E Reason:

Vision difficulty is correct. Vision difficulties, including blurred vision, visual field deficits, and other visual disturbances, are common manifestations of PML. Damage to the optic nerves or areas of the brain involved in visual processing can result in vision difficulties.

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Correct Answer is B

Explanation

Choice A Reason:

Pregabalin is incorrect. Pregabalin is a medication used to treat neuropathic pain, seizures, and generalized anxiety disorder. It is not associated with an increased risk of PML.

Choice B Reason:

Natalizumab is correct.: Natalizumab is a monoclonal antibody used to treat relapsing forms of MS. It is associated with an increased risk of developing PML, particularly in individuals who are JC virus antibody positive. Regular monitoring of JC virus antibody status and clinical vigilance is required when using natalizumab to reduce the risk of PML.

Choice C Reason:

Furosemide: Furosemide is a loop diuretic used to treat edema and hypertension. It is not associated with an increased risk of PML.

Choice D Reason:

Metoprolol is incorrect .Metoprolol is a beta-blocker used to treat hypertension, angina, and heart failure. It is not associated with an increased risk of PML.

A. "Cerebral edema is caused by osmotic cerebral edema." B. "Cerebral edema is caused by whole body inflammation which affects the brain the most." C. "Cerebral edema is caused by the by-products of the pathogen that causes the meningitis." D. "Cerebral edema is caused by cerebrospinal fluid flowing from the intraventricular space to the interstitial area of the brain."

Correct Answer is C

Explanation

A.Osmotic edema refers to fluid shifts due to changes in osmotic gradients (as seen in conditions like hyponatremia), not the inflammatory process of meningitis.

B.While inflammation is a key part of the body's response in meningitis, the edema is not a result of generalized whole-body inflammation. The edema is more directly linked to local inflammatory reactions in the brain triggered by the pathogen’s by-products.

C.Bacterial cell walls, endotoxins, and other components released by the bacteria directly stimulate inflammation, causing the breakdown of the BBB and allowing fluid and inflammatory cells to leak into the brain tissue.

D.This description is more aligned with the pathophysiology of conditions like hydrocephalus rather than meningitis. In meningitis, cerebral edema is primarily due to the inflammatory response, not abnormal CSF flow.

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A nurse is caring for a client who has multiple sclerosis and is being evaluated for progressive multifocal leukoencephalopathy (PML). Which of the following findings should the nurse recognize as manifestations of this condition? (Select All that Apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has multiple sclerosis and is experiencing progressive multifocal leukoencephalopathy (PML). Which of the following medications should the nurse recognize is associated with the development of PML?

Correct Answer is B

Explanation

A nurse is caring for a client admitted with meningitis. The student nurse asks, "I know that the client has a lot of edemas in the brain, but what causes it?" Which of the following responses from the nurse best answers the student's question?

Correct Answer is C

Explanation

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A nurse is caring for a client who has multiple sclerosis and is being evaluated for progressive multifocal leukoencephalopathy (PML). Which of the following findings should the nurse recognize as manifestations of this condition?
(Select All that Apply.)