A nurse is providing teaching to a client who has a new diagnosis of multiple sclerosis. Which of the following statements should the nurse make?
"Use a cane when walking to maintain your balance."
"Plan to take a hot bath once a week to reduce stress."
"Engage in a rigorous exercise program to maintain muscle tone."
"Place a scatter rug in your bathroom to prevent falling"
The Correct Answer is A
Choice A reason:
"Use a cane when walking to maintain your balance" is the correct statement Multiple sclerosis (MS) is a chronic autoimmune condition that affects the central nervous system, leading to various neurological symptoms. Mobility and balance issues are common among individuals with MS, and using a cane can be helpful in providing stability and support while walking. It can also reduce the risk of falls and improve the client's overall safety and confidence when ambulating.
Choice B reason:
"Plan to take a hot bath once a week to reduce stress” is not appropriate statement. Heat sensitivity is a common symptom in individuals with MS, and exposure to heat, such as hot baths or saunas, can exacerbate MS symptoms. It is generally advisable for individuals with MS to avoid excessive heat exposure as it can worsen fatigue and other neurological symptoms.
Choice C reason:
"Engage in a rigorous exercise program to maintain muscle tone" is not appropriate. While exercise is beneficial for individuals with MS, particularly in maintaining muscle strength and flexibility, it is essential to avoid a rigorous or overly strenuous exercise program. High-intensity exercise may lead to increased fatigue and exacerbation of MS symptoms. A personalized exercise plan that considers the individual's specific abilities and limitations is recommended.
Choice D reason
"Place a scatter rug in your bathroom to prevent falling" is not appropriate statement. Placing a scatter rug in the bathroom is not advisable, especially for individuals with mobility and balance issues like those with MS. Scatter rugs can create tripping hazards and increase the risk of falls. It is essential to keep the bathroom floor clear and use non-slip mats to improve safety.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Muscle stiffness is not a common or serious adverse effect of ibuprofen. Ibuprofen is an anti-inflammatory drug that can reduce pain and stiffness caused by arthritis.
B. Stomach pain or bloody stools are signs of gastrointestinal bleeding, which is a serious and potentially fatal adverse effect of ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can cause ulceration, perforation, and hemorrhage of the stomach or intestines . The nurse should ask the client about any gastrointestinal symptoms and advise them to avoid alcohol, smoking, and other NSAIDs while taking ibuprofen.
C. Dry cough is not a common or serious adverse effect of ibuprofen. Dry cough is more likely to be caused by angiotensin-converting enzyme (ACE) inhibitors, which are used to treat hypertension and heart failure.
D. Increase in urine output is not a common or serious adverse effect of ibuprofen. Ibuprofen can cause renal impairment, which can lead to decreased urine output, not increased urine output. The nurse should monitor the client's renal function tests and fluid balance while taking ibuprofen.
Correct Answer is D
Explanation
Choice A reason
Ensuring that the client's family supports the provider's decision for surgery is not an appropriate action. While family support is essential in the decision-making process, the primary responsibility lies with the client's health care surrogate or designated decision-maker. The family's support is not a substitute for obtaining informed consent from the designated decision-maker.
Choice B reason
Sending the unsigned informed consent form to the facility's risk manager is not appropriate action. The nurse should not send an unsigned informed consent form to the facility's risk manager. Unsigned consent forms do not have any legal significance or validity. The nurse should work with the health care surrogate to ensure that the consent form is appropriately completed and signed.
Choice C reason
Determining if the procedure is medically necessary for the client is not appropriate action. While the medical necessity of the procedure is important, the decision about the procedure's necessity should be made by the medical team and discussed with the health care surrogate. The nurse's role is to facilitate communication and ensure that the surrogate is informed and involved in the decision-making process.
Choice D reason
When a client is in a coma and unable to provide informed consent, the health care surrogate or designated decision-maker becomes responsible for making medical decisions on behalf of the client. It is essential for the nurse to ensure that the health care surrogate is aware of the situation, understands the risks and benefits of the surgical procedure, and has provided informed consent on behalf of the client.
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