A nurse is reviewing the laboratory results from a cerebrospinal fluid test for a client who has multiple sclerosis. Which of the following findings should the nurse expect?

Increased glucose level

Decreased lactic acid level

Increased protein level

Decreased WBC count

Answer and Explanation

The Correct Answer is C

A. Increased glucose level: CSF glucose levels are typically normal in multiple sclerosis. An increase in glucose is more commonly associated with systemic hyperglycemia or specific infections, not demyelinating diseases like MS.

B. Decreased lactic acid level: A decreased lactic acid level is not a characteristic finding in multiple sclerosis. Lactic acid in CSF is more relevant in differentiating types of infections, such as bacterial versus viral meningitis.

C. Increased protein level: Elevated protein in the CSF is a common finding in multiple sclerosis, often due to increased immunoglobulin production and the presence of oligoclonal bands, reflecting immune system activity in the CNS.

D. Decreased WBC count: While a mild increase in WBC count may be seen in MS, a decreased WBC count is not typical or diagnostic of the disease. Leukocyte levels in CSF are usually normal or slightly elevated in MS.

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Correct Answer is B

Explanation

A. Dry mouth: Dry mouth is a common and generally mild side effect of sertraline and other SSRIs. It can typically be managed with increased fluid intake or sugar-free lozenges and does not suggest a medical emergency.

B. Excessive sweating: Excessive sweating, especially when accompanied by symptoms such as confusion, agitation, muscle rigidity, or fever, may indicate serotonin syndrome. This is a potentially life-threatening condition and requires immediate medical evaluation.

C. Constipation: Constipation is a possible side effect of many antidepressants, including sertraline. However, it is not associated with serotonin syndrome and can often be managed with dietary changes or mild laxatives.

D. Insomnia: Insomnia is a known, non-urgent side effect of sertraline that may improve over time or be managed with sleep hygiene techniques. It does not indicate the presence of serotonin syndrome.

A. Place the client in restraints. B. Escort the client to a place of seclusion. C. Offer the client PRN medication, D. Offer the client choices for a diversionary activity.

Correct Answer is D

Explanation

A. Place the client in restraints:Restraints are a last-resort intervention and should only be used when the client poses an immediate danger to self or others and less restrictive methods have failed. Initiating restraints first violates the client’s rights and can escalate agitation.

B. Escort the client to a place of seclusion:Seclusion, like restraints, is a restrictive intervention that should only be used after less invasive strategies have been attempted. Removing a client without consent may also worsen their aggression or fear.

C. Offer the client PRN medication:While medication may be helpful in calming the client, it should not be the first step unless the client is in imminent danger or past strategies have failed. Attempting non-pharmacologic interventions first respects the client’s autonomy.

D. Offer the client choices for a diversionary activity:This is the least restrictive intervention and a therapeutic first approach. Providing the client with options promotes autonomy, can redirect aggression, and helps prevent escalation through calming, client-centered communication.

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A nurse is reviewing the laboratory results from a cerebrospinal fluid test for a client who has multiple sclerosis. Which of the following findings should the nurse expect?

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Naxlex Comprehensive Predictor Exams

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