A nurse is teaching a client who has amyotrophic lateral sclerosis (ALS) about the end stages of the disease process. Which of the following information should the nurse include in the teaching?
"You might wear splints over affected joints while you are sleeping."
"You will be given dexamethasone to treat muscle atrophy."
"You might require a machine to keep your airway open.
"You will receive nutrition through a central venous access device.
The Correct Answer is C
Choice A rationale:
Wearing splints over affected joints while sleeping is a strategy to prevent contractures, which are common in ALS.
Choice B rationale:
Dexamethasone is not used to treat muscle atrophy in ALS.
Choice C rationale:
As ALS progresses, clients may lose the ability to control their respiratory muscles, and a machine such as a ventilator may be required to assist with breathing.
Choice D rationale:
Nutrition through a central venous access device is not a standard intervention for ALS, as the focus is on preserving the client's ability to eat and swallow for as long as possible.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Maternal hemoglobin and hematocrit levels are important indicators of the mother's health but are not direct indicators of fetal well-being.
Choice B rationale:
A Coombs test is performed on newborns to assess for hemolytic disease, not to monitor fetal well-being.
Choice C rationale:
A biophysical profile assesses multiple parameters of fetal well-being, including fetal heart rate, fetal movement, fetal breathing, amniotic fluid volume, and fetal tone.
Choice D rationale:
An alpha-fetoprotein test is a screening test for neural tube defects and chromosomal abnormalities but is not typically used to monitor fetal well-being in hypertensive pregnancies.
Correct Answer is B
Explanation
Choice A rationale:
Administering corticosteroids is relevant for clients at risk of preterm labor, not specifically for placenta previa.
Choice B rationale:
Placenta previa can lead to bleeding and potential fetal distress. Continuous monitoring of fetal heart rate (FHR) and uterine contractions is essential to promptly identify any signs of distress.
Choice C rationale:
Terbutaline is a tocolytic medication used to suppress uterine contractions, and it's not relevant for managing uterine atony associated with placenta previa.
Choice D rationale:
Performing a vaginal exam can further increase the risk of bleeding in cases of placenta previa and is generally contraindicated due to the risk of disturbing the placental site.
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