In caring for a client with exacerbations of multiple sclerosis, the nurse recognizes that the exacerbations result in which pathologic change?

Choice A reason: A furuncle is a painful abscess caused by Staphylococcus aureus infecting a hair follicle, leading to purulent, tender nodules. This bacterial etiology is the primary risk factor, as S. aureus colonizes skin and invades follicles, causing localized infection. This aligns with dermatological pathology for furuncle development.

Choice B reason: Insect or spider bites may cause secondary infections but are not the primary etiology of furuncles. Furuncles specifically result from S. aureus folliculitis. Bites cause different lesions, like cellulitis, making this incorrect for the typical pathological process leading to a furuncle’s formation.

Choice C reason: Inadequate blood supply may impair healing but does not directly cause furuncles. S. aureus infection of hair follicles is the primary etiology. Poor perfusion is a risk for chronic wounds, not acute folliculitis, making this incorrect for the pathological etiology of a furuncle.

Choice D reason: Sexual contact with an infected partner may transmit STDs but is unrelated to furuncles, which are caused by S. aureus skin infections. Furuncles are not sexually transmitted, making this incorrect, as the etiology is bacterial colonization of hair follicles, not interpersonal transmission.

Choice A reason: Acute lymphoblastic leukemia (ALL) is an aggressive malignancy of lymphoid cells, often achieving complete remission with intensive chemotherapy, especially in children. Suppression without remission is not typical, as ALL responds well to treatment, targeting rapidly dividing blast cells. CLL, a slower-progressing disease, better fits the description of suppression without complete cure.

Choice B reason: Chronic lymphocytic leukemia (CLL) is a low-grade malignancy of mature B-lymphocytes, often managed with chemotherapy to suppress disease progression rather than achieve complete remission. CLL’s indolent nature means it can be controlled, but residual disease persists due to slow cell turnover, aligning with the question’s description of suppression.

Choice C reason: Acute myelogenous leukemia (AML) is an aggressive malignancy of myeloid cells, requiring intensive chemotherapy or stem cell transplant for potential remission. Suppression without remission is less common, as AML treatment aims for complete response. CLL’s chronic nature makes it more likely to result in disease control rather than cure.

Choice D reason: Hairy-cell leukemia is a rare, indolent B-cell malignancy highly responsive to purine analogs, often achieving long-term remission or near-cure. Suppression without remission is not characteristic, as treatment typically yields durable responses. CLL’s partial response to chemotherapy better matches the scenario of ongoing disease suppression.