The nurse is caring for a client with multiple sclerosis (MS). The client tells the nurse the hardest thing to deal with is the fatigue. When teaching the client how to reduce fatigue, what action should the nurse suggest?

Increasing the dose of muscle relaxants

Taking a hot bath at least three times a week.

Avoiding naps during the day

Working with Occupational and Physical Therapy

Answer and Explanation

The Correct Answer is D

A. Muscle relaxants (e.g., baclofen) are used to control spasticity in MS, but increasing the dose does not target fatigue. In fact, higher doses can increase drowsiness and worsen fatigue.

B. Heat can exacerbate symptoms in MS (Uhthoff’s phenomenon), including fatigue, muscle weakness, and visual disturbances. Hot baths should be avoided.

C. Clients with MS often benefit from energy conservation techniques, which may include short, planned rest periods or naps. Avoiding all naps can worsen exhaustion.

D. Occupational and physical therapy teach clients energy conservation, pacing activities, and safe exercise routines, which are highly effective strategies for reducing fatigue in MS.

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Correct Answer is A

Explanation

A. A client with Parkinson’s disease who urgently needs to use the bathroom is at high risk for falls due to rigidity, tremors, and shuffling gait. Needing to move quickly to the bathroom further increases the risk of injury, making this the priority for immediate assessment and assistance.
B. Refusing bisphosphonate therapy for osteoporosis is important to address but does not present an immediate safety risk requiring urgent assessment.
C. A client who is 3 days post–hip fracture surgery requires ongoing monitoring, but this is expected care and not an immediate fall or injury risk compared with the Parkinson’s client.
D. An older adult ambulating may need monitoring for safety, but unless new symptoms arise, this does not pose the same level of urgency as the Parkinson’s client who needs urgent toileting.

A. "God cannot possibly be good if people are allowed to get this horrible disease." B. "The test results must be mixed up with someone else's. I feel better now." C. "I just want to get better. A friend of mine had success with a plant-based diet." D. "I've made peace with everyone, and I'm actually ready to move on."

Correct Answer is A

Explanation

A. This statement reflects anger, directed toward God, life, or the situation itself. In the anger phase of grief, clients often express frustration, blame, or resentment.
B. This reflects denial, as the client is refusing to accept the accuracy of the diagnosis.
C. This reflects bargaining, as the client is hoping that by making lifestyle changes, the illness can be reversed.
D. This reflects acceptance, as the client has made peace with the diagnosis and is preparing emotionally for death.

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The nurse is caring for a client with multiple sclerosis (MS). The client tells the nurse the hardest thing to deal with is the fatigue. When teaching the client how to reduce fatigue, what action should the nurse suggest?

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