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 C

Explanation

A. Renal calculi (kidney stones) can cause flank pain and hematuria, but this client’s systemic infection signs (fever, tachycardia, chills, elevated WBC) point toward a urinary tract infection progressing to pyelonephritis, not stones.

B. A CT scan might be used later to assess for obstruction or complications, but it is not the first step. Immediate diagnostic confirmation of infection is needed.

C. The client’s presentation strongly suggests acute pyelonephritis (upper urinary tract infection with systemic involvement). A urinalysis and urine culture are the priority initial diagnostic tests to confirm infection and guide treatment. This should be done before starting antibiotics whenever possible.

D. An EKG may be indicated in cases of electrolyte imbalance (e.g., hyperkalemia in renal failure), but this client’s electrolytes and creatinine are within range. It is not a priority at this time.

A. The client drinks wine at night. B. The client takes acetaminophen for pain. C. The client has a body mass index (BMI) of 33. D. The client is of childbearing age.

Correct Answer is C

Explanation

A. Moderate wine consumption is not a contributing factor to knee pain, swelling, or crepitus.
B. Acetaminophen is commonly used for pain relief and does not cause joint damage or inflammation.
C. A BMI of 33 indicates obesity, which increases stress and mechanical load on weight-bearing joints such as the knees. This can lead to early onset of osteoarthritis, presenting with swelling, pain, and crepitus.
D. Being of childbearing age is not a risk factor for joint degeneration or knee crepitus

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Blood Pressure	118/78 mmHg
Heart Rate	112 beats/minute
Respiratory Rate	22 breaths/minute
Temperature	102.8 F (39.3 C)
WBC	16000 (Ret: 4000-11000)
BUN	24 mg/dL (Ref: 8-20 mg/dL)
Creatinine	1.1 mg/dL (Ref: 0.6-1.2 mg/dL)

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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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

The nurse is caring for a client who states they have swelling in their knee, pain, and crepitus after running. What part of the client's health history will the nurse note as a possible cause of their symptoms?

Correct Answer is C

Explanation

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