The nurse is caring for a patient with multiple sclerosis.
What action will the nurse implement to improve physical functioning?
Encourage a regular exercise routine.
Administer corticosteroids daily.
Turn and reposition every 2 hours.
Administer beta interferon 2.
The Correct Answer is A
Choice A rationale
Encouraging a regular exercise routine is essential for improving physical functioning in patients with multiple sclerosis. Exercise helps maintain muscle tone, improves balance, and reduces the severity of fatigue, which are common challenges in MS. While the nurse must ensure the patient avoids overexertion and overheating, a tailored program focusing on stretching and strengthening can significantly enhance mobility. Physical activity also supports cardiovascular health and psychological well-being, which are critical for long-term functional independence.
Choice B rationale
Corticosteroids are typically administered to manage acute exacerbations of multiple sclerosis by reducing neuroinflammation and shortening the duration of relapses. However, they are not usually administered on a daily, long-term basis for the primary purpose of improving baseline physical functioning due to their significant side effects, such as osteoporosis and hyperglycemia. While helpful for inflammation, they do not replace the physical rehabilitation needed to improve muscle strength or coordination in a stable patient.
Choice C rationale
Turning and repositioning every 2 hours is a standard nursing intervention to prevent pressure injuries in immobile patients. While this is a necessary safety measure for a patient who is bedbound, it is not an active intervention designed to improve the physical functioning or mobility of a patient with multiple sclerosis. To improve functioning, the nurse should focus on interventions that encourage the patient to move themselves and engage in active rehabilitation rather than passive positioning.
Choice D rationale
Beta interferon 2 is an immunomodulating therapy used to reduce the frequency and severity of relapses in relapsing-remitting multiple sclerosis. While these disease-modifying therapies are crucial for slowing the progression of the disease and preventing future disability, the administration of the medication itself is a pharmacological intervention rather than a direct physical action to improve current functioning. Functional improvement is better achieved through physical therapy and active exercise programs that build strength and coordination.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Fever assessment is a common nursing intervention used to identify inflammatory or infectious processes like pelvic inflammatory disease or appendicitis. Normal body temperature ranges from 97.0 F to 99.0 F. While a fever would provide diagnostic clues, it is not the most immediate priority when a client presents with severe localized pain and vaginal bleeding, which may indicate a life-threatening ruptured ectopic pregnancy requiring rapid surgical or medical intervention.
Choice B rationale
Identifying the timing of the last void helps the nurse assess bladder function and potential urinary tract involvement in abdominal pain. However, urinary status is secondary to the need for a focused reproductive history in this clinical scenario. While a full bladder could exacerbate discomfort or interfere with a physical examination, it does not provide the critical information needed to determine if the client is experiencing a gynecological emergency that compromises systemic stability.
Choice C rationale
Determining the date of the last menstrual period is the highest priority because it helps the nurse assess the possibility of pregnancy. Severe lower quadrant pain and vaginal bleeding in a woman of childbearing age are classic signs of an ectopic pregnancy. Rapid identification of pregnancy status allows the healthcare team to prioritize life-saving interventions, as rupture can lead to massive internal hemorrhage, hypovolemic shock, and rapid maternal physiological decline.
Choice D rationale
Asking about the last bowel movement helps evaluate gastrointestinal causes of abdominal pain, such as constipation or bowel obstruction. While gastrointestinal issues can cause lower quadrant distress, they are generally less acute than a suspected ruptured ectopic pregnancy. In an emergency setting, the nurse must first rule out the most lethal possibilities related to the client's specific symptoms of vaginal bleeding combined with severe localized pelvic pain before exploring digestive issues.
Correct Answer is B
Explanation
Choice A rationale
Doxycycline is a tetracycline antibiotic commonly used to treat Chlamydia trachomatis. The standard regimen often involves 100 milligrams taken twice daily for 7 days. If the client states she followed this protocol correctly, it indicates adherence to the treatment plan and is unlikely to be the cause of a recurrence or persistent infection. Proper completion of the antibiotic course is essential for eradicating the intracellular pathogen and preventing complications like pelvic inflammatory disease.
Choice B rationale
Chlamydia is a highly communicable sexually transmitted infection. If the client did not inform her partner, it is highly probable that the partner remained untreated and asymptomatic, acting as a reservoir for the bacteria. Upon resuming sexual activity, the client likely experienced reinfection through the untreated partner. Effective management of chlamydia must include the concurrent treatment of all recent sexual contacts to break the cycle of transmission and prevent the recurrence of clinical symptoms.
Choice C rationale
While alcohol consumption is generally discouraged during any medication regimen to avoid gastric irritation or metabolic interference, moderate intake of wine does not specifically neutralize the antibacterial efficacy of doxycycline. Unlike metronidazole, which causes a disulfiram-like reaction with alcohol, doxycycline does not have a direct contraindication with 1 or 2 glasses of wine. Therefore, this behavior is unlikely to be the primary reason the treatment for the chlamydia infection failed or why symptoms returned.
Choice D rationale
Practicing abstinence during the entire course of antibiotic treatment is a critical nursing instruction. It ensures that the infected tissues have time to heal and prevents the transmission of the bacteria to others or the immediate reinfection of the client before the pathogen is fully cleared. If the client successfully practiced abstinence while taking the medication, this behavior would support the success of the treatment rather than being the cause of the yellow discharge and itchiness.
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