The nurse is educating a patient who is newly diagnosed with amyotrophic lateral sclerosis (ALS). Which statement would be the most appropriate for the nurse to include in education?

"ALS is caused by excess chemicals in the brain. The symptoms can be controlled with medication."

"The disease is progressive and will eventually lead to paralysis while maintaining cognitive function."

"Before you lose cognitive function, you should consider creating an advanced directive."

"Despite severe symptoms right now, most patients recover with treatment."

Answer and Explanation

The Correct Answer is B

A) "ALS is caused by excess chemicals in the brain. The symptoms can be controlled with medication."
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that results in the progressive loss of motor neurons, which leads to muscle weakness, atrophy, and paralysis. It is not caused by "excess chemicals in the brain," and there are currently no medications that can cure ALS or completely control its symptoms. Medications such as riluzole can slow the progression slightly, but they do not stop or reverse the disease.

B) "The disease is progressive and will eventually lead to paralysis while maintaining cognitive function."
ALS is indeed a progressive neurodegenerative disease that leads to the gradual loss of muscle function due to the death of motor neurons. Over time, the patient will experience muscle weakness, atrophy, and paralysis, while the cognitive function typically remains intact until the later stages of the disease, although some patients may develop frontotemporal dementia. it is essential for the patient to understand that the disease will progressively impair their physical abilities while leaving cognitive functions largely unaffected in most cases.

C) "Before you lose cognitive function, you should consider creating an advanced directive."
While it is important for individuals with ALS to plan for the future, this statement is not entirely accurate. Cognitive function in ALS is often preserved throughout most of the disease, although there is a subset of patients who may develop frontotemporal dementia. It would be more appropriate to discuss advanced directives early in the disease, but it is not guaranteed that cognitive function will be lost before physical decline.

D) "Despite severe symptoms right now, most patients recover with treatment."
ALS is a progressive disease with no cure, and it does not typically result in recovery. While certain treatments can help manage symptoms or slow the progression of the disease, recovery is not a realistic expectation. Most patients with ALS experience gradual worsening of symptoms and ultimately may require assistance with daily activities as the disease progresses.

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Correct Answer is ["A","C","D"]

Explanation

A) Hyperglycemia:
Prednisone, a glucocorticoid, can increase blood glucose levels by stimulating the liver to produce more glucose and decreasing the effectiveness of insulin. This can lead to hyperglycemia, particularly in individuals who are predisposed to diabetes or glucose intolerance. Therefore, monitoring blood glucose levels is important during prednisone therapy, especially in clients with a history of diabetes or those at risk for developing it.

B) Hyperkalemia:
Prednisone and other corticosteroids typically decrease potassium levels rather than increase them. This occurs because corticosteroids can promote the excretion of potassium in the kidneys. Hyperkalemia is not a common side effect of prednisone therapy. In fact, hypokalemia (low potassium) is more likely to occur, so this is not a concern for clients receiving prednisone.

C) Fluid retention:
One of the common side effects of prednisone is fluid retention due to its effect on the kidneys and the way it can increase sodium reabsorption. This can lead to edema (swelling), especially in the lower extremities, and could also contribute to an increase in blood pressure. Clients taking prednisone, particularly in higher doses or for extended periods, should be monitored for signs of fluid retention and hypertension.

D) GI distress:
Gastrointestinal distress, including gastritis, ulcers, or nausea, is a common side effect of prednisone and other corticosteroids. The risk is higher if the medication is taken on an empty stomach or at high doses. To minimize this, prednisone is typically taken with food or milk, and clients are monitored for signs of GI irritation.

E) Hypotension:
Prednisone can cause increased blood pressure due to fluid retention and the resulting increased blood volume. It can also affect the balance of sodium and potassium, contributing to hypertension rather than hypotension. Hypotension is not a typical side effect of prednisone therapy, and the nurse should be vigilant for signs of high blood pressure rather than low.

A. Digoxin B. Diltiazem C. Propanolol D. Captopril

Correct Answer is A

Explanation

A) Digoxin:
The client’s symptoms of confusion, vision disturbances (such as yellow halos around lights), and anorexia are all classic signs of digoxin toxicity. Digoxin, a cardiac glycoside, is commonly used in the treatment of heart failure and atrial fibrillation. However, it has a narrow therapeutic index, meaning that even slightly elevated blood levels can lead to toxicity. Other common symptoms of digoxin toxicity include bradycardia (which the client is also experiencing with a pulse of 53 bpm), nausea, and vomiting.

B) Diltiazem:
Diltiazem is a calcium channel blocker used to treat hypertension, angina, and atrial fibrillation. While it can cause bradycardia (as evidenced by the client’s pulse of 53 bpm), vision disturbances and anorexia are not typical side effects of this medication. More common side effects include hypotension, edema, and constipation.

C) Propranolol:
Propranolol is a beta-blocker used to treat hypertension, arrhythmias, and angina, as well as to prevent migraines. Bradycardia is a known side effect of beta-blockers, but vision disturbances and anorexia are not typical of propranolol. Moreover, propranolol can cause hypotension and fatigue but would not be as likely to cause the specific symptoms of confusion and vision changes seen in this client.

D) Captopril:
Captopril is an ACE inhibitor commonly used to treat hypertension and heart failure. Common side effects include hypotension, dizziness, and hyperkalemia, but vision disturbances and anorexia are not typical side effects of captopril. The symptoms the client is experiencing are more specific to digoxin toxicity than to captopril's side effects.

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The nurse is educating a patient who is newly diagnosed with amyotrophic lateral sclerosis (ALS). Which statement would be the most appropriate for the nurse to include in education?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with COPD exacerbation has been ordered oral prednisone to be tapered over two weeks. Which of the following side effects does the nurse recognize could occur during prednisone therapy? [Select all that apply.]

Correct Answer is ["A","C","D"]

Explanation

Correct Answer is A

Explanation

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