The nurse is educating the family about anticipated changes during the late stages of amyotrophic lateral sclerosis (ALS) for their father. What teaching point is most important for the nurse to include?

The person's cognitive and mental capacity will most likely remain intact throughout the disease progression.

The person's ability to swallow will remain intact throughout the disease.

The person's risk for seizures increases with progression of the disease.

The person's breathing will not be affected by the disease.

Answer and Explanation

The Correct Answer is A

Choice A reason: ALS is a neurodegenerative disease that affects the motor neurons, which control the voluntary muscles. It does not affect the cognitive or mental functions, such as memory, reasoning, or emotions. Therefore, the person with ALS will be aware of their condition and their surroundings, even when they lose their ability to move, speak, or breathe.

Choice B reason: ALS affects the muscles of the mouth, throat, and chest, which are involved in swallowing. As the disease progresses, the person with ALS will have difficulty swallowing food, liquids, and saliva. This can lead to malnutrition, dehydration, choking, and aspiration pneumonia.

Choice C reason: ALS does not directly cause seizures, which are abnormal electrical activity in the brain. However, some medications used to treat the symptoms of ALS, such as muscle relaxants, may increase the risk of seizures. Therefore, the person with ALS should be monitored for any signs of seizures, such as loss of consciousness, convulsions, or confusion.

Choice D reason: ALS affects the muscles of the diaphragm and the intercostal muscles, which are involved in breathing. As the disease progresses, the person with ALS will have difficulty breathing, especially at night or when lying down. This can lead to respiratory failure, which is the most common cause of death in ALS. Therefore, the person with ALS may need mechanical ventilation or noninvasive positive pressure ventilation to support their breathing.

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Correct Answer is A

Explanation

Choice A reason: The hypoglossal nerve is responsible for the movement of the tongue. It innervates the muscles of the tongue and allows for speech, swallowing, and chewing.

Choice B reason: The trigeminal nerve is responsible for the sensation and motor function of the face. It innervates the muscles of mastication, the skin of the face, and the mucous membranes of the mouth and nose.

Choice C reason: The facial nerve is responsible for the expression and taste of the face. It innervates the muscles of facial expression, the lacrimal and salivary glands, and the anterior two-thirds of the tongue.

Choice D reason: The vestibulocochlear nerve is responsible for the hearing and balance of the ear. It innervates the cochlea and the vestibular apparatus of the inner ear.

A. The disorder is commonly fatal. B. The progressive muscle weakness will begin in the lower extremities and move upward. C. The disorder is caused by a fungal infection. D. The disorder's most significant manifestations are muscle pain and stiffness.

Correct Answer is B

Explanation

Choice A reason: The disorder is commonly fatal, is not a true statement. Guillain-Barre syndrome is a rare and serious condition that affects the peripheral nervous system. It causes inflammation and damage to the nerve fibers, leading to muscle weakness, numbness, and paralysis. However, most people recover from Guillain-Barre syndrome, although some may have long-term complications or disabilities. The mortality rate is about 4% to 7%.

Choice B reason: The progressive muscle weakness will begin in the lower extremities and move upward, is a true statement. Guillain-Barre syndrome usually starts with tingling and weakness in the feet and legs, and then spreads to the arms and upper body. This pattern of weakness is called ascending paralysis, and it can affect the breathing, swallowing, and facial muscles. The weakness usually reaches its peak within two to four weeks, and then gradually improves over months or years.

Choice C reason: The disorder is caused by a fungal infection, is not a true statement. Guillain-Barre syndrome is not caused by a fungal infection, but by an abnormal immune response. The exact cause of Guillain-Barre syndrome is unknown, but it is often preceded by an infection, such as a respiratory or gastrointestinal infection, or a vaccination. The immune system mistakenly attacks the nerve fibers, causing inflammation and damage.

Choice D reason: The disorder's most significant manifestations are muscle pain and stiffness, is not a true statement. Guillain-Barre syndrome's most significant manifestations are muscle weakness and paralysis, not pain and stiffness. Muscle pain and stiffness may occur in some cases, but they are not the main symptoms or the most serious ones. The weakness and paralysis can affect the vital functions, such as breathing, blood pressure, and heart rate, and require intensive care and treatment.

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The nurse is educating the family about anticipated changes during the late stages of amyotrophic lateral sclerosis (ALS) for their father. What teaching point is most important for the nurse to include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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