The nurse is providing education to a client who is newly diagnosed with Multiple Sclerosis (MS). Which client statements indicate the need for additional teaching? SELECT ALL THAT APPLY
“I may experience urinary incontinence.”
“I should not exercise because this may trigger an exacerbation.”
“I need to check the water temperature before I take a bath.”
“I may experience visual disturbances.”
“I should alternate the eye patch every other day to help with the double vision.”
Correct Answer : B,E
Choice A reason:
“I may experience urinary incontinence.” This statement is correct. Urinary incontinence is a common symptom of MS due to the disease’s impact on the nervous system. The client does not need additional teaching regarding this statement.
Choice B reason:
“I should not exercise because this may trigger an exacerbation.” This statement indicates a need for additional teaching. Regular exercise is beneficial for individuals with MS and can help improve strength, mobility, and overall well-being. The nurse should educate the client on safe and appropriate exercise routines.
Choice C reason:
“I need to check the water temperature before I take a bath.” This statement is correct. Clients with MS may have impaired sensation and are at risk for burns if the water is too hot. Checking the water temperature is a necessary precaution.
Choice D reason:
“I may experience visual disturbances.” This statement is correct. Visual disturbances, such as blurred vision or double vision, are common symptoms of MS. The client does not need additional teaching regarding this statement.
Choice E reason:
“I should alternate the eye patch every other day to help with the double vision.” This statement indicates a need for additional teaching. While using an eye patch can help manage double vision, it should be alternated more frequently, typically every few hours, to prevent strain on the covered eye.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason:
Encouraging clients to make decisions without considering their cultural or social background is not aligned with the principles of client-centered care. Understanding and respecting clients’ cultural and social backgrounds are essential for providing holistic and effective care.
Choice B reason:
Ensuring that care plans are tailored to the individual needs and preferences of clients within their community is the cornerstone of client-centered, community-based care. This approach recognizes the unique circumstances of each client and aims to provide personalized care that meets their specific needs and preferences.
Choice C reason:
Focusing primarily on the medical treatment of diseases within a hospital setting is not consistent with community-based care. Community-based care emphasizes providing healthcare services in the community, addressing social determinants of health, and promoting overall well-being outside of hospital settings.
Choice D reason:
Prioritizing the efficiency of healthcare delivery over patient satisfaction and outcomes is contrary to the principles of client-centered care. While efficiency is important, the primary focus should be on achieving positive health outcomes and ensuring patient satisfaction.
Correct Answer is D
Explanation
Choice A reason:
Encouraging the client to use ice therapy to alleviate muscle stiffness is not the best approach for managing multiple sclerosis (MS). While ice therapy can provide temporary relief for muscle stiffness, it does not address the need to increase venous return, prevent stiffness, or maintain muscle strength and endurance. Gentle stretching exercises are more effective for these goals.
Choice B reason:
Administering interferon is a common treatment for MS to help reduce the frequency and severity of relapses. However, it does not directly address the need to increase venous return, prevent stiffness, or maintain muscle strength and endurance. Exercise and physical therapy are more appropriate for these specific goals.
Choice C reason:
Administering corticosteroids is used to manage acute exacerbations of MS by reducing inflammation. While corticosteroids can help manage symptoms during a flare-up, they do not directly contribute to increasing venous return, preventing stiffness, or maintaining muscle strength and endurance. Regular exercise is more effective for these purposes.
Choice D reason:
Encouraging the client to perform gentle stretching exercises daily is the most appropriate action. Stretching exercises help increase venous return, prevent stiffness, and maintain muscle strength and endurance. Regular physical activity is essential for managing MS symptoms and improving overall function and quality of life.
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