The nurse provides care for a client diagnosed with multiple sclerosis. The client has bilateral muscle weakness, frequent muscle spasms, and urinary retention. Which best describes the cause of these manifestations?

Ischemia of the motor and sensory neurons in the brain

Damage and scarring of the white matter in the brain

Infection of the parietal and temporal lobes of the brain

Increased amounts of epinephrine and acetylcholine in the brain

Answer and Explanation

The Correct Answer is B

Choice A reason: Ischemia of the motor and sensory neurons in the brain is not the cause of multiple sclerosis, but a possible consequence of it. Ischemia is a lack of blood supply to the tissues, which may result from inflammation, thrombosis, or embolism. It may cause neuronal death, stroke, or dementia.

Choice B reason: Damage and scarring of the white matter in the brain is the best description of the cause of multiple sclerosis. Multiple sclerosis is an autoimmune disorder that causes the immune system to attack the myelin sheath, which is a protective layer that covers the nerve fibers. The damage and scarring of the myelin sheath, also called demyelination, disrupts the transmission of nerve impulses and causes various neurological symptoms.

Choice C reason: Infection of the parietal and temporal lobes of the brain is not the cause of multiple sclerosis, but a rare complication of it. Infection of the brain, also called encephalitis, may occur due to viral, bacterial, or fungal agents. It may cause fever, headache, confusion, seizures, or coma.

Choice D reason: Increased amounts of epinephrine and acetylcholine in the brain are not the cause of multiple sclerosis, but a possible effect of it. Epinephrine and acetylcholine are neurotransmitters that regulate the sympathetic and parasympathetic nervous systems, respectively. They may be affected by the demyelination of the nerve fibers, which may alter the autonomic functions such as heart rate, blood pressure, digestion, or bladder control.

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Correct Answer is A

Explanation

Choice A reason: Uric acid is the most common type of renal calculi in clients with gout because it is a condition where the blood has a high level of uric acid, which is a waste product that results from the breakdown of purines, which are substances found in some foods and drinks, such as meat, seafood, and beer. Uric acid can form crystals in the joints, causing inflammation and pain, which is known as gout. Uric acid can also form crystals in the urine, causing kidney stones, which are hard deposits of minerals and salts that can block the urinary tract and cause symptoms such as severe pain, blood in the urine, nausea, and fever.

Choice B reason: Struvite is not the most common type of renal calculi in clients with gout because it is a condition where the urine has a high level of ammonia, which is a chemical that results from the breakdown of urea, which is a waste product that is produced by the liver and excreted by the kidneys. Ammonia can form crystals in the urine, along with magnesium, phosphate, and carbonate, creating struvite stones, which are large and staghorn-shaped stones that can fill the entire kidney or the ureter. Struvite stones are usually associated with urinary tract infections, which are caused by bacteria that produce enzymes that increase the urine pH and the ammonia level.

Choice C reason: Cystine is not the most common type of renal calculi in clients with gout because it is a condition where the urine has a high level of cystine, which is an amino acid that is a building block of proteins. Cystine can form crystals in the urine, causing kidney stones, which are rare and hereditary. Cystine stones are caused by a genetic disorder that affects the transport of cystine and other amino acids in the kidneys, resulting in excessive excretion of cystine in the urine.

Choice D reason: Calcium oxalate is not the most common type of renal calculi in clients with gout because it is a condition where the urine has a high level of calcium and oxalate, which are substances that are normally present in the diet and the body. Calcium and oxalate can form crystals in the urine, causing kidney stones, which are the most common type of kidney stones in the general population, but not in clients with gout. Calcium oxalate stones can be caused by various factors, such as dehydration, high intake of animal protein, low intake of fluids, and certain medications.

A. Decreased skin turgor B. Hypoalbuminemia C. Decreased serum cholesterol D. Increased serum sodium

Correct Answer is B

Explanation

Choice A reason: Decreased skin turgor is not the most common clinical manifestation of nephrotic syndrome because it is a sign of dehydration, not nephrotic syndrome. Dehydration is a condition where the body loses more fluid than it takes in, which can cause the skin to lose its elasticity and firmness. Dehydration can be caused by various factors, such as vomiting, diarrhea, fever, or excessive sweating.

Choice B reason: Hypoalbuminemia is the most common clinical manifestation of nephrotic syndrome because it is a condition where the blood has a low level of albumin, which is a protein that helps maintain the fluid balance in the body. Nephrotic syndrome is a kidney disorder that causes the kidneys to leak large amounts of protein into the urine, which reduces the amount of protein in the blood. Albumin is the most abundant protein in the blood, and it helps to keep the fluid in the blood vessels, preventing it from leaking into the tissues. When the albumin level is low, the fluid can escape from the blood vessels and cause edema, which is swelling of the body parts.

Choice C reason: Decreased serum cholesterol is not the most common clinical manifestation of nephrotic syndrome because it is a condition where the blood has a low level of cholesterol, which is a type of fat that is needed for the synthesis of hormones, bile acids, and cell membranes. Decreased serum cholesterol is not a common finding in nephrotic syndrome, because the liver tends to produce more cholesterol to compensate for the loss of protein in the urine. This can lead to hypercholesterolemia, which is a condition where the blood has a high level of cholesterol, which can increase the risk of cardiovascular diseases.

Choice D reason: Increased serum sodium is not the most common clinical manifestation of nephrotic syndrome because it is a condition where the blood has a high level of sodium, which is an electrolyte that helps regulate the fluid and acid-base balance in the body. Increased serum sodium is not a common finding in nephrotic syndrome, because the kidneys tend to excrete more sodium in the urine to balance the fluid loss caused by hypoalbuminemia. This can lead to hyponatremia, which is a condition where the blood has a low level of sodium, which can cause symptoms such as confusion, weakness, seizures, and coma.

Human Serum Albumin (HSA) | BioRender Science Templates

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The nurse provides care for a client diagnosed with multiple sclerosis. The client has bilateral muscle weakness, frequent muscle spasms, and urinary retention. Which best describes the cause of these manifestations?

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Naxlex Comprehensive Predictor Exams

The nurse provides care for a client who has a history of renal calculi. Which type of renal calculi is most common in clients with gout?

Correct Answer is A

Explanation

Which finding is the most common clinical manifestation of nephrotic syndrome?

Correct Answer is B

Explanation

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