The nurse teaches a client with MS to prevent fatigue. Which statements by the client indicate effective teaching? SELECT ALL THAT APPLY

"I'll avoid extreme heat and hot baths."

"I'll try to do all my chores at once."

"I'll exercise daily, even when I feel exhausted."

"I'll rest between activities."

"I'll balance activity with rest periods."

Answer and Explanation

Correct Answer : A,D,E

Rationale:

A. MS patients are sensitive to increases in body temperature due to Uhthoff’s phenomenon, where heat slows nerve conduction in demyelinated neurons. Exposure to heat, hot baths, or hot weather can temporarily worsen fatigue, weakness, and other neurologic symptoms. Avoiding these triggers demonstrates understanding of environmental strategies to minimize fatigue.

B. Attempting to complete all tasks in one session leads to overexertion, which can worsen fatigue and increase the risk of injury or symptom flare-ups. Effective fatigue management involves energy conservation, such as breaking tasks into smaller steps, using adaptive devices, and pacing activities throughout the day. This statement indicates misunderstanding of energy conservation principles.

C. While moderate exercise improves strength and endurance, exercising while fatigued can worsen symptoms, increase risk of falls or injury, and lead to burnout. Patients with MS should follow graded exercise programs and rest as needed, balancing activity with recovery periods. This statement shows a lack of understanding about pacing and self-monitoring.

D. Scheduling short rest periods between tasks conserves energy and reduces cumulative fatigue. This approach allows patients to complete ADLs safely and maintain functional independence, demonstrating comprehension of effective energy management strategies.

E. Maintaining a structured routine that alternates activity and rest supports overall energy management, prevents exacerbation of fatigue, and allows for sustained participation in daily activities. This demonstrates understanding of pacing strategies recommended for MS fatigue management.

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Correct Answer is C

Explanation

Rationale:

A. CBC evaluates white blood cells, red blood cells, and platelets, helping detect infection, anemia, or bleeding disorders. It does not provide information about long-term glycemic control or adherence to diabetes management.

B. LFTs assess hepatic enzyme levels (AST, ALT, bilirubin) and liver health. While some diabetes medications can affect liver function, these tests do not reflect glucose control or adherence to diet, exercise, or medications.

C. Hemoglobin A1c reflects average blood glucose levels over the previous 2–3 months, making it the most reliable indicator of long-term glycemic control. It integrates the effects of diet, exercise, and adherence to prescribed medications, providing a clear picture of how well the client is managing Type 2 diabetes. A target HbA1c is typically <7% for most adults, though individualized goals may vary.

D. Urinalysis may detect glucose, protein, ketones, or infection, but it only provides a snapshot at a single point in time. It cannot accurately assess long-term adherence or average glucose levels.

A. Grilled cheese with apple slices B. Tacos with refried beans C. Scrambled eggs with a side of cottage cheese D. Baked chicken with bacon slices

Correct Answer is C

Explanation

Rationale:

A. While the grilled cheese is soft, the apple slices require significant chewing, increasing the risk of choking or aspiration. Patients with Parkinson’s disease often have oropharyngeal dysphagia, making hard, crunchy foods unsafe.

B. Tacos, especially with a shell or tortilla, require complex chewing and strong jaw coordination. Even soft tortillas can be difficult to manage for someone with impaired chewing and swallowing. Refried beans are soft, but the taco itself makes the meal inappropriate.

C. Both scrambled eggs and cottage cheese are soft, high-protein, easy-to-chew and easy-to-swallow foods, making them ideal for patients with dysphagia related to Parkinson’s disease. Soft, moist foods reduce aspiration risk and promote adequate nutrition in patients with impaired chewing, tongue control, and slowed swallowing reflex.

D. Baked chicken is often dry and difficult to chew, and bacon is tough or crispy, both of which significantly increase aspiration risk. These foods require effective mastication, which is impaired in Parkinson’s disease.

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The nurse teaches a client with MS to prevent fatigue. Which statements by the client indicate effective teaching? SELECT ALL THAT APPLY

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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