Which of the following are common characteristics of patients diagnosed with Amyotrophic Lateral Sclerosis (ALS)?

Difficulty swallowing and speaking associated with descending muscle weakness.

Movement and behavioral unpredictability with declining cognitive abilities.

Muscle weakness starting in bilateral legs with weakness ascending upwards.

Ptosis, fatigue, and generalized muscle weakness.

Answer and Explanation

The Correct Answer is A

A. Difficulty swallowing and speaking associated with descending muscle weakness: Amyotrophic lateral sclerosis (ALS) primarily affects motor neurons, leading to progressive muscle weakness. Difficulty swallowing (dysphagia) and speaking (dysarthria) are common symptoms, and these occur as the muscle weakness affects the tongue, throat, and other muscles responsible for these functions. The weakness typically starts in the limbs and then progresses to involve other areas of the body.

B. Movement and behavioral unpredictability with declining cognitive abilities: While ALS primarily affects motor function, some patients may experience mild cognitive changes or frontotemporal dementia (FTD), but this is not a characteristic feature for most individuals. Behavior and cognitive decline are not typically seen in the majority of ALS cases.

C. Muscle weakness starting in bilateral legs with weakness ascending upwards: This description is more consistent with Guillain-Barré Syndrome (GBS), which often presents with ascending muscle weakness that starts in the lower limbs. In ALS, muscle weakness generally starts in one area (e.g., a limb) and progresses asymmetrically, rather than ascending in a symmetrical pattern.

D. Ptosis, fatigue, and generalized muscle weakness: Ptosis (drooping eyelids) is not a primary or common symptom of ALS. While generalized muscle weakness and fatigue are common in ALS, ptosis is more characteristic of other neuromuscular disorders such as myasthenia gravis.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. A change in the pattern of shortness of breath can be a sign of worsening respiratory or cardiovascular status and may indicate a serious condition such as pulmonary embolism, heart failure, or a pneumothorax. This requires immediate assessment and further investigation to determine the cause.

B. While flank pain (7/10) after receiving oral analgesic could be concerning, the fact that the pain is still significant 15 minutes after medication administration suggests that the pain may not yet be well-controlled. However, this is not as immediately urgent as a change in breathing pattern, so this patient should be assessed after the one with respiratory concerns.

C. Serosanguinous drainage from a JP drain on postoperative day 3 is not uncommon, and this typically does not require immediate intervention unless the drainage increases significantly or becomes more sanguine. This patient should be assessed after the one with a change in shortness of breath.

D. Bilateral wheezes after walking 40 feet, with a pulse oximetry of 96% on room air, is concerning but not as urgent as a change in shortness of breath. The pulse oximetry is within the normal range, and wheezing could be related to mild exertion or an underlying chronic condition (like asthma), but the patient’s condition doesn’t seem to be immediately life-threatening. This patient should be assessed after the patient with shortness of breath.

A. Decrease in blood pressure. B. Decrease in cardiac dysrhythmias. C. Relief of chest pain. D. Decrease in heart rate.

Correct Answer is C

Explanation

A. Decrease in blood pressure: Nitroglycerin can cause vasodilation, leading to a decrease in blood pressure. However, the goal of administering nitroglycerin during an acute myocardial infarction (MI) is not primarily to lower blood pressure, but to improve oxygen supply to the heart and relieve pain. A decrease in blood pressure may occur as a side effect but is not the primary indication for its use.

B. Decrease in cardiac dysrhythmias: While nitroglycerin may help reduce myocardial oxygen demand, it is not specifically aimed at treating or preventing cardiac dysrhythmias. The primary action of nitroglycerin is to relieve chest pain by vasodilation and improving blood flow to the heart muscle.

C. Relief of chest pain: The primary effect of nitroglycerin in the setting of an acute MI is to relieve chest pain (angina). It works by dilating coronary arteries and improving blood flow to the heart muscle, thus reducing ischemia and relieving pain.

D. Decrease in heart rate: Nitroglycerin may have a secondary effect of reducing heart rate due to a reduction in preload and afterload, but this is not the primary objective. Nitroglycerin’s main goal is to relieve chest pain by improving oxygen supply to the heart muscle.

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Which of the following are common characteristics of patients diagnosed with Amyotrophic Lateral Sclerosis (ALS)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is receiving report on their patient assignments for the day. Which patient should be assessed first? The patient...

Correct Answer is A

Explanation

The nurse administers IV nitroglycerin to a client diagnosed with an acute myocardial infarction. In evaluating the effectiveness of this intervention, the nurse should monitor for

Correct Answer is C

Explanation

The nurse is caring for a patient who has had an anterior wall MI. Which of the following complications should the nurse assess for in this patient? (Select All that Apply.)

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The patient with pneumonia is being treated with intravenous antibiotics. The nurse evaluates that the therapy has been effective by which data?

The nurse is to begin a nitroglycerin infusion for a client diagnosed with an anterior wall myocardial infarction. Which assessment finding should the nurse report to the physician immediately?

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