Olivia McRitchie
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NCLEX Nursing (Medical-Surgical) Quiz on Module 13.4: Multiple Sclerosis, created by Olivia McRitchie on 19/11/2018.

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Olivia McRitchie
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Module 13.4: Multiple Sclerosis

Module 13.4: Multiple Sclerosis

Question 1 of 19

1

You have a patient newly diagnosed with multiple sclerosis. Select the statements made by the patient that shows that she understands teaching about this disorder.

Select one or more of the following:

  • "This disease is considered 'immune-mediated' because there is an immune response against the myelin sheath on my axons."

  • "My exposure to malaria as a child triggered this immune response."

  • "Even though the disease has a genetic component, the risk of my kids developing it is only 3-5%."

  • "Part of the reason I developed this disease was because I lived in Africa until I was 16."

  • "MS is a disease of exacerbation and remission. I will know if I am having an exacerbation because it will last 24 hours and be 30 or more days away from the last exacerbation."

  • "I should go to a therapist to get my anxiety under control, because stress and fatigue can cause an exacerbation."

Explanation

Question 2 of 19

1

Which of the following should you teach an MS patient to avoid due to the risk of disease exacerbation?

Select one of the following:

  • Exercising in the heat.

  • Alcohol consumption.

  • Potential allergy triggers (i.e.: pollen, rag weed).

  • CNS depressing medications, such as morphine.

Explanation

Question 3 of 19

1

Select the 3 criteria patients need to be diagnosed with MS.

Select one or more of the following:

  • Lesions in at least 2 separate areas of the CNS.

  • Evidence that the 2 areas of damage occurred at least 1 month apart.

  • No other diagnoses fit.

  • A lumbar puncture positive for IgG

  • Slowed nerve conduction on an evoked potential test.

  • Blood test positive for C-reactive proteins.

Explanation

Question 4 of 19

1

What would an MRI detect in a patient with MS?

Select one of the following:

  • Lesions in the central nervous system.

  • Presence of immunoglobulins, oligoclonal bands, and myelin breakdown.

  • Slowing of electrical conduction.

  • Demyelination of the nerves.

Explanation

Question 5 of 19

1

Which of the following would you NOT find in the cerebrospinal fluid of a patient with MS?

Select one of the following:

  • Elevated immunoglobulins.

  • Oligoclonal bands.

  • Myelin breakdown products.

  • Pus.

Explanation

Question 6 of 19

1

Which test measures the electrical activity of the brain in response to stimulation of sensory nerve pathways?

Select one of the following:

  • Evoked potential tests.

  • Electroencephalogram.

  • MRI.

  • CT.

Explanation

Question 7 of 19

1

Drag and drop the correct drug to the descriptions given.

-: Given to reduce spasticity.

-: Blocks immune system's attack on myelin.

-: Inhibits immune cells and has antioxidant properties that protect nerves from damage.

-: Reduce the number of inflammatory cells that cross the blood-brain barrier, which leads to a reduction of neuronal inflammation. These drugs may slow the progression of disease and decrease severity of attacks.

-: A pyrimidine synthesis inhibitor that inhibits function of lymphocytes.

-: Interferes with movement of immune cells across the blood-brain barrier. Used only when patients cannot tolerate any other treatments.

-: An immunosuppressor that is only used to treat advanced MS.

-: Traps immune cells in the lymph nodes, which makes them unable to access the CNS.

Drag and drop to complete the text.

    Baclofen (Lioresal)
    Glatiramer acetate (Copaxone)
    Dimethyl fumarate (Tecfidera)
    Beta interferons
    Teriflunomide (Aubagio)
    Natalizumab (Tysabri)
    Mitoxantrone (Novantrone)
    Fingolimod (Gilenya)

Explanation

Question 8 of 19

1

What are the nursing responsibilities for a patient taking a beta interferon drug (Avonex, Betaseron, Extavia, Rebif)?

Select one or more of the following:

  • Assessing liver function and CBC for baseline parameters.

  • Assessing liver function and CBC every 3 months.

  • Assessing the injection site.

  • Monitoring for changes in patient's condition and function.

  • Assessing for flushing, chest pain, or heart palpitations.

  • Assessing for bradycardia, diarrhea, cough, and headache.

  • Assess cognitive status.

Explanation

Question 9 of 19

1

Which of the following drugs can cause flushing, chest pain, and heart palpitations?

Select one of the following:

  • Beta interferons

  • Glatiramer acetate (Copaxone)

  • Fingolimod (Gilenya)

  • Mitoxantrone (Novantrone)

Explanation

Question 10 of 19

1

Which of the following drugs can cause bradycardia, diarrhea, cough, and headache?

Select one of the following:

  • Dimethyl fumarate (Tecfidera)

  • Baclofen (Lioresal)

  • Natalizumab (Tysabri)

  • Fingolimod (Gilenya)

Explanation

Question 11 of 19

1

Which of the following drugs is only used as a last resort because it can cause multifocal leukoencephalopathy?

Select one of the following:

  • Natalizumab (Tysabri)

  • Mitoxantrone (Novantrone)

  • Teriflunomide (Aubagio)

  • Dimethyl fumarate (Tecfidera).

Explanation

Question 12 of 19

1

Which of the following drugs will generally only be given for advanced MS because it can cause cardiovascular and other serious side effects?

Select one of the following:

  • Mitoxantrone (Novantrone)

  • Natalizumab (Tysabri)

  • Glatiramer acetate (Copaxone)

  • Beta interferons

Explanation

Question 13 of 19

1

Disease-modifying therapies are approved for the treatment of progressive MS.

Select one of the following:

  • True
  • False

Explanation

Question 14 of 19

1

The progressive, lifelong nature of MS requires that patients take symptoms and participate in nonpharmacologic therapies.

Which of the following medical professionals would NOT be involved in the care of a patient with MS?

Select one of the following:

  • Physical therapist

  • Occupational therapist

  • Speech/language therapist.

  • Cognitive behavioral therapist.

  • Vocational counselor

  • Nutritionist

Explanation

Question 15 of 19

1

You have just taught your MS patient about ways to reduce exacerbations. Which of the following statements made by the patient shows that the teaching has been received?

Select one of the following:

  • "I should only participate in the exercise my physical therapist prescribed."

  • "I should not give in to my fatigue."

  • "Heat is good for me; I should try to be outside as much as I can."

  • "Eating a balanced diet and maintaining adequate hydration will help prevent obesity and keep my bones and muscles healthy."

Explanation

Question 16 of 19

1

MS has the capability to affect all areas of life.

Select one of the following:

  • True
  • False

Explanation

Question 17 of 19

1

Assessment of a patient with MS may include The Expanded Disability Status Scale and the MS Functional Composite scale.

Select one of the following:

  • True
  • False

Explanation

Question 18 of 19

1

You have a 30-year-old patient with MS that is refusing to use a walker. Which of the following statements made by you, the nurse, is appropriate?

Select one of the following:

  • "You need to use your walker. It can increase independence and help you move safely."

  • "I cannot force you to do anything you don't want to do."

  • "Let's sit down and discuss the pros and cons of using a walker."

  • "I know you feel like it'll decrease your independence, but your walker actually increases your independence."

Explanation

Question 19 of 19

1

Select interventions that can help patients with a self-care deficit be more independent in ADLs.

Select one or more of the following:

  • Encourage the patient to wear arm and/or wrist braces.

  • Teach the patient to self-catheterize.

  • Encouraging the patient to use plate guards and modified utensils.

  • Teach the patient how to modify the consistency of their favorite foods.

  • Encourage the patient to exercise.

  • Teach the patient to drink plenty of fluids and have a voiding schedule

  • Encourage the patient to decrease dependence on others.

Explanation

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