Olivia McRitchie
Quiz por , criado more than 1 year ago

NCLEX Nursing (Medical-Surgical) Quiz sobre Module 13.4: Multiple Sclerosis, criado por Olivia McRitchie em 19-11-2018.

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Olivia McRitchie
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Module 13.4: Multiple Sclerosis

Questão 1 de 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.

Selecione uma ou mais das seguintes:

  • "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."

Explicação

Questão 2 de 19

1

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

Selecione uma das seguintes:

  • Exercising in the heat.

  • Alcohol consumption.

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

  • CNS depressing medications, such as morphine.

Explicação

Questão 3 de 19

1

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

Selecione uma ou mais das seguintes:

  • 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.

Explicação

Questão 4 de 19

1

What would an MRI detect in a patient with MS?

Selecione uma das seguintes:

  • Lesions in the central nervous system.

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

  • Slowing of electrical conduction.

  • Demyelination of the nerves.

Explicação

Questão 5 de 19

1

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

Selecione uma das seguintes:

  • Elevated immunoglobulins.

  • Oligoclonal bands.

  • Myelin breakdown products.

  • Pus.

Explicação

Questão 6 de 19

1

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

Selecione uma das seguintes:

  • Evoked potential tests.

  • Electroencephalogram.

  • MRI.

  • CT.

Explicação

Questão 7 de 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.

Arraste e solte para completar o texto.

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

Explicação

Questão 8 de 19

1

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

Selecione uma ou mais das seguintes:

  • 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.

Explicação

Questão 9 de 19

1

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

Selecione uma das seguintes:

  • Beta interferons

  • Glatiramer acetate (Copaxone)

  • Fingolimod (Gilenya)

  • Mitoxantrone (Novantrone)

Explicação

Questão 10 de 19

1

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

Selecione uma das seguintes:

  • Dimethyl fumarate (Tecfidera)

  • Baclofen (Lioresal)

  • Natalizumab (Tysabri)

  • Fingolimod (Gilenya)

Explicação

Questão 11 de 19

1

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

Selecione uma das seguintes:

  • Natalizumab (Tysabri)

  • Mitoxantrone (Novantrone)

  • Teriflunomide (Aubagio)

  • Dimethyl fumarate (Tecfidera).

Explicação

Questão 12 de 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?

Selecione uma das seguintes:

  • Mitoxantrone (Novantrone)

  • Natalizumab (Tysabri)

  • Glatiramer acetate (Copaxone)

  • Beta interferons

Explicação

Questão 13 de 19

1

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

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 14 de 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?

Selecione uma das seguintes:

  • Physical therapist

  • Occupational therapist

  • Speech/language therapist.

  • Cognitive behavioral therapist.

  • Vocational counselor

  • Nutritionist

Explicação

Questão 15 de 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?

Selecione uma das seguintes:

  • "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."

Explicação

Questão 16 de 19

1

MS has the capability to affect all areas of life.

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 17 de 19

1

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

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 18 de 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?

Selecione uma das seguintes:

  • "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."

Explicação

Questão 19 de 19

1

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

Selecione uma ou mais das seguintes:

  • 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.

Explicação

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