Adult health III THEORY EXAM 3 MULTIPLE
SCLEROSIS
Multiple Sclerosis
1. A client diagnosed with multiple sclerosis has an acute onset of visual
changes, fatigue, and leg weakness. The client says that the last time this
happened, recovery occurred in a few weeks. Which classification of
multiple sclerosis is the client experiencing?
A) Progressive relapsing
B) Secondary-progressive
C) Relapsing remitting
D) Primary-progressive
Answer: C
Explanation: A) There are four classifications of multiple sclerosis. The client has
an exacerbation of symptoms and has a history of full recovery. This is classified
as relapsing-remitting and is the most common type. Primary progressive is a
steady worsening of the disease with occasional minor recovery. Secondary-
progressive begins as relapsing-remitting, but the disease becomes worse between
exacerbations. Progressive relapsing is rare, with the disease progressing from the
onset with periods of exacerbation.
2. A young adult client complains of blurred vision and muscle spasms that
come and go over the past several months. On what information from the
client's history should the nurse focus to help identify this help problem?
A) Family history of Parkinson disease
B) Family history of epilepsy
C) Is an immigrant from Germany
D) Has been depressed
Answer: C
Explanation: A) Multiple sclerosis is primarily a disease of people of northern
European ancestry. The onset of multiple sclerosis is usually between the ages of
20 and 50, with the peak at age 30. Family history of epilepsy, Parkinson disease,
and depression are important items of the client's history but do not support a
diagnosis of MS.
, 3. A client with a history of relapsing-remitting multiple sclerosis is expecting
her first child. What would be indicated for this client?
A) Suggest reproductive counseling, as multiple sclerosis can be genetic.
B) Instruct to expect a period of remission after delivery of the baby.
C) Instruct to expect an exacerbation of symptoms while pregnant.
D) Discuss pain control during labor, as contractions will be severe.
Answer: A
Explanation: A) A definite genetic factor has not been established; however, studies
suggest that genetic factors make some individuals more susceptible to the disorder
than others. Reproductive counseling would be recommended for this client.
Pregnancy often brings about remission of multiple sclerosis, but with a slightly
increased relapse rate postpartum. The strength of uterine contractions in a client
with multiple sclerosis is not severe, and because clients often have lessened
sensation, labor may be almost painless.
4. A client with relapsing-remitting multiple sclerosis tells the nurse that even
though the primary symptoms of exacerbation are leg spasms and blurred
vision, the hardest part is trying to get through the day because of being so
tired. Which diagnosis should the nurse identify as a priority for this client?
A) Fatigue
B) Disturbed Sensory Perception
C) Impaired Physical Mobility
D) Self-Care Deficit
Answer: A
Explanation: A) The client states that the worst part of the disease exacerbation is
being tired even though leg spasms and blurred vision are present. The nurse
should identify the diagnosis of Fatigue as being a priority for this client. The
diagnoses of Impaired Physical Mobility because of the leg spasms and Disturbed
Sensory Perception because of the blurred vision are additional nursing diagnoses
applicable for this client, but they are not the priority based on the client's
statement. The client may or may not have a Self-Care Deficit.
, 5. A client admitted with an exacerbation of multiple sclerosis is demonstrating
frustration with eating because hand and arm spasms prevent the proper use
of utensils. What should the nurse do to assist this client?
A) Consult with Occupational Therapy regarding assistive devices for meals.
B) Counsel the client to select finger foods for meals.
C) Plan time to feed the client.
D) Consult with Physical Therapy regarding hand and arm exercises.
Answer: A
Explanation: A) Since the ability to feed oneself is essential to positive self-
concept and self-esteem, the nurse should consult with Occupational Therapy for
devices that the client can use to maintain independence at meal times. The nurse
should not counsel the client to select finger foods for meals, or feed the client.
This would not support the client's self-concept and self-esteem needs. Physical
Therapy might be consulted for hand splints, but hand and arm exercises might not
be beneficial for this client.
6. A client with multiple sclerosis is observed transferring from the bed to a
motorized wheelchair and applying splints to the lower extremities before
entering the bathroom to perform morning self-care. What could the nurse
conclude regarding this observation?
A) The client uses assistive devices to optimize autonomy.
B) The client needs instruction to conduct morning care before applying splints to
lower extremities.
C) The client is dependent upon assistive devices.
D) The client is reliant upon assistive devices for independent.
Answer: A
Explanation: A) The nurse observed the client independently transfer from the bed
to a motorized wheelchair, apply splints, and enter the bathroom to perform
morning self-care. This is evidence that the client uses assistive devices to optimize
autonomy. The statement "Client is reliant upon assistive devices for
independence" indicates that the client is not autonomous. The statement "Client is
dependent upon assistive devices" also indicates the client is not autonomous. The
statement "Client needs instruction to conduct morning care before applying splints
to lower extremities" does not take into consideration the client's preference, which
might be to apply the splints before doing self-care.
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