Multiple Sclerosis (Lippincott) Training
Exam Questions 100%Well Answered.
The nurse should conduct a focused assessment with the client with multiple sclerosis for risk of which
of the following? Select all that apply.
1. Dehydration.
2. Falls.
3. Seizures.
4. Skin break down.
5. Fatigue. - Answer 2, 4, 5. The client with multiple sclerosis is at risk for falls due to muscle
weakness, skin breakdown due to bowel and bladder incontinence, and fatigue. The client is not at risk
for dehydration; seizures are not associated with myelin destruction.
The nurse is teaching a client with bladder dysfunction from multiple sclerosis (MS) about bladder
training at home. Which instructions should the nurse include in the teaching plan? Select all that apply.
1. Restrict fluids to 1,000 mL/24 hours.
2. Drink 400 to 500mL with each meal.
3. Drink fluids midmorning, midafternoon, and late afternoon. 4. Attempt to void at least every 2 hours.
5. Use intermittent catheterization as needed. - Answer 2, 3, 4, 5. Maintaining urinary function in a
client with neurogenic bladder dysfunction from MS is an important goal. The client should ideally drink
400 to 500 mL with each meal; 200 mL midmorning, midafternoon, and late afternoon; and attempt to
void at least every 2 hours to prevent infection and stone formation. The client may need to catheterize
herself to drain residual urine in the bladder. Restricting fluids during the day will not produce sufficient
urine. However, in bladder training for nighttime continence, the client may restrict fluids for 1 to 2 hours
before going to bed. The client should drink at least 2,000 mL every 24 hours.
Which of the following is not a typical clinical manifestation of multiple sclerosis (MS)?
1. Double vision.
2. Sudden bursts of energy.
3. Weakness in the extremities.
, 4. Muscle tremors. - Answer 2. With MS, hyperexcitability and euphoria may occur, but because of
muscle weakness, sudden bursts of energy are unlikely. Visual disturbances, weakness in the extremities,
and loss of muscle tone and tremors are common symptoms of MS.
A client with multiple sclerosis (MS) is receiving baclofen (Lioresal). The nurse determines that the drug
is effective when it achieves which of the following?
1. Induces sleep.
2. Stimulates the client's appetite.
3. Relieves muscular spasticity.
4. Reduces the urine bacterial count. - Answer 3. Baclofen is a centrally acting skeletal muscle relaxant
that helps relieve the muscle spasms common in MS. Drowsiness is an adverse effect, and driving should
be avoided if the medication produces a sedative effect. Baclofen does not stimulate the appetite or
reduce bacteria in the urine.
A client has had multiple sclerosis (MS) for 15 years and has received various drug therapies. What is the
primary reason why the nurse has found it difficult to evaluate the effectiveness of the drugs that the
client has used?
1.The client exhibits intolerance to many drugs.
2.The client experiences spontaneous remissions from time to time.
3.The client requires multiple drugs simultaneously.
4.The client endures long periods of exacerbation before the illness responds to a particular drug. -
Answer 2. Evaluating drug effectiveness is difficult because a high percentage of clients with MS exhibit
unpredictable episodes of remission, exacerbation, and steady progress without apparent cause. Clients
with MS do not necessarily have increased intolerance to drugs, nor do they endure long periods of
exacerbation before the illness responds to a particular drug. Multiple drug use is not what makes
evaluation of drug effectiveness difficult.
When the nurse talks with a client with multiple sclerosis who has slurred speech, which nursing
intervention is contraindicated?
1. Encouraging the client to speak slowly.
2. Encouraging the client to speak distinctly.
3. Asking the client to repeat indistinguishable words.
Exam Questions 100%Well Answered.
The nurse should conduct a focused assessment with the client with multiple sclerosis for risk of which
of the following? Select all that apply.
1. Dehydration.
2. Falls.
3. Seizures.
4. Skin break down.
5. Fatigue. - Answer 2, 4, 5. The client with multiple sclerosis is at risk for falls due to muscle
weakness, skin breakdown due to bowel and bladder incontinence, and fatigue. The client is not at risk
for dehydration; seizures are not associated with myelin destruction.
The nurse is teaching a client with bladder dysfunction from multiple sclerosis (MS) about bladder
training at home. Which instructions should the nurse include in the teaching plan? Select all that apply.
1. Restrict fluids to 1,000 mL/24 hours.
2. Drink 400 to 500mL with each meal.
3. Drink fluids midmorning, midafternoon, and late afternoon. 4. Attempt to void at least every 2 hours.
5. Use intermittent catheterization as needed. - Answer 2, 3, 4, 5. Maintaining urinary function in a
client with neurogenic bladder dysfunction from MS is an important goal. The client should ideally drink
400 to 500 mL with each meal; 200 mL midmorning, midafternoon, and late afternoon; and attempt to
void at least every 2 hours to prevent infection and stone formation. The client may need to catheterize
herself to drain residual urine in the bladder. Restricting fluids during the day will not produce sufficient
urine. However, in bladder training for nighttime continence, the client may restrict fluids for 1 to 2 hours
before going to bed. The client should drink at least 2,000 mL every 24 hours.
Which of the following is not a typical clinical manifestation of multiple sclerosis (MS)?
1. Double vision.
2. Sudden bursts of energy.
3. Weakness in the extremities.
, 4. Muscle tremors. - Answer 2. With MS, hyperexcitability and euphoria may occur, but because of
muscle weakness, sudden bursts of energy are unlikely. Visual disturbances, weakness in the extremities,
and loss of muscle tone and tremors are common symptoms of MS.
A client with multiple sclerosis (MS) is receiving baclofen (Lioresal). The nurse determines that the drug
is effective when it achieves which of the following?
1. Induces sleep.
2. Stimulates the client's appetite.
3. Relieves muscular spasticity.
4. Reduces the urine bacterial count. - Answer 3. Baclofen is a centrally acting skeletal muscle relaxant
that helps relieve the muscle spasms common in MS. Drowsiness is an adverse effect, and driving should
be avoided if the medication produces a sedative effect. Baclofen does not stimulate the appetite or
reduce bacteria in the urine.
A client has had multiple sclerosis (MS) for 15 years and has received various drug therapies. What is the
primary reason why the nurse has found it difficult to evaluate the effectiveness of the drugs that the
client has used?
1.The client exhibits intolerance to many drugs.
2.The client experiences spontaneous remissions from time to time.
3.The client requires multiple drugs simultaneously.
4.The client endures long periods of exacerbation before the illness responds to a particular drug. -
Answer 2. Evaluating drug effectiveness is difficult because a high percentage of clients with MS exhibit
unpredictable episodes of remission, exacerbation, and steady progress without apparent cause. Clients
with MS do not necessarily have increased intolerance to drugs, nor do they endure long periods of
exacerbation before the illness responds to a particular drug. Multiple drug use is not what makes
evaluation of drug effectiveness difficult.
When the nurse talks with a client with multiple sclerosis who has slurred speech, which nursing
intervention is contraindicated?
1. Encouraging the client to speak slowly.
2. Encouraging the client to speak distinctly.
3. Asking the client to repeat indistinguishable words.
