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Module 13.4: Multiple Sclerosis

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NCLEX Nursing (Medical-Surgical) Quiz on Module 13.4: Multiple Sclerosis, created by Olivia McRitchie on 19/11/2018.
Olivia McRitchie
Quiz by Olivia McRitchie, updated more than 1 year ago
Olivia McRitchie
Created by Olivia McRitchie almost 6 years ago
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Question 1

Question
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.
Answer
  • "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."

Question 2

Question
Which of the following should you teach an MS patient to avoid due to the risk of disease exacerbation?
Answer
  • Exercising in the heat.
  • Alcohol consumption.
  • Potential allergy triggers (i.e.: pollen, rag weed).
  • CNS depressing medications, such as morphine.

Question 3

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

Question 4

Question
What would an MRI detect in a patient with MS?
Answer
  • Lesions in the central nervous system.
  • Presence of immunoglobulins, oligoclonal bands, and myelin breakdown.
  • Slowing of electrical conduction.
  • Demyelination of the nerves.

Question 5

Question
Which of the following would you NOT find in the cerebrospinal fluid of a patient with MS?
Answer
  • Elevated immunoglobulins.
  • Oligoclonal bands.
  • Myelin breakdown products.
  • Pus.

Question 6

Question
Which test measures the electrical activity of the brain in response to stimulation of sensory nerve pathways?
Answer
  • Evoked potential tests.
  • Electroencephalogram.
  • MRI.
  • CT.

Question 7

Question
Drag and drop the correct drug to the descriptions given. -[blank_start]Baclofen (Lioresal)[blank_end]: Given to reduce spasticity. -[blank_start]Glatiramer acetate (Copaxone)[blank_end]: Blocks immune system's attack on myelin. -[blank_start]Dimethyl fumarate (Tecfidera)[blank_end]: Inhibits immune cells and has antioxidant properties that protect nerves from damage. -[blank_start]Beta interferons[blank_end]: 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. -[blank_start]Teriflunomide (Aubagio)[blank_end]: A pyrimidine synthesis inhibitor that inhibits function of lymphocytes. -[blank_start]Natalizumab (Tysabri)[blank_end]: Interferes with movement of immune cells across the blood-brain barrier. Used only when patients cannot tolerate any other treatments. -[blank_start]Mitoxantrone (Novantrone)[blank_end]: An immunosuppressor that is only used to treat advanced MS. -[blank_start]Fingolimod (Gilenya)[blank_end]: Traps immune cells in the lymph nodes, which makes them unable to access the CNS.
Answer
  • Baclofen (Lioresal)
  • Glatiramer acetate (Copaxone)
  • Dimethyl fumarate (Tecfidera)
  • Beta interferons
  • Teriflunomide (Aubagio)
  • Natalizumab (Tysabri)
  • Mitoxantrone (Novantrone)
  • Fingolimod (Gilenya)

Question 8

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

Question 9

Question
Which of the following drugs can cause flushing, chest pain, and heart palpitations?
Answer
  • Beta interferons
  • Glatiramer acetate (Copaxone)
  • Fingolimod (Gilenya)
  • Mitoxantrone (Novantrone)

Question 10

Question
Which of the following drugs can cause bradycardia, diarrhea, cough, and headache?
Answer
  • Dimethyl fumarate (Tecfidera)
  • Baclofen (Lioresal)
  • Natalizumab (Tysabri)
  • Fingolimod (Gilenya)

Question 11

Question
Which of the following drugs is only used as a last resort because it can cause multifocal leukoencephalopathy?
Answer
  • Natalizumab (Tysabri)
  • Mitoxantrone (Novantrone)
  • Teriflunomide (Aubagio)
  • Dimethyl fumarate (Tecfidera).

Question 12

Question
Which of the following drugs will generally only be given for advanced MS because it can cause cardiovascular and other serious side effects?
Answer
  • Mitoxantrone (Novantrone)
  • Natalizumab (Tysabri)
  • Glatiramer acetate (Copaxone)
  • Beta interferons

Question 13

Question
Disease-modifying therapies are approved for the treatment of progressive MS.
Answer
  • True
  • False

Question 14

Question
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?
Answer
  • Physical therapist
  • Occupational therapist
  • Speech/language therapist.
  • Cognitive behavioral therapist.
  • Vocational counselor
  • Nutritionist

Question 15

Question
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?
Answer
  • "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."

Question 16

Question
MS has the capability to affect all areas of life.
Answer
  • True
  • False

Question 17

Question
Assessment of a patient with MS may include The Expanded Disability Status Scale and the MS Functional Composite scale.
Answer
  • True
  • False

Question 18

Question
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?
Answer
  • "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."

Question 19

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