NUR200 - M2 - Multiple Sclerosis - NCLEX and ATI;
Nursing: A Concept-Based Approach to Learning, 2e
(Pearson) Module 13 Mobility Exemplar 13.4 Multiple
Sclerosis 2024 Graded A+
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.
Page Ref: 877
Cognitive Level: Analyzing
Client Need: Physiological Integrity
Nursing Process: Assessment
Learning Outcome: 1. Describe the pathophysiology, etiology, clinical manifestations,
and direct and indirect causes of multiple sclerosis.
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.
Page Ref: 877
Cognitive Level: Analyzing
Client Need: Physiological Integrity
Nursing Process: Assessment
, Learning Outcome: 2. Identify risk factors and prevention methods associated with
multiple sclerosis.
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.
Page Ref: 876-877
Cognitive Level: Analyzing
Client Need: Physiological Integrity
Nursing Process: Planning
Learning Outcome: 3. Illustrate the nursing process in providing culturally competent
care across the life span for individuals with multiple sclerosis.
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.
Page Ref: 883
Cognitive Level: Applying
Client Need: Physiological Integrity
Nursing Process: Planning
Learning Outcome: 4. Formulate priority nursing diagnoses appropriate for an individual
with multiple sclerosis.
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
Nursing: A Concept-Based Approach to Learning, 2e
(Pearson) Module 13 Mobility Exemplar 13.4 Multiple
Sclerosis 2024 Graded A+
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.
Page Ref: 877
Cognitive Level: Analyzing
Client Need: Physiological Integrity
Nursing Process: Assessment
Learning Outcome: 1. Describe the pathophysiology, etiology, clinical manifestations,
and direct and indirect causes of multiple sclerosis.
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.
Page Ref: 877
Cognitive Level: Analyzing
Client Need: Physiological Integrity
Nursing Process: Assessment
, Learning Outcome: 2. Identify risk factors and prevention methods associated with
multiple sclerosis.
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.
Page Ref: 876-877
Cognitive Level: Analyzing
Client Need: Physiological Integrity
Nursing Process: Planning
Learning Outcome: 3. Illustrate the nursing process in providing culturally competent
care across the life span for individuals with multiple sclerosis.
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.
Page Ref: 883
Cognitive Level: Applying
Client Need: Physiological Integrity
Nursing Process: Planning
Learning Outcome: 4. Formulate priority nursing diagnoses appropriate for an individual
with multiple sclerosis.
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
