MS / ALS / MS / GBS PART #3 QUESTIONS WITH
COMPLETE SOLUTIONS
. A patient with amyotrophic lateral sclerosis (ALS) is
hospitalized with pneumonia. Which nursing action will be
included in the plan of care?
a. Assist with active range of motion.
b. Observe for agitation and paranoia.
c. Give muscle relaxants as needed to reduce spasms.
d. Use simple words and phrases to explain procedures. Correct
Answers ANS: A
ALS causes progressive muscle weakness, but assisting the
patient to perform active ROM will help to maintain strength as
long as possible. Psychotic symptoms such as agitation and
paranoia are not associated with ALS. Cognitive function is not
affected by ALS, and the patient's ability to understand
procedures will not be impaired. Muscle relaxants will further
increase muscle weakness and depress respirations.
A 28-year-old woman who has multiple sclerosis (MS) asks the
nurse about risks associated with pregnancy. Which response by
the nurse is accurate?
a. "MS symptoms may be worse after the pregnancy."
b. "Women with MS frequently have premature labor."
c. "Symptoms of MS are likely to become worse during
pregnancy."
d. "MS is associated with a slightly increased risk for congenital
defects." Correct Answers ANS: A
During the postpartum period, women with MS are at greater
risk for exacerbation of symptoms. There is no increased risk for
congenital defects in infants born of mothers with MS.
,Symptoms of MS may improve during pregnancy. Onset of
labor is not affected by MS.
A 30-year-old was diagnosed with amyotrophic lateral sclerosis
(ALS). Which statement by the client would indicate a need for
more teaching from the nurse?
A) "I will have progressive muscle weakness."
B) "I will lose strength in my arms."
C) "My children are at greater risk to develop this disease."
D) "I need to remain active for as long as possible." Correct
Answers C
Feedback:
There is no known cause for ALS, and no reason to suspect
genetic inheritance. ALS usually begins with muscle weakness
of the arms and progresses. The client is encouraged to remain
active for as long as possible to prevent respiratory
complications.
A client who is recently diagnosed with amyotrophic lateral
sclerosis (ALS) is to be discharged home. The nurse should
teach the family to:
1. monitor the client's urine output at home.
2. check the client's level of consciousness frequently.
3. check bony prominences and reposition the client every 2
hours.
4. serve the client a high red meat diet. Correct Answers
Answer: 3
1. It is not necessary to monitor the client's urine output, but the
family is encouraged to provide good hydration.
2. Clients with ALS maintain their mental acuity.
, 3. The client is usually bedridden, and should be turned every 2
hours and monitored for breakdown on bony prominences.
4. Clients with ALS lose their ability to swallow, and could
aspirate on pieces of meat.
A client with advanced ALS is admitted to the hospital. Because
of manifestations that are common in clients with ALS, the
nurse should:
a. attempt to institute bowel-training activities.
b. provide the client with small, frequent feedings.
c. obtain an order for intermittent catheterization.
d. orient the client to his or her surroundings frequently. Correct
Answers B
The course of the disease is relentlessly progressive. Cognition,
as well as bowel and bladder sphincters, remains intact. The
client may be malnourished because of dysphagia. Encourage
small, frequent, high-nutrient feedings. The nurse should assess
for aspiration and choking. A feeding tube may be considered
during the course of the illness.
A female client has experienced an episode of myasthenic crisis.
The nurse would assess whether the client has precipitating
factors such as:
a. Getting too little exercise
b. Taking excess medication
c. Omitting doses of medication
d. Increasing intake of fatty foods Correct Answers Answer C.
Myasthenic crisis often is caused by undermedication and
responds to the administration of cholinergic medications, such
as neostigmine (Prostigmin) and pyridostigmine (Mestinon).
Cholinergic crisis (the opposite problem) is caused by excess
COMPLETE SOLUTIONS
. A patient with amyotrophic lateral sclerosis (ALS) is
hospitalized with pneumonia. Which nursing action will be
included in the plan of care?
a. Assist with active range of motion.
b. Observe for agitation and paranoia.
c. Give muscle relaxants as needed to reduce spasms.
d. Use simple words and phrases to explain procedures. Correct
Answers ANS: A
ALS causes progressive muscle weakness, but assisting the
patient to perform active ROM will help to maintain strength as
long as possible. Psychotic symptoms such as agitation and
paranoia are not associated with ALS. Cognitive function is not
affected by ALS, and the patient's ability to understand
procedures will not be impaired. Muscle relaxants will further
increase muscle weakness and depress respirations.
A 28-year-old woman who has multiple sclerosis (MS) asks the
nurse about risks associated with pregnancy. Which response by
the nurse is accurate?
a. "MS symptoms may be worse after the pregnancy."
b. "Women with MS frequently have premature labor."
c. "Symptoms of MS are likely to become worse during
pregnancy."
d. "MS is associated with a slightly increased risk for congenital
defects." Correct Answers ANS: A
During the postpartum period, women with MS are at greater
risk for exacerbation of symptoms. There is no increased risk for
congenital defects in infants born of mothers with MS.
,Symptoms of MS may improve during pregnancy. Onset of
labor is not affected by MS.
A 30-year-old was diagnosed with amyotrophic lateral sclerosis
(ALS). Which statement by the client would indicate a need for
more teaching from the nurse?
A) "I will have progressive muscle weakness."
B) "I will lose strength in my arms."
C) "My children are at greater risk to develop this disease."
D) "I need to remain active for as long as possible." Correct
Answers C
Feedback:
There is no known cause for ALS, and no reason to suspect
genetic inheritance. ALS usually begins with muscle weakness
of the arms and progresses. The client is encouraged to remain
active for as long as possible to prevent respiratory
complications.
A client who is recently diagnosed with amyotrophic lateral
sclerosis (ALS) is to be discharged home. The nurse should
teach the family to:
1. monitor the client's urine output at home.
2. check the client's level of consciousness frequently.
3. check bony prominences and reposition the client every 2
hours.
4. serve the client a high red meat diet. Correct Answers
Answer: 3
1. It is not necessary to monitor the client's urine output, but the
family is encouraged to provide good hydration.
2. Clients with ALS maintain their mental acuity.
, 3. The client is usually bedridden, and should be turned every 2
hours and monitored for breakdown on bony prominences.
4. Clients with ALS lose their ability to swallow, and could
aspirate on pieces of meat.
A client with advanced ALS is admitted to the hospital. Because
of manifestations that are common in clients with ALS, the
nurse should:
a. attempt to institute bowel-training activities.
b. provide the client with small, frequent feedings.
c. obtain an order for intermittent catheterization.
d. orient the client to his or her surroundings frequently. Correct
Answers B
The course of the disease is relentlessly progressive. Cognition,
as well as bowel and bladder sphincters, remains intact. The
client may be malnourished because of dysphagia. Encourage
small, frequent, high-nutrient feedings. The nurse should assess
for aspiration and choking. A feeding tube may be considered
during the course of the illness.
A female client has experienced an episode of myasthenic crisis.
The nurse would assess whether the client has precipitating
factors such as:
a. Getting too little exercise
b. Taking excess medication
c. Omitting doses of medication
d. Increasing intake of fatty foods Correct Answers Answer C.
Myasthenic crisis often is caused by undermedication and
responds to the administration of cholinergic medications, such
as neostigmine (Prostigmin) and pyridostigmine (Mestinon).
Cholinergic crisis (the opposite problem) is caused by excess
