1) A client diagnosed with multiple sclerosis has an acute Answer: C
onset of visual changes, fatigue, and leg weakness. The Explanation: A) There are four classifications of multiple sclerosis. The client has
client says that the last time this happened, recovery an exacerbation of symptoms and has a history of full recovery. This is classified
occurred in a few weeks. Which classification of multiple as relapsing-remitting and is the most common type. Primary-progressive is a
sclerosis is the client experiencing? steady worsening of the disease with occasional minor recovery. Secondary-
A) Progressive-relapsing progressive begins as relapsing-remitting but the disease becomes worse between
B) Secondary-progressive exacerbations. Progressive-relapsing is rare, with the disease progressing from the
C) Relapsing-remitting onset with periods of exacerbation.
D) Primary-progressive 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 Answer: C
muscle spasms that come and go over the past several Explanation: A) Multiple sclerosis is primarily a disease of people of northern
months. On what information from the client's history European ancestry. The onset of multiple sclerosis is usually between the ages of
should the nurse focus to help identify this help problem? 20 and 50, with the peak at age 30. Family history of epilepsy, Parkinson disease,
A) Family history of Parkinson disease and depression are important items of the client's history but do not support a
B) Family history of epilepsy diagnosis of MS.
C) Is an immigrant from Germany Page Ref: 877
D) Has been depressed 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 Answer: A
sclerosis is expecting her first child. What would be Explanation: A) A definite genetic factor has not been established; however,
indicated for this client? studies suggest that genetic factors make some individuals more susceptible to the
A) Suggest reproductive counseling, as multiple sclerosis disorder than others. Reproductive counseling would be recommended for this
can be genetic. client. Pregnancy often brings about remission of multiple sclerosis, but with a
B) Instruct to expect a period of remission after delivery slightly increased relapse rate postpartum. The strength of uterine contractions in a
of the baby. client with multiple sclerosis is not severe, and because clients often have lessened
C) Instruct to expect an exacerbation of symptoms while sensation, labor may be almost painless.
pregnant. Page Ref: 876-877
D) Discuss pain control during labor, as contractions will Cognitive Level: Analyzing
be severe. 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.
onset of visual changes, fatigue, and leg weakness. The Explanation: A) There are four classifications of multiple sclerosis. The client has
client says that the last time this happened, recovery an exacerbation of symptoms and has a history of full recovery. This is classified
occurred in a few weeks. Which classification of multiple as relapsing-remitting and is the most common type. Primary-progressive is a
sclerosis is the client experiencing? steady worsening of the disease with occasional minor recovery. Secondary-
A) Progressive-relapsing progressive begins as relapsing-remitting but the disease becomes worse between
B) Secondary-progressive exacerbations. Progressive-relapsing is rare, with the disease progressing from the
C) Relapsing-remitting onset with periods of exacerbation.
D) Primary-progressive 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 Answer: C
muscle spasms that come and go over the past several Explanation: A) Multiple sclerosis is primarily a disease of people of northern
months. On what information from the client's history European ancestry. The onset of multiple sclerosis is usually between the ages of
should the nurse focus to help identify this help problem? 20 and 50, with the peak at age 30. Family history of epilepsy, Parkinson disease,
A) Family history of Parkinson disease and depression are important items of the client's history but do not support a
B) Family history of epilepsy diagnosis of MS.
C) Is an immigrant from Germany Page Ref: 877
D) Has been depressed 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 Answer: A
sclerosis is expecting her first child. What would be Explanation: A) A definite genetic factor has not been established; however,
indicated for this client? studies suggest that genetic factors make some individuals more susceptible to the
A) Suggest reproductive counseling, as multiple sclerosis disorder than others. Reproductive counseling would be recommended for this
can be genetic. client. Pregnancy often brings about remission of multiple sclerosis, but with a
B) Instruct to expect a period of remission after delivery slightly increased relapse rate postpartum. The strength of uterine contractions in a
of the baby. client with multiple sclerosis is not severe, and because clients often have lessened
C) Instruct to expect an exacerbation of symptoms while sensation, labor may be almost painless.
pregnant. Page Ref: 876-877
D) Discuss pain control during labor, as contractions will Cognitive Level: Analyzing
be severe. 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.
