MED SURG GALEN EXAM 1/ NEWEST
2025 COMPLETE QUESTIONS AND
CORRECT VERIFIED ANSWERS/ WELL
GRADED A+//NEWEST VERSION
Relapsing- remitting MS - CORRECT ANSWERS-Symptoms develop and then
dissipate. Most common ; requires treatment during acute symptoms but generally at
baseline
Primary Progressive MS - CORRECT ANSWERS-Steady and gradual disability
progression.
Age group 15-45; average age of diagnosis is 29 in women, 31 in men.
Secondary progressive
Progressive-relapsing
Multiple Sclerosis Assessment - CORRECT ANSWERS-Ask about vision, mobility, and
sensory perception changes
Symptoms are often vague
Are symptoms intermittent or becoming progressively worse?
Symptoms: See chart 43-1, page 889
LOPDUV: Limb weakness, Optic neuritis, Paresthesia, Diplopia, Urinary incontinence,
Vertigo
Physical Exam: Weakness, numbness, tingling, brisk reflexes, gait disturbances (more
progressive cases), intention tremors
Multiple Sclerosis (MS) Disgnosis - CORRECT ANSWERS-Symptom presentation as
well as an MRI (lesions)
Lumbar Puncture
Muscle cramping secondary to spasticity
,Weakness
Charcot Triad: Dysarthria, Nystagmus, Intention Tremor
Dysmetria
Trigeminal Neuralgia
Twitching of facial muscles
HEAT INTOLERANCE
Fatigue and dizziness
Cognitive difficulties
Depression/euphoria
Dementia
Lumbar Puncture (MS) - CORRECT ANSWERS-Obtain consent
Spinal needle injected into subarachnoid space
Position patient in a fetal side-lying position
Local anesthetic
Three to five tubes CSF collected
Post LP: Obtain VS, neuro checks, observe needle site for leakage, bedrest
Nursing Care for MS (Risk for, Airway, Body, Urinary and Bowel incontinence) -
CORRECT ANSWERS-Risk for infection: MS drugs alter immunity, teach patents to
avoid crowds and sick people
Dysarthria/dysphagia: SLP referral
Fatigue
Encourage rest - but encourage participation to keep the client active. Plan accordingly
for activities and allow time for completion
Urinary and bowel incontinence
Anticholinergics: Oxybutynin
UTI Surveillance - Encourage fluids
Avoiding caffeinated products
,Nursing Care for MS (Pain, Medications, Vision Changes) - CORRECT ANSWERS-
Pain
Pain control, as prescribed: Baclofen, Diazepam
Medications
Teach how to administer parenteral forms Interferons
Vision changes
Eye patch for diplopia
Encourage vision exams
Teach the client how to scan a room (peripheral vision loss)
Drug Therapy for (MS) for Acute exacerbations - CORRECT ANSWERS-with IV
methylprednisolone: Iv x 2-3 days followed by po steroid taper x 3-4 months
Drug Therapy for Disease progression - CORRECT ANSWERS-Interferon beta-1a (IM)
or Interferon B-1b (SQ). Glatiramer (SQ): Relatively safe during pregnancy. These
drugs are immunomodulators, makes patients vulnerable to infection. Must report any
s/s infection to PMD immediately.
Natalizumab, Fingolimod: Oral drugs but second line, used less due to adverse effects
Drug Therapy for MS for various symptoms - CORRECT ANSWERS-Muscle spasticity:
Baclofen, Valium
Fatigue and narcolepsy: Amantadine, Modafinil,
Pain (trigeminal): Phenytoin, pregabalin, carbamazepine
Urinary urgency: Oxybutynin
Transient Ischemic Attack (TIA) - CORRECT ANSWERS-Tried interruption in cerebral
blow flow Resolve within 30-60 minutes
Symptoms - blurred vision, diplopia, ataxia, extremity weakness, numbness, vertigo,
aphasia and dysarthria.
, Warning Signs of TIA - CORRECT ANSWERS-Care is aimed at reducing risk factors for
a CVA.
Carotid US : May need CEA?
Cardiac management (A-Fib)
CT Head
Reduce HTN, control diabetes, heart healthy diet, STOP SMOKING!
Prescriptive therapy includes statins, anti-hypertensives, and anti-platelets(?).
Stroke - CORRECT ANSWERS-Known as a brain attack where the perfusion to the
brain suddenly becomes interrupted.
Fifth leading cause of death worldwide
Classified as either ischemic (90%) or hemorrhagic (10%)
Ischemic strokes may be: - CORRECT ANSWERS-Thrombotic: Due to atherosclerotic
plaques
Embolic: Dislodged clot. Major risk factors include a-fib or DVT in a patient with a PFO.
Stroke Patho - CORRECT ANSWERS-Ischemic stroke
Most common type of stroke.
Thrombotic
Hx: HTN, Vascular disease
Prodromal TIA
Embolic
Hx: AFIB, Endocarditis
Hemorrhagic
Hx: HTN, Vessel disorders
Stroke Numbers - CORRECT ANSWERS-Accounts for 1/19 deaths in US. Ranked
number 5 among cause of death in the US.
14% of patients in the hospital suffer from a stroke.
2025 COMPLETE QUESTIONS AND
CORRECT VERIFIED ANSWERS/ WELL
GRADED A+//NEWEST VERSION
Relapsing- remitting MS - CORRECT ANSWERS-Symptoms develop and then
dissipate. Most common ; requires treatment during acute symptoms but generally at
baseline
Primary Progressive MS - CORRECT ANSWERS-Steady and gradual disability
progression.
Age group 15-45; average age of diagnosis is 29 in women, 31 in men.
Secondary progressive
Progressive-relapsing
Multiple Sclerosis Assessment - CORRECT ANSWERS-Ask about vision, mobility, and
sensory perception changes
Symptoms are often vague
Are symptoms intermittent or becoming progressively worse?
Symptoms: See chart 43-1, page 889
LOPDUV: Limb weakness, Optic neuritis, Paresthesia, Diplopia, Urinary incontinence,
Vertigo
Physical Exam: Weakness, numbness, tingling, brisk reflexes, gait disturbances (more
progressive cases), intention tremors
Multiple Sclerosis (MS) Disgnosis - CORRECT ANSWERS-Symptom presentation as
well as an MRI (lesions)
Lumbar Puncture
Muscle cramping secondary to spasticity
,Weakness
Charcot Triad: Dysarthria, Nystagmus, Intention Tremor
Dysmetria
Trigeminal Neuralgia
Twitching of facial muscles
HEAT INTOLERANCE
Fatigue and dizziness
Cognitive difficulties
Depression/euphoria
Dementia
Lumbar Puncture (MS) - CORRECT ANSWERS-Obtain consent
Spinal needle injected into subarachnoid space
Position patient in a fetal side-lying position
Local anesthetic
Three to five tubes CSF collected
Post LP: Obtain VS, neuro checks, observe needle site for leakage, bedrest
Nursing Care for MS (Risk for, Airway, Body, Urinary and Bowel incontinence) -
CORRECT ANSWERS-Risk for infection: MS drugs alter immunity, teach patents to
avoid crowds and sick people
Dysarthria/dysphagia: SLP referral
Fatigue
Encourage rest - but encourage participation to keep the client active. Plan accordingly
for activities and allow time for completion
Urinary and bowel incontinence
Anticholinergics: Oxybutynin
UTI Surveillance - Encourage fluids
Avoiding caffeinated products
,Nursing Care for MS (Pain, Medications, Vision Changes) - CORRECT ANSWERS-
Pain
Pain control, as prescribed: Baclofen, Diazepam
Medications
Teach how to administer parenteral forms Interferons
Vision changes
Eye patch for diplopia
Encourage vision exams
Teach the client how to scan a room (peripheral vision loss)
Drug Therapy for (MS) for Acute exacerbations - CORRECT ANSWERS-with IV
methylprednisolone: Iv x 2-3 days followed by po steroid taper x 3-4 months
Drug Therapy for Disease progression - CORRECT ANSWERS-Interferon beta-1a (IM)
or Interferon B-1b (SQ). Glatiramer (SQ): Relatively safe during pregnancy. These
drugs are immunomodulators, makes patients vulnerable to infection. Must report any
s/s infection to PMD immediately.
Natalizumab, Fingolimod: Oral drugs but second line, used less due to adverse effects
Drug Therapy for MS for various symptoms - CORRECT ANSWERS-Muscle spasticity:
Baclofen, Valium
Fatigue and narcolepsy: Amantadine, Modafinil,
Pain (trigeminal): Phenytoin, pregabalin, carbamazepine
Urinary urgency: Oxybutynin
Transient Ischemic Attack (TIA) - CORRECT ANSWERS-Tried interruption in cerebral
blow flow Resolve within 30-60 minutes
Symptoms - blurred vision, diplopia, ataxia, extremity weakness, numbness, vertigo,
aphasia and dysarthria.
, Warning Signs of TIA - CORRECT ANSWERS-Care is aimed at reducing risk factors for
a CVA.
Carotid US : May need CEA?
Cardiac management (A-Fib)
CT Head
Reduce HTN, control diabetes, heart healthy diet, STOP SMOKING!
Prescriptive therapy includes statins, anti-hypertensives, and anti-platelets(?).
Stroke - CORRECT ANSWERS-Known as a brain attack where the perfusion to the
brain suddenly becomes interrupted.
Fifth leading cause of death worldwide
Classified as either ischemic (90%) or hemorrhagic (10%)
Ischemic strokes may be: - CORRECT ANSWERS-Thrombotic: Due to atherosclerotic
plaques
Embolic: Dislodged clot. Major risk factors include a-fib or DVT in a patient with a PFO.
Stroke Patho - CORRECT ANSWERS-Ischemic stroke
Most common type of stroke.
Thrombotic
Hx: HTN, Vascular disease
Prodromal TIA
Embolic
Hx: AFIB, Endocarditis
Hemorrhagic
Hx: HTN, Vessel disorders
Stroke Numbers - CORRECT ANSWERS-Accounts for 1/19 deaths in US. Ranked
number 5 among cause of death in the US.
14% of patients in the hospital suffer from a stroke.
