Inquire through: | Professional | Confidential Support
Chapter 40: Concepts of Care for Patients
With Problems of the Central Nervous
System: The Spinal Cord Ignatavicius:
Medical-Surgical Nursing, 10th Edition
Verified and Updated Questions and
Answers (100% Correct Answers)
1. The nurse is preparing to teach a client recently diagnosed with multiple sclerosis
about taking glatiramer acetate. Which statement by the client indicates a need for
further teaching?
a. "I will rotate injection sites to prevent skin irritation."
b. "I need to avoid large crowds and people with infection."
c. "I should report any flulike symptoms to my primary health care provider."
d. "I will report any signs of infection to my primary health care provider."
Answer: ANS: C
Glatiramer is given by subcutaneous injection. The first dose is administered under
medical supervision, but the nurse teaches the client how to self-administer the
medication after the initial dose, reminding the client about the need to rotate
injection sites. Like other immunomodulators, this drug can make the client
susceptible to infection. However, flulike symptoms occur more commonly with
interferons rather than glatiramer.
2. A nurse assesses a client with multiple sclerosis after administering prescribed
fingolimod. For which common side effect would the nurse monitor?
a. Peripheral edema
b. Facial flushing
c. Tachycardia
d. Fever
Answer: ANS: B
, Inquire through: | Professional | Confidential Support
Fingolimod is an oral immunomodulator that has two common side effects—facial
flushing and GI disturbance, such as diarrhea. Peripheral edema, tachycardia, and
fever are not common side effects of this drug.
3. A client who has multiple sclerosis reports increased severe muscle spasticity and
tremors. What nursing action is most appropriate to manage this client's concern?
a. Request a prescription for an antispasmodic drug such as baclofen.
b. Prepare the client for deep brain stimulation surgery.
c. Refer the client to a massage therapist to relax the muscles.
d. Consult with the occupational therapist for self-care assistance.
Answer: ANS: A
Clients who have multiple sclerosis often have muscle spasticity which may be
reduced by drug therapy, such as baclofen. While massage and assistance with self-
care may be helpful, these interventions are not the most effective and therefore not
the most appropriate in managing muscle spasticity. If drug therapy and other
interventions do not help reduce muscle spasms, some client are candidates for deep
brain stimulation as a last resort
4. A client with multiple sclerosis is being discharged from rehabilitation. Which
statement would the nurse include in the client's discharge teaching?
a. "Be sure that you use a wheelchair when you go out in public."
b. "Wear an undergarment brief at all times in case of incontinence."
c. "Avoid overexertion, stress, and extreme temperature if possible."
d. "Avoid having sexual intercourse to conserve energy."
Answer: ANS: C
Clients who have multiple sclerosis have chronic fatigue and are prone to disease
exacerbation (flare-up) is they overexert, are stressed, or are exposed to extreme
temperature and humidity. They should not wear briefs unless they have actual
problems with continence and should not use a wheelchair if they are able to
ambulate with a cane or walker. Maintaining independence and self-esteem is
important, so participating in sexual activities is encouraged.
Chapter 40: Concepts of Care for Patients
With Problems of the Central Nervous
System: The Spinal Cord Ignatavicius:
Medical-Surgical Nursing, 10th Edition
Verified and Updated Questions and
Answers (100% Correct Answers)
1. The nurse is preparing to teach a client recently diagnosed with multiple sclerosis
about taking glatiramer acetate. Which statement by the client indicates a need for
further teaching?
a. "I will rotate injection sites to prevent skin irritation."
b. "I need to avoid large crowds and people with infection."
c. "I should report any flulike symptoms to my primary health care provider."
d. "I will report any signs of infection to my primary health care provider."
Answer: ANS: C
Glatiramer is given by subcutaneous injection. The first dose is administered under
medical supervision, but the nurse teaches the client how to self-administer the
medication after the initial dose, reminding the client about the need to rotate
injection sites. Like other immunomodulators, this drug can make the client
susceptible to infection. However, flulike symptoms occur more commonly with
interferons rather than glatiramer.
2. A nurse assesses a client with multiple sclerosis after administering prescribed
fingolimod. For which common side effect would the nurse monitor?
a. Peripheral edema
b. Facial flushing
c. Tachycardia
d. Fever
Answer: ANS: B
, Inquire through: | Professional | Confidential Support
Fingolimod is an oral immunomodulator that has two common side effects—facial
flushing and GI disturbance, such as diarrhea. Peripheral edema, tachycardia, and
fever are not common side effects of this drug.
3. A client who has multiple sclerosis reports increased severe muscle spasticity and
tremors. What nursing action is most appropriate to manage this client's concern?
a. Request a prescription for an antispasmodic drug such as baclofen.
b. Prepare the client for deep brain stimulation surgery.
c. Refer the client to a massage therapist to relax the muscles.
d. Consult with the occupational therapist for self-care assistance.
Answer: ANS: A
Clients who have multiple sclerosis often have muscle spasticity which may be
reduced by drug therapy, such as baclofen. While massage and assistance with self-
care may be helpful, these interventions are not the most effective and therefore not
the most appropriate in managing muscle spasticity. If drug therapy and other
interventions do not help reduce muscle spasms, some client are candidates for deep
brain stimulation as a last resort
4. A client with multiple sclerosis is being discharged from rehabilitation. Which
statement would the nurse include in the client's discharge teaching?
a. "Be sure that you use a wheelchair when you go out in public."
b. "Wear an undergarment brief at all times in case of incontinence."
c. "Avoid overexertion, stress, and extreme temperature if possible."
d. "Avoid having sexual intercourse to conserve energy."
Answer: ANS: C
Clients who have multiple sclerosis have chronic fatigue and are prone to disease
exacerbation (flare-up) is they overexert, are stressed, or are exposed to extreme
temperature and humidity. They should not wear briefs unless they have actual
problems with continence and should not use a wheelchair if they are able to
ambulate with a cane or walker. Maintaining independence and self-esteem is
important, so participating in sexual activities is encouraged.
