NUR200 - M2 - Multiple Sclerosis - NCLEX and ATI
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
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
