A nurse is collecting data on a client who has multiple sclerosis. The client reports there are times when the symptoms are active and times when there are no symptoms. Which of the following types of multiple sclerosis does this pattern indicate?
Primary progressive multiple sclerosis
Relapsing-remitting multiple sclerosis
Secondary progressive multiple sclerosis
Clinically isolating syndrome
The Correct Answer is B
A. Primary progressive multiple sclerosis is characterized by a gradual progression of symptoms without relapses, so this does not match the client's pattern.
B. Relapsing-remitting multiple sclerosis is defined by episodes of exacerbation (active symptoms) followed by periods of remission (no symptoms), which aligns with the client's description.
C. Secondary progressive multiple sclerosis follows an initial relapsing-remitting course but leads to a more continuous decline in function, so it does not match the pattern described.
D. Clinically isolating syndrome refers to a single episode of neurological symptoms but does not indicate the pattern of relapses and remissions typical of relapsing-remitting multiple sclerosis.
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Correct Answer is B
Explanation
A. A contrecoup injury is a true injury and can be significant; stating it is not considered "true" is incorrect and indicates a lack of understanding.
B. This statement accurately describes coup and contrecoup injuries, where a coup injury occurs at the site of impact and a contrecoup injury occurs on the opposite side of the brain.
C. This statement is incorrect because a coup injury does not occur secondary to the contrecoup; they can happen simultaneously during trauma.
D. Contrecoup injuries can be just as severe as coup injuries, and the healing process varies; stating they are easier to heal from is misleading and reflects a misunderstanding.
Correct Answer is B
Explanation
A. Documenting the findings and continuing the visit does not address the potential seriousness of the weight gain and edema in a patient with heart failure. It is important to act promptly on such findings.
B. Notifying the RN case manager of the change in status is essential because a weight gain of this magnitude, along with generalized edema, may indicate worsening heart failure. This requires a timely assessment and possible adjustment of the treatment plan, including medication and fluid management.
C. While reinforcing the importance of daily weights is beneficial for long-term management, it is not an immediate intervention for the acute change in the patient’s condition.
D. Ensuring the client has been taking their prescribed diuretic is important, but the nurse should first communicate the significant changes to the RN case manager for further evaluation and intervention, as this might require a medication review or adjustment.