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 D
Explanation
A. Nicardipine is a calcium channel blocker primarily used to manage blood pressure but does not directly reduce ICP.
B. Phenytoin is an anticonvulsant used to prevent seizures, which may occur after a hemorrhage, but it does not address increased ICP.
C. Dopamine is used to increase blood pressure and cardiac output but does not play a role in reducing ICP.
D. Mannitol is an osmotic diuretic that helps decrease ICP by drawing fluid from brain tissue into the bloodstream, thus relieving pressure within the skull. It is the most appropriate intervention for managing increased ICP.
Correct Answer is A
Explanation
A. A positive result in a Tensilon test is indicated by a temporary improvement in muscle strength following the administration of edrophonium (Tensilon), which confirms the diagnosis of myasthenia gravis.
B. A "pill-rolling" tremor is associated with Parkinson's disease and is not a relevant finding in myasthenia gravis or the Tensilon test.
C. The Tensilon test assesses muscle strength rather than electrical charge in the muscle; therefore, an increase in electrical activity is not a relevant measure for this test.
D. No change in muscle strength indicates a negative result for myasthenia gravis, suggesting that the test did not confirm the diagnosis.