Chapter 23: Drugs for Multiple Sclerosis

Chapter 23: Drugs for Multiple Sclerosis

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient has been newly diagnosed with multiple sclerosis (MS), and the nurse provides teaching about the medications for the disease. Which statement by the patient indicates a need for further teaching?

a.	“I may need to take additional drugs at times of acute relapse.”
b.	“I will need to take medication indefinitely.”
c.	“If medication is begun early, permanent remission can be achieved.”
d.	“Some symptoms may need to be managed with symptom-specific drugs.”

 

 

ANS:  C

Drug therapy can reduce the frequency and severity of relapses, maintain quality of life, and prevent permanent damage to axons, but it does not produce permanent remission. Patients may need to take additional drugs during times of relapse and will need to take medications indefinitely. Some symptoms may be managed with symptom-specific drugs.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   p. 199 | pp. 200-202

TOP:   Nursing Process: Evaluation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Physiologic Adaptation

 

2. A patient has been diagnosed with multiple sclerosis (MS) for 10 years and has a history of 3 periods of neurologic dysfunction lasting several weeks separated by long periods of full recovery. In the past 6 months, the patient has had a prolonged period of neurologic dysfunction without remission. The nurse understands that the patient may have which MS subtype?

a.	Primary progressive MS
b.	Progressive-relapsing MS
c.	Relapsing-remitting MS
d.	Secondary progressive MS

 

 

ANS:  D

Secondary progressive MS occurs when a patient with relapsing-remitting MS develops steadily worsening dysfunction with or without plateaus or acute exacerbations, or minor remissions. Within 10 to 20 years of onset, about 50% of patients with MS will develop this type. Primary progressive MS occurs when symptoms grow progressively more intense from the onset. Progressive-relapsing MS is similar to primary progressive MS, but with acute exacerbations imposed on the steadily worsening symptoms. Relapsing-remitting MS is the most common initial presentation, which is characterized by recurrent, clearly defined episodes of symptoms with periods of remission with relapse occurring approximately twice every 3 years.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 200

TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance

 

3. A patient has been diagnosed with primary progressive multiple sclerosis for 1 year and reports a recent brief period of being symptom free. The nurse will tell the patient that this indicates what?

a.	Hope for long-term remission
b.	Temporary improvement
c.	Development of relapsing-remitting MS
d.	Development of secondary progressive MS

 

 

ANS:  B

Patients with primary progressive MS have symptoms that grow progressively more intense over time; patients may experience occasional plateaus or temporary improvement, but they do not have clear remissions. This episode does not represent hope for long-term remission or the development of a different subtype of MS.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 200

TOP:   Nursing Process: Diagnosis

MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance

 

4. A patient is being treated with interferon beta-1a [Avonex] for relapsing-remitting MS. The patient calls the clinic to report headache, fever, chills, and muscle aches after administering a dose. What will the nurse recommend?

a.	Acetaminophen or ibuprofen
b.	Asking the provider to order a complete blood count (CBC)
c.	Coming to the clinic for evaluation for leukoencephalopathy
d.	Discontinuing the drug immediately

 

 

ANS:  A

Patients treated with interferon beta can experience flulike reactions that diminish over time. Acetaminophen or ibuprofen may be used to treat symptoms. A CBC is not indicated. Leukoencephalopathy is a side effect of natalizumab, not interferon beta. It is not necessary to discontinue the drug.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 202-203

TOP:   Nursing Process: Evaluation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies