What should a nurse include in his discharge teaching for a client with multiple sclerosis?

Multiple sclerosis NCLEX questions for nursing students. Multiple sclerosis is a neuro disease that affects the central nervous system.

In the previous NCLEX review, I explained about other neurological disorders, so be sure to check those reviews out.

As the nurse, it is important to know the pathophysiology of multiple sclerosis, the types of drugs used to treat this condition, signs and symptoms, and the nursing interventions.

Don’t forget to watch the lecture on multiple sclerosis before taking the quiz below.

Multiple Sclerosis NCLEX Questions

This quiz will test your knowledge on multiple sclerosis (MS) in preparation for the NCLEX exam.

(NOTE: When you hit submit, it will refresh this same page. Scroll down to see your results.)

1. Select all the TRUE statements about the pathophysiology of multiple sclerosis:

A. “The dendrites on the neuron are overstimulated leading to the destruction of the axon.”

B. “The myelin sheath, which is made up of Schwann cells, is damaged along the axon.”

C. “This disease affects the insulating structure found on the neuron in the central nervous system.”

D. “The dopaminergic neurons in the part of the brain called substantia nigra have started to die.”

The answers are B and C. In multiple sclerosis the myelin sheath (which is the insulating and protective structure made up of Schwann cells that protects the axon) is damaged. MS affects the CNS (central nervous system) and when the myelin sheath becomes damaged it leads to a decrease in nerve transmission.

2. True or False: Multiple Sclerosis tends to affect men more than women and occurs during the ages of 50-70 years.

False: MS affects WOMEN more than men and shows up during the ages of 20-40 years.

3. True or False: Patients with multiple sclerosis have different signs and symptoms because this disease can affect various areas of the peripheral nervous system.

False: Yes, patients with MS have different signs and symptoms because lesions can present at different locations in the CENTRAL NERVOUS SYSTEM….hence the brain and spinal cord (not the peripheral nervous system).

4. A patient is suspected of having multiple sclerosis. The neurologist orders various test. The patient’s MRI results are back and show lesions on the cerebellum and optic nerve. What signs and symptoms below would correlate with this MRI finding in a patient with multiple sclerosis?

A. Blurry vision

B. Pain when moving eyes

C. Dysarthria

D. Balance and coordination issues

E. “Pill rolling” of fingers and hands

G. Heat intolerance

H. Dark spots in vision

I. Ptosis

The answers are A, B C, D, and H. If lesions are present on the optic nerves, optic neuritis can occurs which can lead to blurry vision, pain when moving the eyes, and dark spots in the vision. If cerebellar lesions are found, this can affect movement, speech, and some cognitive abilities. This would present as dysarthria (issues articulating words), and balance/coordination issues. “Pill rolling” of the fingers and hands is found in Parkinson’s disease. Ptosis is common in myasthenia gravis, and heat intolerance in thyroid issues.

5. You’re performing a head-to-toe assessment on a patient with multiple sclerosis. When you ask the patient to move the head and neck downward the patient reports an “electric shock” sensation that travels down the body. You would report your finding to the doctor that the patient is experiencing:

A. Romberg’s Sign

B. Lhermitte’s Sign

C. Uhthoff’s Sign

D. Homan’s Sign

The answer is B. This finding is known as Lhermitte’s Sign.

6. Which finding below represents a positive Romberg Sign in a patient with multiple sclerosis?

A. The patient report dark spots in the visual fields during the confrontation visual field test.

B. When the patient closes the eyes and stands with their feet together they start to lose their balance and sway back and forth.

C. The patient’s sign and symptoms increase when expose to hot temperatures.

D. The patient reports an electric shock feeling when the head and neck are moved downward.

The answer is B. This is an example of a positive Romberg’s Sign.

7. Your patient is scheduled for a lumbar puncture to help diagnose multiple sclerosis. The patient wants clarification about what will be found in the cerebrospinal fluid during the lumbar puncture to confirm the diagnosis of MS. You explain that ____________ will be present in the fluid if MS is present.

A. high amounts of IgM

B. oligoclonal bands

C. low amounts of WBC

D. oblong red blood cells and glucose

The answer is B. These specific proteins, oligoclonal bands, which are immunoglobulins will be found in the CSF. This demonstrates there is inflammation in the CNS and is a common finding in multiple sclerosis.

8. You’re developing a plan of care for a patient with multiple sclerosis who presents with Uhthoff’s Sign. What interventions will you include in the patient’s plan of care? Select all that apply:

A. Avoid movements of the head and neck downward

B. Keep room temperature cool

C. Encourage patient to use warm packs and heating pads for symptoms

D. Educate the patient on three ways to avoid overheating during exercise

The answers are B and D. Uhthoff’s Sign is where when the patient experiences too much heat their symptoms increase and get worst. Therefore, it is important the patient stays cool and doesn’t overheat (overheating can come from outside temperatures, exercise, emotional events etc.). The room should be cool and the patient should be encouraged to exercise but to avoid overheating.

9. During your discharge teaching to a patient with multiple sclerosis, you educate the patient on how to avoid increasing symptoms and relapses. You tell the patient to avoid:

A. Cold temperatures

B. Infection

C. Overexertion

D. Salt

F. Stress

The answer is B, C, and F. The patient should also avoid extreme heat, which can increase symptoms.

10. A patient with multiple sclerosis has issues with completely emptying the bladder. The physician orders the patient to take ___________, which will help with bladder emptying.

A. Bethanechol

B. Oxybutynin

C. Avonex

D. Amantadine

The answer is A. This medication is a cholinergic medication that will help with bladder emptying.

11. A patient is receiving Interferon Beta for treatment of multiple sclerosis. As the nurse you will stress the importance of?

A. Physical exercise to improve fatigue

B. Low fat diet

C. Hand hygiene and avoiding infection

D. Reporting ideation of suicide

The answer is C. Interferon Beta decreases the number of relapses of symptoms in MS patients by decreasing the immune system response, but it lowers the white blood cells count. Hence, there is a risk of infection. It is very important the nurse stresses the importance of hand hygiene and avoiding infection.

12. Which medications below can help treat muscle spasms in a patient with multiple sclerosis? Select all that apply:

A. Propranolol

B. Isoniazid

C. Baclofen

D. Diazepam

E. Modafinil

The answers are C and D. These medications treat muscle spasms in patients with MS.

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