ALS practice questions

Which assessment data would make the nurse suspect that the client has ALS?
1. history of a cold or GI upset in the last month
2. Complaints of double vision and drooping eyelids
3. Fatigue, progressive muscle weakness, and twitching.
4. Loss of sensation below the level of the umbilicus.
1. Wrong. Guillan-Barre.
2. Wrong. Myasthenia Gravis
3. Correct.
4. Wrong. Spinal cord injury.

Which intervention should the nurse take with the client recently diagnosed with ALS?
1. Discuss a percutaneous gastrostomy tube.
2. Explain how a fistula is accessed.
3. Provide an advance directive.
4. Refer to a PT for leg braces.
3. It is never too early to discuss advance directives with a client diagnosed with a terminal illness.

Which diagnostic test is used to confirm ALS?
1. Electromyelogram (EMG).
2. Muscle biopsy.
3. Serum creatine kinase enzyme (CK).
4. Pulmonary function test.
1. Wrong. EMG differentiates neuropathy from myopathy.
2. Correct. Biopsy confirms changes consistent with atrophy and loss of muscle fiber, characteristics of ALS.
3. Wrong. CK may or may not be elevated.
4. Wrong. This only confirms pulmonary involvement, not a diagnosis.

The client is diagnosed with ALS. Which client problem would be most appropriate for this client?
1. Disuse syndrome?
2. Altered body image.
3. F/E imbalance.
4. Alteration in pain.
1. Correct. Disuse syndrome is associated with bedrest.
2. Wrong. Client does not usually have a change in body image.
3. Wrong. ALS does not affect kidneys/circ.
4. Wrong. ALS is not painful.

The client with ALS is admitted to the medical unit with SOB, dsypnea, and resp. complications. Which intervention should the nurse implement first?
1. Elevate HOB 30 degrees.
2. Administer oxygen via nasal cannula.
3. Assess lung sounds.
4. Obtain a pulse ox reading.
1. Wrong Helps, but not first intervention.
2. Correct. Oxygen should be given immediately to help alleviate the difficulty breathing. Oxygenation is a priority.
3. Wrong. Assessment won’t help client to breathe.
4. Wrong. Pulse ox will not alleviate resp distress.

The son of a client diagnosed with ALS asks the nurse, “Is there any chance that I could get the disease?” Which statement is most appropriate?
1. “It must be scary to think you might get ALS.”
2. “No, the disease is not genetic or contagious.”
3. “ALS does have a genetic factor and runs in families.”
4. “If you are exposed to the same virus, you could get it.”
1. Wrong. He’s not sure if he’s going to get ALS. Not appropriate.
2. Wrong. Incorrect information.
3. Correct. There is a genetic factor with ALS that is linked to a chromosome 21 defect.
4. Wrong. Not virus related, though possible environmental factors.

A newly diagnosed DM Type I client has been stabilized with daily insulin injections. A nurse prepares a discharge teaching plan regarding the insulin and plans to reinforce which of the following concenpts? a. always keep insulin vials refrigerated b. …

A nurse is caring for a client who is receiving medication intramuscularly. The nurse should recognize that this route? Increase infection rates A nurse is planning care for a client who has had stroke resulting in aphasia and dysphagia. Which …

1. A 68-year-old patient who is hospitalized with pneumonia is disoriented and confused 3 days after admission. Which information indicates that the patient is experiencing delirium rather than dementia? The patient was oriented and alert when admitted The patient’s speech …

A 78-year-old client is admitted to the emergency department with numbness and weak- ness of the left arm and slurred speech. Which nursing intervention is priority? 1. Prepare to administer recombinant tissue plasminogen activator (rt-PA). 2. Discuss the precipitating factors …

A nurse has administered midazolam (Versed) IV bolus to a client before a procedure. The client’s blood pressure is 86/40mm Hg and pulse is 134/min. Which of the following is an appropriate action by the nurse? A.)Administer naloxone (Narcan) IV. …

Best position for detecting a low-pitched diastolic murmur Left lateral recumbant position- on Left side, right arm across chest, left arm across top of head pointing upwards A nurse is performing a respiratory examination on a client who has pneumonia. …

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