Question

Which symptoms are commonly associated with Parkinson’s disease? (Select all that apply)

Answer 1

Correct Answers:

Pill-rolling tremor
Rigidity
Dysphagia
Bradykinesia

Rationale :

🧠Pill-rolling tremor is a classic resting tremor of Parkinson’s due to dopamine depletion in the basal ganglia, especially the substantia nigra.

🪖Rigidity (often cogwheel or lead-pipe) reflects increased muscle tone from disrupted extrapyramidal modulation.

🐢Bradykinesia—slowed initiation and execution of movement—is a cardinal feature, driving functional issues like reduced arm swing and masked facies.

🥤Dysphagia can occur from oropharyngeal bradykinesia/rigidity, elevating aspiration risk and nutritional concerns.

📌Core Message

Parkinson’s centers on dopamine loss producing resting tremor, rigidity, bradykinesia, and possible dysphagia—not hypotonia or hyperreflexia.

Answer 2

Correct Answers:

Anticipate need for palliative care discussions
Encourage high-calorie, nutrient-dense meals
Assess respiratory function regularly
Implement aspiration precautions
Provide communication aids

Rationale :

🌬️ALS progressively weakens respiratory muscles, so regular respiratory assessment (vital capacity, signs of hypoventilation) is critical for timely ventilatory support.

🍽️Because energy expenditure increases while function declines, high-calorie, nutrient-dense meals help prevent malnutrition and weight loss.

🗣️Aspiration precautions address dysphagia from bulbar involvement, reducing the risk of aspiration pneumonia—a major cause of morbidity.

💬Communication aids (e.g., AAC devices) maintain autonomy and quality of life as dysarthria advances.

🕊️Early palliative care discussions align treatment with goals of care, addressing symptom burden and advance planning in a non-curative disease.

📌Core Message

ALS care focuses on respiratory monitoring, nutrition, aspiration prevention, communication support, and early palliative planning—not strength reversal.

Answer 3

Correct Answers:

2.5

Rationale :

🧮Use dose = ordered ÷ concentration: 50 mg ÷ 20 mg/mL = 2.5 mL.

📏This proportional setup ensures the exact volume matches the prescribed dose.

✅Checking units (mg with mg/mL) confirms the mL result is appropriate.

🛡️Rounding is unnecessary here because 2.5 mL is exact from the calculation.

📌Core Message

Apply dose–concentration arithmetic directly: 50 mg at 20 mg/mL equals 2.5 mL.

Answer 4

Correct Answers:

Place the client on aspiration precautions
Consult a speech-language pathologist
Offer thickened liquids
Encourage the client to speak more slowly

Rationale :

🛡️Aspiration precautions are essential with dysphagia, reducing risk of aspiration pneumonia.

🗣️A speech-language pathologist evaluates dysarthria/dysphagia and guides safe swallowing strategies and communication.

🥛Thickened liquids slow flow, allowing better airway protection during swallow in oropharyngeal dysphagia.

⏱️Encouraging slow speech helps articulatory control in dysarthria, improving intelligibility and reducing fatigue.

📌Core Message

Manage MS-related dysphagia/dysarthria with aspiration precautions, SLP consultation, thickened liquids, and paced speech.

Answer 5

Correct Answers:

Autoimmune demyelination of the CNS

Rationale :

🧠MS is characterized by autoimmune-mediated demyelination within the central nervous system (brain, optic nerves, spinal cord).

🧷Loss of myelin disrupts saltatory conduction, producing varied neurologic deficits over time and space.

🧪Pathology includes inflammation, demyelinated plaques, and axonal injury, explaining relapses and progression.

🧭This CNS process distinguishes MS from peripheral neuropathies and neurotransmitter disorders.

📌Core Message

MS is autoimmune CNS demyelination, impairing neural conduction with disseminated lesions.

Answer 6

Correct Answers:

Difficulty swallowing

Rationale :

🥄Difficulty swallowing signals bulbar involvement in ALS, reflecting progression from limb weakness to cranial motor neuron dysfunction.

🌊Bulbar decline heightens aspiration risk and often necessitates diet changes or tube feeding.

🫁Progression to bulbar symptoms commonly precedes respiratory compromise, a key prognostic issue.

🧭This trajectory aligns with ALS’s mixed upper and lower motor neuron degeneration over time.

📌Core Message

In ALS, bulbar symptoms like dysphagia mark disease progression and increased aspiration/respiratory risk.

Answer 7

Correct Answers:

0.8

Rationale :

🧮Compute dose = ordered ÷ concentration: 7,855 units ÷ 10,000 units/mL = 0.7855 mL.

📐Round to the tenths place per instruction: 0.8 mL.

🧪Unit consistency (units with units/mL) ensures a valid mL volume.

🛡️Rounding to a syringe-appropriate increment supports safe administration.

📌Core Message

Heparin volume equals ordered units ÷ concentration, then round: 0.7855 → 0.8 mL.

Answer 8

Correct Answers:

Rapidly ascending paralysis

Rationale :

🪜Guillain-Barré Syndrome classically presents with rapidly ascending weakness/paralysis, starting in the legs and moving upward.

⚡It follows an immune-mediated attack on peripheral myelin/axons (often post-infectious), disrupting nerve conduction.

🔎Early identification matters because progression can reach respiratory muscles, requiring monitoring of vital capacity.

🧭The ascending pattern helps differentiate GBS from other neuropathies with different onset/topography.

📌Core Message

GBS typically shows rapidly ascending paralysis from immune-mediated peripheral nerve involvement.

Answer 9

Correct Answers:

Pain and paresthesia

Rationale :

🌩️Pain and paresthesia reflect sensory nerve involvement typical in GBS, accompanying motor weakness.

🧪Inflammatory demyelination/axonal damage impairs sensory conduction, producing tingling, burning, and aching pain.

🧭These symptoms often precede or parallel ascending weakness, aiding early recognition.

🛡️Management includes analgesia and supportive care while monitoring for autonomic and respiratory complications.

📌Core Message

Sensory symptoms—notably pain and paresthesia—commonly accompany GBS’s ascending motor weakness.

Answer 10

Correct Answers:

Bladder training with scheduled voiding
Avoiding caffeine and artificial sweeteners
Encouraging intermittent self-catheterization
Restricting fluids before bedtime

Rationale :

🕰️Bladder training with scheduled voiding can improve urge/functional control in neurogenic bladder due to MS.

☕Avoiding caffeine and artificial sweeteners reduces bladder irritability, decreasing urgency/frequency.

🧴Intermittent self-catheterization is appropriate when incomplete emptying/overflow is suspected, preventing retention-related leakage.

🌙Restricting fluids before bedtime mitigates nocturia without causing daytime dehydration, complementing other strategies.

📌Core Message

MS urinary symptoms benefit from scheduled voiding, avoiding irritants, intermittent self-catheterization if retention is present, and evening fluid limits.

1 :
Which symptoms are commonly associated with Parkinson’s disease? (Select all that apply)

2 :
The nurse is caring for a client with ALS. Which interventions are most important to include in the plan of care? (Select all that apply)

3 :
A patient is ordered 50 mg of Gentamicin (Garamycin) by IM injection. The drug is available in 20 mg/mL vials. How many mL should you administer?

4 :
A client with MS reports new difficulty speaking clearly and says her words “come out slurred.” She also has trouble swallowing liquids. Which interventions should the nurse implement? (Select all that apply)

5 :
MS is best described as:

6 :
Which symptom suggests ALS progression?

7 :
Doctor’s Order: Heparin 7,855 units SubQ BID; Available: Heparin 10,000 units per mL. How many mL will you administer? (Round your answer to the tenths place.)

8 :
Guillain-Barré Syndrome typically begins with:

9 :
Which assessment finding is expected in Guillain-Barré Syndrome?

10 :
A 45-year-old client with progressive MS reports urinary frequency and urgency, along with occasional dribbling. She denies dysuria. Which interventions should the nurse recommend? (Select all that apply)

1 : Which symptoms are commonly associated with Parkinson’s disease? (Select all that apply)

2 : The nurse is caring for a client with ALS. Which interventions are most important to include in the plan of care? (Select all that apply)

3 : A patient is ordered 50 mg of Gentamicin (Garamycin) by IM injection. The drug is available in 20 mg/mL vials. How many mL should you administer?

4 : A client with MS reports new difficulty speaking clearly and says her words “come out slurred.” She also has trouble swallowing liquids. Which interventions should the nurse implement? (Select all that apply)

5 : MS is best described as:

6 : Which symptom suggests ALS progression?

7 : Doctor’s Order: Heparin 7,855 units SubQ BID; Available: Heparin 10,000 units per mL. How many mL will you administer? (Round your answer to the tenths place.)

8 : Guillain-Barré Syndrome typically begins with:

9 : Which assessment finding is expected in Guillain-Barré Syndrome?

10 : A 45-year-old client with progressive MS reports urinary frequency and urgency, along with occasional dribbling. She denies dysuria. Which interventions should the nurse recommend? (Select all that apply)

1 :
Which symptoms are commonly associated with Parkinson’s disease? (Select all that apply)

2 :
The nurse is caring for a client with ALS. Which interventions are most important to include in the plan of care? (Select all that apply)

3 :
A patient is ordered 50 mg of Gentamicin (Garamycin) by IM injection. The drug is available in 20 mg/mL vials. How many mL should you administer?

4 :
A client with MS reports new difficulty speaking clearly and says her words “come out slurred.” She also has trouble swallowing liquids. Which interventions should the nurse implement? (Select all that apply)

5 :
MS is best described as:

6 :
Which symptom suggests ALS progression?

7 :
Doctor’s Order: Heparin 7,855 units SubQ BID; Available: Heparin 10,000 units per mL. How many mL will you administer? (Round your answer to the tenths place.)

8 :
Guillain-Barré Syndrome typically begins with:

9 :
Which assessment finding is expected in Guillain-Barré Syndrome?

10 :
A 45-year-old client with progressive MS reports urinary frequency and urgency, along with occasional dribbling. She denies dysuria. Which interventions should the nurse recommend? (Select all that apply)