CNRN Neurodegenerative Disorders Nursing 1 — Questions and Answers
Question 1: Which type of multiple sclerosis is characterized by steadily worsening neurologic function from disease onset without distinct relapses or remissions?
- Relapsing-remitting MS
- Primary progressive MS (Correct answer)
- Secondary progressive MS
- Progressive-relapsing MS
Correct answer: Primary progressive MS
Primary progressive MS (PPMS) is characterized by continuous neurological decline from disease onset without distinct relapses or remissions.
Question 2: Which set of signs represents the four cardinal motor features of Parkinson's disease?
- Tremor, rigidity, bradykinesia, and postural instability (Correct answer)
- Spasticity, hyperreflexia, clonus, and ataxia
- Chorea, dystonia, athetosis, and ballismus
- Flaccidity, fasciculations, atrophy, and areflexia
Correct answer: Tremor, rigidity, bradykinesia, and postural instability
The four cardinal signs of Parkinson's disease are resting tremor, rigidity, bradykinesia (slowness of movement), and postural instability.
Question 3: A patient with ALS is experiencing dysphagia. Which nursing intervention is the HIGHEST priority?
- Encourage three large meals per day to maintain caloric intake
- Assess swallowing function and implement aspiration precautions (Correct answer)
- Place the patient on a regular diet to prevent nutritional deficits
- Administer antiemetics before all meals
Correct answer: Assess swallowing function and implement aspiration precautions
Dysphagia in ALS creates significant aspiration risk; assessing swallowing and implementing aspiration precautions is the priority to prevent life-threatening aspiration pneumonia.
Question 4: Which clinical feature best differentiates early Alzheimer's disease from other dementias?
- Prominent visual hallucinations occurring early in the disease course
- Insidious onset with predominant short-term memory impairment (Correct answer)
- Stepwise cognitive decline following repeated small strokes
- Rapid progression with myoclonus and cerebellar ataxia
Correct answer: Insidious onset with predominant short-term memory impairment
Alzheimer's disease characteristically presents with insidious onset where short-term memory impairment is the predominant early feature.
Question 5: A nurse is caring for a patient with relapsing-remitting MS. Which medication class is used as a disease-modifying therapy to reduce relapse frequency?
- Corticosteroids
- Beta-interferons (Correct answer)
- Anticholinergics
- Calcium channel blockers
Correct answer: Beta-interferons
Beta-interferons (e.g., interferon beta-1a, beta-1b) are disease-modifying therapies that reduce the frequency and severity of MS relapses by modulating the immune response.
Question 6: Huntington's disease is caused by which genetic mutation?
- CAG trinucleotide repeat expansion on chromosome 4 (Correct answer)
- Deletion of chromosome 22q11
- Point mutation in the PARK2 gene on chromosome 6
- Trisomy of chromosome 21
Correct answer: CAG trinucleotide repeat expansion on chromosome 4
Huntington's disease results from an expansion of CAG trinucleotide repeats in the HTT gene on chromosome 4, leading to progressive striatal neurodegeneration.
Question 7: A patient with myasthenia gravis develops sudden respiratory distress and profound muscle weakness after starting a new antibiotic. This presentation is MOST consistent with:
- Cholinergic crisis from acetylcholinesterase inhibitor overdose
- Myasthenic crisis precipitated by the antibiotic (Correct answer)
- Acute Guillain-Barré syndrome
- Lambert-Eaton myasthenic syndrome
Correct answer: Myasthenic crisis precipitated by the antibiotic
Myasthenic crisis — severe muscle weakness and respiratory failure — can be precipitated by certain antibiotics (e.g., aminoglycosides, fluoroquinolones) that impair neuromuscular transmission.
CNRN Neurodegenerative Disorders Nursing 1
Which type of multiple sclerosis is characterized by steadily worsening neurologic function from disease onset without distinct relapses or remissions?