A patient presents with gradual-onset weakness, spasticity, hyperreflexia, and positive Babinski sign. Imaging reveals demyelinating plaques in the white matter of the brain and spinal cord. Which of the following neurological conditions is most likely responsible for these symptoms?

Correct Answer: B

Rationale: The symptoms described - gradual-onset weakness, spasticity, hyperreflexia, positive Babinski sign, and demyelinating plaques in the white matter of the brain and spinal cord - are indicative of multiple sclerosis (MS). MS is an autoimmune disease where the body's immune system attacks the myelin sheath, leading to the formation of plaques in the central nervous system. The characteristic symptoms of MS include weakness, spasticity (stiffness in muscles), hyperreflexia (exaggerated reflex responses), and positive Babinski sign (upward movement of the big toe). While ALS (Amyotrophic lateral sclerosis) presents with progressive muscle weakness and atrophy without sensory involvement and demyelinating plaques, Guillain-Barré syndrome (GBS) is typically an acute inflammatory demyelinating polyneuropathy affecting peripheral nerves rather than the central nervous system, and myast

Correct Answer: C

Rationale: The nurse's primary responsibility in responding to a patient's questions about their diagnosis and treatment options is to listen actively and provide accurate, honest, and comprehensive answers. This approach helps build trust between the patient and the healthcare team, allows the patient to make informed decisions about their care, and ensures that the patient understands their condition and the recommended treatment plan. Providing vague answers or ignoring the patient's questions can lead to confusion, anxiety, and mistrust, which can hinder the patient's overall care and recovery. Referring the patient to the physician for all questions may be appropriate for certain medical inquiries, but the nurse plays a crucial role in educating and supporting the patient throughout their healthcare journey.

Correct Answer: B

Rationale: The nurse's priority when a patient appears confused and disoriented during a consultation is to provide clear and simple explanations and assess for any underlying causes of confusion. It is essential to ensure that the patient understands the information being provided and to address any potential reasons for the confusion, such as medication side effects, medical conditions, or cognitive impairment. Ignoring the patient's confusion or assuming they cannot understand can lead to misunderstandings, errors in care, and ultimately jeopardize the patient's well-being. It is crucial to approach the situation with empathy, patience, and a focus on ensuring effective communication and understanding between the nurse and the patient.

Correct Answer: B

Rationale: The best response for the nurse in this situation would be to listen actively to the patient's concerns, acknowledge the lack of information, and offer to address the issue. It is important for healthcare providers to validate the patient's feelings and actively work towards resolving any issues that are causing frustration. By being empathetic and willing to address the problem, the nurse can help improve the patient's experience and build trust in the healthcare team. Dismissing or ignoring the patient's frustration can lead to further dissatisfaction and breakdown in communication. It is crucial for healthcare providers to prioritize open communication and address any concerns or lack of information promptly.

Correct Answer: C

Rationale: The patient's presentation of excessive thirst, frequent urination, and fatigue align with the classic symptoms of diabetes mellitus. The laboratory findings of hypernatremia (high sodium levels), hyperglycemia (high blood sugar levels), and metabolic acidosis further support this diagnosis. In diabetes mellitus, the body is unable to properly regulate blood sugar levels due to either insufficient insulin production (Type 1 diabetes) or ineffective use of insulin by the cells (Type 2 diabetes). This leads to high blood sugar levels, causing symptoms such as polyuria (frequent urination), polydipsia (excessive thirst), and fatigue. The metabolic acidosis is a result of the body's breakdown of fats and proteins for energy due to the lack of glucose utilization in the cells.