Correct Answer: B

Rationale: This statement is not accurate. Relapsing-remitting multiple sclerosis (RRMS) is characterized by periods of new symptoms or relapses that develop over days or weeks and usually improve partially or completely. These episodes are followed by periods of remission where the disease does not progress.
Therefore RRMS does not cause a steady and gradual decline in function. This is the correct answer. Stress and extreme fatigue can trigger a relapse in RRMS.
Therefore it is important for patients to avoid these triggers to manage their symptoms effectively. This statement is incorrect. RRMS is the most common disease course at the time of diagnosis. It is not the least common type of multiple sclerosis. This statement is not accurate. Medications for RRMS known as disease-modifying treatments (DMT) are designed to reduce the frequency and severity of relapses. They are not intended to be taken only during times of relapse but rather on an ongoing basis to manage the disease.

Correct Answer: A,C,D

Rationale: An electrical cord on the floor over a walkway can pose a tripping hazard increasing the risk of falls. It's important to keep walkways clear of any obstacles to prevent falls. Using a cane to ambulate does not necessarily increase the risk of falls. In fact canes are often used to improve balance and stability reducing the risk of falls. However it's important that the cane is used correctly and is the right height for the individual. Unsecured throw rugs especially over a slippery surface like a tile floor can easily cause someone to slip and fall. It's recommended to secure rugs with non-slip backing or remove them entirely from high-traffic areas. Macular degeneration can lead to vision loss which can increase the risk of falls. Individuals with vision impairments may not be able to see hazards in their path making them more prone to falls.

Correct Answer: C

Rationale: While palliative care can indeed help improve a patient's quality of life it is not typically aimed at curing the disease or significantly prolonging life. Instead the focus is on managing symptoms and improving comfort.
Therefore the statement 'This treatment should help me live a little longer and give me hope for a cure' does not accurately reflect the goals of palliative care. The statement 'I will continue my strict dietary plan' does not necessarily indicate an understanding of palliative care. While maintaining good nutrition can be an important part of managing some conditions palliative care is more focused on symptom management and improving quality of life. Strict dietary restrictions may not be necessary or beneficial in a palliative care context. The statement 'I am hoping this will limit my discomfort and give me the best quality of life for me' accurately reflects the goals of palliative care. Palliative care aims to manage symptoms including pain and discomfort and to improve the patient's quality of life. The statement 'This is not working and I plan to stop treatment' does not necessarily reflect an understanding of palliative care. While a patient has the right to stop treatment at any time this decision should be based on a thorough understanding of their condition and the potential benefits and drawbacks of continuing or discontinuing treatment.

Correct Answer: A

Rationale: Chronic stress is a prolonged often overwhelming feeling of stress that can negatively impact a person's daily life. It can be caused by various factors including high-pressure jobs challenging relationships and living in poverty. Living in poverty is a long-term situation that can cause chronic stress due to the constant worry about meeting basic needs such as food shelter and healthcare. This continuous worry and fear can lead to chronic stress. A motor vehicle accident is typically an acute stress event. While it can cause significant stress at the moment it is usually not a long-term stressor unless it results in severe injury or trauma that significantly impacts a person's daily life. Being a victim of a crime can indeed cause stress but it is typically considered an acute stress event. However if the crime results in long-term effects such as physical harm or psychological trauma it could potentially lead to chronic stress. The loss of a loved one can cause both acute and chronic stress. The initial loss can cause acute stress and the subsequent grieving process can lead to chronic stress especially if the individual has difficulty moving through the stages of grief. However not everyone who loses a loved one will experience chronic stress.

Correct Answer: D

Rationale: Initiating life-saving measures such as a rapid response call would not be appropriate in this context. The patient is in a hospice setting which focuses on providing comfort and quality of life for patients who are nearing the end of life rather than aggressive lifesaving interventions. Calling the provider because these signs and symptoms are abnormal would not be the correct response. In a hospice setting these symptoms are expected and are indicative of the natural dying process. The statement that rapid respirations that are unusually deep and regular are curative for the patient is incorrect. Cheyne-Stokes respirations characterized by a pattern of increasing and then decreasing depth of breath followed by a period of apnea are often seen in patients nearing the end of life. They are not curative but are a sign of the body's decreasing metabolic demands and changing physiology as death approaches. The nurse understanding that these are impending signs of death and are normal is the correct response. The symptoms described including loss of appetite swelling of the limbs increased sleep Cheyne-Stokes respirations and hallucinations are all common in the final stages of life. Recognizing these signs can help the nurse provide appropriate care and support to the patient and their family during this time.