Question 1

The problems associated with multiple sclerosis are due to which of the following?&#10;A) Denervated peripheral muscle fibers&#10;B) Demyelinated peripheral nerves&#10;C) Destruction of the anterior horn cells&#10;D) Demyelinated central nerves

Accepted Answer

Multiple sclerosis is a neurological disorder in which the immune system attacks and damages the myelin sheath that surrounds and insulates nerve fibers in the central nervous system. This results in demyelination of central nerves, which causes a range of symptoms such as muscle weakness, numbness, tingling, vision problems, and difficulty with coordination and balance. Denervated peripheral muscle fibers (A) and destruction of the anterior horn cells (C) are not directly related to multiple sclerosis, while demyelinated peripheral nerves (B) are not a characteristic feature of the disease.

Question 2

Which form of multiple sclerosis is the most common and features repeated episodes in which the client has a loss of function and then the function returns?&#10;A) Secondary-progressive&#10;B) Primary-progressive&#10;C) Relapsing-remitting&#10;D) Progressive-relapsing

Accepted Answer

Relapsing-remitting MS is the most common form, characterized by repeated episodes of flare-ups followed by periods of remission where the function returns. This pattern can continue for many years before progressing to a more continuous pattern of symptoms in secondary-progressive MS. Primary-progressive MS is characterized by a steady deterioration of function without the flare-up episodes, while progressive-relapsing MS has both continuous worsening of function and episodes of flare-ups.

Question 3

You are reviewing the medical record of your next patient,who has Parkinson's disease.The neurologist has indicated that this man has bradykinesia.What does this mean?&#10;A) He has no movement available.&#10;B) His movements are slow.&#10;C) He has oscillations in his movements.&#10;D) His movements are very erratic and quick.

Accepted Answer

Bradykinesia refers to slowness of movement, which is a common symptom of Parkinson's disease.

Question 4

The progression of Parkinson's disease has been described in stages.Which description best fits Stage IV of the disease progression?&#10;A) Client is able to complete all activities of daily living (ADLs) but has difficulties with balance reactions.&#10;B) The client experiences marked impairment and is bedridden.&#10;C) The client has mild asymmetrical involvement but no problem with ADLs.&#10;D) Although still ambulatory, the client needs assistance with ADLs.

Accepted Answer

In Stage IV of Parkinson's disease, the client is still ambulatory but needs assistance with ADLs. This stage is characterized by severe symptoms and significant impairments, including postural instability, gait disturbances, and difficulty with balance reactions. However, the client is not yet bedridden and is still able to move with assistance.

Question 5

What are common psychosocial issues seen with clients who are diagnosed with Huntington's disease?&#10;A) Depression&#10;B) Suicidal thoughts&#10;C) Emotional lability&#10;D) All of the above

Accepted Answer

Depression, suicidal thoughts, and emotional lability are all common psychosocial issues seen with clients who are diagnosed with Huntington's disease. Depression is often seen due to the challenging nature of the disease, while suicidal thoughts may arise from feelings of hopelessness and a lack of control. Emotional lability, or mood swings, is also common due to the overall impact on the brain and nervous system.

Question 6

Amyotrophic lateral sclerosis has three clinical subtypes.Which type is associated with a quicker progression and problems with dysphagia and dysarthria?&#10;A) Progressive bulbar palsy&#10;B) Progressive spinal muscular atrophy&#10;C) Primary lateral sclerosis&#10;D) Primary medial sclerosis

Accepted Answer

Progressive bulbar palsy is the subtype of ALS that is associated with a quicker progression and problems with dysphagia and dysarthria. This subtype affects the muscles that control speech, swallowing, and breathing.

Question 7

What are the three classic clinical symptoms of Parkinson's disease?&#10;A) Resting tremor, spasticity, rigidity&#10;B) Resting tremor, impaired voluntary movement, rigidity&#10;C) Spasticity, impaired postural reflexes, decorticate posture&#10;D) Spasticity, choreiform movements, impaired postural reflexes

Accepted Answer

The three classic clinical symptoms of Parkinson's disease are resting tremor, impaired voluntary movement (also known as bradykinesia), and rigidity. Spasticity is not a common feature of Parkinson's disease, and the other options listed are not characteristic symptoms of the disease.

Question 8

You are evaluating a 42-year-old man with Huntington's disease.You notice that as he is sitting in a chair,his hands are in constant motion.This motion continues even when you are speaking with him.What is this motion called?

A) Athetosis
B) Ballistic
C) Chorea
D) Decerebrate

Accepted Answer

Chorea is a common movement disorder seen in patients with Huntington's disease. It is characterized by involuntary, irregular, rapid, and unpredictable movements of the limbs, face, and trunk. The movements are typically brief, jerky, and writhing in nature and occur when the patient is relaxed or at rest. Chorea can be exacerbated by stress or excitement and can affect speech and swallowing. The constant hand motion observed in the patient is a classic sign of chorea.

Question 9

Your next client,a 71-year-old woman,has been diagnosed with Alzheimer's disease and has moderate memory loss for recent personal experiences and is having problems managing her finances.Using the four-stage classification method,identify the stage in which your client is at this time.

A) 1: Very mild to mild cognitive decline
B) 2: Mild to moderate decline
C) 3: Moderate to moderately severe decline
D) 4: Severe cognitive decline

Accepted Answer

The client's symptoms of moderate memory loss for recent personal experiences and difficulty managing finances suggest she is in the mild to moderate decline stage of Alzheimer's disease, which aligns with stage 2 in the four-stage classification method.

Question 10

Which statement best represents the function of occupational therapy with clients in the partially independent phase (Phase II)of amyotrophic lateral sclerosis?&#10;A) Progressive resistive exercises on a daily basis along with stretching&#10;B) Gentle resistive exercise on a daily basis along with training for suctioning&#10;C) Assess and instruct in use of assistive technology and potential power mobility&#10;D) Instruct family members in skin care and train in suctioning

Accepted Answer

Occupational therapy in the partially independent phase of ALS focuses on maximizing independence and quality of life through the use of assistive technology and potential power mobility. This stage of the disease is characterized by increasing weakness and loss of function, so addressing mobility and accessibility needs is a priority for occupational therapy interventions. Options A and B may not be appropriate for clients in this stage of the disease, as they involve resistive exercise that may exacerbate weakness and fatigue. Option D may be important, but is not the primary focus of occupational therapy in this phase.

Deck 35: Degenerative Diseases of the Central Nervous System