Factors Affecting Neuromuscular Functioning

Every question here, with the answer

1. A patient has muscle weakness and undergoes nerve conduction velocity (NCV) testing. The results are normal. Which interpretation is most consistent with this finding?

   1. The patient should be diagnosed with a complete spinal cord injury.
   2. The disorder is more likely stemming from the nervous system.
   3. The disorder is likely caused by a muscular problem.
   4. The patient has a confirmed diagnosis of multiple sclerosis.

   Answer: The disorder is likely caused by a muscular problem.

   The section states that normal NCV testing suggests a muscular cause, while slow or abnormal NCV testing suggests a nervous system cause. NCV testing can help guide the source of the problem, but it does not by itself confirm MS or spinal cord injury.

2. A nurse is teaching a patient who will have electromyography (EMG). Which information should the nurse include? Select all that apply.

   1. Some patients report pain with needle insertion.
   2. The test evaluates how muscles respond to nervous system stimulation.
   3. The test usually takes sixty to ninety minutes.
   4. Lingering muscle soreness may occur for a few days after the procedure.
   5. The procedure typically causes severe pain for most patients.

   Answer: Some patients report pain with needle insertion., The test evaluates how muscles respond to nervous system stimulation., The test usually takes sixty to ninety minutes., Lingering muscle soreness may occur for a few days after the procedure.

   EMG is used to evaluate muscle response to nervous system stimulation and usually takes 60 to 90 minutes. The section notes that it typically does not cause much pain, although some patients report pain with needle insertion and lingering soreness for a few days.

3. A patient newly diagnosed with relapsing-remitting multiple sclerosis asks what this subtype means. Which response by the nurse is most accurate?

   1. “This is the rarest subtype and includes steady worsening with acute relapses.”
   2. “This type occurs only after another MS subtype has already been diagnosed.”
   3. “Your symptoms will steadily worsen from the beginning without remission.”
   4. “Your symptoms occur as attacks, and between attacks they may improve or resolve completely.”

   Answer: “Your symptoms occur as attacks, and between attacks they may improve or resolve completely.”

   Relapsing-remitting MS is characterized by exacerbations or attacks followed by improvement or complete resolution during remission. The other options describe primary-progressive, secondary-progressive, and progressive-relapsing MS.

4. A nurse is assessing an infant for early signs of cerebral palsy. Which findings are consistent with early signs listed in the section? Select all that apply.

   1. Overly stiff or floppy extremities
   2. Leg stiffening or scissoring when being picked up
   3. Eyelid drooping and double vision
   4. Inability to roll over after 6 months of age
   5. Head lag when being picked up from lying on the back

   Answer: Overly stiff or floppy extremities, Leg stiffening or scissoring when being picked up, Inability to roll over after 6 months of age, Head lag when being picked up from lying on the back

   The section lists head lag, overly stiff or floppy extremities, leg stiffening or scissoring, and inability to roll over after 6 months as early signs of cerebral palsy. Eyelid drooping and double vision are symptoms associated with myasthenia gravis, not early signs of cerebral palsy in this section.

5. A nurse is reviewing possible diagnostic testing for a patient with suspected neuromuscular impairment. Which statements are accurate? Select all that apply.

   1. Electrolyte imbalances can cause muscle weakness or paralysis.
   2. Blood tests can assist with confirmation of a disorder or help rule out other causes.
   3. Genetic testing is the most accurate test for neuromuscular disorders that are genetic in nature.
   4. Muscle biopsy may be useful when other tests are inconclusive.
   5. CT and MRI scans are usually conclusive for specific neuromuscular disorders.

   Answer: Electrolyte imbalances can cause muscle weakness or paralysis., Blood tests can assist with confirmation of a disorder or help rule out other causes., Genetic testing is the most accurate test for neuromuscular disorders that are genetic in nature., Muscle biopsy may be useful when other tests are inconclusive.

   Blood tests can support confirmation or rule out other causes, and electrolyte imbalances can cause weakness or paralysis. Muscle biopsy can be useful if other tests are inconclusive, and genetic testing is most accurate for genetic neuromuscular disorders; CT and MRI are not usually conclusive for specific disorders.