A nurse is assessing a 58-year-old client who was recently d… | 마이메르시 MyMerci
마이메르시 — 문제와 상세 해설까지 전부 무료 무료로 시작하기
Adult Health
문제

A nurse is assessing a 58-year-old client who was recently diagnosed with amyotrophic lateral sclerosis (ALS). Which assessment finding would be most characteristic of early-stage ALS?

해설
Early-stage ALS typically presents with asymmetric muscle weakness and fasciculations, most commonly beginning in the hands and forearms. This distinguishes it from other neurological conditions.
같은 주제 다음 문제A 65-year-old male client with amyotrophic lateral sclerosis (ALS) is being assessed by th…

심화 해설

Clinical Judgment This question assesses the ability to distinguish the early features of amyotrophic lateral sclerosis (ALS) from other neurological disorders. The key points are asymmetry and fasciculations. Because ALS affects both upper and lower motor neurons, early signs include a mix of lower motor neuron damage (muscle atrophy, fasciculations) and upper motor neuron damage (spasticity, hyperreflexia). The most common site of onset is the distal limbs (hands, feet), characterized by an asymmetric pattern that starts on one side and gradually spreads. Memory Tip: ALS = Asymmetry + Limb onset + Spasms (fasciculations). Remember that "ALS starts Asymmetrically, with Limb twitching (Spasms)." KR vs US: In Korea, the term 'Lou Gehrig's disease' may be more familiar. While the diagnostic approach is similar, in the US, early intervention through a Multidisciplinary Clinic and respiratory management (such as non-invasive ventilation) are conducted very systematically. The nurse's role also emphasizes linking patients with an early Palliative Care team alongside symptom management.

임상 시나리오

Clinical Practice Guide
When assessing ALS patients, use standardized tools such as the ALSFRS-R (ALS Functional Rating Scale-Revised) to quantitatively track functional decline. Regularly monitoring respiratory function (maximum inspiratory pressure, forced vital capacity) is directly linked to life prognosis.
Caution:
A key distinguishing feature of ALS is the preservation of sensation, bladder/bowel function, and cognitive function. Therefore, if there are impairments in these areas, you should suspect other diagnoses (such as myelopathy, multiple sclerosis, etc.) rather than ALS. Be careful of traps in SATA (Select All That Apply) questions that include these 'preserved functions' as incorrect options.

핵심 개념

Merci NCLEX-RN Question Bank 3,445 문제 · 로그인 없이 바로 볼 수 있어요

마이메르시로 국가고시 완벽 대비

기출문제와 상세 해설을 무료로. 내 약점을 분석하고 진도를 관리하며 더 똑똑하게 공부하세요.

무료로 시작하기

학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요.