Neuromuscular Disorders Practice Questions
12 free Neuromuscular Disorders practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
What is the characteristic pattern of weakness in Guillain-Barré syndrome?
- A Upper limb weakness progressing down to the lower limbs
- B Facial weakness only with no involvement of the limbs
- C Symmetric ascending weakness with diminished reflexes
- D Asymmetric patchy weakness confined to one single limb
Correct answer: Symmetric ascending weakness with diminished reflexes
GBS often begins with tingling and weakness in the legs that ascends upward, with reflexes usually reduced or lost.
What is a key nursing concern for a patient with Guillain-Barré syndrome?
- A Risk of pressure ulcers only, with no respiratory involvement
- B Monitoring for respiratory muscle weakness and ventilatory failure
- C Only ambulation risk, since respiratory function stays normal
- D Anticipating full spontaneous recovery within the first 24 hours
Correct answer: Monitoring for respiratory muscle weakness and ventilatory failure
GBS can progress rapidly to involve respiratory muscles, making monitoring of breathing critical.
One of the earliest symptoms of multiple sclerosis (MS) is often:
- A Persistent symmetric paralysis of both legs from the onset
- B Visual changes (optic neuritis) or numbness in one limb
- C Complete cognitive collapse developing within a few days
- D Isolated bladder dysfunction without any other symptoms
Correct answer: Visual changes (optic neuritis) or numbness in one limb
MS frequently presents with visual symptoms (optic neuritis) or sensory disturbances like numbness or tingling.
What is the primary pathophysiologic process in multiple sclerosis (MS)?
- A Degeneration of peripheral nerves outside the spinal cord only
- B Autoimmune demyelination in the central nervous system
- C A bacterial infection that directly destroys skeletal muscle fibers
- D Primary necrosis of muscle cells without any nerve involvement
Correct answer: Autoimmune demyelination in the central nervous system
MS is an autoimmune disease affecting the myelin sheath in the CNS, leading to neurological deficits.
In Guillain-Barré syndrome, cerebrospinal fluid analysis typically shows which finding?
- A Low protein level with an elevated white-cell count
- B Normal protein with a normal white-cell count
- C Elevated protein with normal cell count (albuminocytologic dissociation)
- D Very high cell count with bacteria seen on Gram stain
Correct answer: Elevated protein with normal cell count (albuminocytologic dissociation)
A hallmark finding in GBS is an elevated CSF protein level with a normal white blood cell count.
Which nursing intervention is appropriate for a patient with multiple sclerosis (MS) experiencing fatigue and difficulty walking?
- A Encourage unlimited physical activity with no scheduled rest
- B Cluster care and use energy-conservation strategies with rest
- C Discourage the patient from using any mobility assistive device
- D Require the patient to stand and walk unaided throughout the day
Correct answer: Cluster care and use energy-conservation strategies with rest
Nurses should help MS patients conserve energy with planned rest periods, assistive devices, and paced activity.
A nurse is planning care for a patient with Guillain-Barré syndrome who is progressing through the recovery (rehabilitation) phase. What is a priority intervention to include?
- A Avoid all mobility efforts entirely to prevent any falls
- B Fall prevention, stretching, assistive devices, spasticity control
- C Provide cognitive therapy only and ignore physical mobility
- D Allow unsupervised home exercise without any safety checks
Correct answer: Fall prevention, stretching, assistive devices, spasticity control
Care for GBS patients in recovery phase involves fall-prevention, muscle stretching, safe ambulation strategies.
A patient with multiple sclerosis (MS) asks how treatment works because 'there’s no cure'. The best explanation is:
- A Shorten acute attacks, slow progression and manage symptoms
- B Fully restore normal myelin and reverse all nerve damage
- C Provide temporary relief but never alter the disease course
- D Cure the disease through surgical removal of plaques
Correct answer: Shorten acute attacks, slow progression and manage symptoms
There is no cure for MS, but treatments focus on managing acute exacerbations, modifying the disease course, and symptom relief.
Which nursing action is important for a patient with Guillain-Barré syndrome who is developing ascending weakness and difficulty swallowing?
- A Slight increase in heart rate with no respiratory change
- B Decreased forced vital capacity with rising CO₂ retention
- C Mild fine tremor in the fingers and hands
- D Stable oxygen saturation of 98% with a normal respiratory rate
Correct answer: Decreased forced vital capacity with rising CO₂ retention
Declining respiratory function in GBS is a sign of impending respiratory failure and requires urgent attention.
In patients with multiple sclerosis (MS), heat intolerance may worsen symptoms due to which phenomenon?
- A Increased conduction speed in demyelinated nerves
- B Demyelinated axons conduct poorly as temperature rises (Uhthoff’s phenomenon)
- C Heat selectively repairs the damaged myelin sheath
- D Heat reliably improves nerve conduction in every patient
Correct answer: Demyelinated axons conduct poorly as temperature rises (Uhthoff’s phenomenon)
In MS, heat can worsen symptoms due to demyelinated axons being vulnerable to increased temperature, known as Uhthoff’s sign.
A distinguishing clinical feature that suggests Guillain-Barré syndrome and not multiple sclerosis (MS) is:
- A Remitting and relapsing episodes of neurological symptoms over years
- B Gradual onset of vision problems developing over many months
- C Rapid flaccid paralysis over hours to days after a GI or respiratory infection
- D Isolated sensory changes occurring without any limb weakness
Correct answer: Rapid flaccid paralysis over hours to days after a GI or respiratory infection
GBS is characterized by a rapid onset of flaccid paralysis often after an infection, while MS has a different course.
For a patient with Guillain-Barré syndrome, what is an important nursing assessment during intravenous immunoglobulin (IVIG) therapy?
- A Monitor only the patient’s blood glucose levels
- B Assess for fluid overload, renal dysfunction, headache and thrombosis risk
- C Withhold all monitoring because IVIG carries no adverse effects
- D Monitor only the patient’s hearing and balance
Correct answer: Assess for fluid overload, renal dysfunction, headache and thrombosis risk
IVIG therapy in GBS may cause specific adverse effects, necessitating vigilant nursing assessment.