The nurse is assessing a client with multiple sclerosis (MS). Which findings would the nurse expect? SELECT ALL THAT APPLY

Rationale: A. One of the hallmark early signs of MS is optic neuritis, which occurs when demyelination affects the optic nerve. This results in sudden or subacute vision loss in one eye, often accompanied by pain with eye movement. Visual symptoms may be transient or partially recover, but repeated episodes are common. Recognizing optic neuritis is important for early diagnosis and initiation of disease-modifying therapy. B. MS commonly affects cranial nerves III, IV, and VI or their central pathways, leading to ocular motor dysfunction. This can cause: Diplopia (double vision) due to extraocular muscle weakness or impaired nerve conduction, Blurred vision from optic nerve involvement or demyelination in visual pathways, Nystagmus in some patients These symptoms contribute to difficulty reading, driving, and performing fine visual tasks and often worsen with fatigue or heat (Uhthoff’s phenomenon). C. Bradykinesia is a slowness of voluntary movement seen in Parkinson’s disease, not MS. While MS can cause motor weakness, spasticity, or coordination deficits, true bradykinesia is absent. Confusing the two may lead to misdiagnosis. D. Fatigue is one of the most common and disabling symptoms of MS, affecting up to 80% of patients. It can be primary (from demyelination and CNS changes) or secondary (from sleep disturbance, depression, infection, or heat). Fatigue often: Worsens in the afternoon or after activity, Impairs ADLs, work performance, and quality of life and Requires energy conservation strategies, pacing, and sometimes pharmacologic management E. Depression is common in MS due to a combination of: Neurochemical changes from CNS demyelination and psychological stress of living with a chronic, unpredictable disease Depression can negatively impact adherence to medications, physical activity, and disease self-management. Screening and early treatment are essential.