The nurse is providing medical information to an adult patient with amyotrophic lateral sclerosis (ALS). The patient understands the nature of the disease if he or she asks which of the following questions?


• Asking about advance directives and planning for execution of a living will indicates understanding of the progressive and terminal reality of ALS.

• In ALS, there is steady decline in muscle strength and, unlike multiple sclerosis, there are no exacerbations and remissions. ALS is a progressive motor neuron disease that is incurable and eventually leads to death.

• Patients who have ALS most likely will experience respiratory failure as the disease progresses, and they need to communicate their wishes regarding ventilator support. It is the nurse's responsibility to explore the patient's wishes and facilitate discussion within the family. 

• Incorrect: There is no way to halt progression of ALS.

• Incorrect: It is not considered a communicable disease.

• Incorrect: ALS does not respond to chemotherapy.

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