Myasthenia Gravis By Rnpedia
Choose the letter of the correct answer.
- 1.
- A.
Visual disturbances, including diplopia
- B.
Ascending paralysis and loss of motor function
- C.
Cogwheel rigidity and loss of coordination
- D.
Progressive weakness that is worse at the day’s end
- 2.The diagnostic work-up of a client hospitalized with complaints of progressive weakness and fatigue confirms a diagnosis of myasthenia gravis. The medication used to treat myasthenia gravis is:
- A.
Prostigmine (neostigmine)
- B.
Atropine (atropine sulfate)
- C.
Didronel (etidronate)
- D.
Tensilon (edrophonium)
- 3.
- A.
Brief exaggeration of symptoms
- B.
Prolonged symptomatic improvement
- C.
Rapid but brief symptomatic improvement
- D.
Symptomatic improvement of just the ptosis
- 4.The initial nursing goal for a client with myasthenia gravis during the diagnostic phase of her hospitalization would be to:
- A.
Develop a teaching plan
- B.
Facilitate psychologic adjustment
- C.
Maintain the present muscle strength
- D.
Prepare for the appearance of myasthenic crisis
- 5.The most significant initial nursing observations that need to be made about a client with myasthenia include:
- A.
Ability to chew and speak distinctly
- B.
Degree of anxiety about her diagnosis
- C.
Ability to smile an to close her eyelids
- D.
Respiratory exchange and ability to swallow
- 6.
- A.
Administer the medication exactly on time
- B.
Administer the medication with food or mild
- C.
Evaluate the client’s muscle strength hourly after medication
- D.
Evaluate the client’s emotional side effects between doses
- 7.Helen, a client with myasthenia gravis, begins to experience increased difficulty in swallowing. To prevent aspiration of food, the nursing action that would be most effective would be to:
- A.
Change her diet order from soft foods to clear liquids
- B.
Place an emergency tracheostomy set in her room
- C.
Assess her respiratory status before and after meals
- D.
Coordinate her meal schedule with the peak effect of her medication, Mestinon
- 8.
- A.
Ulcerative colitis
- B.
Blood dyscrasia
- C.
Intestinal obstruction
- D.
Spinal cord injury
- 9.While reviewing a client’s chart, the nurse notices that the female client has myasthenia gravis. Which of the following statements about neuromuscular blocking agents is true for a client with this condition?
- A.
The client may be less sensitive to the effects of a neuromuscular blocking agent.
- B.
Succinylcholine shouldn’t be used; pancuronium may be used in a lower dosage.
- C.
Pancuronium shouldn’t be used; succinylcholine may be used in a lower dosage.
- D.
Pancuronium and succinylcholine both require cautious administration.
- 10.A female client has experienced an episode of myasthenic crisis. The nurse would assess whether the client has precipitating factors such as:
- A.
Getting too little exercise
- B.
Taking excess medication
- C.
Omitting doses of medication
- D.
Increasing intake of fatty foods
- 11.The nurse is teaching the female client with myasthenia gravis about the prevention of myasthenic and cholinergic crises. The nurse tells the client that this is most effectively done by:
- A.
Eating large, well-balanced meals
- B.
Doing muscle-strengthening exercises
- C.
Doing all chores early in the day while less fatigued
- D.
Taking medications on time to maintain therapeutic blood levels
- 12.A client with myasthenia gravis ask the nurse why the disease has occurred. The nurse bases the reply on the knowledge that there is:
- A.
A genetic in the production acetylcholine
- B.
A reduced amount of neurotransmitter acetylcholine
- C.
A decreased number of functioning acetylcholine receptor sites
- D.
An inhibition of the enzyme ACHE leaving the end plates folded
- 13.Which of the following is not an autoimmune disease?
- A.
Graves disease
- B.
Myasthenia gravis
- C.
Insulin-dependent diabetes mellitus
- D.
Alzheimer's disease
- 14.The nursing assistant reports to you, the RN, that the patient with myasthenia gravis (MG) has an elevated temperature (102.20 F), heart rate of 120/minute, rise in blood pressure (158/94), and was incontinent off urine and stool. What is your best first action at this time?
- A.
Administer an acetaminophen suppository.
- B.
Notify the physician immediately.
- C.
Recheck vital signs in 1 hour.
- D.
Reschedule patient’s physical therapy.
- 15.Myasthenia gravis is due to ____ receptors being blocked and destroyed by antibodies.
- A.
Epinephrine
- B.
Nicotinic
- C.
Acetylcholine
- D.
Transient
- 16.
- A.
Promotes the removal of antibodies that impair the transmission of impulses
- B.
Stimulates the production of acetylcholine at the neuromuscular junction.
- C.
Decreases the production of autoantibodies that attack the acetylcholine receptors.
- D.
Inhibits the breakdown of acetylcholine at the neuromuscular junction.
- 17.A client with myasthenia gravis has been receiving Neostigmine (Prostigmin). This drug acts by:
- A.
Stimulating the cerebral cortex
- B.
Blocking the action of cholinesterase
- C.
Replacing deficient neurotransmitters
- D.
Accelerating transmission along neural swaths
- 18.In making a diagnosis of myasthenia gravis Edrophonium HCI (Tensilon) is used. The nurse knows that this drug will cause a temporary increase in:
- A.
Muscle strength
- B.
Symptoms
- C.
Blood pressure
- D.
Consciousness
- 19.Toy with a tentative diagnosis of myasthenia gravis is admitted for diagnostic make up. Myasthenia gravis can confirmed by:
- A.
Kernigs sign
- B.
Brudzinski’s sign
- C.
A positive sweat chloride test
- D.
A positive edrophonium (Tensilon) test
- 20.Myasthenia gravis reflects a deficiency in communication by _______________ because receptors for this neurotransmitter have been destroyed.
- A.
Acetylcholine
- B.
Norepinephrine
- C.
GABA
- D.
Dopamine
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