A patient with myasthenia gravis is admitted to the hospital with respiratory
insufficiency and severe weakness. When is a diagnosis of cholinergic crisis
made?
a. The patient's respiration is impaired because of muscle weakness.
b. Administration of edrophonium (Tensilon) increases muscle weakness.
c. Administration of edrophonium (Tensilon) results in improved muscle
contractility.
d. EMG reveals decreased response to repeated stimulation of muscles.
b.
The reduction of the acetylcholine (ACh) effect in myasthenia gravis (MG) is
treated with anticholinesterase drugs, which prolong the action of ACh at the
neuromuscular synapse, but too much of these drugs will cause a cholinergic
crisis with symptoms very similar to those of MG. To determine whether the
patient's manifestations are due to a deficiency of ACh or to too much
anticholinesterase drug, the anticholinesterase drug edrophonium chloride
(Tensilon) is administered. If the patient is in cholinergic crisis, the patient's
symptoms will worsen; if the patient is in a myasthenic crisis, the patient will
improve.
“‘“
During care of a patient in myasthenic crisis, maintenance of what is the
nurse's first priority for the patient?
a. Mobility
b. Nutrition
c. Respiratory function
d. Verbal communication
c.
,The patient in myasthenic crisis has severe weakness and fatigability of all
skeletal muscles, affecting the patient's ability to breathe, swallow, talk, and
move. However, the priority of nursing care is monitoring and maintaining
adequate ventilation.
When providing care for a patient with ALS, the nurse recognizes what as
one of the most distressing problems experienced by the patient?
a. Painful spasticity of the face and extremities
b. Retention of cognitive function with total degeneration of motor function
c. Uncontrollable writhing and twisting movements of the face, limbs, and
body
d. Knowledge that there is a 50% chance the disease has been passed to any
offspring
b.
In ALS there is gradual degeneration of motor neurons with extreme muscle
wasting from lack of stimulation and use. However, cognitive function is not
impaired and patients feel trapped in a dying body. Chorea manifested by
writhing, involuntary movements is characteristic of HD. As an autosomal
dominant genetic disease, HD also has a 50% chance of being passed to
each offspring.
“‘“
In providing care for patients with chronic, progressive neurologic disease,
what is the major goal of treatment that the nurse works toward?
a. Meet the patient's personal care needs.
b. Return the patient to normal neurologic function.
,c. Maximize neurologic functioning for as long as possible.
d. Prevent the development of additional chronic diseases.
c.
Many chronic neurologic diseases involve progressive deterioration in
physical or mental capabilities and have no cure, with devastating results for
patients and families. Health care providers can only attempt to alleviate
physical symptoms, prevent complications, and assist patients in maximizing
function and self-care abilities for as long as possible.
“‘“
The nurse determines that teaching about management of migraine
headaches has been effective when the patient says which of the following?
a. "I can take the (Topamax) as soon as a headache starts."
b. "A glass of wine might help me relax and prevent a headache."
c. "I will lie down someplace dark and quiet when the headaches begin."
d. "I should avoid taking aspirin and sumatriptan (Imitrex) at the same time."
C.
It is recommended that the patient with a migraine rest in a dark, quiet area.
Topiramate (Topamax) is used to prevent migraines and must be taken for
several months to determine effectiveness. Aspirin or other nonsteroidal
antiinflammatory medications can be taken with the triptans. Alcohol may
precipitate migraine headaches.
A patient who is having an acute exacerbation of multiple sclerosis has a
prescription for methylprednisolone (Solu-Medrol) 160 mg IV. The label on the
vial reads: methylprednisolone 125 mg in 2 mL. How many mL will the nurse
administer?
, 2.56. With a concentration of 125 mg/2 mL, the nurse will need to administer
2.56 mL to obtain 160 mg of methylprednisolone.
The nurse will assess a 67-year-old patient who is experiencing a cluster
headache for
a. nuchal rigidity.
b. unilateral ptosis.
c. projectile vomiting.
d. throbbing, bilateral facial pain.
B.
Unilateral eye edema, tearing, and ptosis are characteristic of cluster
headaches. Nuchal rigidity suggests meningeal irritation, such as occurs with
meningitis. Although nausea and vomiting may occur with migraine
headaches, projectile vomiting is more consistent with increased intracranial
pressure (ICP). Unilateral sharp, stabbing pain, rather than throbbing pain, is
characteristic of cluster headaches.
While the nurse is transporting a patient on a stretcher to the radiology
department, the patient begins having a tonic-clonic seizure. Which action
should the nurse take?
a. Insert an oral airway during the seizure to maintain a patent airway.
b. Restrain the patient's arms and legs to prevent injury during the seizure.
c. Time and observe and record the details of the seizure and postictal state.
d. Avoid touching the patient to prevent further nervous system stimulation.
C.
insufficiency and severe weakness. When is a diagnosis of cholinergic crisis
made?
a. The patient's respiration is impaired because of muscle weakness.
b. Administration of edrophonium (Tensilon) increases muscle weakness.
c. Administration of edrophonium (Tensilon) results in improved muscle
contractility.
d. EMG reveals decreased response to repeated stimulation of muscles.
b.
The reduction of the acetylcholine (ACh) effect in myasthenia gravis (MG) is
treated with anticholinesterase drugs, which prolong the action of ACh at the
neuromuscular synapse, but too much of these drugs will cause a cholinergic
crisis with symptoms very similar to those of MG. To determine whether the
patient's manifestations are due to a deficiency of ACh or to too much
anticholinesterase drug, the anticholinesterase drug edrophonium chloride
(Tensilon) is administered. If the patient is in cholinergic crisis, the patient's
symptoms will worsen; if the patient is in a myasthenic crisis, the patient will
improve.
“‘“
During care of a patient in myasthenic crisis, maintenance of what is the
nurse's first priority for the patient?
a. Mobility
b. Nutrition
c. Respiratory function
d. Verbal communication
c.
,The patient in myasthenic crisis has severe weakness and fatigability of all
skeletal muscles, affecting the patient's ability to breathe, swallow, talk, and
move. However, the priority of nursing care is monitoring and maintaining
adequate ventilation.
When providing care for a patient with ALS, the nurse recognizes what as
one of the most distressing problems experienced by the patient?
a. Painful spasticity of the face and extremities
b. Retention of cognitive function with total degeneration of motor function
c. Uncontrollable writhing and twisting movements of the face, limbs, and
body
d. Knowledge that there is a 50% chance the disease has been passed to any
offspring
b.
In ALS there is gradual degeneration of motor neurons with extreme muscle
wasting from lack of stimulation and use. However, cognitive function is not
impaired and patients feel trapped in a dying body. Chorea manifested by
writhing, involuntary movements is characteristic of HD. As an autosomal
dominant genetic disease, HD also has a 50% chance of being passed to
each offspring.
“‘“
In providing care for patients with chronic, progressive neurologic disease,
what is the major goal of treatment that the nurse works toward?
a. Meet the patient's personal care needs.
b. Return the patient to normal neurologic function.
,c. Maximize neurologic functioning for as long as possible.
d. Prevent the development of additional chronic diseases.
c.
Many chronic neurologic diseases involve progressive deterioration in
physical or mental capabilities and have no cure, with devastating results for
patients and families. Health care providers can only attempt to alleviate
physical symptoms, prevent complications, and assist patients in maximizing
function and self-care abilities for as long as possible.
“‘“
The nurse determines that teaching about management of migraine
headaches has been effective when the patient says which of the following?
a. "I can take the (Topamax) as soon as a headache starts."
b. "A glass of wine might help me relax and prevent a headache."
c. "I will lie down someplace dark and quiet when the headaches begin."
d. "I should avoid taking aspirin and sumatriptan (Imitrex) at the same time."
C.
It is recommended that the patient with a migraine rest in a dark, quiet area.
Topiramate (Topamax) is used to prevent migraines and must be taken for
several months to determine effectiveness. Aspirin or other nonsteroidal
antiinflammatory medications can be taken with the triptans. Alcohol may
precipitate migraine headaches.
A patient who is having an acute exacerbation of multiple sclerosis has a
prescription for methylprednisolone (Solu-Medrol) 160 mg IV. The label on the
vial reads: methylprednisolone 125 mg in 2 mL. How many mL will the nurse
administer?
, 2.56. With a concentration of 125 mg/2 mL, the nurse will need to administer
2.56 mL to obtain 160 mg of methylprednisolone.
The nurse will assess a 67-year-old patient who is experiencing a cluster
headache for
a. nuchal rigidity.
b. unilateral ptosis.
c. projectile vomiting.
d. throbbing, bilateral facial pain.
B.
Unilateral eye edema, tearing, and ptosis are characteristic of cluster
headaches. Nuchal rigidity suggests meningeal irritation, such as occurs with
meningitis. Although nausea and vomiting may occur with migraine
headaches, projectile vomiting is more consistent with increased intracranial
pressure (ICP). Unilateral sharp, stabbing pain, rather than throbbing pain, is
characteristic of cluster headaches.
While the nurse is transporting a patient on a stretcher to the radiology
department, the patient begins having a tonic-clonic seizure. Which action
should the nurse take?
a. Insert an oral airway during the seizure to maintain a patent airway.
b. Restrain the patient's arms and legs to prevent injury during the seizure.
c. Time and observe and record the details of the seizure and postictal state.
d. Avoid touching the patient to prevent further nervous system stimulation.
C.
