MYASTHENIA GRAVIS

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

MYASTHENIA GRAVIS

This Assessment Is Powered By ACHIEVERS NCLEX-RN CONSULT.

Visit www.achieversnclexrn.com

Email: info@achieversnclexrn.com

Total Questions: 35

Passmark: 25/35

BEST WISHES

Email *

Q1. A client is admitted with a diagnosis of myasthenia gravis. What interventions should the nurse include to manage this client's swallowing and chewing impairment?
SATA
*

1 point

1. Provide foods that are soft and tender.

2. Allow client to rest between bites.

3. Encourage client to drink thickened liquids.

4. Position upright with head tilted slightly backwards.

5. Dissolve the cholinesterase inhibitor medication in water.

Required

Q2. A nurse is caring for a client with myasthenia gravis. The nurse understands that the risk of respiratory infection is increased in this client due to which of the following?
*

1 point

A. Narrowed airways

B. Impaired immunity

C. Ineffective coughing

D. Thickening of secretions

Q3. The nurse administers pyridostigmine to a client with myasthenia gravis. The nurse practices safe medication administration by performing which priority action?
*

1 point

1. Schedule administration of pyridostigmine at the same time every day.

2. Ask the client to hold the medication cup and self-administer the medication.

3. Observe the client taking a sip of water before administering the medication.

4. Administer pyridostigmine 45–60 minutes before eating a meal.

Q4. The nurse is caring for a patient with myasthenia gravis after thymectomy. She notices that the client's breathing is shallow and labored. Why does she suspect that the patient is having a cholinergic crisis rather than a myasthenic crisis?

Select one:

*

1 point

1. The patient's symptoms improve after administration of an anticholinesterase

2. The patient is nauseated and drooling

3. The patient's weakness worsened suddenly

4. The patient has difficulty speaking

Q5. The client is scheduled for a Tensilon test to check for Myasthenia Gravis. Which medication should be kept available during the test?
*

1 point

A:Atropine sulfate

B: Furosemide

C:Prostigmin

D: Promethazine

Q6. The nurse provides instruction to a client diagnosed with myasthenia gravis about the condition. Which statement by the client indicates to the nurse the need for further teaching?
*

1 point

1. "I cannot drink alcoholic beverages."

2. "I should not go places that are crowded."

3. "I should try to stay calm."

4. "I can use my hot tub daily."

Q7. *

1 point

Option 1

Option 2

Option 3

Option 4

Q8. The nurse is administering medications for clients on a medical unit. Which medication should the nurse administer first?
*

1 point

1. The narcotic pain medication to a client complaining that his pain is an “8.”

2. A loop diuretic to a client diagnosed with heart failure who has 3 pitting edema.

3. An anticholinesterase medication to a client diagnosed with myasthenia gravis.

4. An antacid to a client with pyrosis who has called several times over the intercom.

Q9. The nurse provides discharge teaching to a client with myasthenia gravis. Which client statement indicates further teaching is needed? *

1 point

1. "I should take a shower and wash my hair in the morning."

2. "I should use paper and pencil to communicate with my husband."

3. "I should avoid places that I know will be crowded."

4. "I should plan my day around an afternoon rest period."

Q10. A physician diagnoses a client with myasthenia gravis, prescribing pyridostigmine (Mestinon), 60 mg P.O. every 3 hours. Before administering this anticholinesterase agent, the nurse reviews the client’s history. Which preexisting condition would contraindicate the use of pyridostigmine?

*

1 point

A. Ulcerative colitis

B. Blood dyscrasia

C. Intestinal obstruction

D. Spinal cord injury

Q11. Karina, a client with myasthenia gravis, is to receive immunosuppressive therapy. The nurse understands that this therapy is effective because it:
*

1 point

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.

Q12. The nurse is planning care for a client admitted with a diagnosis of new onset myasthenia gravis. Which nursing interventions should the nurse include in order to decrease the risk of aspiration?

Select all that apply
*

1 point

1. Provide thin liquids such as water with meals.

2. Offer small bites of food.

3. Allow client to rest between each bite of food.

4. Offer small meals in the morning and larger meals in the evening.

5. Position client upright with head tilted slightly back when eating.

6. Provide meals 30 minutes before administration of cholinesterase inhibitor medication.

Required

Q13. The nurse provides care to a client who is newly diagnosed with myasthenia gravis. Which intervention represents the nurse's highest priority?
*

1 point

1. Provide frequent rest periods.

2. Assist the client during mealtime.

3. Instill eye drops as prescribed.

4. Monitor the client's blood sugar.

Q14. A client with myasthenia gravis is receiving pyridostigmine (Mestinon). The nurse monitors for signs and symptoms of cholinergic crisis caused by overdose of the medication. The nurse checks the medication supply to ensure that which medication is available for administration if a cholinergic crisis occurs?
*

1 point

1. Vitamin K

2. Atropine sulfate

3. Protamine sulfate

4. Acetylcysteine (Mucomyst)

Q15. A client with myasthenia gravis is suspected of having cholinergic crisis. Which of the following indicate that this crisis exists?
*

1 point

1. Ataxia

2. Mouth sores

3. Hypotension

4. Hypertension

Q16. A nurse working in a neurology clinic receives the following telephone messages. Which client should the nurse call back first?
*

1 point

1. Client prescribed sumatriptan who has throbbing left temple pain preceded by an aura

2. Client taking carbidopa-levodopa who has dizziness when rising from a sitting or lying position

3. Client with myasthenia gravis who has a fever and increasing difficulty swallowing

4. Client with trigeminal neuralgia who reports burning cheek pain after eating ice cream

Q17. A client with a history of myasthenia gravis (MG) has been discharged from the hospital following a thymectomy. When teaching the client how to prevent complications, the home care nurse emphasizes what daily actions are most important?
Select all that apply

*

1 point

1. Include daily weight lifting exercises.

2. Practice stress reduction techniques.

3. Complete chores early in the day.

4. Take medications on time and prior to meals.

5. Eat three large meals daily.

Required

Q18. The nurse is assessing a client who is suspected of having myasthenia gravis. Which of the following would be an expected finding? Select all that apply.
*

1 point

A. Diplopia

B. Butterfly rash

C. Facial muscle weakness

D. Shuffling gait

E. Ptosis

Required

Q19. Which of the following clients have an increased risk for developing pneumonia? (Select all that apply.)

*

1 point

A. Client who has dysphagia

B. Client who has AIDS

C. Client who was vaccinated for pneumococcus and influenza 6 months ago

D. Client who is postoperative and has received local anesthesia

E. Client who has a closed head injury and is receiving ventilation

F. Client who has myasthenia gravis

Required

Q20. A female client has experienced an episode of myasthenic crisis. The nurse would assess whether the client has precipitating factors such as:

1 point

A. Getting too little exercise.

B. Taking excess medication.

C. Omitting doses of medication.

D. Increasing intake of fatty foods.

Clear selection

Q21. The nurse provides education for a client who is newly diagnosed with myasthenia gravis and prescribed pyridostigmine. Which instruction is appropriate when addressing the client’s basic care and comfort needs? *

1 point

1. “Avoid eating large meals on days you feel fatigued when taking pyridostigmine.”

2. “Eat approximately 30-60 minutes after you take pyridostigmine.”

3. “Take the pyridostigmine only on days you feel tired.”

4. “Do not eat protein while on pyridostigmine.”

Q22. When caring for a client with myasthenia gravis, it is most important for the nurse to consider which action?
*

1 point

1. prevent accidents from falls as a result of vertigo.

2. maintain fluid and electrolyte balance.

3. control situations that could increase ICP and cerebral edema.

4. assess muscle groups toward the end of the day.

Q23. The nurse cares for a client diagnosed with myasthenia gravis. Which of the following clinical manifestations would the nurse expect to see?

Select all that apply.

*

1 point

1. Rigidity.

2. Muscle weakness that improves with rest.

3. Paresthesia of the lower extremities.

4. Propulsive gait.

5. Ptosis.

6. Diplopia.

Required

Q24. A client with myasthenia gravis is undergoing assessment. Which of the following symptoms does the nurse expect? (Select all that apply)
*

1 point

A. Hyperkalemia

B. Double vision

C. Moon faces

D. Anuria

E. Dysphagia

Required

Q25. The nurse is assessing a client with myasthenia gravis who has a dose of pyridostigmine (Mestinon) ordered for 7 am. Prior to giving the medication the nurse observes and notes diplopia, dysphagia and a weak cough. The client has ordered breakfast for 8 am. Which of the following actions should the nurse take first?
*

1 point

A. give the pt edrophonium chloride (tensilon)

B.adm. the pyridostigmine asap

C.hold the med. & notify the HCP

D.Assess for lower extremity weakness

Q26. The nurse is giving the client pyridostigmine. Which of the following is an expected outcome of administering this medication?
*

1 point

1. To lessen urine output in diabetic ketoacidosis

2. To improve muscle weakness in myasthenia gravis

3. To improve symptoms of kidney infection

4. To decrease intraocular pressure in glaucoma

Q27. The nurse is caring for a client with myasthenia gravis. What is essential for the nurse to teach this client regarding treatment?
*

1 point

1. Frequent low-calorie snacks.

2. Strict monitoring of intake and output.

3. Use of sweeping gaze when walking.

4. Setting the alarm clock for medication times.

Q28. The nurse cares for the client diagnosed with asthma. The physician orders neostigmine IM. Which of the following actions by the nurse is MOST appropriate?
*

1 point

1. Administer the medication.

2. Check the blood pressure and pulse.

3. Ask the pharmacy if the medication can be given orally.

4. Notify the physician.

Q29. The nurse is passing morning medication on a busy medical-surgical unit and has been delayed in completing rounds. When re-evaluating how to distribute the remaining scheduled medications, which client would the nurse consider at greatest risk if medications are late?
*

1 point

1. The client with congestive heart failure receiving digoxin.

2. The client with epilepsy scheduled to receive phenytoin.

3. The client with myasthenia gravis on pyridostigmine.

4. The client with hypertension due for daily nifedipine.

Q30. At 8 AM, medications are prescribed for assigned clients. Which medication should the nurse administer first?
*

1 point

1. Acetylsalicylic acid for a client with a history of coronary artery disease and ischemic stroke

2. Metformin for a client with serum glucose of 285 mg/dL (15.8 mmol/L) who is scheduled for a CT scan with contrast

3. Morphine sulfate for a client with terminal lung cancer who has chronic bone pain

4. Pyridostigmine for a client with myasthenia gravis exacerbation who reports difficulty swallowing

Q31. A client is admitted to the hospital with an exacerbation of myasthenia gravis. What are the appropriate nursing actions? Select all that apply.
*

1 point

1.Administer an anticholinesterase drug AC

2.Anticipate a need for an anticholinergic drug3.Develop a bladder training schedule

4.Encourage semi-solid food consumption

5.Teach the necessity for annual flu vaccination

Required

Q32. A client with myasthenia gravis has been prescribed to take pyridostigmine (Mestinon). What health teaching will the nurse include related to this drug? Select all that apply.

*

1 point

A. "Watch for signs and symptoms of myasthenic crisis."

B. "Take the drug about an hour before eating a meal."

C. "Take the same dose of medication every day."

D. "Take the drug with food to prevent nausea."

E. "Do not take sedatives or sleeping pills while on this drug."

Required

Q33. 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:

1 point

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

Q34. The LPN/LVN whom you are supervising comes to you and says, "I gave the client with myasthenia gravis 90 mg of neostigmine (Prostigmin) instead of the ordered 45 mg!" In which order should you perform the following actions?

1. Assess the client's heart rate.
2. Complete a medication error report.
3. Ask the LPN/LVN to explain how the error occurred.
4. Notify the physician of the incorrect medication dose. *

1 point

Q35. Which activity is contraindicated for a client with myasthenia

gravis before meals?

1 point

A. Deep breathing and coughing exercise

B. Range of motion exercises

C. Talking for long periods over the phone

D. Watching TV

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms