Which nursing assessment is most significant for a client who is suspected of having myasthenia gravis?

1.
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The nurse is caring for a client admitted with suspected myasthenia gravis. Which finding is usually associated with a diagnosis of myasthenia gravis?
- 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.
Jane, a 20- year old college student gets admitted to the hospital with a tentative diagnosis of myasthenia gravis. She is scheduled to have a series of diagnostic studies for myasthenia gravis, including a Tensilon test. While preparing her for this procedure, the nurse explains that her response to the medication will confirm the diagnosis if Tensilon produces:
- A.
  Brief exaggeration of symptoms
- B.
  Prolonged symptomatic improvement
- C.
  Rapid but brief symptomatic improvement
- D.
  Symptomatic improvement of just the ptosis
3.
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
4.
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
5.
Helen is diagnosed with myasthenia gravis and pyridostigmine bromide (Mestinon) therapy is started. The Mestinon dosage is frequently changed during the first week. While the dosage is being adjusted, the nurse’s priority intervention is to:
- 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
6.
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
7.
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?
- A.
  Ulcerative colitis
- B.
  Blood dyscrasia
- C.
  Intestinal obstruction
- D.
  Spinal cord injury
8.
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.
9.

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
10.
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
11.
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
12.
Which of the following is not an autoimmune disease?
- A.
  Graves disease
- B.
  Myasthenia gravis
- C.
  Insulin-dependent diabetes mellitus
- D.
  Alzheimer's disease
13.
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.
14.
Myasthenia gravis is due to ____ receptors being blocked and destroyed by antibodies.
- A.
  
  Epinephrine
- B.
  Nicotinic
- C.
  Acetylcholine
- D.
  Transient
15.
Karina, a client who has myasthenia gravis is to receive immunosuppressive therapy. The nurse understands that this therapy is effective because it:
- 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.
16.
A client with myasthenia gravis has been receiving Neostigmine (Prostigmin). What does 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
17.
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
18.
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
19.
Myasthenia gravis reflects a deficiency in communication by _______________ because receptors for this neurotransmitter have been destroyed.
- A.
  Acetylcholine
- B.
  Norepinephrine
- C.
  GABA
- D.
  Dopamine
20.
The medication that is used to treat myasthenia gravis is:
- A.
  Prostigmine (neostigmine)
- B.
  Atropine (atropine sulfate)
- C.
  Both A & B
- D.
  None of these

Which nursing assessment is the most significant for a client who is suspected of having myasthenia gravis?

Single fiber electromyography (EMG), considered the most sensitive test for myasthenia gravis, detects impaired nerve-to-muscle transmission.

Which assessments would be performed when a client is suspected of having myasthenia gravis?

The main test for myasthenia gravis is a blood test to look for a type of antibody (produced by the immune system) that stops signals being sent between the nerves and muscles. A high level of these antibodies usually means you have myasthenia gravis.

What is the priority nursing assessment for a patient with myasthenia gravis?

Nursing priorities for patients with acquired autoimmune myasthenia gravis are reviewed. Three key aspects of care are discussed: assessment of weakness, knowledge of treatments and medications, and understanding the need for patient education and support.

Which assessment finding is most associated with myasthenia gravis MG )?

Droopy eyelids or double vision is the most common symptom at initial presentation of MG, with more than 75% of patients. These symptoms progress from mild to more severe disease over weeks to months.

Which nursing assessment is most significant for a client who is suspected of having myasthenia gravis?

Which nursing assessment is the most significant for a client who is suspected of having myasthenia gravis?

Which assessments would be performed when a client is suspected of having myasthenia gravis?

What is the priority nursing assessment for a patient with myasthenia gravis?

Which assessment finding is most associated with myasthenia gravis MG )?

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