Question 1

The nurse provides care to a patient diagnosed with myasthenia gravis (MG) who is prescribed corticosteroid therapy. Which data require immediate notification of the healthcare provider?

Accepted Answer

Hyperglycemia is a serious side effect of corticosteroid therapy, especially in patients with myasthenia gravis, as it can indicate steroid-induced diabetes. Immediate notification of the healthcare provider is necessary for appropriate management.

Question 2

The nurse is reviewing discharge instructions for a patient with myasthenia gravis. What should the nurse emphasize regarding medications?

Accepted Answer

Patients with myasthenia gravis should keep extra doses of medication readily available, such as in the car, to manage symptoms effectively and prevent exacerbations.

Question 3

A patient with Guillain-Barré syndrome (GBS) is receiving plasmapheresis. The nurse monitors this patient for which complication of this treatment?

Accepted Answer

Plasmapheresis can increase the risk of infections, including septicemia, due to the removal of antibodies and other immune components from the blood.

Question 4

Which statement by the patient with myasthenia gravis indicates the need for further teaching?

Accepted Answer

The correct statement for myasthenia gravis patients regarding medication timing is typically to take medication 30 minutes before eating to improve swallowing and reduce the risk of aspiration, not 30 minutes before or after. This indicates a misunderstanding and the need for further teaching.

Question 5

A patient is being prepared for a Tensilon test. What does the nurse ensure is available before the beginning of this test?

Accepted Answer

Atropine sulfate is kept on hand during a Tensilon test to reverse the effects of the Tensilon if necessary, as it can cause bradycardia or other cholinergic reactions.

Question 6

A patient is diagnosed with myasthenia gravis. What information does the nurse include in an explanation of this disease process?

Accepted Answer

Myasthenia gravis is an autoimmune disorder where the body's immune system attacks and destroys the acetylcholine receptor sites at the neuromuscular junction. This leads to decreased nerve conduction and muscle weakness.

Question 7

The nurse is planning care for a patient with Guillain-Barré syndrome (GBS). Which intervention will help with neuropathic pain?

Accepted Answer

Gabapentin is a medication that can help manage neuropathic pain, which is common in patients with Guillain-Barré syndrome (GBS).

Question 8

The nurse correlates which data from a patient's history as a risk factor for trigeminal neuralgia?

Accepted Answer

Hypertension is a recognized risk factor for trigeminal neuralgia, as it can contribute to the compression or damage of the trigeminal nerve through vascular changes.

Question 9

The nurse provides care for a patient diagnosed with myasthenia gravis (MG). Which is the priority when administering the prescribed dose of pyridostigmine (Mestinon)?

Accepted Answer

Administering pyridostigmine 30 to 60 minutes before meals is crucial for patients with myasthenia gravis (MG) because it enhances muscle strength, thereby improving the ability to swallow and reducing the risk of aspiration during meals.

Question 10

The nurse notes that a patient with Guillain-Barré syndrome (GBS) sweats profusely. What should the nurse do about this finding?

Accepted Answer

Sweating is a common symptom of GBS. The nurse should change the patient's linen and gown and keep them comfortable.

Question 11

A patient with Guillain-Barré syndrome (GBS) asks how the illness develops. What should the nurse respond about the pathophysiology of the disorder?

Accepted Answer

Guillain-Barré syndrome (GBS) is characterized by the immune system damaging the myelin sheath, which is the protective covering of nerves. This damage disrupts the normal transmission of nerve signals, leading to the symptoms of GBS.

Question 12

A patient with myasthenia gravis is experiencing sweating and pallor. After administering edrophonium (Tensilon), which finding suggests the patient is experiencing a cholinergic crisis?

Accepted Answer

Edrophonium is a cholinesterase inhibitor used in the diagnosis of myasthenia gravis. In a cholinergic crisis, caused by excessive medication, there is an overabundance of acetylcholine. Fasciculations (muscle twitching) are a sign of cholinergic crisis, not an improvement in myasthenic symptoms.

Question 13

A patient with progressively deteriorating lower extremity motor and sensory function is having a lumbar puncture. What finding suggests that this patient has Guillain-Barré syndrome (GBS)?

Accepted Answer

Elevated protein level in the cerebrospinal fluid (CSF) is a hallmark finding in Guillain-Barré syndrome (GBS), often with a normal white blood cell count, a pattern known as albuminocytological dissociation.

Question 14

A patient being evaluated for Guillain-Barré syndrome (GBS) presents with bilateral symmetrical muscle weakness and sensory changes of both feet and legs. The nurse correlates which key finding to this disease process?

Accepted Answer

Areflexia, or the absence of reflexes, is a key finding in Guillain-Barré syndrome (GBS), correlating with the disease's characteristic peripheral nerve involvement that leads to muscle weakness and sensory changes.

Question 15

The nurse prioritizes which nursing diagnosis as the highest in the patient with Guillain-Barré syndrome (GBS)?

Accepted Answer

Ineffective Breathing Pattern related to skeletal muscle weakness secondary to destruction of myelin sheath is the highest priority in Guillain-Barré syndrome (GBS) because it directly impacts the patient's ability to breathe effectively, which is essential for life. GBS can lead to respiratory failure as the disease progresses and affects the muscles involved in breathing.

Question 16

A patient seeks treatment for progressively deteriorating motor and sensory function. What question is essential for the nurse to ask when completing this patient's health history?

Accepted Answer

Asking about recent lung or stomach infections is essential because certain neurological conditions that affect motor and sensory functions, such as Guillain-Barré syndrome, can be triggered by infections in these areas.

Question 17

A patient with myasthenia gravis has lost 6 kg of weight over the last 2 months. What should the nurse suggest to improve this patient's nutritional status?

Accepted Answer

Taking medication before meals can help improve muscle strength, making it easier for the patient to chew and swallow food, thus improving nutritional intake.

Question 18

The nurse monitors for which clinical manifestation in the patient diagnosed with trigeminal neuralgia?

Accepted Answer

Trigeminal neuralgia is characterized by sudden, severe, sharp, or electric shock-like pain typically affecting one side of the face. The pain is due to irritation of the trigeminal nerve and does not typically cause impaired swallowing, visual disturbances, or impaired extraocular movements.

Question 19

The nurse is caring for a patient with myasthenia gravis. Which assessment data provide the nurse with the earliest indication of the patient's potential respiratory deterioration?

Accepted Answer

Vital capacity is the earliest indicator of respiratory deterioration in patients with myasthenia gravis, as it measures the maximum amount of air a patient can exhale after a maximum inhalation, directly reflecting the patient's ability to ventilate.

Question 20

The nurse provides care to a patient who is admitted to confirm a suspected diagnosis of myasthenia gravis (MG). Which medication prescription does the nurse question for this patient?

Accepted Answer

Erythromycin, an antibiotic, can exacerbate the symptoms of myasthenia gravis (MG) by potentially increasing muscle weakness. Therefore, its use in patients with MG should be questioned or used with caution.

Quiz 38: Coordinating Care for Patients With Peripheral Nervous System Disorders