Deck 21: Drugs for Neuromuscular Disorders

Question 1

Which lab result is a priority for the nurse to assess for a client who is prescribed dantrolene (Dantrium)?

A) Creatinine clearance
B) Serum amylase
C) Hemoglobin and hematocrit
D) Aspartate aminotransferase (AST) and alanine aminotransferase (ALT)

Answer 1

Aspartate aminotransferase (AST) and alanine aminotransferase (ALT)

Question 2

A client asks the nurse, "Can you tell me how capsaicin works to treat muscle pain?" Which statement should the nurse include in the response?

A) "Stimulates the body to produce endorphins that block the pain signal."
B) "Decreases the sensation of pain by interfering with the chemical messengers."
C) "Decreases the activity of the chemicals that stimulate muscle contraction."
D) "Interferes with the muscles ability to isometrically contract."

Answer 2

"Decreases the sensation of pain by interfering with the chemical messengers."

Question 3

Which is the nurse's priority assessment when monitoring a client receiving dantrolene (Dantrium) intravenously?

A) Urinary output
B) Blood glucose
C) Breath sounds
D) Intravenous site

Answer 3

Intravenous site

Question 4

Which information should the nurse include in the education of the body movement for a client with a neuromuscular disorder? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Body movement depends on an intact spinal cord.
B) Body movement depends on proper functioning of muscles.
C) Body movement depends on intact nerves.
D) Body movement depends on proper endocrine functioning.

Question 5

Which statement describes the primary difference between centrally acting muscle relaxants and direct-acting antispasmodics?

A) Centrally acting agents inhibit neurons of the central nervous system, while direct-acting agents stimulate neurons of the central nervous system.
B) Centrally acting agents stimulate neurons of the central nervous system, while direct-acting agents stimulate neurons of the peripheral nervous system.
C) Centrally acting agents inhibit neurons of the central nervous system, while direct-acting agents work at the level of the neuromuscular junction and skeletal muscles.
D) Centrally acting agents stimulate the central nervous system, while direct-acting agents inhibit neuronal conduction of the central nervous system.

Question 6

The nurse is preparing to provide education about the nonpharmacological treatment of muscle spasms for a client with a neuromuscular disorder. Which information should the nurse include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Application of heat or cold
B) Ultrasound
C) Massage
D) Relaxation techniques
E) Guided imagery

Question 7

The nurse is reviewing the prescription history for a client prescribed dantrolene (Dantrium). Which prescription should concern the nurse?

A) Verapamil (Calan)
B) Insulin
C) Clarithromycin (Biaxin)
D) Methylphenidate (Concerta)

Question 8

Which area of the body when damaged commonly results in spasticity?

A) Cerebral cortex
B) Peripheral nerves
C) Brainstem
D) Spinal cord

Question 9

Which common adverse effect of cyclobenzaprine (Amrix) should the nurse include when educating the client?

A) Alopecia
B) Tongue swelling
C) Drowsiness
D) Hypotension

Question 10

Which should the nurse understand is the primary therapeutic goal for the use of pharmacotherapy in the treatment of a neuromuscular disorder?

A) Stop the client's muscle spasms
B) Improve appearance
C) Promote the ease of exercise
D) Promote independence

Question 11

The nurse is creating a plan of care for a client prescribed cyclobenzaprine experiencing muscle spasms. Which outcome should the nurse anticipate?

A) Stabilized vital signs
B) Improved self-concept
C) Uninterrupted sleep
D) Increased bladder tone

Question 12

For which client experiencing muscle spasms is direct-acting antispasmodic medication dantrolene sodium (Dantrium) contraindicated?

A) A 20-year-old with a spinal cord injury
B) A 57-year-old with congestive heart failure
C) A 40-year-old with multiple sclerosis
D) A 65-year-old with a cerebral vascular accident

Question 13

The nurse is preparing to provide education for a client prescribed cyclobenzaprine (Amrix). Which information should the nurse include in the education?

A) Increase the intake of fiber.
B) Restrict the intake of sodium.
C) Increase the intake of protein.
D) Avoid the use of caffeine.

Question 14

A client tells the nurse they are awakened during the night with leg and foot cramps. Which response should the nurse provide the client?

A) "You may need a muscle relaxant."
B) "Increase your intake of vitamin B6."
C) "Take a warm bath before going to bed."
D) "Apply heat to relieve the cramping."

Question 15

Which should the nurse include in the plan of care for the client that has received baclofen (Lioresal)?

A) Fall precautions
B) Intake and output
C) Fluid restriction
D) Dietary restrictions

Question 16

A client is experiencing muscle discomfort resulting from weight lifting. Which prescription should the nurse anticipate will be included in the treatment?

A) Baclofen (Lioresal)
B) Clonazepam (Klonopin)
C) Ibuprofen
D) Clonidine (Catapres)

Question 17

The nurse observes the repeated pattern of muscle contraction of a client's leg for 5 seconds followed by 2 seconds of relaxation. Which terminology should the nurse use to document the finding?

A) Clonic spasm
B) Tonic spasm
C) Spasticity
D) Dystonia

Question 18

A client asks the nurse how skeletal muscle relaxants work. Which response should the nurse provide the client?

A) "They inhibit upper motor neuron activity within the central nervous system."
B) "They work primarily by stimulating the peripheral nervous system."
C) "They increase the amount of neurotransmitter within the muscles."
D) "They stimulate motor activity within the brainstem."

Question 19

The educator is reviewing botulinum toxin type B (Myobloc) with a nurse. Which should the educator include in the discussion?

A) Classified as a cholinergic agonist.
B) The therapeutic effect can last up to a year.
C) It can take 6 months to experience the therapeutic effect.
D) High doses are toxic causing food poisoning.

Question 20

A client has been prescribed dantrolene (Dantrium). Which question should the nurse ask the client?

A) "Do you have a history of gastric ulcer disease?"
B) "Do you have a history of psoriasis?"
C) "Do you have a history of gallbladder disease?"
D) "Are you currently pregnant?"

Question 21

Which statement made by a client prescribed cyclobenzaprine (Amrix) requires additional teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "My wife and I are driving our motor home to the beach tomorrow."
B) "I am going home to mow my lawn."
C) "I take a nap every afternoon."
D) "I just checked out a new book from the library."
E) "I am taking my grandchildren to the zoo tomorrow."

Question 22

Which clients prescribed dantrolene (Dantrium) should the nurse recognize have the greatest risk for liver toxicity? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) A 49-year-old woman who has a history of esophagitis
B) A 60-year-old man with pneumonia
C) A 38-year-old woman who has type 2 diabetes
D) An 18-year-old who injured his leg playing soccer
E) A 26-year-old woman who has an ostomy

Question 23

A client prescribed cyclobenzaprine (Amrix) one week prior for the treatment of neck spasms reports the medication is not working. Which statements should the nurse provide the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "You will need to increase the frequency of the dosage."
B) "You should discontinue the prescription."
C) "It is important you continue to take the prescription."
D) "You may require a different prescription."
E) "Let's discuss some nonpharmacological techniques that can be used with the prescription."

Question 24

The nurse has provided parental education of the treatment plan for the spasticity their 2-year-old is experiencing. Which statements by the parents indicate additional teaching is required? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "At some point, our child may require surgery to correct this spasticity."
B) "As long as we continue our child's medications, the spasticity can be controlled."
C) "Our physical therapy sessions should focus on flexing our child's muscles."
D) "We should repeat the exercises several times with each muscle group."
E) "It is best to give our child a rest from physical therapy by skipping 1 week a month."

Question 25

The nurse has provided discharge teaching for a client who had an abobotulinumtoxinA (Dysport) injection. Which symptoms should the nurse instruct the client to immediately report? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Chest pain
B) Urinary retention
C) Heart palpitations
D) Difficulty swallowing
E) Eye spasm

Question 26

A client prescribed onabotulinumtoxinA (Botox) for muscle spasms states to the nurse, "This prescription will also make my face look younger." Which information should the nurse provide the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Once you start on the medication, it may take a week or so before you notice a change in your skin."
B) "Be certain you take the medication with a full glass of water because it can be hard on your kidneys."
C) "There are many different uses for that drug, depending on how it is administered."
D) "You may need additional treatments with the medication in a few months."
E) "You should be aware that side effects of the medication can occur hours or weeks after your treatment."

Question 27

The nurse is reviewing the records of a client prescribed cyclobenzaprine (Amrix). Which findings should the nurse be most concerned about? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) The client reports drinking wine each day with dinner.
B) The client has a history of using nasal saline spray for allergies.
C) The client was prescribed a MAO inhibitor last month.
D) The client's blood glucose was elevated at the last visit.
E) The client had an ulnar fracture repaired a year ago.

Question 28

The nurse suspects that a client is developing malignant hyperthermia. Which is the priority nursing intervention?

A) Administer dantrolene intravenously.
B) Control associated symptoms.
C) Discontinue the triggering prescription.
D) Rapidly assess for supporting signs and symptoms.

Question 29

A client who experienced malignant hyperthermia is being treated with dantrolene. Which assessment findings should the nurse recognize are an adverse reaction to the treatment? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Swelling at the IV site
B) Muscle weakness
C) Sore throat
D) Irritability
E) Anorexia