Deck 21: Drugs for Neuromuscular Disorders

Question 1

The patient receives dantrolene (Dantrium)for treatment of muscle spasms following a spinal cord injury.What is the best outcome for this patient?
1)Patient will have stabilized vital signs.
2)Patient will have and improved self-concept.
3)Patient will sleep without pain.
4)Patient will have increased bladder tone.

Answer 1

3

Question 2

A patient tells the nurse,"I have been reading about using castor oil as a treatment for muscle cramping.Do you know anything about that?" How should the nurse respond to this ? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"Why don't you ask the doctor about whether it works or not?"
2)"I think you take a tablespoon twice a day."
3)"The castor oil should be warmed before use."
4)"Soak a flannel cloth with the castor oil and apply it to your muscle."
5)"You must wear gloves when handling castor oil."

Answer 2

3,4

Question 3

Which of the following lists of treatment options would be considered optimal for treating a muscle spasm with an unknown cause?
1)Anti-inflammatory agents,casting,and ultrasound
2)Analgesics,antibiotics,and heat application
3)Analgesics,muscle relaxants,and massage
4)Anti-inflammatory agents,immobilization,and fluid and electrolyte replacement

Answer 3

3

Question 4

The nurse teaches the patient with a neuromuscular disorder about nonpharmacological treatment of muscle spasms.What will the best information include? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Application of heat or cold
2)Ultrasound
3)Massage
4)Relaxation techniques
5)Guided imagery

Question 5

Which statement is correct in regard to the muscle relaxant botulinum toxin type B (Myobloc)?
1)It can be classified as a cholinergic agonist.
2)Increased muscle strength is often seen within a couple of weeks.
3)It can take 6 months for the effects to be seen.
4)In high doses,it is poisonous,causing the same symptoms food poisoning does.

Question 6

The physician has ordered dantrolene (Dantrium)for a patient.What is a priority assessment by the nurse prior to administering this medication?
1)Does the patient have gastric ulcer disease?
2)Does the patient have cardiovascular disease?
3)Does the patient have gallbladder disease?
4)Is the patient pregnant or lactating?

Question 7

Spasticity is most commonly caused by damage to what area of the body?
1)Cerebral cortex
2)Peripheral nerves
3)Brainstem
4)Spinal cord

Question 8

The patient tells the nurse that she awakens frequently during the night because of leg and foot cramps.What is the best response by the nurse?
1)"Ask your physician for a muscle relaxant."
2)"Increase your intake of calcium."
3)"Take a warm bath before going to bed."
4)"Apply heat to relieve the cramping."

Question 9

The nurse teaches a class about muscle movement to a group of patients who have neuromuscular disorders.What will the best plan of the nurse include? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Body movement depends on an intact spinal cord.
2)Body movement depends on proper functioning of muscles.
3)Body movement depends on intact nerves.
4)Body movement depends on proper endocrine functioning.
5)Body movement depends on the level of consciousness.

Question 10

Which statement about skeletal muscle relaxants is correct?
1)They inhibit upper motor neuron activity within the central nervous system.
2)They work primarily by stimulating the peripheral nervous system.
3)They increase the amount of neurotransmitter within the muscles.
4)They stimulate motor activity within the brainstem.

Question 11

The patient receives dantrolene (Dantrium)for muscle spasticity.Which lab result is a priority for the nurse to assess?
1)Creatinine clearance
2)Serum amylase
3)Hemoglobin and hematocrit
4)Aspartate aminotransferase (AST)and alanine aminotransferase (ALT)

Question 12

The patient receives dantrolene (Dantrium).A consulting physician orders hydroxyzine (Vistaril)for the patient and he begins taking it.What will the best assessment by the nurse reveal?
1)Confusion
2)Hypertension
3)Respiratory depression
4)Delirium

Question 13

Which of the following patients suffering from muscle spasms should not receive the direct-acting antispasmodic medication dantrolene sodium (Dantrium)?
1)20-year-old suffering from a spinal cord injury
2)57-year-old suffering from congestive heart failure
3)40-year-old suffering from multiple sclerosis
4)65-year-old suffering from a cerebral vascular accident

Question 14

Which of the following is a common adverse effect of cyclobenzaprine (Flexeril)?
1)Alopecia
2)Tongue swelling
3)Drowsiness
4)Hypotension

Question 15

The patient receives dantrolene (Dantrium)intravenously (IV).What will a priority assessment by the nurse include?
1)Assessing the patient's urinary output
2)Assessing the patient's blood glucose
3)Assessing the patient's breath sounds
4)Assessing the patient's intravenous (IV)site

Question 16

The patient is started on a medication to treat a neuromuscular disorder.What does the nurse teach as the primary therapeutic goal of the medication?
1)To stop the patient's muscle spasms
2)To improve the patient's appearance
3)To promote exercise in the patient
4)To allow the patient increased independence

Question 17

The physician prescribes cyclobenzaprine (Flexeril)for the patient.When doing medication education,what will the best information of the nurse include?
1)Increase the intake of fiber while taking this medication.
2)Restrict the intake of sodium while taking this medication.
3)Increase the intake of protein while taking this medication.
4)Do not drink any caffeine while taking this medication.

Question 18

Which statement describes the primary difference between centrally acting muscle relaxants and direct-acting antispasmodics?
1)Centrally acting agents inhibit neurons of the central nervous system,while direct-acting agents stimulate neurons of central nervous system.
2)Centrally acting agents stimulate neurons of the central nervous system,while direct-acting agents stimulate neurons of the peripheral nervous system.
3)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.
4)Centrally acting agents stimulate the central nervous system,while direct-acting agents inhibit neuronal conduction of the central nervous system.

Question 19

The nurse identifies a patient with a repeating pattern of muscle contraction of the leg for 5 seconds followed by 2 seconds of relaxation as experiencing
1)a clonic spasm.
2)a tonic spasm.
3)spasticity.
4)dystonia.

Question 20

The patient receives dantrolene (Dantrium).Which medication would the nurse evaluate as being contraindicated with dantrolene (Dantrium)?
1)Verapamil (Calan)
2)Insulin
3)Clarithromycin (Biaxin)
4)Methylphenidate (Concerta)

Question 21

A patient who has cerebral palsy is beginning to experience spasticity of the muscles in the upper arm.Which medications would the nurse if prescribed for this patient? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Metaxalone (Skelaxin)dosed three times a day
2)Chlorzoxazone (Parafon Forte)dosed four times a day
3)Carisoprodol (Soma)dosed three times a day
4)Intrathecal baclofen (Lioresal)
5)Tizanidine (Zanaflex)dosed twice a day

Question 22

The patient's health care provider prescribed dantrolene sodium (Dantrium)25 mg daily for the treatment of neck spasms secondary to spinal cord injury.The patient reports that the medication is "not working," even though it has been 45 days since the medication was started.What changes in this patient's plan of care would the nurse anticipate? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Increase in the dosage frequency to twice a day
2)Discontinuation of the medication
3)Increase in the frequency of hepatic function tests
4)Change to a different medication
5)Addition of succinylcholine (Anectine)to the patient's medications

Question 23

The parents of a 2-year-old who has cerebral palsy are only now beginning to accept that their child will have a permanent disability.The nurse has been instructing the parents about the treatment for the spasticity their child is experiencing.Which statements by the parents indicate that the nurse should plan additional teaching sessions? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"At some point,our child may require surgery to correct this spasticity."
2)"As long as we continue our child's medications,the spasticity can be controlled."
3)"Our physical therapy sessions should focus on flexing our child's muscles."
4)"We should repeat the exercises several times with each muscle group."
5)"It is best to give our child a rest from physical therapy by skipping 1 week a month."

Question 24

The patient tells the nurse,"The doctor is going to start me on Botox for the muscle spasms in my neck.I've always wanted to try that.It will make me look younger." What information should the nurse provide to this patient regarding onabotulinumtoxinA (Botox)? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"Once you start on the medication,it may take a week or so before you notice a change in your skin."
2)"Be certain you take the medication with a full glass of water because it can be hard on your kidneys."
3)"There are many different uses for that drug,depending on how it is administered."
4)"You may have to have additional treatments with the medication in a few months."
5)"You should be aware that side effects of the medication can occur hours or weeks after your treatment."