Deck 24: Drugs for Neuromuscular Disorders: Myasthenia Gravis, Multiple Sclerosis, and Muscle Spasms

Question 1

A client is ordered to receive adrenocorticotropic hormone (ACTH) for multiple sclerosis. Which nursing intervention would be most appropriate to protect this client from the side effects of this medication?

A) Implement infection control measures.
B) Administer antiemetics as needed.
C) Give laxatives daily and as needed.
D) Administer acetaminophen q4h.

Answer 1

Implement infection control measures.

Question 2

The client is prescribed Flexeril to relieve muscle spasms. The most important instruction that the nurse can give the client is to take the medication:

A) on an empty stomach.
B) with food or milk.
C) upon arising.
D) with water only.

Answer 2

with food or milk.

Question 3

The client has been ordered to be treated with Edrophonium (Tension). The client who is most likely to be ordered this drug is the one who is suspected of having:

A) multiple sclerosis.
B) seizure disorders.
C) parkinsonism.
D) myasthenia gravis (MG).

Answer 3

myasthenia gravis (MG).

Question 4

A nurse is teaching a client who has been prescribed carisoprodol (Soma) for treatment of acute skeletal muscle spasms. Which instruction will the nurse include in the client's teaching plan?

A) Take carisoprodol 1 hour before meals.
B) Discontinue taking carisoprodol if experiencing drowsiness.
C) Report episodes of rapid heart rate.
D) Carisoprodol is usually taken for no longer than 7 days.

Question 5

A client with myasthenia gravis is noted to be salivating, tearing, and sweating. The client complains of muscle weakness. What would the nurse anticipate administering?

A) Pyridostigmine bromide
B) Neostigmine
C) Edrophonium
D) Atropine sulfate

Question 6

As part of a teaching session, a client with myasthenia gravis and her family are receiving instructions from the nurse. The nurse teaches the client that overdosing of cholinesterase inhibitor may result in cholinergic crisis. The client is taught about which signs and symptoms of cholinergic crisis?

A) Decreased muscle strength and decreased salivation
B) Increased salivation and sweating
C) Muscle weakness and increased salivation
D) Muscle spasticity and decreased salivation

Question 7

A client is admitted to a nursing unit with an acute exacerbation of multiple sclerosis (MS). What drug, frequently used to decrease the inflammatory response, is used during an acute MS attack?

A) Nonsteroidal antiinflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin, others)
B) Adrenocorticotropic hormone (ACTH)
C) Biologic response modifiers, such as interferon beta-1b (Betaseron)
D) Immunosuppressants, such as cyclophosphamide (Cytoxan)

Question 8

A nurse is aware that when treating a client with cholinesterase inhibitors, it is imperative to have the antidote at the bedside. The nurse anticipates that the client will be ordered:

A) epinephrine.
B) norepinephrine.
C) atropine.
D) edrophonium chloride (Tensilon).

Question 9

A client with myasthenia gravis and his family are receiving instructions from the nurse. The nurse teaches the client that insufficient dosing of cholinesterase inhibitor may result in myasthenia crisis. The client is taught about which signs and symptoms of myasthenia crisis?

A) Decreased muscle strength in the lower extremities
B) Increased salivation and sweating
C) Muscle weakness and increased salivation
D) Muscle weakness; difficulty in breathing and swallowing

Question 10

A client is ordered to receive carisoprodol (Soma) for muscle relaxation. The client takes the medication for 3 weeks and then abruptly stops. The client is at increased risk for:

A) excessive muscle relaxation.
B) decreased range of motion.
C) increased inflammation.
D) rebound muscle spasms.

Question 11

The client is suspected of having multiple sclerosis. Which diagnostic test is the client most likely to be ordered?

A) Computed tomography scan
B) Magnetic resonance imaging (MRI)
C) Protein in the cerebrospinal fluid
D) Angiography

Question 12

A child with cerebral palsy and spasticity is being treated with baclofen (Lioresal). Because drowsiness is a side effect, the nurse plans to administer the medication:

A) during meals.
B) a half-hour before physical therapy.
C) during morning care.
D) at bedtime.

Question 13

The client has been ordered to be treated with Robaxin. The client calls the nurse in a panic and reports that his urine is black in color. The nurse's response should be based on the knowledge that this is indicative of a(n) _______ to the medication.

A) anaphylactic reaction
B) adverse reaction
C) subnormal response
D) expected response

Question 14

A client with chronic and progressive multiple sclerosis is ordered to receive cyclophosphamide (Cytoxan) to decrease symptoms. Based on this class of drug, which nursing diagnosis is a priority during this treatment?

A) Risk for injury owing to seizure activity
B) Risk for infection owing to immunosuppression
C) Risk for constipation owing to neurotoxicity
D) Risk for deficient fluid volume owing to diuresis

Question 15

A client is diagnosed with multiple sclerosis and is to receive home care. The home care nurse is aware that some drugs are contraindicated with this disease, including:

A) histamine₂ blockers.
B) calcium channel blockers.
C) adrenocorticotropic hormone (ACTH).
D) glucocorticoids.

Question 16

The nurse receives report on a client with multiple sclerosis who is scheduled to be treated with Cytoxan. The nurse anticipates that the client will be:

A) wheelchair enabled.
B) experiencing motor weakness.
C) complaining of fatigue.
D) diagnosed with optic neuritis.

Question 17

A client with myasthenia gravis demonstrates diplopia, ptosis, and dysphagia. The client is ordered to receive pyridostigmine bromide (Mestinon). What would indicate a positive outcome?

A) Increase in the ability to sleep
B) Decrease in muscle weakness
C) Increase in hemiparesis
D) Decrease in metabolic rate

Question 18

A client is being evaluated for multiple sclerosis. The nurse may observe which symptoms of multiple sclerosis?

A) Diplopia and weakness of the extremities
B) Rigidity and tremors
C) Masked facies and pill-rolling motion of the hand
D) Memory loss and inability to concentrate

Question 19

The nurse recognizes that a dose of an AChE inhibitor was given 1 hour late. The nurse anticipates that the client will exhibit which symptom as a result of the late dosage?

A) Excessive salivation
B) Difficulty breathing
C) Muscle weakness
D) Bradycardia