Question 1

The nurse is reading the results of a single-fiber electromyography completed on a patient suspected of having myasthenia gravis.Which information would validate this patient's diagnosis?

Accepted Answer

Increased jitter is a characteristic finding in patients with myasthenia gravis on a single-fiber electromyography. Nerve compression and increased antibodies are not specific to myasthenia gravis, and decreased muscle response can be seen in other neuromuscular disorders.

Question 2

A patient is experiencing bilateral symmetrical muscle weakness and sensory changes of both feet and legs.What should the nurse expect to assess that determines the presence of Guillain-Barré syndrome (GBS)?

Accepted Answer

Areflexia, or absence of reflexes, is a hallmark sign of Guillain-Barré syndrome. This is due to the destruction of peripheral nerves and damage to the myelin sheath, which disrupts nerve conduction and reflexes. Hyporeflexia and hyperreflexia may be seen in other neurological conditions, but are not typically associated with GBS. Hyperanalgesia, or increased sensitivity to pain, may be present in some cases of GBS, but it is not a specific or defining feature.

Question 3

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

Fasciculations (twitching of muscles) suggest a cholinergic crisis, which happens when there is an excess of acetylcholine in the body due to overstimulation of cholinergic receptors. Other symptoms may include nausea, vomiting, diarrhea, excessive salivation, miosis (constricted pupils), and respiratory distress. Administering edrophonium, a short-acting cholinesterase inhibitor, can help differentiate between a myasthenic crisis (not enough acetylcholine) and a cholinergic crisis. If the patient's symptoms worsen after receiving edrophonium, it indicates a cholinergic crisis and the medication should be stopped and appropriate treatment initiated.

Question 4

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 is a common finding in the cerebrospinal fluid of patients with Guillain-Barré syndrome, as it is a result of the inflammatory process affecting the nerves. This is known as albuminocytologic dissociation. The other options are not typically seen in GBS.

Question 5

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

Accepted Answer

The answer of The nurse is reviewing discharge instructions for...

Question 6

A patient with Guillain-Barré syndrome (GBS)is receiving plasmapheresis.What finding should the nurse identify as being a 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 7

The nurse is caring for a patient with myasthenia gravis.Which assessment should the nurse complete to determine respiratory functioning?

Accepted Answer

The answer of The nurse is caring for a patient...

Question 8

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 an autoimmune disorder in which the immune system mistakenly attacks the myelin sheath that covers the nerves, resulting in nerve damage and muscle weakness. This damage disrupts the communication between the nerves and muscles, leading to the characteristic symptoms of GBS. The disorder often follows a viral or bacterial infection, and it is thought that the immune response triggered by the infection mistakenly targets the myelin sheath.

Question 9

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

Accepted Answer

Gabapentin is an anticonvulsant that can also be used to treat neuropathic pain. Turning and repositioning every two hours, applying sequential compression devices, and performing passive range of motion can help prevent complications such as pressure ulcers and muscle atrophy, but they do not directly address neuropathic pain.

Question 10

The nurse is reviewing orders written for a patient with trigeminal neuralgia.Which medication should the nurse expect to be prescribed for this patient?

Accepted Answer

Trigeminal neuralgia, also known as tic douloureux, is a severe facial pain disorder that is commonly treated with carbamazepine. Cogentin and Compazine are medications used to treat extrapyramidal symptoms and nausea/vomiting, respectively, but they are not typically used in the treatment of trigeminal neuralgia. Hydrochlorothiazide is a diuretic used to treat hypertension and edema and is not related to the treatment of trigeminal neuralgia.

Question 11

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

Accepted Answer

The nurse should change the patient's linen and gown and keep them comfortable. Sweating is a common symptom in patients with GBS, and the nurse can help keep the patient comfortable by changing their linens and clothing as needed. A cooling blanket may not be necessary unless the patient develops a fever, which is not mentioned in the scenario. Notification of the health-care provider may be necessary if there are other concerning symptoms or changes in the patient's condition. Monitoring body temperature every two hours may be necessary if there are signs of fever, but is not specifically indicated in this scenario.

Question 12

The nurse is conducting a physical examination on a female patient experiencing trigeminal neuralgia.What observation indicates that the pain is triggered by hygienic practices?

Accepted Answer

If the patient is experiencing trigeminal neuralgia triggered by hygienic practices, then activities like combing her hair or brushing her teeth may be painful. Therefore, observing that her hair is not combed may indicate that the pain is triggered by hygienic practices. The other options are not necessarily related to trigeminal neuralgia triggered by hygienic practices.

Question 13

A patient with Guillain-Barré syndrome (GBS)loses respiratory function three weeks into the acute phase.When should the nurse expect respiratory function to return in this patient?

Accepted Answer

Respiratory function typically returns early in the recovery stage of GBS. The plateau phase usually lasts for a few days to 2 weeks, and the recovery stage can last for several months.

Question 14

A client is diagnosed with myasthenia gravis.What should the nurse explain about this disease process?

Accepted Answer

The answer of A client is diagnosed with myasthenia gravis.What...

Question 15

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 16

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

Accepted Answer

Planning medication doses to occur before meals can help improve the patient's ability to eat and maintain adequate nutrition. Myasthenia gravis can cause muscle weakness, including in the muscles used for eating, so taking medication before meals can help improve muscle strength and ability to eat. Eating three large meals per day may be difficult for a patient with myasthenia gravis, and restricting drinking fluids prior to and during meals can also make it harder to eat enough food. Increasing fat and carbohydrates in meals is not necessarily the best approach without considering the patient's overall nutritional needs and goals.

Question 17

The nurse notes that a patient has been diagnosed with trigeminal neuralgia.What should the nurse expect the patient to be experiencing?

Accepted Answer

Trigeminal neuralgia is a condition characterized by intense facial pain that can be triggered by activities such as eating, speaking, or touching the face. It does not typically cause nausea, sensory deficits, or motor weakness.

Question 18

The nurse notes that a patient's primary complaint is burning pain on the right side of the face.What should the nurse realize this patient is describing?

Accepted Answer

The answer of The nurse notes that a patient's primary...

Question 19

The nurse is concerned that a patient is at risk for trigeminal neuralgia.What information in the patient's medical record did the nurse use to make this clinical decision?

Accepted Answer

Trigeminal neuralgia is commonly associated with hypertension or other cardiovascular diseases. The other options provided do not directly relate to trigeminal neuralgia.

Question 20

A patient is being prepared for a tensilon test.What should the nurse ensure is available prior to the beginning of this test?

Accepted Answer

Atropine sulfate is necessary to have available during a tensilon test to treat any potential bradycardia or asystole that may occur as a result of the test. Oxygen, intravenous fluids, and nasogastric suction are not typically necessary for this test.

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

The nurse is reading the results of a single-fiber electromyography completed on a patient suspected of having myasthenia gravis.Which information would validate this patient's diagnosis?

A patient is experiencing bilateral symmetrical muscle weakness and sensory changes of both feet and legs.What should the nurse expect to assess that determines the presence of Guillain-Barré syndrome (GBS) ?

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

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) ?

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

A patient with Guillain-Barré syndrome (GBS) is receiving plasmapheresis.What finding should the nurse identify as being a complication of this treatment?