A nurse in the emergency department is caring for a client who is suspected to be in a cholinergic crisis. Which of the following factors should the nurse identify as a possible cause?

High purine diet

High protein diet

Not exercising enough

Taking too much of the prescribed medication

Answer and Explanation

The Correct Answer is D

Choice A reason: A high purine diet is more commonly associated with gout and hyperuricemia, not cholinergic crisis.

Choice B reason: A high protein diet is not directly related to cholinergic crisis. The crisis is related to medication levels rather than dietary factors.

Choice C reason: Not exercising enough is not a direct cause of cholinergic crisis. Physical activity levels do not impact the balance of acetylcholine in the body in this context.

Choice D reason: A cholinergic crisis occurs due to excessive accumulation of acetylcholine, often from taking too much of prescribed anticholinesterase medications. This can lead to overstimulation of the neuromuscular junction and symptoms such as muscle weakness and respiratory distress.

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Correct Answer is B

Explanation

Choice A reason: A sore that appears to be healed is not a common indicator of malignancy. It is usually associated with infections or other skin conditions.

Choice B reason: Changes in a mole's shape and size are classic warning signs of melanoma, a type of skin cancer. Moles that become asymmetrical, have irregular borders, vary in color, grow in diameter, or evolve over time need to be evaluated by a healthcare provider.

Choice C reason: Purulent drainage from a mole could indicate an infection, but it is not a typical sign of malignancy.

Choice D reason: Intense pruritus (itching) can be associated with skin conditions, but it is not a definitive indicator of malignancy. While itching can occasionally be a symptom of skin cancer, it is not as specific as changes in mole appearance.

A. Pyridostigmine B. Flumazenil C. Acetylcholine D. Atropine

Correct Answer is D

Explanation

Choice A reason: Pyridostigmine is a medication used to treat myasthenia gravis by inhibiting acetylcholinesterase, but it is not used as an antidote for edrophonium overdose. Pyridostigmine helps improve muscle strength by increasing the amount of acetylcholine available at the neuromuscular junction.

Choice B reason: Flumazenil is an antidote for benzodiazepine overdose and has no effect on edrophonium. It works by competitively inhibiting the actions of benzodiazepines on the GABA receptor.

Choice C reason: Acetylcholine itself is not used as an antidote for edrophonium overdose. Administering acetylcholine would not counteract the effects of excessive acetylcholinesterase inhibition caused by edrophonium.

Choice D reason: Atropine is the correct antidote for edrophonium overdose. Atropine is an anticholinergic drug that can counteract the excessive accumulation of acetylcholine caused by edrophonium, thereby alleviating symptoms such as bradycardia and muscle weakness.

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A nurse in the emergency department is caring for a client who is suspected to be in a cholinergic crisis. Which of the following factors should the nurse identify as a possible cause?

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Naxlex Comprehensive Predictor Exams

A nurse evaluates a client who presents to the provider's office to assess multiple nevi. Which finding should the nurse highlight to the provider as a possible sign of malignancy?

Correct Answer is B

Explanation

A client admitted to the hospital with suspected myasthenic crisis was prescribed edrophonium (Tensilon). The nurse misread the dosage and administered a higher dose than prescribed. The doctor has ordered an antidote to be given. What medication does the nurse anticipate administering?

Correct Answer is D

Explanation

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