A nurse is caring for a patient who has myasthenia gravis and is experiencing a crisis.
The nurse should assess for which condition as a possible trigger of a myasthenic crisis?
Diet high in protein.
Taking too much medication.
Orthostatic hypotension.
Respiratory infection.
The Correct Answer is D
Choice A rationale
A diet high in protein is generally beneficial for individuals with myasthenia gravis, as protein is essential for muscle health and overall strength. It does not trigger a myasthenic crisis, which is typically precipitated by factors that exacerbate neuromuscular junction dysfunction, not dietary protein intake.
Choice B rationale
Taking too much medication, specifically cholinergic medications used to treat myasthenia gravis, can lead to a cholinergic crisis, not a myasthenic crisis. A cholinergic crisis is characterized by excessive acetylcholine, leading to symptoms like muscle fasciculations, salivation, lacrimation, and bradycardia, distinguishing it from theasthenic crisis's muscle weakness.
Choice C rationale
Orthostatic hypotension is a drop in blood pressure upon standing and can be a symptom associated with myasthenia gravis or its treatments (e.g., anticholinesterase inhibitors), but it is not a direct trigger for a myasthenic crisis. A crisis involves severe muscle weakness, particularly affecting respiratory muscles, not primarily blood pressure regulation.
Choice D rationale
Respiratory infection is a very common and significant trigger for a myasthenic crisis. Infections, particularly respiratory ones, increase metabolic demand, cause systemic inflammation, and can exacerbate the autoimmune attack on acetylcholine receptors at the neuromuscular junction, leading to profound muscle weakness, including life-threatening respiratory muscle paralysis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Palpating along the lumbar vertebral column primarily assesses for spinal tenderness or musculoskeletal issues, not specifically kidney inflammation. The kidneys are retroperitoneal organs, and direct palpation of the lumbar area might not elicit specific tenderness related to pyelonephritis, which involves renal parenchymal inflammation.
Choice B rationale
Striking a flat hand covering the costovertebral angle (CVA) elicits pain if the kidney capsule is inflamed, a classic sign of pyelonephritis. This maneuver, known as CVA tenderness, directly assesses for inflammation of the renal parenchyma or surrounding structures, which become sensitive to percussion with infection.
Choice C rationale
Pushing fingers upward into the two lowest intercostal spaces would primarily assess for liver or spleen enlargement, or tenderness related to the lower ribs, not directly for kidney tenderness. The kidneys are situated more posteriorly and superiorly, making this approach less effective for assessing pyelonephritis.
Choice D rationale
Percussing between the iliac crest and ribs at the midaxillary line targets the flank area but is not the most precise method for assessing kidney tenderness. While it's in the general vicinity, the CVA percussion directly overlies the kidney and is a more specific and sensitive maneuver for pyelonephritis.
Correct Answer is A
Explanation
Choice A rationale
Topical corticosteroids are the mainstay of treatment for contact dermatitis. This inflammatory skin condition is characterized by a delayed hypersensitivity reaction, and corticosteroids reduce inflammation, pruritus, and erythema by suppressing the immune response, inhibiting cytokine release, and stabilizing lysosomal membranes, thus alleviating symptoms locally.
Choice B rationale
Intravenous corticosteroids are generally reserved for severe, widespread, or recalcitrant cases of contact dermatitis, or when there is significant systemic involvement, such as severe angioedema or airway compromise. For typical localized contact dermatitis, topical application is preferred to minimize systemic side effects.
Choice C rationale
Intravenous antibiotics are indicated for bacterial infections. Contact dermatitis is an inflammatory, non-infectious condition caused by exposure to an allergen or irritant. Therefore, antibiotics would not be a primary treatment unless there is a secondary bacterial infection complicating the dermatitis, which is not the typical initial presentation.
Choice D rationale
Oral antibiotics, like intravenous antibiotics, are used to treat bacterial infections. Contact dermatitis is not caused by bacteria but rather by an inflammatory immune response to external agents. Administering oral antibiotics without evidence of secondary bacterial infection would be inappropriate and ineffective for treating the underlying dermatitis.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.