A patient exhibits ptosis of both eyes and the provider orders edrophonium (Tensilon). The nurse notes immediate improvement of the ptosis.
The nurse understands that this patient most likely has which disorder?
Myasthenia gravis.
Cerebral palsy.
Multiple sclerosis.
Muscle spasm.
The Correct Answer is A
Choice A rationale
Myasthenia gravis is an autoimmune neuromuscular disorder characterized by weakness and fatigue of the skeletal muscles. Improvement of ptosis after administration of edrophonium (Tensilon), a short-acting acetylcholinesterase inhibitor, is a diagnostic indicator of myasthenia gravis.
Choice B rationale
Cerebral palsy is a group of permanent movement disorders that appear in early childhood. It is primarily caused by abnormal development or damage to the brain and does not exhibit rapid improvement with edrophonium.
Choice C rationale
Multiple sclerosis is a chronic illness involving the central nervous system, where the immune system attacks the protective sheath (myelin) that covers nerve fibers. It does not respond to edrophonium as myasthenia gravis does.
Choice D rationale
Muscle spasm refers to an involuntary contraction of a muscle that can be sudden and painful. This condition is not typically diagnosed or treated with edrophonium, which is specific for myasthenia gravis. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
While "Drug Facts and Comparisons" is a comprehensive source, it is primarily used by pharmacists rather than nurses. Nurses might find it less practical for their day-to-day needs as it is detailed and more suited to in-depth drug comparisons.
Choice B rationale
A nurse drug guide is designed specifically for nurses and includes practical information for administering medications, understanding side effects, and nursing considerations. It’s tailored to the needs of nursing practice.
Choice C rationale
A drug package insert provides detailed information about a specific drug, including indications, dosage, and side effects. However, it lacks the breadth of information about multiple drugs and nursing considerations compared to a nurse drug guide.
Choice D rationale
The Physician’s Drug Reference (PDR) is an excellent resource but is more suited for physicians. It provides detailed drug information but may not focus on nursing-specific considerations and practical administration advice.
Correct Answer is ["A","C"]
Explanation
Choice A rationale
Teaching the patient how to cope with therapy helps ensure the best outcomes by promoting adherence and understanding of the treatment regimen.
Choice B rationale
Nurses should not alter drug regimens; this is the responsibility of the prescribing healthcare provider.
Choice C rationale
Evaluating the effectiveness of therapy is a critical nursing responsibility to ensure that the treatment is achieving the desired outcomes.
Choice D rationale
While providing therapy is part of nursing care, it should not include altering the medication regimen.
Choice E rationale
Recommending over-the-counter medications is not within the nurse's scope of practice and should be done by a healthcare provider.
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