Jane, a 20-year old college student is admitted to the hospital with a tentative diagnosis of myasthenia gravis. She is scheduled to have a series of diagnostic studies for myasthenia gravis, including a Tensilon test. In preparing her for this procedure, the nurse explains that her response to the medication will confirm the diagnosis if Tensilon produces:
The client shows a marked improvement of muscle strength.
The client has muscles become weakened due to the impaired ability to respond to nerve signals
There is reduced amplitude of electrical stimulation in the muscle.
The anti-acetylcholine receptor antibodies are present.
The Correct Answer is A
Choice A rationale: The Tensilon test involves injecting edrophonium, and in myasthenia gravis, temporary improvement in muscle strength confirms the diagnosis by demonstrating increased acetylcholine activity at the neuromuscular junction.
Choice B rationale: This describes the pathophysiology of myasthenia gravis but doesn’t directly confirm the diagnosis via the Tensilon test.
Choice C rationale: While this may be seen in myasthenia gravis, the Tensilon test specifically aims to observe improved muscle strength after administration.
Choice D rationale: While the presence of these antibodies is a characteristic of myasthenia gravis, the Tensilon test is used to assess the immediate response to the medication for diagnostic confirmation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale: Low blood pressure sensed by baroreceptors in the kidneys would stimulate the renin-angiotensin-aldosterone system, which regulates blood pressure and sodium balance.
Choice B rationale: Low osmolality sensed by osmoreceptors in the kidneys would
indicate that the body has excess water and needs to excrete it, which would inhibit ADH release.
Choice C rationale: ADH, or antidiuretic hormone, is a peptide hormone that regulates the water balance in the body. It is released from the posterior pituitary gland in response to signals from the hypothalamus. When the plasma osmolarity, or the concentration of solutes in the blood, is high, it means that the body is dehydrated and needs to conserve water. The osmoreceptors in the hypothalamus detect this change and stimulate the release of ADH, which acts on the kidneys to increase water
reabsorption and decrease urine output. This helps to lower the plasma osmolarity and restore the water balance.
Choice D rationale: High concentration of potassium sensed by chemoreceptors in the carotid body would affect the acid-base balance and respiratory rate, but not ADH
release.
Correct Answer is B
Explanation
Choice A rationale: this corresponds with 25 mg which is lower than the prescribed amount.
Choice B rationale: To answer this question, we need to use the formula: volume (mL) = dose (mg) / concentration (mg/mL). We plug in the given values: volume (mL) = 35 mg / 25 mg/mL. We simplify the fraction: volume (mL) = 7/5. We convert the fraction to a
decimal: volume (mL) = 1.4. Therefore, the nurse should administer 1.4 mL of promethazine.
Choice C rationale: this corresponds with 37.5 mg which is too high.
Choice D rationale: this corresponds with 17.5 mg which is too low.
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