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.

Answer and Explanation

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.

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Correct Answer is A

Explanation

Choice A rationale: These lab findings, particularly concentrated urine (high specific gravity) and hyponatremia, are consistent with SIADH, where excessive ADH secretion leads to water retention and dilutional hyponatremia.

Choice B rationale: While it can affect sodium levels, Cushing's syndrome typically results in hypernatremia or normal sodium levels rather than hyponatremia.

Choice C rationale: Usually presents with hyponatremia but not specifically with high urine specific gravity or hematocrit.

Choice D rationale: DI is associated with high serum sodium and low urine specific gravity due to excessive excretion of dilute urine.

A. intubation and mechanical ventilation. B. IV infusion of (Sandoglobulin). C. administration of methylprednisolone (Solu-Medrol). D. insertion of a nasogastric (NG) feeding tube

Correct Answer is B

Explanation

Choice A rationale: Intubation and mechanical ventilation may be needed if the respiratory muscles are affected by GBS, but this is not a routine intervention at this stage.

Choice B rationale: One of the main treatments of GBS is IV immunoglobulin therapy (IVIG), which involves infusing antibodies from donated blood plasma to block the harmful immune response that damages the nerves. Sandoglobulin is one of the brand names of IVIG used for GBS. IVIG can help shorten the duration and severity of the disease, and improve the recovery rate.

Choice C rationale: Methylprednisolone is a corticosteroid that can reduce inflammation, but it is not recommended for GBS, as it may worsen the condition or increase the risk of infection.

Choice D rationale: NG feeding tube may be required if the patient has difficulty swallowing, but this is also not a standard intervention at this time.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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