The nurse assumes care of a patient who has myasthenia gravis and notes that a dose of neostigmine (Prostigmin) due 1 hour prior was not given. The nurse will anticipate the patient to exhibit which symptoms?

Excessive salivation

Respiratory paralysis

Muscle weakness

Muscle spasms

Answer and Explanation

The Correct Answer is C

A) Excessive salivation: Neostigmine (Prostigmin) is a cholinesterase inhibitor, which works by increasing the levels of acetylcholine at neuromuscular junctions. If a dose is missed, excessive salivation can be a side effect of too much acetylcholine activity, but it is not the most immediate symptom in this case. Muscle weakness is a more direct consequence of a missed dose.

B) Respiratory paralysis: While respiratory weakness or paralysis can occur in myasthenia gravis, it is usually associated with a severe form of the disease or if the patient is in a myasthenic crisis. A single missed dose of neostigmine typically does not result in respiratory failure unless the patient is already in a very fragile state.

C) Muscle weakness: Neostigmine helps to improve neuromuscular transmission by inhibiting the breakdown of acetylcholine, which is crucial for muscle contraction. A missed dose would directly lead to a reduction in acetylcholine levels, exacerbating the characteristic muscle weakness of myasthenia gravis. Muscle weakness is the most anticipated symptom when neostigmine is not administered on time.

D) Muscle spasms: Muscle spasms are typically not a symptom of missed neostigmine therapy. Instead, muscle weakness occurs due to impaired neuromuscular transmission. Spasms might occur if there is significant overstimulation of the muscles, but this is more associated with electrolyte imbalances or other neuromuscular issues

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Correct Answer is ["A","C","E","F"]

Explanation

A) Bradycardia: Bradycardia is a common symptom of a cholinergic crisis. It results from excessive acetylcholine at the neuromuscular junction, which can overstimulate the parasympathetic nervous system, leading to a decrease in heart rate.

B) Rash: A rash is not a typical symptom of a cholinergic crisis. Rash might occur as a side effect of medications or other conditions, but it is not a hallmark feature of a cholinergic crisis in myasthenia gravis.

C) Vomiting: Vomiting is a potential symptom of a cholinergic crisis. It occurs due to the excessive stimulation of the parasympathetic nervous system, which can cause gastrointestinal distress and nausea.

D) Fever: Fever is not typically associated with a cholinergic crisis, but it can occur if there is an underlying infection or other condition. A cholinergic crisis itself usually leads to symptoms like weakness and excessive salivation, not fever.

E) Weakness: Weakness is a hallmark symptom of a cholinergic crisis, as it results from overstimulation at the neuromuscular junction, leading to muscle fatigue and paralysis. This is similar to the symptoms of myasthenia gravis, but in a cholinergic crisis, the weakness is more profound.

F) Drooling: Drooling is another common symptom of a cholinergic crisis. Excessive acetylcholine can lead to excessive salivation due to overstimulation of the parasympathetic nervous system.

A. the patella reflex "knee jerk" activated by tapping the patella tendon B. abdominal viscera the beginning of depolarization in the cardiac conduction of impulses C. the act of typing a report using a computer keyboard D. withdrawing the hand after touching a hot surface

Correct Answer is C

Explanation

A) The patella reflex ("knee jerk") activated by tapping the patella tendon: The patellar reflex is a monosynaptic spinal reflex that involves the somatic nervous system but is a reflex action rather than a voluntary motor function. The somatic nervous system governs voluntary movements, but reflex actions like the patellar reflex are involuntary responses that do not require higher brain input, though they involve somatic motor pathways.

B) Abdominal viscera the beginning of depolarization in the cardiac conduction of impulses: This process is primarily under the control of the autonomic nervous system (ANS), not the somatic nervous system. The ANS regulates involuntary processes like heart rate and digestion, while the somatic nervous system controls voluntary movements and somatic sensation.

C) The act of typing a report using a computer keyboard: Typing is a voluntary motor activity, controlled by the somatic nervous system. The somatic system is responsible for conscious, voluntary actions such as moving muscles in the arms, hands, and fingers to type. This is the most accurate example of a somatic function.

D) Withdrawing the hand after touching a hot surface: This is a reflex action known as the "withdrawal reflex," which involves the somatic nervous system. However, it is an involuntary action triggered by a sensory stimulus. While it does involve the somatic system, it is not a voluntary action like typing, and reflexes are considered part of the automatic response mechanisms.

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The nurse assumes care of a patient who has myasthenia gravis and notes that a dose of neostigmine (Prostigmin) due 1 hour prior was not given. The nurse will anticipate the patient to exhibit which symptoms?

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Naxlex Comprehensive Predictor Exams

A client with myasthenia gravis is experiencing a cholinergic crisis. Which symptoms are associated with this condition? (Select all that apply.)

Correct Answer is ["A","C","E","F"]

Explanation

Which of the following physiologic principles would be considered a function of the somatic nervous system?

Correct Answer is C

Explanation

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The nurse assumes care of a patient who has myasthenia gravis and notes that a dose of neostigmine (Prostigmin) due 1 hour prior was not given. The nurse will anticipate the patient to exhibit which symptoms?