The nurse is assisting while a neurologist administers an edrophonium (Tensilon) test to a client with facial weakness and ptosis. If the test is positive for myasthenia gravis, which outcome would the nurse observe?

Thirty seconds after administration, the facial weakness and ptosis will be relieved for approximately 5 minutes.

After administration, the client will experience worsening facial weakness and ptosis.

After administration of the medication, there will be no change in the status of the ptosis or facial weakness.

The client will have elimination of symptoms lasting at least 24 hours after the administration of the medication.

Answer and Explanation

The Correct Answer is A

This is the correct expected outcome if the test is positive for myasthenia gravis. Edrophonium works quickly to increase acetylcholine levels, leading to temporary improvement in muscle strength. In a patient with myasthenia gravis, administration of edrophonium typically results in a rapid improvement in symptoms like facial weakness and ptosis within 30 to 60 seconds, with the effects lasting for a few minutes. This brief improvement is indicative of a positive result for myasthenia gravis.
B.A Worsening symptoms after administration of edrophonium are not expected and could indicate an adverse reaction or incorrect diagnosis. In myasthenia gravis, edrophonium typically improves symptoms rather than worsening them.
C. No change in symptoms would be unexpected in the case of myasthenia gravis. If edrophonium is effective, there should be a noticeable improvement in symptoms. If there is no change, it might suggest a diagnosis other than myasthenia gravis or that the test is inconclusive.
D. This outcome is not expected. Edrophonium has a very short duration of action, typically relieving symptoms for only a few minutes. The effects do not last for 24 hours. A longer-lasting improvement might be observed with other treatments for myasthenia gravis, such as anticholinesterase medications like pyridostigmine, but not with edrophonium.

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Correct Answer is C

Explanation

A. Mucositis and diarrhea are side effects commonly associated with chemotherapy but are not directly related to myelosuppression. These symptoms are due to the impact of chemotherapy on rapidly dividing cells in the gastrointestinal tract.
B. Nausea and vomiting are common side effects of chemotherapy, primarily due to the treatment's impact on the gastrointestinal tract and the central nervous system.
C. Fever and chills are manifestations directly related to myelosuppression. Myelosuppression leads to a decrease in white blood cells (leukocytes), which compromises the immune system. This increased susceptibility to infection can result in symptoms such as fever and chills. These symptoms are indicative of potential infections or sepsis, which are more common in patients with compromised immune systems due to myelosuppression.

D. Alopecia (hair loss) and weight loss are common side effects of chemotherapy, but they are not directly related to myelosuppression. Alopecia results from the effects of chemotherapy on rapidly dividing hair follicle cells, while weight loss can be a consequence of changes in metabolism or appetite due to chemotherapy.

A. Black, tarry stool B. Clay-colored stool C. Watery stool D. Bright red blood in the stool

Correct Answer is A

Explanation

A. Black, tarry stool is indicative of blood that has been digested in the upper GI tract. The dark color is due to the action of digestive enzymes on blood.
B. Clay-colored stool is typically associated with biliary obstruction, not upper GI bleeding.
C. Watery stool can be caused by various conditions, including infections, inflammatory bowel diseases, and medications. It is not a specific indicator of upper GI bleeding.
D. Bright red blood in the stool is more likely to be associated with lower GI bleeding, such as from hemorrhoids or anal fissures.

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The nurse is assisting while a neurologist administers an edrophonium (Tensilon) test to a client with facial weakness and ptosis. If the test is positive for myasthenia gravis, which outcome would the nurse observe?

Nursing Test Bank

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