The nurse is providing education for a client diagnosed with myasthenia gravis (MG) taking pyridostigmine. The nurse understands teaching has been effective when the client states, "I will

use pyridostigmine as needed to relieve symptoms of muscle weakness and fatigue."

be able to crush the sustained release tablet because of difficulty swallowing."

skip a dose if I have symptoms of fatigue to minimize side effects of the medications."

take pyridostigmine 30-60 minutes before meals to improve muscle function."

Answer and Explanation

The Correct Answer is D

A. Use pyridostigmine as needed to relieve symptoms of muscle weakness and fatigue: Pyridostigmine should not be used on an "as-needed" basis, as it is a long-acting medication that works by maintaining a steady level of acetylcholine at the neuromuscular junction. The client needs to take the medication regularly at prescribed intervals, not sporadically, to maintain consistent symptom control. This statement reflects a misunderstanding of the medication's use.

B. Be able to crush the sustained release tablet because of difficulty swallowing: Sustained-release (or extended-release) tablets should not be crushed because doing so can cause the medication to be released too quickly, leading to potential side effects or overdose. If the client has difficulty swallowing, an alternative form of the medication, such as a liquid or split tablet, should be considered. This statement reflects a lack of understanding regarding the proper administration of the medication.

C. Skip a dose if I have symptoms of fatigue to minimize side effects of the medications: Skipping doses of pyridostigmine is not appropriate. The medication should be taken as prescribed, even if the client feels fatigued. Fatigue is a symptom of myasthenia gravis, not necessarily a side effect of the medication. Consistent dosing is important for controlling the disease and preventing worsening of symptoms. Skipping doses can lead to inadequate symptom control and potential exacerbation of weakness.

D. Take pyridostigmine 30-60 minutes before meals to improve muscle function: This statement indicates that the client understands the appropriate use of pyridostigmine for managing myasthenia gravis (MG). Pyridostigmine is an acetylcholinesterase inhibitor that helps improve neuromuscular transmission, and it is typically taken 30-60 minutes before meals. This timing helps optimize muscle strength during the period when the client is eating, as muscle weakness can make swallowing more difficult. By taking the medication before meals, the client is more likely to experience improved muscle function when needed most.

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Correct Answer is ["56"]

Explanation

Calculate the infusion rate in mL/min.

The total volume to be infused is 500 mL.

The infusion time is 90 minutes.

The infusion rate = 500 mL / 90 minutes = 5.5556 mL/min.

Calculate the drip rate in gtt/min.

The drop factor is 10 gtt/mL.

We need to deliver 5.5556 mL/min.

To find the drip rate, we can set up a proportion:

10 gtt / 1 mL = x gtt / 5.5556 mL

Cross-multiplying:

x = 10 gtt/mL x 5.5556 mL = 55.5556 gtt

Round the answer to the nearest whole number.

56 gtt/min.

A. Administer antiplatelet and anticoagulant medications to prevent further clot formation. B. Relieve the blockage in the coronary artery and restore blood flow to the heart muscle. C. Provide pain relief and initiate cardiac rehabilitation. D. Stabilize the dient's blood pressure and administer thrombolytic therapy.

Correct Answer is B

Explanation

A) Administer antiplatelet and anticoagulant medications to prevent further clot formation:
While antiplatelet and anticoagulant medications are essential in the management of STEMI to reduce the risk of further clot formation, they are not the primary goal of treatment in the immediate phase. These medications are typically administered before or during the procedure (such as during cardiac catheterization) to prevent new clots, but the primary objective is to restore blood flow to the heart muscle through reperfusion therapy, either by angioplasty or thrombolytics.

B) Relieve the blockage in the coronary artery and restore blood flow to the heart muscle:
This is the primary goal of treatment in STEMI. The most urgent intervention for a client with an ST elevation myocardial infarction (STEMI) is to relieve the blockage in the coronary artery and restore blood flow to the ischemic heart muscle. This is typically achieved through percutaneous coronary intervention (PCI) via cardiac catheterization, which involves either angioplasty (ballooning the artery) or stent placement. Restoring blood flow as quickly as possible reduces the extent of myocardial damage, improves the prognosis, and prevents complications like heart failure.

C) Provide pain relief and initiate cardiac rehabilitation:
Pain relief is important in the initial management of STEMI, typically with nitroglycerin and opioids for chest pain. However, the immediate goal in the ED is to address the underlying cause of the chest pain, which is the blockage of blood flow. Cardiac rehabilitation, while essential for long-term recovery, is not the immediate goal of treatment during the acute phase of a STEMI. The primary focus should be on restoring circulation to the affected myocardium.

D) Stabilize the client's blood pressure and administer thrombolytic therapy:
Stabilizing the client’s blood pressure is important, especially if the client is hypotensive, but it is not the main treatment goal. Thrombolytic therapy (clot-busting medications) is an option if PCI is not available or if it needs to be done within a certain time frame; however, the current best practice in STEMI is to perform PCI as soon as possible. Thrombolytics are typically used when PCI is not immediately available, but the ideal treatment is to restore blood flow through catheterization in a timely manner, as it is more effective than thrombolytic therapy at re-opening the blocked artery.

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The nurse is providing education for a client diagnosed with myasthenia gravis (MG) taking pyridostigmine. The nurse understands teaching has been effective when the client states, "I will

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Naxlex Comprehensive Predictor Exams

A patient is prescribed 500 ml of Normal Saline to be infused over 90 minutes. The drop factor on the tubing is 10 gtt/mL. At what rate should the nurse regulate the IV (gtt/min)? (Round to the nearest whole number)

Correct Answer is ["56"]

Explanation

A client is admitted to the Emergency Department (ED) with a suspected ST elevation myocardial infarction (STEMI) involving the inferior wall. The nurse anticipates that this client will be immediately scheduled for the cardiac catheterization laboratory. The goal of treatment is to:

Correct Answer is B

Explanation

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