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Thorough Answer Explanations
207.) A client is suspected of having myasthenia gravis, and the health care provider
administers edrophonium (Enlon) to determine the diagnosis. After administration of this
medication, which of the following would indicate the presence of myasthenia gravis?
1. Joint pain
2. A decrease in muscle strength
3. An increase in muscle strength
4. Feelings of faintness, dizziness, hypotension, and signs of flushing in the client -
CORRECT ANS- -3. An increase in muscle strength
Rationale:
Edrophonium is a short-acting acetylcholinesterase inhibitor used as a diagnostic agent.
When a client with suspected myasthenia gravis is given the medication intravenously, an
increase in muscle strength would be seen in 1 to 3 minutes. If no response occurs,
another dose is given over the next 2 minutes, and muscle strength is again tested. If no
increase in muscle strength occurs with this higher dose, the muscle weakness is not
caused by myasthenia gravis. Clients receiving injections of this medication commonly
demonstrate a drop of blood pressure, feel faint and dizzy, and are flushed.
208.) A client with myasthenia gravis verbalizes complaints of feeling much weaker than
normal. The health care provider plans to implement a diagnostic test to determine if the
client is experiencing a myasthenic crisis and administers edrophonium (Enlon). Which of
the following would indicate that the client is experiencing a myasthenic crisis?
1. Increasing weakness
2. No change in the condition
3. An increase in muscle spasms
4. A temporary improvement in the condition - CORRECT ANS- -auto-define "A client with
myasthen..."
,Rationale:
Edrophonium (Enlon) is administered to determine whether the client is reacting to an
overdose of a medication (cholinergic crisis) or to an increasing severity of the disease
(myasthenic crisis). When the edrophonium (Enlon) injection is given and the condition
improves temporarily, the client is in myasthenic crisis. This is known as a positive test.
Increasing weakness would occur in cholinergic crisis. Options 2 and 3 would not occur in
either crisis.
209.) A client with multiple sclerosis is receiving diazepam (Valium), a centrally acting
skeletal muscle relaxant. Which of the following would indicate that the client is
experiencing a side effect related to this medication?
1. Headache
2. Drowsiness
3. Urinary retention
4. Increased salivation - CORRECT ANS- -2. Drowsiness
Rationale:
Incoordination and drowsiness are common side effects resulting from this medication.
Options 1, 3, and 4 are incorrect.
210.) Dantrolene (Dantrium) is prescribed for a client with a spinal cord injury for
discomfort resulting from spasticity. The nurse tells the client about the importance of
follow-up and the need for which blood study?
1. Creatinine level
2. Sedimentation rate
3. Liver function studies
4. White blood cell count - CORRECT ANS- -3. Liver function studies
Rationale:
Dantrolene can cause liver damage, and the nurse should monitor liver function studies.
Baseline liver function studies are done before therapy starts, and regular liver function
, studies are performed throughout therapy. Dantrolene is discontinued if no relief of
spasticity is achieved in 6 weeks.
211.) A client with epilepsy is taking the prescribed dose of phenytoin (Dilantin) to control
seizures. A phenytoin blood level is drawn, and the results reveal a level of 35 mcg/ml.
Which of the following symptoms would be expected as a result of this laboratory result?
1. Nystagmus
2. Tachycardia
3. Slurred speech
4. No symptoms, because this is a normal therapeutic level - CORRECT ANS- -3. Slurred
speech
Rationale:
The therapeutic phenytoin level is 10 to 20 mcg/mL. At a level higher than 20 mcg/mL,
involuntary movements of the eyeballs (nystagmus) appear. At a level higher than 30
mcg/mL, ataxia and slurred speech occur.
212.) Mannitol (Osmitrol) is being administered to a client with increased intracranial
pressure following a head injury. The nurse assisting in caring for the client knows that
which of the following indicates the therapeutic action of this medication?
1. Prevents the filtration of sodium and water through the kidneys
2. Prevents the filtration of sodium and potassium through the kidneys
3. Decreases water loss by promoting the reabsorption of sodium and water in the loop of
Henle
4. Induces diuresis by raising the osmotic pressure of glomerular filtrate, thereby inhibiting
tubular reabsorption of water and solutes - CORRECT ANS- -4. Induces diuresis by raising
the osmotic pressure of glomerular filtrate, thereby inhibiting tubular reabsorption of water
and solutes
Rationale:
Improvement with Premier Exam Questions and
Thorough Answer Explanations
207.) A client is suspected of having myasthenia gravis, and the health care provider
administers edrophonium (Enlon) to determine the diagnosis. After administration of this
medication, which of the following would indicate the presence of myasthenia gravis?
1. Joint pain
2. A decrease in muscle strength
3. An increase in muscle strength
4. Feelings of faintness, dizziness, hypotension, and signs of flushing in the client -
CORRECT ANS- -3. An increase in muscle strength
Rationale:
Edrophonium is a short-acting acetylcholinesterase inhibitor used as a diagnostic agent.
When a client with suspected myasthenia gravis is given the medication intravenously, an
increase in muscle strength would be seen in 1 to 3 minutes. If no response occurs,
another dose is given over the next 2 minutes, and muscle strength is again tested. If no
increase in muscle strength occurs with this higher dose, the muscle weakness is not
caused by myasthenia gravis. Clients receiving injections of this medication commonly
demonstrate a drop of blood pressure, feel faint and dizzy, and are flushed.
208.) A client with myasthenia gravis verbalizes complaints of feeling much weaker than
normal. The health care provider plans to implement a diagnostic test to determine if the
client is experiencing a myasthenic crisis and administers edrophonium (Enlon). Which of
the following would indicate that the client is experiencing a myasthenic crisis?
1. Increasing weakness
2. No change in the condition
3. An increase in muscle spasms
4. A temporary improvement in the condition - CORRECT ANS- -auto-define "A client with
myasthen..."
,Rationale:
Edrophonium (Enlon) is administered to determine whether the client is reacting to an
overdose of a medication (cholinergic crisis) or to an increasing severity of the disease
(myasthenic crisis). When the edrophonium (Enlon) injection is given and the condition
improves temporarily, the client is in myasthenic crisis. This is known as a positive test.
Increasing weakness would occur in cholinergic crisis. Options 2 and 3 would not occur in
either crisis.
209.) A client with multiple sclerosis is receiving diazepam (Valium), a centrally acting
skeletal muscle relaxant. Which of the following would indicate that the client is
experiencing a side effect related to this medication?
1. Headache
2. Drowsiness
3. Urinary retention
4. Increased salivation - CORRECT ANS- -2. Drowsiness
Rationale:
Incoordination and drowsiness are common side effects resulting from this medication.
Options 1, 3, and 4 are incorrect.
210.) Dantrolene (Dantrium) is prescribed for a client with a spinal cord injury for
discomfort resulting from spasticity. The nurse tells the client about the importance of
follow-up and the need for which blood study?
1. Creatinine level
2. Sedimentation rate
3. Liver function studies
4. White blood cell count - CORRECT ANS- -3. Liver function studies
Rationale:
Dantrolene can cause liver damage, and the nurse should monitor liver function studies.
Baseline liver function studies are done before therapy starts, and regular liver function
, studies are performed throughout therapy. Dantrolene is discontinued if no relief of
spasticity is achieved in 6 weeks.
211.) A client with epilepsy is taking the prescribed dose of phenytoin (Dilantin) to control
seizures. A phenytoin blood level is drawn, and the results reveal a level of 35 mcg/ml.
Which of the following symptoms would be expected as a result of this laboratory result?
1. Nystagmus
2. Tachycardia
3. Slurred speech
4. No symptoms, because this is a normal therapeutic level - CORRECT ANS- -3. Slurred
speech
Rationale:
The therapeutic phenytoin level is 10 to 20 mcg/mL. At a level higher than 20 mcg/mL,
involuntary movements of the eyeballs (nystagmus) appear. At a level higher than 30
mcg/mL, ataxia and slurred speech occur.
212.) Mannitol (Osmitrol) is being administered to a client with increased intracranial
pressure following a head injury. The nurse assisting in caring for the client knows that
which of the following indicates the therapeutic action of this medication?
1. Prevents the filtration of sodium and water through the kidneys
2. Prevents the filtration of sodium and potassium through the kidneys
3. Decreases water loss by promoting the reabsorption of sodium and water in the loop of
Henle
4. Induces diuresis by raising the osmotic pressure of glomerular filtrate, thereby inhibiting
tubular reabsorption of water and solutes - CORRECT ANS- -4. Induces diuresis by raising
the osmotic pressure of glomerular filtrate, thereby inhibiting tubular reabsorption of water
and solutes
Rationale:
