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

Bradycardia

Rash

Vomiting

Fever

Drooling

Answer and Explanation

Correct Answer : A,C,E

A. Bradycardia

Bradycardia (slow heart rate) is a symptom of cholinergic crisis. Excessive stimulation of acetylcholine receptors can lead to bradycardia.

B. Rash

Rash is not typically associated with cholinergic crisis. Instead, it may be associated with other conditions or drug reactions.

C. Vomiting

Vomiting is a symptom of cholinergic crisis. Excessive stimulation of the gastrointestinal tract by acetylcholine can lead to increased gastrointestinal motility and nausea/vomiting.

D. Fever

Fever is not typically associated with cholinergic crisis. Instead, it may suggest an infection or other inflammatory condition.

E. Drooling

Drooling is a symptom of cholinergic crisis. Excessive stimulation of salivary glands by acetylcholine can lead to increased salivation and drooling.

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Correct Answer is B

Explanation

A. Decreased ascites

Ascites (accumulation of fluid in the abdominal cavity) is more directly related to portal hypertension and liver cirrhosis. While lactulose may contribute to fluid balance, its primary therapeutic effect in hepatic encephalopathy is the reduction of ammonia levels.

B. Decreased ammonia level

Lactulose is a medication commonly used in the treatment of hepatic encephalopathy, a condition associated with liver disease. The therapeutic effect of lactulose in this context is to reduce blood ammonia levels. Lactulose works by promoting the excretion of ammonia in the form of ammonium ions in the colon, thereby lowering ammonia concentrations in the blood.

C. Decreased jaundice

Jaundice is often associated with liver dysfunction, but lactulose is not primarily used to address jaundice. Its primary role in liver disease is in the management of hepatic encephalopathy.

D. Decreased blood pressure

Blood pressure is not a direct therapeutic target of lactulose in the context of liver disease. Lactulose's primary therapeutic effect is related to reducing ammonia levels and managing hepatic encephalopathy.

A. A respiratory rate of 14 B. A pulse of 102 C. Blood pressure of 88/60 mmHg D. A temperature of 100.2°F

Correct Answer is C

Explanation

A. A respiratory rate of 14

A respiratory rate of 14 is within the normal range and is not typically a reason to hold benztropine. Respiratory depression is not a common side effect of this medication.

B. A pulse of 102

A pulse rate of 102 is also within the normal range, and changes in heart rate are generally not a prominent side effect of benztropine. This finding alone is not a typical reason to hold the medication.

C. Blood pressure of 88/60 mmHg

This is the correct choice. Anticholinergic medications, like benztropine, can cause side effects such as a decrease in blood pressure. A blood pressure of 88/60 mmHg may be a concern, and the nurse should hold the dose and notify the physician.

D. A temperature of 100.2°F

An elevated temperature of 100.2°F is not a direct contraindication to benztropine administration. Fever is not a typical side effect of this medication, so an increased temperature alone is not a reason to hold the dose.

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

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Naxlex Comprehensive Predictor Exams

Lactulose is ordered for a patient with liver disease. What would indicate the medication is exerting a positive therapeutic effect on the patient?

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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