A nurse educator who leads a residency program for new nurses is educating the new nurses on the trajectory of chronic illness. The nurse recognizes a need for further teaching when one of the new nurses states which of the following?

"A primary goal when caring for clients who have a chronic illness is to cure them of the condition."

"Clients with chronic illness may have to dedicate a lot of time to managing their disease."

"Individuals with the same chronic illness may experience a completely different trajectory of the illness."

"The client and caregiver should be educated on the prescribed treatment plan."

Answer and Explanation

The Correct Answer is A

A.   This statement is incorrect because many chronic illnesses are not curable. The goal of care for chronic illnesses is often to manage the condition, improve quality of life, and prevent complications, rather than achieving a complete cure.
B.   This statement is accurate. Managing a chronic illness often requires significant time and effort, including medication adherence, lifestyle changes, and regular medical appointments.
C.   The trajectory of a chronic illness can vary greatly between individuals, even those with the same condition. Factors such as genetics, lifestyle, and access to care can influence the course of the illness.
D.   This statement is accurate. Educating the client and caregiver about the prescribed treatment plan is essential for optimal management of chronic illnesses. This includes understanding medication dosages, side effects, and lifestyle modifications.

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Correct Answer is A

Explanation

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.

A. Furosemide slow IV push B. 0.9% sodium chloride with 5% dextrose C. Ketoconazole and insulin D. Potassium chloride IV infusion

Correct Answer is B

Explanation

A. Furosemide is a loop diuretic used to treat fluid overload by increasing urine output. In an Addisonian crisis, the primary issue is the severe lack of adrenal hormones rather than fluid overload. Administering furosemide is not indicated in this situation, as it does not address the underlying cause of the crisis or correct electrolyte imbalances that are common in Addisonian crisis.
B. This is a common intravenous fluid choice for managing Addisonian crisis. The 0.9% sodium chloride (normal saline) helps to restore blood volume and correct electrolyte imbalances, while the 5% dextrose provides glucose to support energy needs. This combination helps to address hypovolemia (low blood volume) and prevent hypoglycemia (low blood sugar), both of which can occur in an adrenal crisis.

C. Ketoconazole is an antifungal medication that can be used to treat Cushing’s syndrome, not Addisonian crisis. Insulin is used to manage blood glucose levels and would not be the primary treatment for Addisonian crisis. This option does not directly address the adrenal insufficiency or the immediate needs of an Addisonian crisis.
D. Addisonian crisis often presents with hyponatremia (low sodium) and hyperkalemia (high potassium) due to inadequate aldosterone production. Administering potassium chloride could exacerbate hyperkalemia, which is a concern in Addisonian crisis. Therefore, potassium chloride infusion is not appropriate and could worsen the electrolyte imbalance.

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A nurse educator who leads a residency program for new nurses is educating the new nurses on the trajectory of chronic illness. The nurse recognizes a need for further teaching when one of the new nurses states which of the following?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is A

Explanation

A nurse is admitting a client who is experiencing an Addisonian crisis. Which of the following should the nurse anticipate an order for?

Correct Answer is B

Explanation

A client who has a new diagnosis of Parkinson's Disease asks the nurse "Why did I develop this disease? What caused it?" Which response should the nurse provide?

A nurse is caring for a client who has undergone a bilateral adrenalectomy. The nurse monitors for which of the following signs of Addisonian crisis?

A nurse in a pulmonology clinic is preparing a client for spirometry testing. Which question should the nurse ask the client during the preparation for this test?

A nurse in a clinic is reviewing the home medications of client who has a history of asthma, and who is at the clinic to have a routine annual physical. Which statement made by the patient would indicate a need for further action by the nurse?

A client is diagnosed with chronic stable angina caused by plaques in the coronary arteries. The client receives a prescription for sublingual nitroglycerin to use as needed when angina occurs. Which additional medication does the nurse anticipate would be prescribed for this client?

A nurse is caring for a client who has shortness of breath and a chronic cough. The client has smoked one pack of cigarettes per day for the last 20 years. Which finding on the client's chest x-ray would be consistent with a diagnosis of advanced COPD?

Which information will the nurse include when teaching a patient who is scheduled for a radiofrequency catheter ablation for treatment of atrial flutter?

A nurse is assessing a client who has chronic kidney disease and notes that the client has small crystals on his forehead. The nurse understands that this manifestation is a result of an excess of which substance in the body?