A nurse in the emergency department is caring for a client who has myasthenia gravis and is in crisis.
Which of the following factors should the nurse identify as a possible cause of myasthenic crisis?
Not exercising enough.
Eating a diet high in protein.
Developing a respiratory infection.
Taking too much prescribed medication.
The Correct Answer is C
Choice A rationale
Not exercising enough is generally not a direct cause of myasthenic crisis. While regular exercise can improve overall health, myasthenic crisis is primarily triggered by factors that acutely worsen neuromuscular transmission, such as infections or medication issues, rather than a lack of physical activity. Myasthenia gravis is an autoimmune disorder characterized by fluctuating muscle weakness.
Choice B rationale
Eating a diet high in protein does not typically cause myasthenic crisis. While nutrition is important for overall health, there is no scientific evidence suggesting that high protein intake directly exacerbates or precipitates a myasthenic crisis. The crisis is usually linked to acute physiological stressors that further impair acetylcholine receptor function at the neuromuscular junction.
Choice C rationale
Developing a respiratory infection is a common precipitating factor for myasthenic crisis. Infections, particularly respiratory ones, increase systemic inflammation and metabolic demand, which can exacerbate the autoimmune attack on acetylcholine receptors at the neuromuscular junction. This further impairs nerve-to-muscle communication, leading to severe muscle weakness, particularly affecting respiratory muscles and potentially requiring ventilatory support.
Choice D rationale
Taking too much prescribed medication, specifically anticholinesterase inhibitors used to manage myasthenia gravis, can lead to a cholinergic crisis, which mimics some symptoms of myasthenic crisis but is distinct. A cholinergic crisis results from the overstimulation of acetylcholine receptors. While both are critical, the question specifically asks about myasthenic crisis, which is more commonly triggered by under-medication, infection, or other stressors, not typically an overdose of prescribed medications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
Choice A rationale
Decreased visual acuity, a common age-related change, significantly impairs an older adult's ability to perceive environmental hazards such as uneven surfaces or obstacles. This sensory deficit directly increases the risk of tripping and falling, leading to head injuries.
Choice B rationale
While older adults can be involved in motor vehicle crashes, it is not considered one of the *common reasons* for head injuries specifically *due to falls* in this demographic. Falls are a far more prevalent cause of head injuries in the elderly population compared to vehicular accidents.
Choice C rationale
Polypharmacy, the concurrent use of multiple medications, often leads to adverse drug reactions like orthostatic hypotension, dizziness, and altered gait. These side effects compromise balance and increase the likelihood of falls, a primary cause of head injuries in older adults.
Choice D rationale
Age-related sarcopenia and generalized muscle weakness diminish an older adult's ability to maintain balance and recover from a stumble. Weakness in lower extremities particularly reduces postural stability, making falls more probable and increasing susceptibility to head trauma.
Choice E rationale
Chronic hypertension itself does not directly cause falls or head injuries. However, poorly controlled hypertension or its treatment can sometimes lead to orthostatic hypotension, which can then contribute to falls. The direct link is less prominent than other factors.
Choice F rationale
Previous military experience has no direct scientific correlation with an increased risk of head injuries due to falls in older adults. This factor is irrelevant to the physiological and environmental causes of falls in the elderly population.
Correct Answer is D
Explanation
Choice A rationale
Slurred speech, also known as dysarthria, is typically associated with neurological conditions affecting motor control of speech, such as stroke or Parkinson's disease. While severe anemia might cause generalized weakness, it is not a direct or common symptom of iron deficiency impacting speech articulation.
Choice B rationale
Confusion can be a symptom of severe or prolonged anemia due to inadequate oxygen delivery to the brain. However, it is more commonly associated with acute and severe reductions in hemoglobin or other systemic conditions that impair cerebral perfusion, rather than a primary symptom of typical iron deficiency anemia.
Choice C rationale
Pain is not a direct or primary symptom of iron deficiency anemia. Pain is more characteristic of other types of anemia, such as sickle cell anemia (due to vaso-occlusive crises) or pernicious anemia (due to neurological involvement), or due to conditions causing the iron deficiency.
Choice D rationale
Fatigue is the most common and often the earliest symptom of iron deficiency anemia. This occurs because iron is crucial for hemoglobin synthesis, and insufficient hemoglobin impairs oxygen transport to tissues, leading to cellular hypoxia and a profound lack of energy. Normal hemoglobin levels for adults are typically 12-16 g/dL for females and 13-17 g/dL for males.
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