A nurse is assessing a client who has Guillain-Barre Syndrome, and notes that the client's breathing is shallow and the client is short of breath. The nurse understands that that the client's respiratory distress is caused by which of the following?

Degeneration of nerves in the brainstem and spinal cord.

Pleural effusion caused by immobility.

Demyelination of nerves that stimulate the respiratory muscles.

Bronchoconstriction and edema of the airways.

Answer and Explanation

The Correct Answer is C

A.   While GBS primarily affects peripheral nerves (nerves outside the brain and spinal cord), it does not typically cause direct degeneration of nerves in the brainstem and spinal cord. Therefore, this option is not correct in the context of respiratory distress in GBS.
B.   Pleural effusion caused by immobility: Pleural effusion, an accumulation of fluid in the pleural cavity around the lungs, is not a typical complication of GBS. It is more commonly associated with conditions such as heart failure, pneumonia, or malignancy, rather than directly with GBS.
C.   In Guillain-Barre Syndrome, demyelination of nerves affects the transmission of signals from the brain to the muscles, including those responsible for respiration. As a result, respiratory muscles may become weak or paralyzed, leading to shallow breathing and respiratory distress.
D.   While respiratory distress can occur in some neurological conditions due to autonomic dysfunction or secondary complications, such as aspiration pneumonia, bronchoconstriction and airway edema are not typical manifestations of GBS itself.

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Correct Answer is D

Explanation

A. Defibrillation is used to treat life-threatening arrhythmias such as ventricular fibrillation or pulseless ventricular tachycardia, where the heart is in a chaotic rhythm without an effective contraction.

B. This procedure is performed to relieve significant blockages in coronary arteries that are causing myocardial ischemia or infarction. While coronary artery disease can contribute to cardiac issues, it is not the primary intervention for treating atrial fibrillation with a rapid ventricular response and associated symptoms like dizziness, shortness of breath, and hypotension.
C. While an echocardiogram may be useful in assessing the overall cardiac function and structure, it is not an immediate intervention for the acute management of atrial fibrillation with a rapid ventricular response and unstable symptoms.
D. Synchronized cardioversion is a procedure used to convert certain types of rapid arrhythmias, including atrial fibrillation, to a normal sinus rhythm by delivering a synchronized electrical shock to the heart at a specific point in the cardiac cycle.

A. The client has developed moon face. B. The client complains of muscle spasticity. C. The client drinks alcohol several days per week. D. The client is taking birth control pills.

Correct Answer is C

Explanation

A. Moon face is a common side effect of prednisone, a corticosteroid medication. It results from fluid retention and redistribution of fat in the face. While moon face is a cosmetic concern, it is not typically an urgent or critical finding that requires immediate reporting.
B. Muscle spasticity may develop but does not pose an immediate risk that requires urgent attention.
C. Alcohol consumption can interact with both prednisone and interferon B-1a, potentially leading to increased drug levels in the bloodstream and intensifying side effects. This interaction can also increase the risk of liver problems, which is particularly concerning given that interferon B-1a may cause liver issues.
D. Birth control pills have been a subject of debate regarding their effect on multiple sclerosis but a study found that oral hormonal contraceptives did not appear to be associated with an increased chance of MS relapses.

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A nurse is assessing a client who has Guillain-Barre Syndrome, and notes that the client's breathing is shallow and the client is short of breath. The nurse understands that that the client's respiratory distress is caused by which of the following?

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A female client with multiple sclerosis is being treated with prednisone and the immunomodulator drug interferon B-1a to manage the condition. Which finding is the most important for the nurse to report to the provider?

Correct Answer is C

Explanation

A client who has been diagnosed with chronic stable angina is placed on multiple medications to manage the condition. The nurse understands that the client is receiving rosuvastatin for which reason?

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A nurse is providing education to a client who has chronic obstructive pulmonary disease and will begin using fluticasone by metered dose inhaler every 12 hours for maintenance. Which of the following instructions should the nurse include?

A nurse is assessing a client who has Guillain-Barre Syndrome, and notes that the client's breathing is shallow and the client is short of breath. The nurse understands that that the client's respiratory distress is caused by which of the following?