A nurse is explaining myasthenia gravis to a family. Which of the following points would be included in the explanation? (Select All that Apply.)

Is it caused by demyelination of the nerve fibers.

Is it thought to be an autoimmune disease.

It is associated with destruction of acetylcholine receptor sites.

Once symptoms present, it has a 5-year survival rate.

It is a chronic and progressive muscular disease.

Is it best treated with antibiotics.

Answer and Explanation

Correct Answer : B,C,E

A) Is it caused by demyelination of the nerve fibers:
Myasthenia gravis is not primarily caused by demyelination of nerve fibers. It is characterized by dysfunction at the neuromuscular junction, specifically involving the acetylcholine receptors.

B) Is it thought to be an autoimmune disease:
This is correct. Myasthenia gravis is considered an autoimmune disorder in which the body's immune system mistakenly targets and attacks its own tissues, particularly the acetylcholine receptors at the neuromuscular junction.

C) It is associated with destruction of acetylcholine receptor sites:
This is correct. In myasthenia gravis, there is a reduction in the number of functional acetylcholine receptors due to autoimmune-mediated destruction or blocking of these receptors.

D) Once symptoms present, it has a 5-year survival rate:
This statement is inaccurate. Myasthenia gravis is a chronic condition, but survival rates are not determined by the onset of symptoms. With appropriate treatment, many individuals with myasthenia gravis can manage their symptoms effectively and have a normal life expectancy.

E) It is a chronic and progressive muscular disease:
This is correct. Myasthenia gravis is a chronic neuromuscular disorder characterized by fluctuating muscle weakness and fatigue. While it is chronic, it is not necessarily progressive in all cases, as symptoms may stabilize or improve with treatment.

F) Is it best treated with antibiotics:
Antibiotics are not the primary treatment for myasthenia gravis. Treatment typically involves medications that enhance neuromuscular transmission, such as acetylcholinesterase inhibitors or immunosuppressive drugs, along with other supportive measures.

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Correct Answer is A

Explanation

Answer: A. “Syncope episodes may occur when taking this medication.”

Rationale:

A) “Syncope episodes may occur when taking this medication.”
Syncope (fainting) is a possible side effect of donepezil, a cholinesterase inhibitor used to treat Alzheimer’s disease. Donepezil can cause bradycardia, which may lead to a decrease in blood pressure and reduced blood flow to the brain, resulting in syncope. It's important for family members to monitor for episodes of dizziness, fainting, or lightheadedness, particularly when the client changes positions (orthostatic hypotension).

B) “You will need to monitor for constipation.”
Constipation is not commonly associated with donepezil use. In fact, donepezil may cause diarrhea or gastrointestinal upset due to its cholinergic effects. Family members should be more concerned about potential gastrointestinal disturbances such as nausea, vomiting, or diarrhea rather than constipation.

C) “This medication may cause tachycardia.”
Donepezil is more likely to cause bradycardia (a slower-than-normal heart rate) rather than tachycardia (a fast heart rate). Bradycardia is a known side effect because the medication increases acetylcholine, which enhances parasympathetic activity, leading to a slower heart rate.

D) “You should administer the medication each morning.”
Donepezil is typically administered in the evening before bed. This schedule helps reduce the risk of daytime gastrointestinal side effects, like nausea and vomiting, which can interfere with daily activities. Administering the medication at night can also reduce the impact of potential dizziness or syncope during the day.

A. Hypoglycemia B. Arrhythmias C. Hypertension D. Hypokalemia E. Angina

Correct Answer is ["B","C","E"]

Explanation

A) Hypoglycemia:
Propranolol, a nonselective beta-blocking agent, can mask some of the symptoms of hypoglycemia, such as tachycardia and tremors, by blocking the sympathetic response. Therefore, it is not typically used in the treatment of hypoglycemia and may even exacerbate low blood sugar levels.

B) Arrhythmias:
Propranolol is commonly used in the treatment of various cardiac arrhythmias. By blocking beta-adrenergic receptors in the heart, it reduces the heart rate and myocardial contractility, thereby helping to control arrhythmias such as atrial fibrillation and ventricular tachycardia.

C) Hypertension:
Propranolol is effective in lowering blood pressure and is often prescribed for the management of hypertension. Its beta-blocking action reduces cardiac output and suppresses renin release, leading to decreased systemic vascular resistance and blood pressure.

D) Hypokalemia:
Propranolol does not have a direct role in the treatment of hypokalemia. While it can potentially exacerbate hypokalemia through its effects on potassium metabolism, it is not a primary treatment for this electrolyte imbalance.

E) Angina:
Propranolol is indicated for the treatment of angina pectoris, particularly in cases of stable angina. By reducing myocardial oxygen demand through its negative chronotropic and inotropic effects, it helps relieve anginal symptoms and improve exercise tolerance."

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A nurse is explaining myasthenia gravis to a family. Which of the following points would be included in the explanation? (Select All that Apply.)

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Naxlex Comprehensive Predictor Exams

A nurse is teaching the family of a client who has Alzheimer’s disease about donepezil. Which of the following information should the nurse include in the teaching?

Correct Answer is A

Explanation

Rationale:

The client has been ordered a nonselective beta-blocking agent called propranolol, PO. Propranolol is used in the treatment of which disorders (Select All that Apply.)

Correct Answer is ["B","C","E"]

Explanation

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