A nurse suspects a client who has myasthenia gravis is experiencing a myasthenic crisis. Which of the following interventions should the nurse take?

Administer an anticholinesterase medication.

Instruct the client to perform the pursed lip breathing.

Prepare to administer a vasoconstrictor.

Prepare the client for mechanical ventilation.

Answer and Explanation

The Correct Answer is D

Choice A reason:

Administering an anticholinesterase medication is not the primary intervention during a myasthenic crisis. While these medications can improve muscle strength in myasthenia gravis, they are not sufficient in the event of a crisis.

Choice B reason:

Pursed lip breathing is a technique used to manage dyspnea but is not adequate for the acute management of a myasthenic crisis, which can involve respiratory muscle paralysis.

Choice C reason:

Vasoconstrictors are not used in the treatment of myasthenic crisis. This condition is not related to vascular issues but to neuromuscular transmission failure leading to respiratory failure.

Choice D reason:

Mechanical ventilation is the correct intervention as it provides the necessary respiratory support when the patient's respiratory muscles are too weak to maintain adequate ventilation.

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Correct Answer is B

Explanation

The P wave is the first wave on the ECG strip and represents the electrical activity of the atria. It reﬂects the depolarization of the atrial myocardium, which is the process of changing the electrical charge of the cardiac cells from negative to positive, triggering a contraction. The P wave precedes the QRS complex, which represents ventricular depolarization, and the T wave, which represents ventricular repolarization.

The other options are not correct because:

a. Slow repolarization of ventricular Purkinje fibers. This statement is incorrect because it describes the U wave, which is a small and sometimes invisible wave that follows the T wave on the ECG strip. It reﬂects the repolarization of the ventricular Purkinje fibers, which are specialized cardiac cells that conduct electrical impulses to the ventricles. The U wave is more prominent in conditions that cause hypokalemia, such as diuretic use or vomiting.

c. Early ventricular repolarization. This statement is incorrect because it describes the ST segment, which is the ﬂat line between the QRS complex and the T wave on the ECG strip. It reﬂects the early phase of ventricular repolarization, which is the process of restoring the electrical charge of the cardiac cells to negative after a contraction. The ST segment can be elevated or depressed in conditions that cause myocardial ischemia or injury, such as angina or myocardial infarction.

d. Ventricular depolarization. This statement is incorrect because it describes the QRS complex, which is the largest and most visible wave on the ECG strip. It reﬂects the depolarization of the ventricular myocardium, which triggers a ventricular contraction. The QRS complex follows the P wave and precedes the T wave on the ECG strip.

A. Thick, deformed toenails B. Edema C. Dependent rubor D. Hair loss

Correct Answer is B

Explanation

Edema is a common finding in clients who have chronic venous insufficiency, due to the impaired venous return and increased capillary pressure. The edema is usually worse at the end of the day and improves with elevation.

a. Thick, deformed toenails are more likely to be seen in clients who have fungal infections or peripheral arterial disease, not chronic venous insufficiency.

c. Dependent rubor is a sign of peripheral arterial disease, not chronic venous insufficiency. It is a reddish color of the lower extremities that occurs when they are lowered and disappears when they are elevated.

d. Hair loss is another sign of peripheral arterial disease, not chronic venous insufficiency. It is caused by the reduced blood supply to the hair follicles.

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A nurse suspects a client who has myasthenia gravis is experiencing a myasthenic crisis. Which of the following interventions should the nurse take?

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