Jane, a 20-year old college student is admitted to the hospital with a tentative diagnosis of myasthenia gravis. She is scheduled to have a series of diagnostic studies for myasthenia gravis, including a Tensilon test. In preparing her for this procedure, the nurse explains that her response to the medication will confirm the diagnosis if Tensilon produces:
The client shows a marked improvement of muscle strength.
The client has muscles become weakened due to the impaired ability to respond to nerve signals
There is reduced amplitude of electrical stimulation in the muscle.
The anti-acetylcholine receptor antibodies are present.
The Correct Answer is A
Choice A rationale: The Tensilon test involves injecting edrophonium, and in myasthenia gravis, temporary improvement in muscle strength confirms the diagnosis by demonstrating increased acetylcholine activity at the neuromuscular junction.
Choice B rationale: This describes the pathophysiology of myasthenia gravis but doesn’t directly confirm the diagnosis via the Tensilon test.
Choice C rationale: While this may be seen in myasthenia gravis, the Tensilon test specifically aims to observe improved muscle strength after administration.
Choice D rationale: While the presence of these antibodies is a characteristic of myasthenia gravis, the Tensilon test is used to assess the immediate response to the medication for diagnostic confirmation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale: While joint deformities are concerning in RA, the immediate attention would be required for an acute, red, hot, swollen joint which could indicate an active inflammatory process.
Choice B rationale: Redness, heat, and swelling in a joint are signs of an acute flare in rheumatoid arthritis and might require urgent intervention to manage the inflammation.
Choice C rationale: Puffy-looking areas behind the knee might indicate joint involvement but might not require immediate attention as much as an acutely inflamed joint.
Choice D rationale: Jaw pain while eating can be a symptom of TMJ involvement in RA, but an acutely inflamed joint would generally take precedence.
Correct Answer is A
Explanation
Choice A rationale: Gloves should be worn during direct contact with the client's skin. This is a standard precaution that applies to all clients, but especially to those with infectious diseases that can be transmitted through contact. Secondary syphilis is highly contagious and can be spread through direct contact with the skin lesions or mucous
membranes of an infected person.
Choice B rationale: This is incorrect because secondary syphilis requires more than standard precautions to prevent transmission.
Choice C rationale: This is incorrect because handwashing is a basic component of standard precautions and is not sufficient to prevent the spread of syphilis.
Choice D rationale: This is incorrect because a mask is not necessary for contact precautions, unless the client has respiratory symptoms or is undergoing aerosol- generating procedures.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.