The nurse is assisting while a neurologist administers an edrophonium (Tensilon) test to a client with facial weakness and ptosis. If the test is positive for myasthenia gravis, which outcome would the nurse observe?

Thirty seconds after administration, the facial weakness and ptosis will be relieved for approximately 5 minutes.

After administration, the client will experience worsening facial weakness and ptosis.

After administration of the medication, there will be no change in the status of the ptosis or facial weakness.

The client will have elimination of symptoms lasting at least 24 hours after the administration of the medication.

Answer and Explanation

The Correct Answer is A

This is the correct expected outcome if the test is positive for myasthenia gravis. Edrophonium works quickly to increase acetylcholine levels, leading to temporary improvement in muscle strength. In a patient with myasthenia gravis, administration of edrophonium typically results in a rapid improvement in symptoms like facial weakness and ptosis within 30 to 60 seconds, with the effects lasting for a few minutes. This brief improvement is indicative of a positive result for myasthenia gravis.
B.A Worsening symptoms after administration of edrophonium are not expected and could indicate an adverse reaction or incorrect diagnosis. In myasthenia gravis, edrophonium typically improves symptoms rather than worsening them.
C. No change in symptoms would be unexpected in the case of myasthenia gravis. If edrophonium is effective, there should be a noticeable improvement in symptoms. If there is no change, it might suggest a diagnosis other than myasthenia gravis or that the test is inconclusive.
D. This outcome is not expected. Edrophonium has a very short duration of action, typically relieving symptoms for only a few minutes. The effects do not last for 24 hours. A longer-lasting improvement might be observed with other treatments for myasthenia gravis, such as anticholinesterase medications like pyridostigmine, but not with edrophonium.

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Correct Answer is B

Explanation

A. Furosemide is a loop diuretic used to treat fluid overload by increasing urine output. In an Addisonian crisis, the primary issue is the severe lack of adrenal hormones rather than fluid overload. Administering furosemide is not indicated in this situation, as it does not address the underlying cause of the crisis or correct electrolyte imbalances that are common in Addisonian crisis.
B. This is a common intravenous fluid choice for managing Addisonian crisis. The 0.9% sodium chloride (normal saline) helps to restore blood volume and correct electrolyte imbalances, while the 5% dextrose provides glucose to support energy needs. This combination helps to address hypovolemia (low blood volume) and prevent hypoglycemia (low blood sugar), both of which can occur in an adrenal crisis.

C. Ketoconazole is an antifungal medication that can be used to treat Cushing’s syndrome, not Addisonian crisis. Insulin is used to manage blood glucose levels and would not be the primary treatment for Addisonian crisis. This option does not directly address the adrenal insufficiency or the immediate needs of an Addisonian crisis.
D. Addisonian crisis often presents with hyponatremia (low sodium) and hyperkalemia (high potassium) due to inadequate aldosterone production. Administering potassium chloride could exacerbate hyperkalemia, which is a concern in Addisonian crisis. Therefore, potassium chloride infusion is not appropriate and could worsen the electrolyte imbalance.

A. The procedure uses electrical energy to destroy areas of the conduction system. B. The procedure uses cold therapy to stop the formation of the flutter waves. C. The procedure removes clots which have formed in the atria. D. The procedure stimulates the growth of new conduction pathways between the atria.

Correct Answer is A

Explanation

A. Radiofrequency catheter ablation involves the use of electrical energy (radiofrequency energy) delivered through a catheter to destroy or ablate the areas of the heart tissue responsible for the abnormal electrical signals causing atrial flutter. This destruction of tissue helps to interrupt the abnormal electrical pathways and restore normal rhythm.
B. The procedure for atrial flutter ablation does not use cold therapy. Instead, it uses radiofrequency energy (heat) to ablate the tissue. Cold therapy, or cryoablation, is a different technique that uses extreme cold to achieve similar effects but is not the standard approach for radiofrequency catheter ablation.
C. Radiofrequency catheter ablation does not involve removing clots. The primary purpose of the procedure is to ablate abnormal tissue causing arrhythmias, not to address clots. Managing clots may involve anticoagulant therapy or other treatments, but it is not the focus of ablation.
D. Radiofrequency catheter ablation does not stimulate the growth of new conduction pathways. Instead, it aims to destroy the abnormal conduction pathways responsible for arrhythmias.

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The nurse is assisting while a neurologist administers an edrophonium (Tensilon) test to a client with facial weakness and ptosis. If the test is positive for myasthenia gravis, which outcome would the nurse observe?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is admitting a client who is experiencing an Addisonian crisis. Which of the following should the nurse anticipate an order for?

Correct Answer is B

Explanation

Which information will the nurse include when teaching a patient who is scheduled for a radiofrequency catheter ablation for treatment of atrial flutter?

Correct Answer is A

Explanation

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