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Chapter 21 Drugs for Neuromuscular Disorders and Muscle Spasms Questions &Exam (elaborations) answers 100% satisfaction guarantee
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  • 11 de agosto de 2024
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  • 2024/2025
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  • chapter 21 drugs for neuromuscular disorders and

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STUVIA 2024/2025
Chapter 21: Drugs for Neuromuscular Disorders
and Muscle Spasms
A 40-year-old woman is diagnosed with myasthenia gravis, and her provider recommends removal of
her thymus gland. She asks the nurse why this would be helpful. The nurse will explain that removal
of the thymus gland may:
a. increase binding of acetylcholine (ACh) molecules to ACh receptors.
b. increase the amount of ACh available at neuromuscular junction sites.
c. reduce the number of acetylcholine receptor sites.
d. reduce symptoms of myasthenia gravis following surgery. - ✔✔ANS: D

Thymic hyperplasia and tumors are common in patients with myasthenia gravis. The thymus gland is
involved in systemic immunity that is active during infancy and early childhood, but the gland normally
shrinks during adulthood. Approximately 70% of MG patients have thymic hyperplasia. A thymectomy
(removal of the thymus gland) is most beneficial because it can cause a reduction of symptoms
following the surgery.

A client with myasthenia gravis is experiencing a cholinergic crisis. Which symptoms are associated
with this condition? (Select all that apply.)
%


a. Bradycardia
b. Rash
c. Vomiting
d. Fever
e. Drooling
f. Weakness - ✔✔ANS: A, C, E, F

Bradycardia, vomiting, drooling, and weakness can all occur with cholinergic crisis.

A patient has symptoms that are characteristic of multiple sclerosis (MS). Which diagnostic tests are
likely to be ordered to aid in the diagnosis of this patient?
a. Cerebrospinal fluid (CSF) analysis and magnetic resonance imaging (MRI)
b. CSF proteins and an angiography
c. Serum albumin and a computed tomography (CT) scan
d. Serum anti-acetylcholine antibodies and x-rays - ✔✔ANS: A

Laboratory tests that may suggest MS include CSF analysis, visual evoked potential (VEP) testing,
and MRI.




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, STUVIA 2024/2025
A patient reports weakness of the extremities and diplopia. The nurse knows that these symptoms
are characteristic of which condition?
a. Cerebral palsy (CP)
b. Multiple sclerosis (MS)
c. Myasthenia gravis (MG)
d. Parkinson disease (PD) - ✔✔ANS: B

Diplopia and weakness of the extremities are two symptoms of MS. CP is characterized by muscle
spasticity. MG involves generalized weakness, especially of facial muscles and respiratory muscles.
PD manifests as tremors and difficulty moving and walking.

The nurse assumes care of a patient who has myasthenia gravis and notes that a dose of
neostigmine (Prostigmin) scheduled to be administered 1 hour prior was not given. The nurse will
anticipate the patient to exhibit which symptoms?
a. Excessive salivation
b. Muscle spasms
c. Muscle weakness
d. Respiratory paralysis - ✔✔ANS: C

Neostigmine must be given on time to prevent myasthenic crisis, which is characterized by
%

generalized, severe muscle weakness. The other symptoms are characteristic of cholinergic crisis,
caused by too much medication.

The nurse is caring for a patient who has multiple sclerosis (MS). The patient is experiencing an
acute attack. Which drug does the nurse anticipate the provider will order?
a. Methylprednisolone (Solu-Medrol)
b. Mitoxantrone
c. Glatiramer acetate (Copaxone)
d. Interferon-B (IFN-B) - ✔✔ANS: A

Methylprednisolone (Solu-Medrol) is given to treat an acute attack of MS. Glatiramer acetate and
interferon are used for remission-exacerbation states. Mitoxantrone is given for chronic, progressive
symptoms.

The nurse is caring for a patient who has myasthenia gravis (MG) and takes pyridostigmine bromide
(Mestinon) 60 mg every 4 hours. The patient's last dose was 45 minutes prior. The nurse notes
severe muscle weakness, excess salivation, fasciculations of facial muscles, and pupil constriction.
The nurse will perform which action?
a. Assess the patient for signs of ptosis.
b. Notify the provider to discuss an order for intravenous immune globulin (IVIG).


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