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A nurse is planning the care of a 28-year-old woman hospitalized with a diagnosis of myasthenia gravis. What approach would be most appropriate for the care and scheduling of diagnostic procedures for this patient?
- A. All at one time, to provide a longer rest period
- B. Before meals, to stimulate her appetite
- C. In the morning, with frequent rest periods
- D. Before bedtime, to promote rest
Correct Answer: C
Rationale: Scheduling procedures in the morning with rest periods minimizes fatigue in myasthenia gravis, where muscle weakness worsens with activity. Other timings risk exhaustion or poor appetite.
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The critical care nurse is admitting a patient in myasthenic crisis to the ICU. The nurse should prioritize what nursing action in the immediate care of this patient?
- A. Suctioning secretions
- B. Facilitating ABG analysis
- C. Providing ventilatory assistance
- D. Administering tube feedings
Correct Answer: C
Rationale: Myasthenic crisis causes severe muscle weakness, risking respiratory failure, so ventilatory assistance is the priority. Suctioning, ABGs, and feeding are secondary.
The nurse caring for a patient diagnosed with Guillain-Barr?© syndrome is planning care with regard to the clinical manifestations associated with this syndrome. The nurse's communication with the patient should reflect the possibility of what sign or symptom of the disease?
- A. Intermittent hearing loss
- B. Tinnitus
- C. Tongue enlargement
- D. Vocal paralysis
Correct Answer: D
Rationale: Guillain-Barr?© syndrome affects the vagus nerve (X), potentially causing vocal paralysis or dysphagia. Hearing loss, tinnitus, and tongue enlargement are not associated.
A patient diagnosed with myasthenia gravis has been hospitalized to receive plasmapheresis for a myasthenic exacerbation. The nurse knows that the course of treatment for plasmapheresis in a patient with myasthenia gravis is what?
- A. Every day for 1 week
- B. Determined by the patient's response
- C. Alternate days for 10 days
- D. Determined by the patient's weight
Correct Answer: B
Rationale: Plasmapheresis frequency in myasthenia gravis depends on clinical response, typically daily or alternate days until improvement. Fixed schedules or weight-based dosing are not standard.
A 35-year-old woman is diagnosed with a peripheral neuropathy. When making her plan of care, the nurse knows to include what in patient teaching? Select all that apply.
- A. Inspect the lower extremities for skin breakdown.
- B. Footwear needs to be accurately sized.
- C. Immediate family members should be screened for the disease.
- D. Assistive devices may be needed to reduce the risk of falls.
- E. Dietary modifications are likely necessary.
Correct Answer: A,B,D
Rationale: Peripheral neuropathy requires inspecting for skin breakdown, proper footwear, and assistive devices to prevent falls. It is not genetic, and diet is unrelated.
A 73-year-old man comes to the clinic complaining of weakness and loss of sensation in his feet and legs. Assessment of the patient shows decreased reflexes bilaterally. Why would it be a challenge to diagnose a peripheral neuropathy in this patient?
- A. Older adults are often vague historians.
- B. The elderly have fewer peripheral nerves than younger adults.
- C. Many older adults are hesitant to admit that their body is changing.
- D. Many symptoms can be the result of normal aging process.
Correct Answer: D
Rationale: Symptoms like decreased reflexes in peripheral neuropathy can mimic normal aging, complicating diagnosis. Older adults do not necessarily have fewer nerves or withhold information.