Nokea
What is the etiology and most likely treatment for myasthenia gravis in a 22-year-old female college student?
- A. Autoimmune destruction of skeletal muscle cells; treatment with intensive physical therapy and anabolic steroids.
- B. A decline in functioning acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulins.
- C. Cerebellar lesions; surgical and immunosuppressive treatment.
- D. Excess acetylcholinesterase production; treatment with thymectomy.
Correct Answer: B
Rationale: Myasthenia gravis is characterized by a decline in functioning acetylcholine receptors rather than autoimmune destruction of skeletal muscle cells (Choice A), cerebellar lesions (Choice C), or excess acetylcholinesterase production (Choice D). The most likely treatment for myasthenia gravis involves corticosteroids to reduce inflammation and intravenous immunoglobulins to block the antibodies attacking acetylcholine receptors. Intensive physical therapy and anabolic steroids are not primary treatments for myasthenia gravis.
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An older adult patient has asked her primary care provider for a prescription that will help to resolve her "warped toenails." The care provider has diagnosed the woman with onychomycosis. The nurse should anticipate that this patient will be treated with what drug?
- A. Micafungin (Mycamine)
- B. Terbinafine (Lamisil)
- C. Voriconazole (Vfend)
- D. Fluconazole (Diflucan)
Correct Answer: B
Rationale: The correct answer is B: Terbinafine (Lamisil). Terbinafine is commonly used to treat onychomycosis, a fungal infection of the toenails or fingernails. It works by stopping the growth of the fungus. Micafungin (Mycamine) is an antifungal medication used for different types of fungal infections but is not typically used to treat onychomycosis. Voriconazole (Vfend) is another antifungal medication used for specific fungal infections, but it is not a first-line treatment for onychomycosis. Fluconazole (Diflucan) is also an antifungal medication, but it is more commonly used for yeast infections and may not be as effective for treating onychomycosis compared to terbinafine.
What should the nurse teach the boy about anabolic steroid abuse?
- A. The ability of anabolic steroids to build muscle is greatly exaggerated in the media.
- B. Anabolic steroids are universally dangerous but are especially harmful to adolescents.
- C. The muscle mass resulting from steroid use will atrophy unless doses are continually increased.
- D. Anabolic steroids will reduce the boy's ability to perform weight-bearing exercise later in life.
Correct Answer: B
Rationale: The correct answer is B because anabolic steroids are indeed universally dangerous, but they pose greater risks to adolescents due to their impact on growth and development. Choice A is incorrect because anabolic steroids do have the potential to build muscle mass, though not to the extent often portrayed in the media. Choice C is incorrect as muscle mass gained from steroid use may persist for a period even after discontinuation. Choice D is incorrect as anabolic steroids can enhance muscle performance initially, though long-term use can have adverse effects on health and not specifically on the ability to perform weight-bearing exercises.
A patient who is being administered isoniazid (INH) for tuberculosis has a yellow color in the sclera of her eye. What other finding would lead you to believe that hepatotoxicity has developed?
- A. Diarrhea
- B. Numbness
- C. Diminished vision
- D. Light-colored stools
Correct Answer: A
Rationale: The correct answer is A: Diarrhea. Hepatotoxicity caused by isoniazid can present with various symptoms, including yellow discoloration of the sclera of the eyes, which indicates jaundice. Another common sign of hepatotoxicity is gastrointestinal symptoms such as nausea, vomiting, and diarrhea, which can occur due to liver dysfunction affecting bile production and digestion. Numbness (choice B) is more commonly associated with peripheral neuropathy caused by isoniazid, while diminished vision (choice C) and light-colored stools (choice D) are not typical manifestations of hepatotoxicity.
Why is a beta-blocker prescribed to a client with a history of myocardial infarction?
- A. To reduce myocardial oxygen demand.
- B. To increase cardiac output.
- C. To prevent arrhythmias.
- D. To prevent the development of angina.
Correct Answer: A
Rationale: The primary reason for administering a beta-blocker to a client with a history of myocardial infarction is to reduce myocardial oxygen demand. By reducing myocardial oxygen demand, beta-blockers help decrease the workload on the heart, making it easier for the heart to function effectively. This is crucial for clients with a history of myocardial infarction to prevent further damage to the heart. Choice B is incorrect because beta-blockers do not aim to increase cardiac output; instead, they help improve cardiac function by reducing workload. Choice C is incorrect because while beta-blockers can help prevent certain arrhythmias, the primary reason for their use in this case is to reduce myocardial oxygen demand. Choice D is incorrect as preventing angina is not the primary purpose of administering beta-blockers to a client with a history of myocardial infarction.
What is a critical point the nurse should include in patient education for a patient prescribed tamoxifen (Nolvadex)?
- A. Tamoxifen may increase the risk of venous thromboembolism.
- B. Tamoxifen may decrease the risk of osteoporosis.
- C. Tamoxifen may cause hot flashes and other menopausal symptoms.
- D. Tamoxifen may cause weight gain and fluid retention.
Correct Answer: A
Rationale: The critical point the nurse should include in patient education for a patient prescribed tamoxifen is that it may increase the risk of venous thromboembolism. This is crucial information because tamoxifen is known to promote blood clot formation, and patients need to be aware of the signs and symptoms of blood clots to seek prompt medical attention. Choices B, C, and D are incorrect as tamoxifen is not associated with decreasing the risk of osteoporosis, causing hot flashes and other menopausal symptoms, or directly causing weight gain and fluid retention.