Exam (elaborations)
Myasthenia Gravis Exam – Questions/Solutions (A+)
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Myasthenia Gravis Exam – Questions/Solutions (A+)
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Myasthenia Gravis Exam – Questions/Solutions (A+)5. A client is taking long-term corticosteroids for myasthenia gravis. What
teaching is most important?
a. Avoid large crowds and people who are ill.
b. Check blood sugars four times a day.
c. Use two forms of contraception.
d. Wear properly fitting socks and shoes. lmfaoooo ✔️- ANS: A
Corticosteroids reduce immune function, so clients taking these medications
must avoid being exposed to illness. Long-term use can lead to secondary
diabetes, but the client would not need to start checking blood glucose unless
diabetes had been detected. Corticosteroids do not affect the effectiveness of
contraception. Wearing well-fitting shoes would be important to avoid injury,
but not just because the client takes corticosteroids.
6. A client with myasthenia gravis has the priority client problem of
inadequate nutrition. What assessment finding indicates that the priority goal
for this client problem has been met?
a. Ability to chew and swallow without aspiration
b. Eating 75% of meals and between-meal snacks
c. Intake greater than output 3 days in a row
d. Weight gain of 3 pounds in 1 month ✔️- ANS: D
Weight gain is the best indicator that the client is receiving enough nutrition.
Being able to chew and swallow is important for eating, but adequate
nutrition can be accomplished through enteral means if needed. Swallowing
without difficulty indicates an intact airway. Since the question does not
indicate what the client's meals and snacks consist of, eating 75% may or may
not be adequate. Intake and output refers to fluid balance.
11. A client is receiving plasmapheresis. What action by the nurse best
prevents infection in this client?
a. Giving antibiotics prior to treatments
b. Monitoring the client's vital signs
c. Performing appropriate hand hygiene
d. Placing the client in protective isolation ✔️- ANS: C
Plasmapheresis is an invasive procedure, and the nurse uses good hand
hygiene before and after client contact to prevent infection. Antibiotics are not
, necessary. Monitoring vital signs does not prevent infection but could alert
the nurse to its possibility. The client does not need isolation.
13. A client with myasthenia gravis (MG) asks the nurse to explain the disease.
What response by the nurse is best?
a. "MG is an autoimmune problem in which nerves do not cause muscles to
contract."
b. "MG is an inherited destruction of peripheral nerve endings and junctions."
c. "MG consists of trauma-induced paralysis of specific cranial nerves."
d. "MG is a viral infection of the dorsal root of sensory nerve fibers." ✔️-
ANS: A
MG is an autoimmune disorder in which nerve fibers are damaged and their
impulses do not lead to muscle contraction. MG is not an inherited or viral
disorder and does not paralyze specific cranial nerves.
DIF: Understanding/Comprehe
1. A client with myasthenia gravis is prescribed pyridostigmine (Mestinon).
What teaching should the nurse plan regarding this medication? (Select all
that apply.)
a. "Do not eat a full meal for 45 minutes after taking the drug."
b. "Seek immediate care if you develop trouble swallowing."
c. "Take this drug on an empty stomach for best absorption."
d. "The dose may change frequently depending on symptoms."
e. "Your urine may turn a reddish-orange color while on this drug." ✔️-
ANS: A, B, D
Pyridostigmine should be given with a small amount of food to prevent GI
upset, but the client should wait to eat a full meal due to the potential for
aspiration. If difficulty with swallowing occurs, the client should seek
immediate attention. The dose can change on a day-to-day basis depending on
the client's manifestations. Taking the drug on an empty stomach is not
related although the client needs to eat within 45 to 60 minutes afterwards.
The client's urine will not turn reddish-orange while on this drug.
3. A client with myasthenia gravis is malnourished. What actions to improve
nutrition may the nurse delegate to the unlicensed assistive personnel (UAP)?
(Select all that apply.)
a. Assessing the client's gag reflex
b. Cutting foods up into small bites
c. Monitoring prealbumin levels
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