A 32-year-old female client is admitted to the hospital with a diagnosis of myasthenia gravis. The nurse is providing education on the management of the disease. Which statement by the client indicates a need for further teaching?
A. “I should take my pyridostigmine (Mestinon) with meals.”
B. “I will avoid stress and get enough rest.”
C. “I need to notify my healthcare provider if I experience difficulty breathing.”
D. “I can stop taking my medications when I feel better.”
E. “I should wear sunglasses and a hat when outdoors to protect my eyes.”
Rationale: Myasthenia gravis is a chronic autoimmune neuromuscular disorder that requires long-term medication management. Abruptly stopping medications can lead to a myasthenic crisis. It is crucial for the client to understand the importance of consistent medication adherence to control symptoms and prevent exacerbations. Correct Answer: D. “I can stop taking my medications when I feel better.”
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NCLEX Questions Critical Thinking: Myasthenia Gravis Symptoms
A 45-year-old male client with myasthenia gravis is scheduled for a thymectomy. The nurse explains the purpose of the surgery. What is the primary rationale for performing a thymectomy in clients with myasthenia gravis?
A. To remove tumors from the thymus gland.
B. To alleviate pain associated with myasthenic symptoms.
C. To correct muscle weakness in the limbs.
D. To decrease acetylcholine production.
E. To modify immune response and reduce antibody production.
Rationale: A thymectomy is performed in myasthenia gravis to alter the immune system’s response and decrease antibody production targeting acetylcholine receptors. This surgical intervention is often beneficial in reducing the severity of symptoms and achieving long-term remission in some cases. Correct Answer: E. To modify immune response and reduce antibody production.
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NCLEX Review: Myasthenia Gravis Disease Treatments
A 28-year-old female client with myasthenia gravis is prescribed neostigmine (Prostigmin). The nurse provides instructions on the medication. What should the nurse include in the teaching regarding neostigmine?
A. “Take the medication on an empty stomach for better absorption.”
B. “Increase fluid intake to prevent dehydration while on this medication.”
C. “Skip the dose if you experience muscle weakness to prevent overdose.”
D. “Monitor for cholinergic crisis symptoms, such as excessive salivation and bradycardia.”
E. “This medication will cure myasthenia gravis with long-term use.”
Rationale: Neostigmine is a cholinesterase inhibitor that increases acetylcholine levels. Overdosing can lead to cholinergic crisis, characterized by excessive muscarinic and nicotinic stimulation. The nurse should educate the client to recognize signs of cholinergic crisis, such as increased salivation and bradycardia, and seek medical attention promptly. Regular monitoring is crucial for preventing complications. Correct Answer: D. “Monitor for cholinergic crisis symptoms, such as excessive salivation and bradycardia.”
NCLEX Focus Exploring Myasthenia Gravis: Causes and Diagnosis
A 36-year-old male client with myasthenia gravis is admitted to the hospital. The nurse is assessing the client’s respiratory status. Which finding would be most concerning in a client with myasthenia gravis?
A. Increased blood pressure
B. Shallow respirations
C. Warm and dry skin
D. Increased muscle strength
E. Dilated pupils
Rationale: Myasthenia gravis can lead to respiratory muscle weakness, and shallow respirations are a sign of compromised ventilation. This finding is particularly concerning as it may indicate impending respiratory failure. Monitoring respiratory status is crucial in clients with myasthenia gravis to detect early signs of respiratory distress and intervene promptly. Correct Answer: B. Shallow respirations
Understanding Myasthenia Gravis: NCLEX Priority Questions
A 40-year-old female client with myasthenia gravis is prescribed prednisone as part of her treatment plan. The nurse is providing education about the medication. What important information should the nurse include in the teaching?
A. Take the medication on an empty stomach.
B. Discontinue the medication if side effects occur.
C. Gradually taper the dose when discontinuing the medication.
D. Expect an immediate improvement in muscle strength.
E. Consume a diet rich in potassium.
Rationale: Abrupt discontinuation of corticosteroids, such as prednisone, can lead to adrenal insufficiency. The nurse should emphasize the importance of following a gradual tapering schedule as prescribed by the healthcare provider to allow the adrenal glands to resume normal function. Sudden withdrawal can result in adrenal crisis, with symptoms such as fatigue, weakness, and hypotension. Correct Answer: C. Gradually taper the dose when discontinuing the medication.
Understanding Myasthenia Gravis: NCLEX Delegation Questions
A 34-year-old pregnant client is diagnosed with myasthenia gravis. The nurse is discussing the management plan with the client. Which statement by the client indicates an understanding of the implications of myasthenia gravis during pregnancy?
A. “I should avoid any physical activity to prevent muscle fatigue.”
B. “I may need to increase my medication dosage during pregnancy.”
C. “Myasthenia gravis does not affect pregnancy or childbirth.”
D. “Breastfeeding is contraindicated while I’m on my medications.”
E. “I should stop taking my medications once I become pregnant.”
Rationale: Pregnancy can impact the severity of myasthenia gravis symptoms, and some women may require adjustments in medication dosage during pregnancy. The nurse should educate the client about the need for close monitoring and collaboration with healthcare providers to ensure optimal management during pregnancy. Increasing medication dosage under healthcare provider guidance is a common strategy to maintain symptom control during this period. Correct Answer: B. “I may need to increase my medication dosage during pregnancy.”
Understanding Myasthenia Gravis: Causes and Symptoms
A 28-year-old female client with myasthenia gravis is admitted to the hospital. The nurse is preparing a care plan for the client. Which nursing intervention is a priority in the care of a client with myasthenia gravis?
A. Administering high-dose corticosteroids.
B. Encouraging vigorous physical exercises.
C. Administering neostigmine before meals.
D. Providing a low-potassium diet.
E. Administering a sedative for relaxation.
Rationale: Administering neostigmine before meals helps improve muscle strength by increasing acetylcholine levels. This intervention is crucial in managing myasthenia gravis symptoms related to muscle weakness. It is important to administer neostigmine at the appropriate times to enhance its effectiveness in facilitating neuromuscular transmission. Correct Answer: C. Administering neostigmine before meals.
NCLEX Practice Questions: Understanding Myasthenia Gravis Causes and Symptoms
A 35-year-old male client with myasthenia gravis is experiencing a myasthenic crisis. The nurse assesses the client and notes respiratory distress. What immediate intervention should the nurse prioritize?
A. Administering an additional dose of pyridostigmine.
B. Providing oxygen therapy.
C. Administering a muscle relaxant.
D. Encouraging deep breathing exercises.
E. Administering a bronchodilator.
Rationale: In a myasthenic crisis, respiratory distress is a critical concern due to respiratory muscle weakness. Providing oxygen therapy helps support adequate oxygenation and ventilation. While addressing the underlying cause is essential, immediate respiratory support is a priority to prevent further deterioration and potential respiratory failure. Correct Answer: B. Providing oxygen therapy.
NCLEX Questions: Focus on Medications for Myasthenia Gravis
A 42-year-old female client with myasthenia gravis is prescribed immunosuppressive therapy. The nurse is providing education about the medication. What key information should the nurse include in the teaching?
A. Expect rapid improvement in symptoms.
B. Discontinue the medication if side effects occur.
C. Report signs of infection promptly.
D. Take the medication on an empty stomach.
E. Increase fluid intake to prevent dehydration.
Rationale: Immunosuppressive therapy increases the risk of infections. Clients should be educated to promptly report any signs of infection, such as fever, cough, or urinary symptoms, to facilitate early intervention and prevent complications. Monitoring for and addressing potential infections is crucial for the overall well-being of clients on immunosuppressive medications. Correct Answer: C. Report signs of infection promptly.
A 30-year-old pregnant client is diagnosed with myasthenia gravis. The nurse is discussing the implications of the condition during pregnancy. What information is essential for the nurse to include in the discussion?
A. Myasthenia gravis poses no risks to the fetus.
B. Medication dosage adjustments may be needed during pregnancy.
C. Pregnancy will alleviate myasthenia gravis symptoms.
D. Breastfeeding is contraindicated while on myasthenia gravis medications.
E. The baby will automatically acquire myasthenia gravis.
Rationale: Pregnancy can impact the severity of myasthenia gravis symptoms, and adjustments in medication dosage may be necessary. The nurse should provide information about the importance of close monitoring and collaboration with healthcare providers during pregnancy to optimize symptom control while ensuring the safety of both the mother and the fetus. Adjusting medication dosage under healthcare provider guidance is a common strategy to manage myasthenia gravis during pregnancy. Correct Answer: B. Medication dosage adjustments may be needed during pregnancy.
