MED SURG FINAL EXAM (MOST RECENT) (+1000 QUESTIONS ALL ANSWERED 100% CORRECT WITH RATIONALE

MED SURG FINAL EXAM (MOST RECENT) (+1000 QUESTIONS ALL ANSWERED 100% CORRECT WITH RATIONALE |VERIFIED TEST BANK| GUARANTEE A+ SCORE 2023-2024

A patient with myasthenia gravis is admitted to the hospital with respiratory insufficiency and severe weakness. When is a diagnosis of cholinergic crisis made?

a. The patient's respiration is impaired because of muscle weakness.

b. Administration of edrophonium (Tensilon) increases muscle weakness.

c. Administration of edrophonium (Tensilon) results in improved muscle contractility.

d. EMG reveals decreased response to repeated stimulation of muscles.

{{Correct Ans- b.

The reduction of the acetylcholine (ACh) effect in myasthenia gravis (MG) is treated with anticholinesterase drugs, which prolong the action of ACh at the neuromuscular synapse, but too much of these drugs will cause a cholinergic crisis with symptoms very similar to those of MG. To determine whether the patient's manifestations are due to a deficiency of ACh or to too much anticholinesterase drug, the anticholinesterase drug edrophonium chloride (Tensilon) is administered. If the patient is in cholinergic crisis, the patient's symptoms will worsen; if the patient is in a myasthenic crisis, the patient will improve.

During care of a patient in myasthenic crisis, maintenance of what is the nurse's first priority for the patient?

a. Mobility

b. Nutrition

c. Respiratory function

d. Verbal communication {{Correct Ans- c.

The patient in myasthenic crisis has severe weakness and fatigability of all skeletal muscles, affecting the patient's ability to breathe, swallow, talk, and move. However, the priority of nursing care is monitoring and maintaining adequate ventilation.

When providing care for a patient with ALS, the nurse recognizes what as one of the most distressing problems experienced by the patient?

a. Painful spasticity of the face and extremities

b. Retention of cognitive function with total degeneration of motor function

c. Uncontrollable writhing and twisting movements of the face, limbs, and body

d. Knowledge that there is a 50% chance the disease has been passed to any offspring {{Correct Ans- b.

In ALS there is gradual degeneration of motor neurons with extreme muscle wasting from lack of stimulation and use. However, cognitive function is not impaired and patients feel trapped in a dying body. Chorea manifested by writhing, involuntary movements is characteristic of HD. As an autosomal dominant genetic disease, HD also has a 50% chance of being passed to each offspring.