no way this works

The nurse is caring for a patient who has myasthenia gravis. The nurse will be alert to symptoms affecting which body system which may indicate that the patient has transitioned to myasthenic crisis?

Respiratory system

A 40-year-old woman is diagnosed with myasthenia gravis, and her provider recommends removal of her thymus gland. She asks the nurse why this would be helpful. The nurse will explain that removal of the thymus gland may:

reduce symptoms of myasthenia gravis following surgery.

The nurse assumes care of a patient who has myasthenia gravis and notes that a dose of neostigmine (Prostigmin) scheduled to be administered 1 hour prior was not given. The nurse will anticipate the patient to exhibit which symptoms?

Muscle weakness

The nurse is caring for a patient who has myasthenia gravis (MG) and takes pyridostigmine bromide (Mestinon) 60 mg every 4 hours. The patient's last dose was 45 minutes prior. The nurse notes severe muscle weakness, excess salivation, fasciculations of facial muscles, and pupil constriction. The nurse will perform which action?

Obtain an order for atropine sulfate.

Which of the following is FALSE regarding pyridostigmine bromide (Mestinon)?

Pyridostigmine is a muscarinic receptor antagonist.

A patient reports weakness of the extremities and diplopia. The nurse knows that these symptoms are characteristic of which condition?

Multiple sclerosis (MS)

A patient has symptoms that are characteristic of multiple sclerosis (MS). Which diagnostic tests are likely to be ordered to aid in the diagnosis of this patient?

Cerebrospinal fluid (CSF) analysis and magnetic resonance imaging (MRI)

The nurse is caring for a patient who has recurrent muscle spasms. The provider has ordered metaxalone (Skelaxin) to treat the spasms. The nurse learns that the patient has a history of drug and alcohol abuse. The nurse will contact the provider to discuss switching this patient to which medication?

Cyclobenzaprine (Flexeril)

The nurse provides teaching to a patient who will begin taking cyclobenzaprine (Flexeril) to treat acute muscle spasms. Which statement by the patient indicates a need for further teaching?

"I will take this medication for 3 months and then stop taking it."

The nurse is performing an admission assessment on a patient who has been taking carisoprodol (Soma) for 3 weeks to treat muscle spasms. The patient reports that the muscle spasms have resolved. The nurse will contact the provider to discuss

ordering a taper of the carisoprodol.

The nurse is teaching a group of nursing students about multiple sclerosis (MS). Which statement by the nurse is correct?

"MS is characterized by lesions or plaques on myelin sheaths of nerves."

The nurse is caring for a patient who has multiple sclerosis (MS). The patient is experiencing an acute attack. Which drug does the nurse anticipate the provider will order?

Methylprednisolone (Solu-Medrol)

The nurse is performing a health history on a patient who has multiple sclerosis. The patient reports episodes of muscle spasticity and recurrence of muscle weakness and diplopia. The nurse will expect this patient to be prescribed which medication?

Interferon-B (IFN-B)

The nurse is preparing to care for a patient who has multiple sclerosis (MS). The nurse learns that the patient receives fingolimod. The nurse knows that which of the following is FALSE about fingolimod?

It is administered IV

Which agent listed below is used in surgery to achieve neuromuscular blockade and paralysis?

Pancuronium bromide (Pavulon)

The nurse is preparing to administer methocarbamol (Robaxin) to a patient who is experiencing acute muscle spasms. The nurse notes discoloration of the patients urine. What will the nurse do?

Administer the next dose of methocarbamol since this is a harmless side effect.

A client with myasthenia gravis is experiencing a cholinergic crisis. Which symptoms are associated with this condition? (SATA)

• Bradycardia

• Vomiting

• Drooling

• Weakness

A patient is prescribed cyclobenzaprine for relief of muscles spasms. What does the nurse instruct the patient to avoid while taking cyclobenzaprine?

Beer

A patient newly diagnosed with myasthenia gravis (MG) is started on neostigmine. What is the most important nursing intervention for this patient?

Administer the drug on time.

The health care provider orders pyridostigmine bromide for a patient. Which assessment will help confirm the therapeutic outcome for this medication?

Increased muscle strength

A patient taking pyridostigmine develops symptoms of a cholinergic crisis. What priority action does the nurse anticipate performing?

Administer atropine.

The nurse is caring for a patient who is experiencing a myasthenic crisis. What is the priority nursing intervention?

Maintain the patient's airway.

A nurse is caring for a patient prescribed neostigmine orally. Which instruction should the nurse include in the patient's plan of care?

Monitor the patient for respiratory depression.

A mechanically ventilated patient receiving a neuromuscular blocking agent has tearing in the eyes and increased heart rate and blood pressure. What is the nurse's initial action?

Notify the physician; patient's level of sedation is inadequate.

The nurse is caring for a patient who has been diagnosed with multiple sclerosis. The health care provider opts to include baclofen as part of this patient's treatment regimen. The nurse recognizes that this is an appropriate medication for this patient because the drug will treat which symptom?

Muscle spasticity

The patient has been prescribed tizanidine and complains of experiencing a dry mouth. What is the nurse's priority action?

Instruct the patient to use sugar-free lozenges to moisten his mouth.

The patient is scheduled to receive a dose of pancuronium bromide prior to undergoing tracheal intubation. The nurse recognizes that this is an appropriate choice for the patient because pancuronium is which type of drug?

Nondepolarizing muscle relaxant

The nurse would anticipate which route of administration for the monoclonal antibody alemtuzumab?

Intravenous

What is the nurse's best explanation of the pathophysiology of myasthenia gravis?

A decreased amount of acetylcholine to cholinergic receptors produces weak muscles and reduced nerve impulses.

The nurse is teaching a patient recently diagnosed with multiple sclerosis about the disease. Which statement is not correct concerning multiple sclerosis?

Goals of treatment are to decrease the inflammation in the nervous system.

A patient with multiple sclerosis is having muscle spasticity. The nurse anticipates which drug will be prescribed to treat the patient's spasticity?

Cyclobenzaprine

4. The nurse anticipates that the health care provider will prescribe which medication to treat a patient with relapsing-remitting multiple sclerosis?

Glatiramer acetate

The nurse is providing medication instructions to a patient with acute muscle spasms who has been prescribed cyclobenzaprine. Which statement indicates to the nurse that the patient understands the instructions?

I plan to take this medication with a glass of milk.

Which instructions will the nurse include in the teaching plan for a patient who is taking pyridostigmine? (SATA)

• Pyridostigmine must always be taken on time.

• Underdosing can result in myasthenic crisis.

• Overdosing can result in cholinergic crisis.

A patient is beginning to take cyclobenzaprine for treatment of acute back spasms. Which interventions will the nurse include in the care of this patient? (SATA.)

• Inform the patient not to abruptly stop taking the muscle relaxant.

• Tell the patient to report dizziness and double vision to the health care provider (HCP).

• Advise the patient to avoid consuming alcohol beverages.

• Taking narcotics at the same time can cause serious side effects.

The patient was just prescribed cycobenzaprine for back spasms. The nurse is reviewing the patient's drug profile and plans to contact the HCP about which drug on the patient's daily profile?

Valerian

A patient taking cyclobenzaprine might experience which of the following anticholinergic side effects? (SATA.)

• Blurred vision

• Dry mouth

• Constipation

• Urinary retention

Which mechanism of action describes how diphenoxylate with atropine treats diarrhea due to chemotherapeutic agents?

inhibits gastric motility

Which action would the nurse take upon receiving a prescription for lorazepam and a glucocorticoid to be given to a patient with chemotherapy-induced nausea and vomiting?

Administer the drugs and assess the patient for relief.

Which vitamin deficiency does the nurse expect to find in a patient who is taking a mineral oil for constipation?

• Vitamin A

• Vitamin D

• Vitamin E

• Vitamin K

Which laboratory finding increases a patient's risk for metabolic acidosis resulting from diarrhea?

low bicarbonate levels

Which intervention would the nurse take for a patient who is undergoing a barium enema test for the detection of colon polyps and has a prescription for rectal bisacodyl?

Administering bisacodyl 1 hour before the barium enema test

Which antiemetic is contraindicated for a patient with glaucoma?

• Hydroxyzine

• Scopolamine

Which drug alleviates nausea caused by chemotherapy?

• Granisetron

• Aprepitant

Which laboratory parameter might occur in a patient who has chronically taken promethazine for nausea?

decrease in leukocyte count

For which condition can cannabinoids be prescribed as a treatment option?

• suppressed appetite due to AIDS

• nausea and vomiting as a result of cancer therapy

Which finding related to diphenoxylate with atropine would the nurse report immediately?

swelling of the lips

Which patient reports takes priority after administration of IV promethazine to treat nausea?

"I can't stop my legs from moving."

Which instruction is the most important to provide to a patient with cirrhosis and diarrhea?

"Avoid taking OTC diarrheal preparations."

Which drug may be part of a patient's postoperative prescriptions to manage nausea and vomiting?

• Droperidol

• Palonosetron

• Hydroxyzine

• Metoclopramide hydrochloride

Which factors contribute to diarrhea?

• spicy foods

• toxins

• malabsorption syndrome

Which antiemetic is associated with photosensitivity?

• Promethazine

• Chlorpromazine HCI

Which adverse effect may result from the use of diphenoxylate with atropine?

• Angioedema

• Paralytic ileus

• Respiratory depression

Which complication may be observed in a renally insufficient patient who has been taking magnesium citrate for constipation?

• heart block

• hypotension

• respiratory depression

Which condition other than nausea and vomiting may be treated with prochlorperazine maleate?

• anxiety

• schizophrenia

For which condition can cannabinoids be prescribed as a treatment option?

• suppressed appetite due to AIDS

• nausea and vomiting as a result of cancer therapy

Which finding related to diphenoxylate with atropine would the nurse report ASAP?

swelling of the lips

Which class of drugs is prescribed to treat adult patients who experience idiopathic constipation?

Selective chloride channel activators

Which OTC laxative would the nurse include in the plan of care for a cardiac patient who reports straining with defecation?

mineral oil

Which laboratory finding may occur in a patient receiving diphenoxylate with atropine?

increased serum liver enzyme levels

Which patient cannot safely receive polycarbophil for constipation?

A patient with hypercalcemia

Which antiemetic drug effectively treats nausea and vertigo?

• Hydroxyzine

• Meclizine hydrochloride

A patient is receiving an aluminum-containing antacid. The nurse will inform the patient to watch for which possible adverse effect?

Constipation

When reviewing the health history of a patient who will be receiving antacids, the nurse recalls that antacids containing magnesium need to be used cautiously in patients with which condition?

Renal failure

The nurse is reviewing the medication orders for a patient who will be taking an H2 antagonist. Which drug may have an interaction if taken along with the H2 antagonist?

Ketoconazole

A patient who has been taking cimetidine (Tagamet) for hyperacidity calls the clinic to say that the medication has not been effective. The nurse reviews his history and notes that which factor may be influencing the effectiveness of this drug?

He smokes two packs of cigarettes a day.

A patient is taking omeprazole (Prilosec) for the treatment of gastroesophageal reflux disease (GERD). The nurse will include which statement in the teaching plan about this medication?

"The entire capsule must be taken whole, not crushed, chewed, or opened."

A patient has excessive and painful gas. The nurse checks the patient's medication orders and prepares to administer which drug for this problem?

Simethicone (Mylicon)

A 75-year-old woman comes into the clinic and states she has had muscle twitching, nausea, and headache. She tells the nurse that she has been taking sodium bicarbonate five or six times a day for the past 3 weeks. The nurse will assess for which potential problem that may occur with overuse of sodium bicarbonate?

Metabolic alkalosis

A patient will be taking a 2-week course of combination therapy with omeprazole (Prilosec) and another drug for a peptic ulcer caused by Helicobacter pylori. The nurse expects a drug from which class to be ordered with the omeprazole?

Antibiotic

A patient is asking advice about which over-the-counter antacid is considered the most safe to use for heartburn. The nurse explains that the reason that calcium antacids are not used as frequently as other antacids is for which of these reasons?

Their use may result in kidney stones

At 0900, the nurse is about to give morning medications, and the patient has asked for a dose of antacid for severe heartburn. Which schedule for the antacid and medications is correct?

Give the medications at 0900, and then the antacid at 1000.

During an admission assessment, the patient tells the nurse that he has been self-treating his heartburn for 1 year with over-the-counter OTC prilosec (omeprazole, a proton pump inhibitor). The nurse is aware that this self-treatment may have which result?

Masked symptoms of serious underlying diseases

An older adult patient had gastric surgery due to a gastrointestinal bleed 3 days ago, and he has been stable since the surgery. This evening, his daughter tells the nurse, "He seems to be more confused this afternoon. He's never been like this. What could be the problem?" The nurse reviews the patient's medication record and suspects that which drug could be the cause of the patient's confusion?

Cimetidine (Tagamet)

The nurse is teaching a patient who will be taking a proton pump inhibitor as long-term

therapy about potential adverse eftects. Which statement is correct?

Long-term use of these drugs may contribute to osteoporosis.

A patient in the intensive care unit has a nasogastric tube and is also receiving a proton pump inhibitor (PPI). The nurse recognizes that the purpose of the PPI is which effect?

Prevent stress ulcers

The nurse is providing patient teaching about antacids. Which statements about antacids are accurate? (SATA.)

• Antacids neutralize acid in the stomach

• Rebound hyperacidity may occur with calcium-based antacids.

• Magnesium-based antacids cause diarrhea.

A patient will be receiving pantoprazole (Protonix), 20 mg IV daily every morning. The medication, once reconstituted, has a strength of 40 mg/10 mL. Identity how many milliliters the nurse will draw up for this dose.

ANS: 5 mL

40 mg: 10 mL :: 20 mg. ml.

(40 × x) = (10 × 20); 40x = 200; x = 5 mL.

Considering common concerns of teenage girls, which oral contraceptive benefit does the nurse realize would be most likely to motivate use?

Dysmenorrhea relief

A patient is taking a combined hormonal contraceptive and reports the most troubling side effect to be depression. The patient has also experienced weight gain. The nurse knows that these are usually associated with

excess progestin.

What information will the nurse include when teaching a patient about hormonal methods of contraception?

"Call your health care provider immediately if you experience severe abdominal pain, chest pain or shortness of breath, headaches, eye disorders, or severe leg pain or swelling."

The nurse identifies which condition as a contraindication to hormone replacement therapy?

History of breast cancer

Which information will the nurse include when teaching a patient about denosumab?

Increase calcium and vitamin D in your diet.

A woman is taking a combination oral contraceptive and asks the nurse why progestin is necessary. The nurse will explain that progestin helps prevent pregnancy by which method?

Altering the quantity and viscosity of cervical mucus

A woman will begin taking a combination oral contraceptive (COC) that has a higher estrogenic activity than her previous COC. When teaching this woman about the new product, the nurse will explain that she may experience which effect(s)?

Cyclic breast changes and chloasma

A woman who has recently begun taking a combination oral contraceptive calls the clinic to report breakthrough bleeding. The nurse will:

counsel her to continue taking the contraceptive as prescribed.

A young woman who is taking Ortho-Tri-Cyclen for contraception tells the nurse that her provider has told her it will help to treat her acne. The nurse explains that this is because this product is:

low in androgenic activity.

A woman who is taking a combined oral contraceptive (COC) that contains 21 days of active pills and 7 days of inert pills reports having headaches accompanying withdrawal bleeding every month. The nurse will:

suggest she ask her provider about changing to a product that allows for continuous oral administration of active contraceptive pills.

A woman who is using a NuvaRing transvaginal contraceptive product calls to report that the ring has slipped out while sleeping. The patient is not sure how long the product was dislodged. The nurse will instruct the patient to rinse the ring with lukewarm water, reinsert the ring, and:

use a back-up method of contraception for 7 days.

A 35-year-old woman asks the nurse about oral contraceptives. The nurse learns that the patient smokes and has a family history of venous thromboembolism (VTE). The nurse will suggest that the patient:

discuss a progestin-only oral contraceptive with her provider.

A woman comes to the clinic for a Depo-Provera injection. The nurse reviews her medical record and notes that it has been 100 days since her last injection. What action will the nurse perform?

Perform a pregnancy test

A 45-year-old woman reports cessation of menses for the past 6 months and asks the nurse if she needs to continue using contraception. The nurse will tell her:

to continue using contraception for at least 6 more months.

A 45-year-old woman who has not had a period for 15 months reports severe hot flashes and poor sleep. The nurse reviews information about hormone replacement therapy and tells this woman that hormone therapy:

should be used at the lowest dose possible for less than 5 years.

The parent of a 16-year-old female tells the nurse that the child has not had a menstrual period in spite of having breast and pubic hair development. The nurse recognizes this as characteristic of which condition?

Primary amenorrhea

A young woman reports not having a period for 7 months. Which test will the provider likely order first to evaluate the cause of amenorrhea in this patient?

Pregnancy test

A woman is diagnosed with polycystic ovarian disease (PCOS) after being unable to conceive. Her provider has ordered metformin (Glucophage) and clomiphene citrate (Clomid). The nurse will explain that metformin is given for which purpose?

To regulate menstrual periods

A 30-year-old woman describes having periods every 30 days, lasting 8 days, with heavy

bleeding. The nurse understands that these are signs of which condition?

Menorrhagia

A woman who has menorrhagia is prescribed ibuprofen, and she asks the nurse how a pain medication can decrease uterine bleeding. The nurse will explain that this is most likely explained by ibuprofen's effects on:

prostaglandin production.

A woman who is infertile has taken 50 mg of clomiphene citrate (Clomid) from days 5 through 9 of a cycle and has not ovulated. The nurse will anticipate that the provider will perform which action?

Increase the dose to 100 mg on days 5 through 9 of her next cycle.

The nurse performs a history on a woman who will begin taking clomiphene citrate (Clomid) to induce ovulation. Which aspect of this patient's history is of concern?

Uterine fibroids