Drug therapy for myasthenia Gravis and Alzheimer's disease

A military nurse is part of a team reviewing the appropriate response to chemical weapons attacks, including sarin, tabun, and soman. When reviewing the physiology of a response to such drugs, the nurse should identify what goal of treatment? A) Restore anticholinesterase function. B) Restore GABA function. C) Restore dopamine function. D) Increase serotonin reuptake.

A) Restore anticholinesterase function.

A patient with myasthenia gravis is administered pyridostigmine (Mestinon) for the first time. She asks the nurse the reason why she has been changed to this medication. Which of the following is the nurse's best response? A) "Pyridostigmine (Mestinon) will allow you to awaken with the ability to swallow." B) "Pyridostigmine (Mestinon) can be taken every other day." C) "Pyridostigmine (Mestinon) is a faster-release form of cholinergic agent." D) "Pyridostigmine (Mestinon) is taken one time per day for better control."

A) "Pyridostigmine (Mestinon) will allow you to awaken with the ability to swallow."

A patient who is being treated for myasthenia gravis is receiving neostigmine, and her pulse drops to 50 after the administration. Which medication should be administered to treat the bradycardia? A) Atropine B) Pseudoephedrine C) Propranolol (Inderal) D) Bethanechol (Urecholine)

A) Atropine

A patient is administered edrophonium (Tensilon) to confirm the diagnosis of myasthenia gravis. What effect will the edrophonium (Tensilon) have 30 minutes after the medication administration, which will confirm the diagnosis? A) Improved breathing B) Decreased fatigue C) Decreased muscle spasms D) Increased urinary output

A) Improved breathing

A patient is diagnosed with Alzheimer's disease. The nurse should anticipate administering which of the following medications? A) Bethanechol (Urecholine) B) Neostigmine (Prostigmin) C) Donepezil (Aricept) D) Physostigmine salicylate (Antilirium)

C) Donepezil (Aricept)

. An 80-year-old man has been diagnosed with early-stage Alzheimer's disease and has begun treatment with donepezil (Aricept). When providing health education to the patient and his wife, the nurse should identify what goal of treatment? A) Remission of Alzheimer's disease B) Cure of Alzheimer's disease C) Improvement of cognition and function D) Resolution of memory and cognitive deficits

C) Improvement of cognition and function

Following recent changes in memory and personality, a 72-year-old man is undergoing neurological testing to rule out Alzheimer's disease. The nurse is aware that this disease is characterized by what pathophysiological phenomena? Select all that apply. A) Meningiomas B) Neuritic plaques C) Neurofibrillary tangles D) Arteriovenous malformations (AVMs) E) Gliomas

C) Neurofibrillary tangles D) Arteriovenous malformations (AVMs)

A 40-year-old woman has received a diagnosis of myasthenia gravis (MG) and is scheduled to begin treatment with oral neostigmine in her home. When providing relevant health education, the nurse should emphasize that successful control of MG symptoms will primarily depend on A) matching each dose of neostigmine to the severity of symptoms at that time. B) making lifestyle modifications to prioritize a healthy diet and regular activity. C) adhering strictly to the prescribed administration schedule. D) developing acceptance of the functional deficits that result from MG.

C) adhering strictly to the prescribed administration schedule

An accidental overdose of neostigmine has prompted the emergency administration of atropine. When assessing the patient, the emergency department nurse should take into account that this intervention will not relieve the effects of neostigmine on A) skeletal muscle. B) smooth muscle. C) the heart. D) glands.

A) skeletal muscle

A nurse is conducting health education with a man who has Alzheimer's disease and his daughter, who is his primary caregiver. The man has been deemed to be a good candidate for treatment with donepezil (Aricept) and will soon begin taking this medication. What teaching point should the nurse convey? A) "Aricept should be taken 1 hour before or 2 hours after any dairy products." B) "It's important to take this medication at bedtime." C) "Aricept should be taken with food to reduce the chance of stomach upset." D) "If you don't notice any cognitive improvement within 2 weeks, the drug should be discontinued.

B) "It's important to take this medication at bedtime"

A 33-year-old female patient with a recent history of visual disturbances and dysphagia has just been diagnosed with myasthenia gravis. The nurse should recognize that this patient's health problem is ultimately attributable to what pathophysiological process? A) Idiopathic overproduction of anticholinesterase B) Autoimmune destruction of acetylcholine receptors C) Demyelination of parasympathetic nerve pathways D) Deficient synthesis of dopamine by the substantia nigra

B) Autoimmune destruction of acetylcholine receptors

A patient has atony of the smooth muscle of the gastrointestinal tract. Which type of medication may be administered to increase smooth muscle strength? A) Anticholinergic drugs B) Cholinergic drugs C) Muscle relaxants D) Selective serotonin reuptake inhibitors

B) Cholinergic drugs

A patient has been receiving bethanechol (Urecholine) for 1 week. One hour after the dose is administered, he develops sweating, flushing, abdominal cramps, and nausea. What is the rationale for the development of these symptoms? A) Myasthenic crisis B) Cholinergic overdose C) Anaphylactic reaction D) Pulmonary edema

B) Cholinergic overdose

A man with a neurogenic bladder secondary to a spinal tumor has been taking bethanechol. The patient has illuminated his call light, and the nurse has found him anxious, diaphoretic, and visibly flushed. Following a safety assessment, what action should the nurse take? A) Prepare to administer an IV dose of epinephrine to mitigate the effects of acetylcholine. B) Contact the physician as the patient may be experiencing a cholinergic crisis. C) Insert a Foley catheter as the patient may have excessive urine in his bladder. D) Assess the volume of the patient's bladder contents using a bladder ultrasound.

B) Contact the physician as the patient may be experiencing a cholinergic crisis.

A patient is diagnosed with a paralytic ileus. Which of the following medications will be administered to treat a paralytic ileus? A) Neostigmine (Prostigmin) B) Donepezil (Aricept) C) Bethanechol (Urecholine) D) Ambenonium (Mytelase)

C) Bethanechol (Urecholine)

A patient with myasthenia gravis is administered neostigmine (Prostigmin). How does this drug produce its therapeutic effect? A) It stimulates the sympathetic nervous system. B) It stimulates the parasympathetic nervous system. C) It stimulates the cardiac smooth muscle. D) It stimulates the respiratory system.

B) It stimulates the parasympathetic nervous system.

Which of the following medications is administered for ingestion of clitocybe mushrooms? A) Pyridostigmine (Mestinon) B) Donepezil (Aricept) C) Rivastigmine (Exelon) D) Atropine sulfate

D) Atropine sulfate

A middle-aged female patient has been admitted to the outpatient treatment unit of the hospital for an edrophonium (Tensilon) test. Shortly after the administration of the medication, the patient reports that her muscle strength is significantly weaker than before the test. The nurse who is participating in the test should recognize that this finding is suggestive of what diagnosis? A) Alzheimer's disease B) Anticholinergic crisis C) Myasthenia gravis D) Cholinergic crisis

D) Cholinergic crisis

When administering anticholinesterase drugs, what assessment finding would indicate the patient is experiencing a toxic effect of the medication? A) Loss of consciousness B) Abdominal distention C) Hypertension D) Muscle weakness

D) Muscle weakness

An older adult patient with a diagnosis of moderate Alzheimer's disease will soon return home with her husband. How can the nurse best facilitate the safe and effective administration of donepezil in the home setting? A) Have the patient explain the rationale for drug therapy repeatedly before discharge. B) Provide a detailed drug monograph to the patient and her husband and offer to answer any questions. C) Assess the patient's need for home care. D) Teach the patient's husband to administer the medication in a timely and safe manner.

D) Teach the patient's husband to administer the medication in a timely and safe manner.