Myasthenia Gravis Quiz Questions And Answers

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Myasthenia Gravis Quiz Questions And Answers - Quiz


Are you ready and confident that you can answer this myasthenia gravis quiz? Myasthenia gravis is a health condition with the weakness and rapid fatigue of the muscles under voluntary control. Here is a test that will test as well as enhance your understanding of how to deal with the patients with myasthenia gravis. So, let us see how good or bad your score is. Best of luck to you!


Questions and Answers
  • 1. 

    Jane, a 20- year old college student gets admitted to the hospital with a tentative diagnosis of myasthenia gravis. She is scheduled to have a series of diagnostic studies for myasthenia gravis, including a Tensilon test. While preparing her for this procedure, the nurse explains that her response to the medication will confirm the diagnosis if Tensilon produces:

    • A.

      Brief exaggeration of symptoms

    • B.

      Prolonged symptomatic improvement

    • C.

      Rapid but brief symptomatic improvement

    • D.

      Symptomatic improvement of just the ptosis

    Correct Answer
    C. Rapid but brief symptomatic improvement
    Explanation
    The correct answer is "Rapid but brief symptomatic improvement." In a Tensilon test, a medication called Tensilon (edrophonium) is administered to the patient. If the patient has myasthenia gravis, which is a neuromuscular disorder, their muscle weakness and fatigue will temporarily improve after taking Tensilon. However, this improvement is short-lived and only lasts for a short period of time. Therefore, if the patient experiences a rapid but brief improvement in their symptoms after taking Tensilon, it confirms the diagnosis of myasthenia gravis.

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  • 2. 

    Which of the following is not an autoimmune disease?

    • A.

      Graves disease

    • B.

      Myasthenia gravis

    • C.

      Insulin-dependent diabetes mellitus

    • D.

      Alzheimer's disease

    Correct Answer
    D. Alzheimer's disease
    Explanation
    Alzheimer's disease is not an autoimmune disease because it is a neurodegenerative disorder that primarily affects the brain. Autoimmune diseases occur when the immune system mistakenly attacks and damages healthy cells and tissues in the body. Graves disease, Myasthenia gravis, and Insulin-dependent diabetes mellitus are all examples of autoimmune diseases where the immune system attacks specific organs or tissues in the body.

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  • 3. 

    Myasthenia gravis is due to ____ receptors being blocked and destroyed by antibodies.

    • A.

      Epinephrine

    • B.

      Nicotinic

    • C.

      Acetylcholine

    • D.

      Transient

    Correct Answer
    C. Acetylcholine
    Explanation
    Myasthenia gravis is an autoimmune disorder where antibodies block and destroy acetylcholine receptors. Acetylcholine is a neurotransmitter that plays a crucial role in transmitting signals between nerve cells and muscles. When the acetylcholine receptors are blocked and destroyed, it leads to muscle weakness and fatigue, which are characteristic symptoms of myasthenia gravis.

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  • 4. 

     In making a diagnosis of myasthenia gravis Edrophonium HCI (Tensilon) is used. The nurse knows that this drug will cause a temporary increase in:

    • A.

      Muscle strength

    • B.

      Symptoms

    • C.

      Blood pressure

    • D.

      Consciousness

    Correct Answer
    A. Muscle strength
    Explanation
    Edrophonium HCI (Tensilon) is used in the diagnosis of myasthenia gravis, a condition characterized by muscle weakness and fatigue. This drug works by inhibiting the breakdown of acetylcholine, a neurotransmitter responsible for muscle contraction. By temporarily increasing the levels of acetylcholine, Edrophonium HCI can improve muscle strength in individuals with myasthenia gravis. Therefore, the correct answer is muscle strength.

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  • 5. 

     Toy with a tentative diagnosis of myasthenia gravis is admitted for diagnostic make up. Myasthenia gravis can confirmed by:

    • A.

      Kernigs sign

    • B.

      Brudzinski’s sign

    • C.

      A positive sweat chloride test

    • D.

      A positive edrophonium (Tensilon) test

    Correct Answer
    D. A positive edropHonium (Tensilon) test
    Explanation
    A positive edrophonium (Tensilon) test is used to confirm the diagnosis of myasthenia gravis. Edrophonium is a medication that temporarily improves muscle strength in individuals with myasthenia gravis. If the patient's muscle strength improves after receiving edrophonium, it suggests that they have myasthenia gravis. This test is commonly used in the diagnostic process for this condition. Kernig's sign and Brudzinski's sign are not specific to myasthenia gravis, and a positive sweat chloride test is associated with cystic fibrosis, not myasthenia gravis.

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  • 6. 

    Myasthenia gravis reflects a deficiency in communication by _______________ because receptors for this neurotransmitter have been destroyed.

    • A.

      Acetylcholine

    • B.

      Norepinephrine

    • C.

      GABA

    • D.

      Dopamine

    Correct Answer
    A. Acetylcholine
    Explanation
    Myasthenia gravis is an autoimmune disorder where the body's immune system mistakenly attacks and destroys the acetylcholine receptors at the neuromuscular junction. Acetylcholine is a neurotransmitter responsible for transmitting signals between nerve cells and muscles, allowing them to communicate. Therefore, the deficiency in communication in myasthenia gravis occurs because the receptors for acetylcholine have been destroyed.

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  • 7. 

     The nurse is caring for a patient admitted with suspected myasthenia gravis. Which finding is usually associated with a diagnosis of myasthenia gravis?

    • A.

      Visual disturbances, including diplopia

    • B.

      Ascending paralysis and loss of motor function

    • C.

      Cogwheel rigidity and loss of coordination

    • D.

      Progressive weakness that is worse at the day’s end

    Correct Answer
    D. Progressive weakness that is worse at the day’s end
    Explanation
    Myasthenia gravis is a neuromuscular disorder characterized by muscle weakness and fatigue. The progressive weakness that worsens at the end of the day is a common symptom of myasthenia gravis. This is known as "fatigubility" and is a result of the muscles becoming weaker with repeated use. The weakness tends to improve after periods of rest. Visual disturbances, such as diplopia (double vision), can also occur in myasthenia gravis, but they are not as specific to the diagnosis as the progressive weakness. Ascending paralysis and loss of motor function, as well as cogwheel rigidity and loss of coordination, are not typically associated with myasthenia gravis.

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  • 8. 

    The medication that is used to treat myasthenia gravis is:

    • A.

      Prostigmine (neostigmine)

    • B.

      Atropine (atropine sulfate)

    • C.

      Both A & B

    • D.

      None of these

    Correct Answer
    A. Prostigmine (neostigmine)
    Explanation
    The correct answer is Prostigmine (neostigmine). Myasthenia gravis is a neuromuscular disorder characterized by muscle weakness and fatigue. Prostigmine (neostigmine) is a medication that works by increasing the levels of acetylcholine, a neurotransmitter, in the body. This helps improve muscle strength and control in individuals with myasthenia gravis. Atropine (atropine sulfate) is not used to treat myasthenia gravis, and the combination of both medications is not typically recommended for this condition. Therefore, the correct medication for treating myasthenia gravis is Prostigmine (neostigmine).

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  • 9. 

    The initial nursing goal for a patient with myasthenia gravis during the diagnostic phase of her hospitalization would be to:

    • A.

      Develop a teaching plan

    • B.

      Facilitate psychological adjustment

    • C.

      Maintain the present muscle strength

    • D.

      Prepare for the appearance of myasthenic crisis

    Correct Answer
    C. Maintain the present muscle strength
    Explanation
    During the diagnostic phase of hospitalization for a client with myasthenia gravis, the initial nursing goal would be to maintain the present muscle strength. This is important because myasthenia gravis is a chronic autoimmune neuromuscular disorder that causes muscle weakness and fatigue. By maintaining the present muscle strength, the nurse can prevent further deterioration and complications. Developing a teaching plan, facilitating psychological adjustment, and preparing for the appearance of a myasthenic crisis may be important goals in the overall care of the client, but they are not the initial priority during the diagnostic phase.

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  • 10. 

    The most significant initial nursing observations that need to be made about a patient with myasthenia include:

    • A.

      Ability to chew and speak distinctly

    • B.

      Degree of anxiety about her diagnosis

    • C.

      Ability to smile an to close her eyelids

    • D.

      Respiratory exchange and ability to swallow

    Correct Answer
    D. Respiratory exchange and ability to swallow
    Explanation
    The most significant initial nursing observations that need to be made about a client with myasthenia include respiratory exchange and ability to swallow. This is because myasthenia gravis is a neuromuscular disorder that can affect the muscles involved in breathing and swallowing. Monitoring the client's respiratory exchange and ability to swallow is crucial in order to assess their respiratory function and ensure their safety and well-being.

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  • 11. 

    Helen is diagnosed with myasthenia gravis, and pyridostigmine bromide (Mestinon) therapy is started. The Mestinon dosage is frequently changed during the first week. While the dosage is being adjusted, the nurse’s priority intervention is to:

    • A.

      Administer the medication exactly on time

    • B.

      Administer the medication with food or mild

    • C.

      Evaluate the client’s muscle strength hourly after medication

    • D.

      Evaluate the client’s emotional side effects between doses

    Correct Answer
    C. Evaluate the client’s muscle strength hourly after medication
    Explanation
    The nurse's priority intervention is to evaluate the client's muscle strength hourly after medication. Myasthenia gravis is a neuromuscular disorder characterized by muscle weakness and fatigue. Pyridostigmine bromide (Mestinon) is a medication commonly used to treat this condition by improving muscle strength. However, the dosage of Mestinon needs to be frequently adjusted during the first week to achieve the optimal therapeutic effect. By evaluating the client's muscle strength hourly after medication, the nurse can assess the effectiveness of the current dosage and make any necessary adjustments to ensure the client's symptoms are adequately managed.

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  • 12. 

    Helen, a patient with myasthenia gravis, begins to experience increased difficulty in swallowing. To prevent aspiration of food, the nursing action that would be most effective would be to:

    • A.

      Change her diet order from soft foods to clear liquids

    • B.

      Place an emergency tracheostomy set in her room

    • C.

      Assess her respiratory status before and after meals

    • D.

      Coordinate her meal schedule with the peak effect of her medication, Mestinon

    Correct Answer
    D. Coordinate her meal schedule with the peak effect of her medication, Mestinon
    Explanation
    Myasthenia gravis is a neuromuscular disorder that affects the muscles, including those involved in swallowing. As the patient experiences increased difficulty in swallowing, coordinating her meal schedule with the peak effect of her medication, Mestinon, would be the most effective nursing action. Mestinon is a medication commonly used to treat myasthenia gravis by improving muscle strength and reducing symptoms. By scheduling meals when the medication is at its peak effect, the client's swallowing ability may be improved, reducing the risk of aspiration of food.

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  • 13. 

    A physician diagnoses a patient with myasthenia gravis, prescribing pyridostigmine (Mestinon), 60 mg P.O. every 3 hours. Before administering this anticholinesterase agent, the nurse reviews the patient's history. Which preexisting condition would contraindicate the use of pyridostigmine?

    • A.

      Ulcerative colitis

    • B.

      Blood dyscrasia

    • C.

      Intestinal obstruction

    • D.

      Spinal cord injury

    Correct Answer
    C. Intestinal obstruction
    Explanation
    Pyridostigmine is an anticholinesterase agent that works by increasing the levels of acetylcholine in the body. It is commonly used to treat myasthenia gravis. However, in the case of intestinal obstruction, the use of pyridostigmine would be contraindicated. Pyridostigmine can increase gastrointestinal motility, which can potentially worsen the obstruction and lead to complications. Therefore, it is important to avoid using pyridostigmine in patients with intestinal obstruction.

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  • 14. 

    While reviewing a patient's chart, the nurse notices that the female patient has myasthenia gravis. Which of the following statements about neuromuscular blocking agents is true for a client with this condition?

    • A.

      The client may be less sensitive to the effects of a neuromuscular blocking agent.

    • B.

      Succinylcholine shouldn’t be used; pancuronium may be used in a lower dosage.

    • C.

      Pancuronium shouldn’t be used; succinylcholine may be used in a lower dosage.

    • D.

      Pancuronium and succinylcholine both require cautious administration.

    Correct Answer
    D. Pancuronium and succinylcholine both require cautious administration.
    Explanation
    In patients with myasthenia gravis, the effects of neuromuscular blocking agents may be prolonged or exaggerated due to the underlying muscle weakness. Therefore, both pancuronium and succinylcholine, which are neuromuscular blocking agents, should be administered with caution in myasthenia gravis patients.

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  • 15. 

    A female patient has experienced an episode of myasthenic crisis. The nurse would assess whether the patient has precipitating factors such as:

    • A.

      Getting too little exercise

    • B.

      Taking excess medication

    • C.

      Omitting doses of medication

    • D.

      Increasing intake of fatty foods

    Correct Answer
    C. Omitting doses of medication
    Explanation
    The nurse would assess whether the client has precipitating factors such as omitting doses of medication. Omitting doses of medication can lead to a myasthenic crisis, as it can cause a decrease in the effectiveness of the medication and a worsening of symptoms. It is important for the nurse to assess if the client has been adhering to their medication regimen in order to determine if this may have contributed to the crisis.

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  • 16. 

    The nurse is teaching the female patient with myasthenia gravis about the prevention of myasthenic and cholinergic crisis. The nurse tells the patient that this is most effectively done by:

    • A.

      Eating large, well-balanced meals

    • B.

      Doing muscle-strengthening exercises

    • C.

      Doing all chores early in the day while less fatigued

    • D.

      Taking medications on time to maintain therapeutic blood levels

    Correct Answer
    D. Taking medications on time to maintain therapeutic blood levels
    Explanation
    Taking medications on time to maintain therapeutic blood levels is the most effective way to prevent myasthenic and cholinergic crises in a client with myasthenia gravis. Myasthenic crisis occurs when there is a severe exacerbation of muscle weakness, while cholinergic crisis is caused by overmedication with cholinesterase inhibitors. By taking medications on time, the patient can ensure that the medication levels in their blood are maintained at a therapeutic level, preventing both types of crises. Eating large, well-balanced meals, doing muscle-strengthening exercises, and doing chores early in the day may be beneficial for managing symptoms, but they do not directly prevent crises.

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  • 17. 

    A patient with myasthenia gravis asks the nurse why the disease has occurred. The nurse bases the reply on the knowledge that there is:

    • A.

      A genetic in the production acetylcholine

    • B.

      A reduced amount of neurotransmitter acetylcholine

    • C.

      A decreased number of functioning acetylcholine receptor sites

    • D.

      An inhibition of the enzyme ACHE leaving the end plates folded

    Correct Answer
    C. A decreased number of functioning acetylcholine receptor sites
    Explanation
    The correct answer is "A decreased number of functioning acetylcholine receptor sites." Myasthenia gravis is an autoimmune disorder where the immune system mistakenly attacks and destroys acetylcholine receptors at the neuromuscular junction. This leads to a decreased number of functioning acetylcholine receptor sites, which affects the transmission of nerve impulses to the muscles, causing muscle weakness and fatigue.

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  • 18. 

    The nursing assistant reports to you, the RN, that the patient with myasthenia gravis (MG) has an elevated temperature (102.20 F), heart rate of 120/minute, rise in blood pressure (158/94), and was incontinent of urine and stool. What is your best first action at this time?

    • A.

      Administer an acetaminophen suppository.

    • B.

      Notify the physician immediately.

    • C.

      Recheck vital signs in 1 hour.

    • D.

      Reschedule patient’s physical therapy.

    Correct Answer
    B. Notify the pHysician immediately.
    Explanation
    The patient with myasthenia gravis is presenting with symptoms of a potential medical emergency, including an elevated temperature, increased heart rate, elevated blood pressure, and incontinence. These symptoms may indicate a worsening of the condition or a potential complication. Therefore, the best first action would be to notify the physician immediately to ensure prompt evaluation and appropriate intervention.

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  • 19. 

    Karina, a patient who has myasthenia gravis, is to receive immunosuppressive therapy. The nurse understands that this therapy is effective because it:

    • A.

      Promotes the removal of antibodies that impair the transmission of impulses

    • B.

      Stimulates the production of acetylcholine at the neuromuscular junction.

    • C.

      Decreases the production of autoantibodies that attack the acetylcholine receptors.

    • D.

      Inhibits the breakdown of acetylcholine at the neuromuscular junction.

    Correct Answer
    C. Decreases the production of autoantibodies that attack the acetylcholine receptors.
    Explanation
    Immunosuppressive therapy is effective in myasthenia gravis because it decreases the production of autoantibodies that attack the acetylcholine receptors. In myasthenia gravis, the immune system mistakenly produces antibodies that target and attack the acetylcholine receptors at the neuromuscular junction. This leads to impaired transmission of impulses and muscle weakness. By decreasing the production of these autoantibodies, immunosuppressive therapy helps to alleviate the symptoms of myasthenia gravis and improve muscle function.

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  • 20. 

    A patient with myasthenia gravis has been receiving Neostigmine (Prostigmin). What does this drug act by?

    • A.

      Stimulating the cerebral cortex

    • B.

      Blocking the action of cholinesterase

    • C.

      Replacing deficient neurotransmitters

    • D.

      Accelerating transmission along neural swaths

    Correct Answer
    B. Blocking the action of cholinesterase
    Explanation
    Neostigmine (Prostigmin) acts by blocking the action of cholinesterase. Cholinesterase is an enzyme that breaks down acetylcholine, a neurotransmitter involved in muscle contraction. By blocking the action of cholinesterase, Neostigmine increases the levels of acetylcholine in the synaptic cleft, leading to improved muscle strength and function in patients with myasthenia gravis.

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Farah Naz |MBBS |
Medical Writer
Farah Naz is a Medical Professional with a Bachelor of Medicine and Bachelor of Surgery (MBBS) from Dow University of Health Sciences. Her academic journey included internships in Radiology, Cardiology, and Neurosurgery. Her contributions to medical research extend to two publications in medical journals, solidifying her position as a promising addition to the field.

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  • Oct 04, 2013
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