A nurse is providing education to the other nurses on the unit on how to differentiate between a myasthenic crisis and a cholinergic crisis. To show that they understand the difference, the nurses could state that they should
a. ask the patient about occupation and family history.
b. assess serum levels of the cholinesterase inhibitors.
c. assess the patient about muscle weakness.
d. administer edrophonium (Tensilon) and monitor the response.
D
The Tensilon test provides information as to whether a patient is experiencing a myasthenic crisis or a cholinergic crisis. If the patient's symptoms worsen with Tensilon, the individual most likely is overmedicated and experiencing a cholinergic crisis; the patient should then be given atropine as an antidote. If the patient's symptoms improve with the administration of Tensilon, the person most likely was undermedicated and is experiencing a myasthenic crisis.
The occupational and family history will not provide information that can differentiate between the two crises.
Serum levels of cholinesterase inhibitors would not provide information that can differentiate between the two crises.
Assessing the patient for muscle weakness will not provide specific enough information to diffe-rentiate between the two crises.
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The novice nurse manager is acting in the role of change agent for the unit. Which statement indicates that this manager needs further training in regard to change?
1. "I must not get so bogged down in details that I lose focus on the ultimate goal." 2. "As we go through this process, I think I need to be flexible but persistent." 3. "Those who are resistant will probably accept it sooner or later with my support." 4. "I think the implementation will go much better if I stay available the whole time."
An autosomal dominant trait is discovered by a nurse constructing a client pedigree. The trait has not appeared in two generations but was strongly evident three generations ago. What advice should the nurse provide for the client?
1. "Your family should be genetically tested for this trait." 2. "The men in your family should be genetically tested for this trait." 3. "This trait existed in your past, but will not be transmitted now." 4. "Your children have a 25% risk of inheriting this trait."
A 2-week-old child responds to a bell during an initial health supervision examination. The child's records do not show that a newborn hearing screening was done. Which of the following is the best action for the nurse to take?
A) Do nothing because responding to the bell proves he does not have a hearing deficit. B) Immediately schedule the infant for a newborn hearing screening. C) Ask the mother to observe for signs that the infant is not hearing well. D) Screen again with the bell at the 2-month-old health supervision visit.
As the dying child becomes weak and fatigued, the nurse should alter the plan of care to include:
a. Restricting the child to bed rest b. Discouraging visitors c. Using a wheelchair or wagon for transportation d. Doing all of the child's care quickly and at once