NCLEX-RN

Category - Pharmacological

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A client with abnormal fatigue and weakness is suspected of having myasthenia gravis. Edrophonium (Tensilon) is administered to diagnose myasthenia gravis. The nurse determines that the client is positive for the Tensilon test if the client demonstrates which of the following?

Improved muscle strength
No improvement in muscle strength
Hoarse voice
Worsening muscle weakness

Explanation

Answer: A - Improved muscle strength after the Tensilon test indicates that the client is positive for myasthenia gravis. No improvement or worsening muscle weakness indicates that the client is negative for myasthenia gravis. Hoarseness or changing of voice is seen in clients with myasthenia gravis.

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