Practice Quiz

NCLEX-RN

Category - Pharmacological

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Roman Ellis, a 32-year-old who has myasthenia gravis, is taking neostigmine (Prostigmine). He calls the clinic because he is having difficulty swallowing, especially in the morning. This symptom is coupled with occasional episodes of weakness. The nurse informs the patient that the symptoms are:
  1. A sign of myasthenic crisis
  2. An expected manifestation of the disease
  3. A sign of cholinergic crisis
  4. A side effect of Prostigmine
Explanation
Answer: B - The correct action of the nurse is to inform the patient that difficulty swallowing and weakness are expected in myasthenia gravis. Delayed medication can cause muscle weakness resulting in swallowing problems. Prostigmine should be taken at least one hour before mealtimes for better swallowing and chewing. Myasthenic crisis is caused by underdosing of anticholinesterase drugs, while cholinergic crisis results from overmedication occurring within 35-40 minutes after the last dose of anticholinesterase drugs.
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