Neurological Question #4


The evening nursing is caring for a client with new onset of myasthenia gravis. The nurse expects to find which of the following assessment observations?


  1. Hand tremors when lifting a gallon of milk.
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  2. Stronger hand grips and steadier gait
    • Rationale:
  3. Pain and tingling to extremities
    • Rationale:
  4. Blurred vision and unclear speech patterns
    • Rationale:



Myasthenia gravis is a chronic autoimmune neuromuscular disease that causes weakness in skeletal muscles including those that control breathing and eye movement. Antibodies block, alter, or destroy receptors for acetylcholine at the neuromuscular junction which prevents muscular contraction. Vision changes, difficulty swallowing, breathing, ptosis, speech, and peripheral weakness are symptoms, and may worsen as the day progresses, so symptoms may be worse in later times of the day. While tremors when lifting the weight of a gallon of liquid may not be a cardinal sign, even though tremors may occur with profound weakness that may occur while using muscles for small low weight tasks. Vision and speech impairments are some of the first noticeable symptoms.

Learning Outcomes

Test Taking Tip

Video Rationale