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A healthcare professional is reviewing the medical record of a client scheduled for a CT scan with contrast media. The healthcare professional should identify which of the following findings as a contraindication to the procedure?
- A. White blood cell count of 6,000/mm³
- B. Urine specific gravity of 1.025
- C. History of asthma
- D. History of allergy to shellfish
Correct Answer: D
Rationale: The correct answer is D, a history of allergy to shellfish. A known allergy to shellfish is a contraindication for the use of contrast media in a CT scan due to the potential risk of an allergic reaction, which could be severe and life-threatening. Choices A, B, and C are not contraindications to the procedure. A normal white blood cell count, urine specific gravity within the normal range, and a history of asthma do not typically interfere with the administration of contrast media for a CT scan.
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A nurse is assessing a client who has Guillain-Barr© syndrome. Which of the following findings should the nurse expect?
- A. Increased urine output.
- B. Hyperactive reflexes.
- C. Hypoactive bowel sounds.
- D. Facial weakness.
Correct Answer: D
Rationale: Facial weakness is a common finding in clients with Guillain-Barr© syndrome due to muscle weakness. While increased urine output is not typically associated with Guillain-Barr© syndrome, hyperactive reflexes are more indicative of conditions like hyperthyroidism or spinal cord injury. Hypoactive bowel sounds are not a classic finding in Guillain-Barr© syndrome, making it an incorrect choice.
A nurse is reviewing the plan of care for a client who is in the manic phase of bipolar disorder. Which of the following interventions should the nurse expect to include?
- A. Encourage group activities to promote socialization.
- B. Encourage the client to take frequent naps throughout the day.
- C. Provide the client with frequent high-calorie snacks.
- D. Promote physical activity during mealtimes to stimulate appetite.
Correct Answer: C
Rationale: Providing high-calorie snacks is essential when caring for a client in the manic phase of bipolar disorder because they often have increased energy expenditure and may not eat adequately due to their heightened activity levels. Encouraging group activities (Choice A) may overwhelm the client further during this phase. Encouraging frequent naps (Choice B) contradicts the need to manage increased energy levels. Promoting physical activity during mealtimes (Choice D) may not be appropriate as it can distract the client from eating, which is crucial in meeting their nutritional needs.
A nurse is reviewing the laboratory report of a client who has been receiving lithium carbonate for the past 12 months. The nurse notes a lithium level of 0.8 mEq/L. Which of the following orders from the provider should the nurse expect?
- A. Withhold the next dose.
- B. Increase the dosage.
- C. Discontinue the medication.
- D. Administer the medication.
Correct Answer: D
Rationale: Administering the medication is appropriate for a stable lithium level of 0.8 mEq/L. A level of 0.8 mEq/L falls within the therapeutic range for lithium, indicating that the client is receiving an adequate dose to maintain therapeutic effects. Withholding the next dose, increasing the dosage, or discontinuing the medication would not be indicated at this lithium level as it is within the desired range for therapeutic benefit. Therefore, the correct action would be to continue administering the medication to ensure the client maintains the therapeutic level of lithium.
A healthcare professional is reviewing the medication history of a client who has a new prescription for warfarin. Which of the following medications should the healthcare professional identify as a contraindication for this client?
- A. Acetaminophen
- B. Ibuprofen
- C. Clopidogrel
- D. Metoprolol
Correct Answer: C
Rationale: The correct answer is C, Clopidogrel. Clopidogrel is an antiplatelet medication that increases the risk of bleeding when taken with warfarin. Acetaminophen (choice A) and metoprolol (choice D) do not have significant interactions with warfarin. Ibuprofen (choice B) is an NSAID that can also increase the risk of bleeding when taken with warfarin, but clopidogrel is a more significant contraindication due to its antiplatelet effects. Therefore, healthcare professionals should be cautious when combining warfarin with clopidogrel due to the increased risk of bleeding compared to other options.
A nurse is caring for a client who has chronic kidney disease and a serum potassium level of 6.5 mEq/L. Which of the following actions should the nurse take?
- A. Administer sodium bicarbonate
- B. Administer sodium polystyrene sulfonate
- C. Administer calcium gluconate
- D. Administer calcium carbonate
Correct Answer: B
Rationale: The correct action for the nurse to take is to administer sodium polystyrene sulfonate. This medication promotes potassium excretion and helps lower serum potassium levels in clients with hyperkalemia, which is indicated by a high potassium level. Sodium bicarbonate (choice A) is not used to treat hyperkalemia. Calcium gluconate (choice C) and calcium carbonate (choice D) are used to manage hyperkalemia by stabilizing cell membranes but are not the initial treatment choice for lowering potassium levels.