Nokea
The nurse is preparing a client for magnetic resonance imaging (MRI) of the abdomen. Which statement by the client would indicate the need to notify the physician?
- A. I haven't had anything to eat or drink since midnight last night.
- B. I really don't like to be in small, enclosed spaces.
- C. I left all my jewelry and my watch at home.
- D. I will practice visualization to remain relaxed during the procedure.
Correct Answer: B
Rationale: An MRI scanner is a narrow, tunnel-like machine that will enclose the client during the test. Clients who are claustrophobic (fear enclosed spaces) may need sedation because it is imperative that they lie still and not panic during the test. Therefore, the nurse should notify the physician about the client's statement. Typically, the client is NPO for 6 to 8 hours before the test, and he or she must remove any metal objects, credit cards, jewelry, and watch before the test. Visualization will assist the client in relaxing during the procedure.
You may also like to solve these questions
A nurse is employed as a gastroenterologist's office nurse. When assessing the client, which objective data would provide useful information for diagnosis?
- A. Client verbalizing symptoms of nausea
- B. 22-lb weight loss in 2 months
- C. Client verbalizes chills and fatigue
- D. Client seated and stating pain
Correct Answer: B
Rationale: The best objective data with useful information is the fact that the client has lost 22 pounds in 2 months, indicating significant weight loss in a short period of time. This is data that, with further questioning, could provide further details for diagnosis. A client verbalizing symptoms of nausea and pain constitutes subjective data. Viewing the client's seated posture offers little data.
The nurse is providing care to a client who has had a percutaneous liver biopsy. For what would the nurse monitor the client?
- A. Signs and symptoms of bleeding
- B. Return of the gag reflex
- C. Passage of stool
- D. Intake and output
Correct Answer: A
Rationale: A major complication after a liver biopsy is bleeding, so it would be important for the nurse to monitor the client for signs and symptoms of bleeding. Return of the gag reflex would be important for the client who had an esophagogastroduodenoscopy to prevent aspiration. Monitoring the passage of stool would be important for a client who had a barium enema or colonoscopy. Monitoring intake and output is a general measure indicated for any client. It is not specific to a liver biopsy.
The nurse is caring for a client following a colonoscopy. During the procedure, two medium-sized polyps were removed. Which nursing assessment in the recovery area is a priority?
- A. Assessment of level of consciousness
- B. Hemoccult test of stool
- C. Vital signs
- D. Ability to tolerate liquids
Correct Answer: C
Rationale: The nurse is correct in assessing vital signs following a colonoscopy with polyp removal as a priority. Vital signs of an increased pulse rate and falling blood pressure can indicate a perforation and bleeding. If a perforation occurs and is not addressed at an early stage, the client's level of consciousness can become affected. There would be no reliable stool present in the bowel to Hemoccult test due to the cleansing agent and potential bleeding from the polyp removal. The ability to tolerate fluids relates to the sedation process and is not as high of a priority.
When assisting with preparing a client scheduled for a barium swallow, which instruction would be appropriate to include?
- A. Avoid smoking for at least 12 to 24 hours before the procedure.
- B. Take vitamin K before the procedure.
- C. Take three cleansing enemas before the procedure.
- D. Avoid the intake of red meat before the procedure.
Correct Answer: A
Rationale: The nurse should instruct the client to avoid smoking for at least a day before the procedure of barium swallow because smoking stimulates gastric motility. The client is advised to take vitamin K before a liver biopsy and instructed to take three cleansing enemas before a barium enema. Instruction to avoid red meat would be appropriate for a client who is having a Hemoccult test.
The nurse is caring for a client following gastrointestinal diagnostic testing. The client verbalizes feeling shame due to having frequent gas. Which nursing suggestion is best?
- A. Having gas following the procedure is normal. Expel the gas to decrease discomfort.
- B. Do not be ashamed. Everyone has gas following the procedure.
- C. The nursing staff is used to having clients with gas due to the procedure completed.
- D. Nurses anticipate that client will have gas following the procedure and provide privacy.
Correct Answer: A
Rationale: The nurse is correct to tell the client that this experience is normal and encourage the client to release the gas to decrease pain and discomfort. Providing information relieving the embarrassment and stating the benefit of the action is most helpful.