Nokea
The nurse is preparing an older client for a magnetic resonance imaging (MRI) with contrast. Which laboratory value should the nurse report to the healthcare provider before the scan is performed?
- A. Fasting blood sugar of 200 mg/dL (11.1 mmol/L).
- B. Glycosylated hemoglobin A1c of 8%.
- C. Blood urea nitrogen of 22 mg/dL (7.9 mmol/L).
- D. Serum creatinine of 1.9 mg/dL (169 umol/L).
Correct Answer: D
Rationale: Serum creatinine of 1.9 mg/dL (169 umol/L) indicates moderate renal insufficiency, which can increase the risk of contrast-induced nephropathy, a sudden deterioration of kidney function after exposure to contrast media used for imaging studies such as MRI. This should be reported to the healthcare provider to assess the risk and benefit of the procedure and to take preventive measures such as hydration or alternative imaging modalities.
You may also like to solve these questions
A client has an absolute neutrophil count (ANC) of 500/mm³ (0.5 x 10â¹/L) after completing chemotherapy. Which intervention is most important for the nurse to implement?
- A. Review need for pneumococcal vaccine.
- B. Implement bleeding precautions.
- C. Assess vital signs every 4 hours.
- D. Place the client in protective isolation.
Correct Answer: D
Rationale: Placing the client in protective isolation is the most important intervention to prevent infections, as a low ANC indicates a high risk of bacterial and fungal infections.
A client who received 6 units of packed red blood cells 3 days ago for a lower gastrointestinal (GI) bleed is now displaying signs of shortness of breath with occasional stridor and is reporting muscle cramping. Which serum laboratory value should the nurse immediately report to the healthcare provider?
- A. Potassium 4.7 mEq/L (4.70 mmol/L).
- B. Magnesium 2.1 mEq/L (0.86 mmol/L).
- C. Calcium 6.5 mg/dL (1.63 mmol/L).
- D. Sodium 135 mEq/L (135 mmol/L).
Correct Answer: C
Rationale: Calcium 6.5 mg/dL (1.63 mmol/L) is below the normal reference range and can cause muscle spasms, cramps, tingling, numbness, and stridor. This critical value should be immediately reported to the healthcare provider, as it can indicate a serious condition such as acute pancreatitis, sepsis, or massive blood transfusion.
While completing a health assessment for a young adult female with acute appendicitis, the client informs the nurse that there is a chance that she may be pregnant. The operating team is preparing to take the client to surgery. Which intervention should the nurse implement immediately?
- A. Perform a bedside pregnancy test.
- B. Continue with surgery as scheduled.
- C. Calculate gestation from last menstrual cycle.
- D. Notify the surgical team to cancel the surgery.
Correct Answer: A
Rationale: Performing a bedside pregnancy test is critical to confirm or rule out pregnancy, as surgery could pose risks to the fetus, informing the surgical team's approach.
History and Physical
Nurses notes
Orders
Flow Sheets
Laboratory Test
The client is a 68-year-old with a history of diabetes, hypertension (HTN), coronary artery disease (CAD), and recently diagnosed with end-stage renal disease (ESRD). She has been placed on hemodialysis three times a week for one month. She presents to the emergency department (ED) with fatigue, generalized weakness, muscle cramps, tingling sensation in arms and legs, and lightheadedness following 3 days of illness during which her husband reports she has complained of nausea and had a poor appetite and was not able to go for her scheduled dialysis.
The nurse is reviewing the physician orders for a 68-year-old client with end-stage renal disease (ESRD) presenting with fatigue, weakness, muscle cramps, tingling, and lightheadedness after missing dialysis. Which of the following physician's orders requires priority attention from the nurse? Select all that apply.
- A. Basic metabolic panel
- B. Echocardiogram
- C. CT scan of abdomen
- D. Blood cultures times 2 sets
- E. Chest X-ray
- F. Placing the client on a continuous cardiac monito
- G. 12 lead EKG
Correct Answer: F,G
Rationale: Placing the client on a continuous cardiac monitor and performing a 12-lead EKG are priority orders due to the client's history of CAD, HTN, and symptoms suggestive of a possible myocardial infarction or arrhythmia.
After teaching a client newly diagnosed with cholecystitis about recommended diet changes, the nurse evaluates the client's learning. Which food choices eliminated by the client indicate to the nurse that teaching has been successful?
- A. Canned vegetables with additional table salt.
- B. Pasta with herbal butter and no meat sauce.
- C. Citrus fruit and melon with a salt substitute.
- D. Whole milk and daily servings of ice cream.
Correct Answer: D
Rationale: Eliminating whole milk and daily ice cream indicates successful teaching, as these high-fat foods can worsen gallbladder inflammation and increase gallstone formation risk.