A client is scheduled for a spiral computed tomography (CT) scan with contrast to evaluate for pulmonary embolism. Which information in the client’s history requires follow up by the nurse?
CT scan that was performed six months earlier.
Takes metformin hydrochloride for type 2 diabetes mellitus.
Report of client’s sobriety for the last five years.
Metal hip prosthesis was placed twenty years ago.
The Correct Answer is B
A) CT scan that was performed six months earlier: A previous CT scan performed six months earlier does not necessarily require follow-up by the nurse. However, it would be important to review the results of the previous CT scan to compare findings and assess for any changes over time.
B) Takes metformin hydrochloride for type 2 diabetes mellitus: This is the correct answer. Metformin is excreted by the kidneys, and contrast media used in CT scans can potentially cause kidney damage, particularly in clients with pre-existing renal impairment. Therefore, clients taking metformin may be at increased risk of developing lactic acidosis if renal function is compromised. It is essential for the nurse to follow up on this information and coordinate with the healthcare provider to determine whether metformin should be temporarily discontinued before the CT scan and when it can be safely resumed.
C) Report of client’s sobriety for the last five years: The client’s sobriety status for the last five years is not directly relevant to the CT scan with contrast for evaluating pulmonary embolism. While substance use history is important for overall health assessment, it does not specifically require follow-up related to the CT scan.
D) Metal hip prosthesis was placed twenty years ago: The presence of a metal hip prosthesis placed twenty years ago may be relevant for certain imaging studies, such as magnetic resonance imaging (MRI) or metal artifact reduction sequence (MARS) MRI, but it is not directly related to the CT scan with contrast for pulmonary embolism evaluation. Therefore, it does not require immediate follow-up by the nurse in this context.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) Obtaining transportation to the emergency department may be unnecessary at this time. The client's sy’ptoms of fatigue and dizziness are likely side effects of the new medication, baclofen, and not indicative of a medical emergency. It's es’ential to assess the severity of symptoms and provide appropriate guidance before considering emergency care.
B) Increasing intake of fluids and high-protein foods may be beneficial for overall health but is not directly related to addressing the side effects of baclofen. While adequate hydration and nutrition are essential, this recommendation may not specifically address the client's sy’ptoms of fatigue and dizziness.
C) Stopping the medication immediately without consulting a healthcare provider is not advisable. Abruptly discontinuing baclofen can lead to withdrawal symptoms and a potential worsening of muscle spasticity. It's cr’cial for the client to discuss any concerns or side effects with their healthcare provider before making any changes to their medication regimen.
D) Advising the client to avoid hazardous activities until symptoms subside is the most appropriate action. Baclofen, as a muscle relaxant, can cause dizziness and fatigue, which may impair the client's ab’lity to safely engage in activities such as driving or operating machinery. By avoiding hazardous activities, the client can reduce the risk of injury or accidents while experiencing these side effects.
Correct Answer is A
Explanation
A) Acetaminophen is metabolized by the liver, and jaundice can indicate liver dysfunction or impairment. Therefore, the nurse should notify the healthcare provider about the scheduled acetaminophen to ensure appropriate monitoring of liver function and to consider alternative pain management options.
B) Prednisone is a corticosteroid that primarily affects the immune system and inflammation and is not directly metabolized by the liver. While prednisone can have side effects related to liver function, such as hepatotoxicity, jaundice is not a common manifestation.
C) Captopril is an angiotensin-converting enzyme (ACE) inhibitor used to treat hypertension and heart failure. While it can affect renal function, jaundice is not a typical side effect of captopril.
D) Omeprazole is a proton pump inhibitor (PPI) used to reduce gastric acid production and treat conditions such as gastroesophageal reflux disease (GERD). It is primarily metabolized in the liver, but jaundice is not a common side effect associated with its use.
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