A client with alcoholism is admitted to a medical-surgical unit with a serum magnesium level of 0.9 mEq/L. Which clinical manifestations would the nurse expect to find in this client?

Choice A reason: I will call dietary to bring you breakfast is not the best response by the nurse. This response may imply that the nurse is willing to compromise the test results or the client's safety by allowing them to eat before the test. The nurse should explain the rationale for fasting and offer the client some water or ice chips if allowed.

Choice B reason: Food may interact with the dye that is used for the test is not the best response by the nurse. This response may be partially true, but it is not specific or clear enough to justify the need for fasting. The nurse should explain that food can affect the absorption and distribution of the radioactive tracer that is injected into the bloodstream for the test, and that eating can also interfere with the quality of the images.

Choice C reason: I will ask the health care provider if the test can be rescheduled is not the best response by the nurse. This response may suggest that the nurse is not confident or knowledgeable about the test protocol or the client's condition. The nurse should explain the importance and urgency of the test and reassure the client that they will be able to eat after the test is done.

Choice D reason: The procedure is usually completed on an empty stomach is the best response by the nurse. This response is accurate and concise, and it informs the client of the standard preparation for the test. The nurse should also provide more details about the test procedure and the expected duration, and answer any questions or concerns that the client may have.

Choice A reason: The Schilling test is not used to diagnose G6PD anemia, which is a genetic disorder that causes red blood cells to break down when exposed to certain substances. The Schilling test is used to measure how well the body absorbs vitamin B12 from the intestine. ¹²

Choice B reason: The Schilling test does not require the patient to be NPO (nothing by mouth) for 12 hours prior to the test. The patient can drink water, but should avoid food for 8 hours before the test. ²

Choice C reason: The Schilling test is a 24-hour urine specimen collection test. The patient is given a dose of radioactive vitamin B12 by mouth and another dose of nonradioactive vitamin B12 by injection. The urine is collected for 24 hours to measure how much of the radioactive vitamin B12 is excreted. This indicates how well the body absorbs vitamin B12 from the intestine. ¹²

Choice D reason: The Schilling test does not entail administration of methylcellulose prior to the test. Methylcellulose is a type of laxative that can interfere with the absorption of vitamin B12. The patient should avoid taking any laxatives, antacids, or antibiotics before the test. ²³