A client with type II diabetes is scheduled to have a computed tomography (CT) scan with IV contrast of the brain to rule out a brain tumor. What health teaching would the nurse include?
Your provider will obtain a signed consent from you prior to the completion of the CT scan.

You’ll need to let your doctor know if you have seafood allergies.

Do not take your scheduled dose of Metformin 500 mg PO.

The procedure will be done at the bedside.

Take your Metformin as usual before the test.

Answer and Explanation

The Correct Answer is B

Title: Choice A Reason:

Patients with seafood allergies may have a higher risk of allergic reactions to iodinated contrast media used in CT scans. However, this is not a definitive contraindication. The nurse should inform the patient to notify their healthcare provider about any known allergies, including seafood, as a precautionary measure. This allows the healthcare team to take necessary steps to prevent any adverse reactions, such as premedication with antihistamines or corticosteroids.

Title: Choice B Reason:

Metformin is a common medication used to manage type II diabetes. When a patient is scheduled for a CT scan with IV contrast, it is crucial to withhold Metformin before the procedure. This is because the combination of Metformin and iodinated contrast can increase the risk of contrast-induced nephropathy (CIN) and lactic acidosis, a rare but serious condition. The general recommendation is to stop Metformin at the time of or prior to the procedure and withhold it for 48 hours after the procedure, resuming only after renal function has been re-evaluated and found to be normal.

Title: Choice C Reason:

CT scans, especially those requiring IV contrast, are typically performed in a radiology suite equipped with the necessary technology and medical personnel. Performing such a procedure at the bedside is uncommon and not standard practice due to the need for specialized equipment and immediate access to emergency care in case of adverse reactions. Therefore, this statement is incorrect.

Title: Choice D Reason:

Taking Metformin as usual before the test is not recommended due to the risk of lactic acidosis when combined with iodinated contrast. As previously mentioned, Metformin should be withheld before and after the procedure until renal function is confirmed to be normal. This precaution helps to prevent any potential complications associated with the interaction between Metformin and the contrast agent.

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Correct Answer is ["A","B","C"]

Explanation

Choice A: Observe for clear drainage.

Reason: Observing for clear drainage is important as it can indicate cerebrospinal fluid (CSF) leakage, especially after nasal or sinus surgery. CSF leakage is a serious complication that requires immediate medical attention. Clear drainage from the nose should be tested for the presence of glucose, which can confirm if it is CSF.

Choice B: Assess for signs of bleeding.

Reason: Assessing for signs of bleeding is crucial in the immediate postoperative period. Nasal packing can sometimes mask ongoing bleeding, so it is important to monitor for any signs of excessive blood loss. This includes checking for blood-soaked dressings, frequent swallowing (which can indicate blood trickling down the throat), and changes in vital signs such as increased heart rate and decreased blood pressure.

Choice C: Watch the client for frequent swallowing.

Reason: Watching the client for frequent swallowing is important because it can be a sign of posterior nasal bleeding. Blood can trickle down the back of the throat, causing the client to swallow frequently. This is a subtle but significant sign that should prompt further investigation and possible intervention.

Choice D: Change the nasal packing.

Reason: This choice is incorrect. Nasal packing should not be changed by the nurse without specific orders from the physician. Changing the packing prematurely can disrupt the surgical site, cause bleeding, and increase the risk of infection. The packing is usually removed by the surgeon or under their direct supervision.

Choice E: Administer a nasal steroid to decrease edema.

Reason: Administering a nasal steroid can help reduce inflammation and edema in the nasal passages. However, this should only be done if prescribed by the physician. Nasal steroids can help improve breathing and reduce discomfort, but they must be used according to medical guidance to avoid potential side effects.

A. Increase in the temperature from 37.5°C (99.5°F) to 38.6°C (101.5°F) B. Decrease in the urinary output from 50 to 30 mL per hour C. Increase in the heart rate from 88 to 110/min D. Decrease in the respiratory rate from 20 to 16/min

Correct Answer is B

Explanation

Choice A reason: An increase in temperature is not a primary indicator of hypovolemic shock. While fever can occur due to infection or inflammation, it is not directly related to hypovolemic shock, which is primarily characterized by a significant loss of blood or fluids leading to decreased perfusion and oxygenation of tissues.

Choice B reason: A decrease in urinary output is a critical sign of hypovolemic shock. When the body loses a significant amount of blood or fluids, the kidneys receive less blood flow, leading to reduced urine production. This is a compensatory mechanism to conserve fluids and maintain blood pressure. Normal urine output is typically around 30 to 50 mL per hour, so a drop below this range is concerning.

Choice C reason: An increase in heart rate is a common response to hypovolemic shock as the body attempts to maintain cardiac output and blood pressure despite the loss of blood volume. Tachycardia (increased heart rate) is one of the early signs of shock, indicating that the heart is working harder to pump blood to vital organs.

Choice D reason: A decrease in respiratory rate is not typical of hypovolemic shock. In fact, hypovolemic shock often leads to an increased respiratory rate (tachypnea) as the body tries to compensate for decreased oxygen delivery to tissues. A decrease in respiratory rate could indicate other issues but is not a hallmark of hypovolemic shock.

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A client with type II diabetes is scheduled to have a computed tomography (CT) scan with IV contrast of the brain to rule out a brain tumor. What health teaching would the nurse include?Your provider will obtain a signed consent from you prior to the completion of the CT scan.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following actions would the nurse take when caring for a client with nasal packing who had surgery 6 hours ago? (Select all that apply)

Correct Answer is ["A","B","C"]

Explanation

A nurse is caring for a client who returns to the nursing unit from the recovery room after a sigmoid colon resection for adenocarcinoma. The client had an episode of intraoperative bleeding. Which finding indicates to the nurse that the client may be developing hypovolemic shock?

Correct Answer is B

Explanation

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A client with type II diabetes is scheduled to have a computed tomography (CT) scan with IV contrast of the brain to rule out a brain tumor. What health teaching would the nurse include?
Your provider will obtain a signed consent from you prior to the completion of the CT scan.