A nurse is caring for a client who is scheduled for a CT scan that requires contrast dye. Which of the following actions is the priority for the nurse to take?
Question the client about allergies before the procedure.
Tell the client to increase fluid intake following the procedure.
Evaluate the client for claustrophobia.
Inform the client about the steps of the procedure.
The Correct Answer is A
Choice A Reason:
Questioning the client about allergies before the procedure is appropriate. It is crucial to assess the client for any allergies, especially to contrast dye, before the procedure. Allergic reactions to contrast dye can range from mild to severe, and prompt identification of potential allergies is essential to prevent adverse reactions. If the client has a known allergy to the contrast dye, alternative imaging methods or pre-medication may be considered.
Choice B Reason:
Telling the client to increase fluid intake following the procedure is inappropriate. This instruction is relevant post-procedure for the elimination of the contrast dye from the body. However, it is not the priority at this moment, and the client's safety during the procedure takes precedence.
Choice C Reason:
Evaluating the client for claustrophobia is appropriate. Assessing for claustrophobia is important, especially if the CT scan involves an enclosed space. However, this assessment can typically be conducted in advance of the procedure during the pre-procedure preparations.
Choice D Reason:
Informing the client about the steps of the procedure is inappropriate. Providing information about the procedure is important for the client's understanding and cooperation. However, ensuring the client's safety during the procedure by assessing for potential allergies to the contrast dye comes first.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Devout practitioners of Buddhism prefer a ritual bath prior to burial.
Explanation: In Buddhism, the funeral customs can vary widely depending on the cultural and regional practices. Some Buddhists may prefer cremation, while others may choose burial. There isn't a strict requirement for a ritual bath, and practices can differ.
B. Devout practitioners of Judaism prefer to be buried 5 days after death.
Explanation: In Judaism, there is a tradition of burying the deceased as soon as possible, ideally within 24 hours. Waiting for 5 days is not consistent with Jewish burial practices.
C. Devout practitioners of Hinduism prefer to be buried after death and not cremated.
Explanation: In Hinduism, cremation is a common practice. Hindus believe in the cycle of reincarnation, and cremation is seen as a way to release the soul from the body. Burial is not a typical practice in Hinduism.
D. Devout practitioners of Islam prefer to have their heads turned toward Mecca at death.
Explanation: In Islam, it is a common practice to bury the deceased with their right side facing the Qiblah, which is the direction of the Kaaba in Mecca. This is part of the Islamic funeral rites.
Correct Answer is B
Explanation
Choice A Reason:
Administering sedative medication should not be the first action. It is important to assess the client's level of comfort and understand the reason for pulling on the NG tube before considering sedation. Sedation may mask underlying issues, and the goal is to address the cause of the behavior.
Choice B Reason:
Assessing the client's level of comfort is the priority. Understanding the reason for pulling on the NG tube is crucial before implementing interventions. The client may be experiencing pain, discomfort, anxiety, or another issue that needs to be addressed.
Choice C Reason:
Applying a restraint should be a last resort and is not the initial action. Restraints are used to ensure safety when other measures have failed. The priority is to address the underlying cause and promote comfort without resorting to restraint.
Choice D Reason:
Documenting the client's behavior is important for the medical record, but it comes after assessing and addressing the immediate needs of the client. Understanding the context and reasons for the behavior is crucial for accurate documentation.
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