A nurse is developing a plan of care for a client who is scheduled for a cerebral angiogram with contrast dye. Which of the following statements by the client should the nurse report to the provider? Select all that apply

“I think I may be pregnant.”

“I take Coumadin.”

“I take antihypertensive medication.”

“I am allergic to shrimp.”

“I am allergic to latex.”

Answer and Explanation

Correct Answer : A,B,D

A cerebral angiogram is a diagnostic imaging procedure that uses iodinated contrast dye and fluoroscopy to visualize cerebral blood flow. Prior to the procedure, the nurse must assess for conditions that could pose a risk or require modification of care, such as pregnancy, bleeding risk from anticoagulants, or allergies to contrast agents. Some client-reported statements, especially those related to contrast dye sensitivity and anticoagulation, require immediate provider notification.

Rationale for Correct Answers:

A. “I think I may be pregnant.”: Exposure to radiation and contrast dye during a cerebral angiogram may pose potential harm to a developing fetus. This possibility should be investigated and reported before proceeding.

B. “I take Coumadin.”: Warfarin is an anticoagulant that increases the client’s risk for bleeding during the procedure. The provider must evaluate coagulation status and possibly pause or adjust therapy.

D. “I am allergic to shrimp.”: Although a seafood allergy does not automatically mean an iodine allergy, a history of shrimp allergy may be associated with contrast dye sensitivity. The provider should assess further and consider premedication to prevent a hypersensitivity reaction.

Rationale for Incorrect Answers:
C. “I take antihypertensive medication.”: Antihypertensive medications are generally safe and may even be beneficial for clients undergoing angiography. There is no need to stop these medications unless directed by the provider.
E. “I am allergic to latex.”: Latex allergy is important to document, but it is not a specific concern related to angiography with contrast dye. Latex-free equipment is widely available, and this allergy does not require cancellation or modification of the procedure itself.

Key Takeaways:
• Always report possible pregnancy, use of anticoagulants, and contrast dye allergy risks before cerebral angiography.
• Latex allergy, while relevant, does not pose a direct risk during contrast administration.
• Routine medications like antihypertensives are generally not contraindicated unless otherwise instructed.

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Correct Answer is A

Explanation

A myelogram is an invasive diagnostic procedure used to visualize the spinal cord, nerve roots, and surrounding subarachnoid space using contrast dye injected into the spinal canal via lumbar puncture. Because of this, the preparation and positioning for a myelogram closely resemble those of a lumbar puncture, including obtaining informed consent, checking for allergies to contrast dye, and proper positioning during and after the procedure.

Rationale for Correct Answer:

A. Lumbar puncture: A myelogram requires injection of contrast dye into the subarachnoid space through a lumbar puncture. Therefore, preparation (e.g., client positioning, sterile technique, consent, allergy screening) and aftercare (e.g., monitoring for headache or CSF leak) are very similar to a standard lumbar puncture.

Rationale for Incorrect Answers:
B. MRI: MRI is a noninvasive imaging procedure that uses magnetic fields and does not involve puncturing the spinal canal or injecting contrast into the CSF unless performed with special contrast protocols.
C. Cerebral angiography: This procedure involves injection of contrast dye into cerebral arteries, typically via a femoral catheter, and does not involve accessing the spinal canal.
D. EEG: EEG is noninvasive and involves placement of electrodes on the scalp to monitor electrical activity in the brain. It does not use contrast dye or invasive techniques.

Key Takeaways:
• Myelogram preparation is most similar to a lumbar puncture due to shared technique and spinal access.
• Contrast dye is used in both procedures, requiring allergy assessment and informed consent.
• Other tests like EEG, MRI, and cerebral angiography differ significantly in terms of invasiveness and preparation.

A. The test will temporarily limit blood flow through the brain. B. An allergy to iodine precludes getting the radio-opaque dye. C. The client will need to endure loud noises during the test. D. The test may result in dizziness or lightheadedness.

Correct Answer is D

Explanation

A positron emission tomography (PET) scan is a functional imaging study that uses a radioactive tracer (often glucose-based) to detect metabolic activity in the body. This scan can be used to identify areas of abnormal brain function, tumors, or degenerative disease. Because the radioactive glucose is injected intravenously, some clients may experience dizziness, lightheadedness, or headache during or after the test as a mild, transient reaction to the tracer or the metabolic shift.

Rationale for Correct Answer:
D. The test may result in dizziness or lightheadedness: Although generally safe, PET scans involve radioactive tracer injection, and clients can experience temporary side effects like dizziness or fatigue. These symptoms are usually mild and resolve quickly, but clients should be informed and monitored.

Rationale for Incorrect Answers

A. The test will temporarily limit blood flow through the brain: PET scans do not limit blood flow; instead, they assess blood flow and glucose metabolism. This statement is inaccurate and misleading.

B. An allergy to iodine precludes getting the radio-opaque dye: PET tracers are not iodine-based. Iodine allergy is relevant for contrast CT scans, but not a contraindication for PET scans.

C. The client will need to endure loud noises during the test: Unlike MRI, PET scans are quiet. There may be some mechanical sounds from the machine, but loud noises are not characteristic of PET imaging.

Key Takeaways:
• PET scans evaluate metabolic activity, not structure, using radioactive tracers.
• Clients may feel lightheaded or dizzy due to tracer injection, but this is usually brief.
• PET scans are quiet, and iodine allergy is not relevant to this procedure.

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A nurse is developing a plan of care for a client who is scheduled for a cerebral angiogram with contrast dye. Which of the following statements by the client should the nurse report to the provider? Select all that apply

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is scheduled for a myelogram and the nurse explains to the client that this is an invasive procedure, which assesses for any lesions in the spinal cord. The nurse should explain that the preparation is similar to which of the following neurologic tests?

Correct Answer is A

Explanation

A client for whom the nurse is caring has positron emission tomography (PET) scheduled. In preparation, what should the nurse explain to the client?

Correct Answer is D

Explanation

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