A nurse is preparing a client for a magnetic resonance angiography (MRA). The client is allergic to iodinated contrast dye. Which of the following actions should the nurse plan to take?

Administer prednisone before the test.

Consult with the provider to change to a CT scan.

Assess the alkaline phosphatase level.

Obtain the client's allergy history to seafood.

Answer and Explanation

The Correct Answer is A

Choice A reason: Administering prednisone before the test may be part of a premedication protocol for clients with a history of allergic reactions to contrast media. However, this is typically done for iodinated contrast used in CT scans, not for gadolinium-based contrast agents used in MRA.

Choice B reason: Consulting with the provider to change to a CT scan would not be appropriate if the client is allergic to iodinated contrast dye, as CT scans commonly use iodinated contrast. MRA typically uses gadolinium-based contrast agents, which may be safer for clients with iodine allergies.

Choice C reason: Assessing the alkaline phosphatase level is not directly related to preparing a client with a contrast dye allergy for an MRA. Alkaline phosphatase is an enzyme measured in blood tests and is not specific to contrast media allergies.

Choice D reason: Obtaining the client's allergy history to seafood is not necessary for MRA preparation. While there is a common misconception that seafood allergies are related to iodinated contrast allergies, the evidence does not support this association.

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Correct Answer is B

Explanation

Choice A reason: Aspirating the catheter to check for a brisk blood return is not typically recommended as a routine action when replacing the dressing of a PICC line used for TPN. This action is performed to verify patency and placement of the catheter, but it is not directly related to the dressing change procedure.

Choice B reason: Using sterile technique for the procedure is essential when replacing the dressing of a PICC line. Maintaining sterility is crucial to prevent infection, as the PICC line provides direct access to the central venous system. The nurse should use sterile gloves and follow aseptic protocols to minimize the risk of introducing pathogens at the catheter insertion site.

Choice C reason: Cleansing the insertion site with hydrogen peroxide is not recommended for PICC line care. Hydrogen peroxide can be damaging to the tissue and may delay healing. Instead, a chlorhexidine-based antiseptic is typically used to clean the skin around the insertion site during dressing changes to reduce microbial flora and prevent infection.

Choice D reason: Flushing the TPN port with 20 mL of 0.9% sodium chloride is a practice used to maintain catheter patency, but it is not part of the dressing change procedure. Flushing is usually done before and after administering medication or nutrition, not specifically during a dressing change.

A. Tap the client's facial nerve and note any facial twitching. B. Strike the client's patellar tendon with a percussion hammer and note any increase in response. C. Gently elevate the client's head and note any nuchal rigidity. D. Run a tongue blade on the outside of the client's sole and note any flaring of the toes.

Correct Answer is C

Explanation

Choice A reason: Tapping the client's facial nerve and noting any facial twitching is not a specific assessment for bacterial meningitis. This action is more related to evaluating facial nerve function and is not typically used to diagnose meningitis.

Choice B reason: Striking the client's patellar tendon with a percussion hammer and noting any increase in response is a test for reflexes, which may or may not be altered in bacterial meningitis. An increased response can be seen in various neurological conditions and is not specific to meningitis.

Choice C reason: Gently elevating the client's head and noting any nuchal rigidity is a key part of the focused assessment for bacterial meningitis. Nuchal rigidity, or stiffness of the neck, is a classic sign of meningitis and is assessed by gently lifting the head and attempting to move the chin toward the chest. If the client resists due to pain or stiffness, this could indicate nuchal rigidity associated with meningitis.

Choice D reason: Running a tongue blade on the outside of the client's sole and noting any flaring of the toes, known as the Babinski sign, is used to assess for central nervous system lesions and is not specific to meningitis. While it can be part of a neurological assessment, it does not specifically indicate bacterial meningitis.

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A nurse is preparing a client for a magnetic resonance angiography (MRA). The client is allergic to iodinated contrast dye. Which of the following actions should the nurse plan to take?

Nursing Test Bank

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