The nurse is preparing an older adult client for a magnetic resonance imaging (MRI) with contrast. Which laboratory value should the nurse report to the healthcare provider before the scan is performed?

Reference Range:

Glycosylated Hemoglobin (4% to 5.9% ]

Creatinine 10.6 to 1.2 mg/dL (53 to 106 μmol/L)]

Glucose [74 to 106 mg/dL (4.1 to 5.9 mmol/L)]

Blood Urea Nitrogen [10 to 20 mg/dL (3.6 to 7.1 mmol/L)]

Fasting blood sugar of 200 mg/dl. (11.1 mmol/L).

Serum creatinine of 1.9 mg/dl. (168 μmol/l)

Glycosylated hemoglobin of 8%.

Blood urea nitrogen of 22 mg/dL (7.9 mmol/L)

Answer and Explanation

The Correct Answer is B

B. Creatinine is a waste product of muscle metabolism that is filtered by the kidneys. Elevated serum creatinine levels may indicate impaired kidney function. Since contrast agents can affect renal function, a serum creatinine level above the reference range should be reported to the healthcare provider before the MRI with contrast.

A. While elevated blood sugar levels may indicate diabetes or poor glycemic control, they are not directly related to kidney function or the risk of contrast-induced nephropathy. Therefore, this value is not the most pertinent for reporting before an MRI with contrast.
C. Glycosylated hemoglobin (HbA1c) reflects average blood glucose levels over the past two to three months and is used to assess long-term glycemic control in diabetes. While elevated HbA1c levels suggest poor diabetes management, they do not directly assess kidney function or the risk of contrast-induced nephropathy.
D. Blood urea nitrogen (BUN) levels reflect the amount of urea nitrogen in the blood and can indicate kidney function. Elevated BUN levels may suggest impaired renal function. However, an elevated serum creatinine is a more reliable marker for renal excretion.

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Correct Answer is B

Explanation

B. Creatinine is a waste product of muscle metabolism that is filtered by the kidneys. Elevated serum creatinine levels may indicate impaired kidney function. Since contrast agents can affect renal function, a serum creatinine level above the reference range should be reported to the healthcare provider before the MRI with contrast.

A. While elevated blood sugar levels may indicate diabetes or poor glycemic control, they are not directly related to kidney function or the risk of contrast-induced nephropathy. Therefore, this value is not the most pertinent for reporting before an MRI with contrast.
C.Glycosylated hemoglobin (HbA1c) reflects average blood glucose levels over the past two to three months and is used to assess long-term glycemic control in diabetes. While elevated HbA1c levels suggest poor diabetes management, they do not directly assess kidney function or the risk of contrast-induced nephropathy.
D. Blood urea nitrogen (BUN) levels reflect the amount of urea nitrogen in the blood and can indicate kidney function. Elevated BUN levels may suggest impaired renal function. However, an elevated serum creatinine is a more reliable marker for renal excretion.

A. Sputum culture positive for Mycobacterium tuberculosis. B. Hemoccult test on sputum collected from hemoptysis. C. Chest x-ray or computed tomography (CT). D. Positive purified protein derivative (PPD) skin test.

Correct Answer is A

Explanation

A. This choice involves culturing a sputum sample collected from the patient to identify the presence of Mycobacterium tuberculosis, the bacterium that causes tuberculosis. A positive result confirms the diagnosis of TB.
B. Hemoccult tests are used to detect hidden (occult) blood in stool samples. While hemoptysis (coughing up blood) can be a symptom of TB, a hemoccult test is not specific for TB diagnosis. It is more commonly used in detecting gastrointestinal bleeding.
C. Imaging studies like chest x-ray or CT scans can reveal abnormalities in the lungs suggestive of TB, such as infiltrates, cavitations, or lymph node enlargement. While these tests can support the diagnosis, they are not definitive on their own.
D. The PPD skin test is a common screening tool for TB exposure. It detects the presence of a delayed hypersensitivity reaction to proteins derived from Mycobacterium tuberculosis. A positive PPD indicates exposure to TB but does not confirm active disease.

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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