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 A

Explanation

A. One of the most common triggers is a distended bladder. When the bladder becomes full, it sends signals to the spinal cord, but due to the injury, these signals are unable to pass beyond the level of injury. This results in uncontrolled sympathetic activation, leading to symptoms such as hypertension, sweating, and headache.
B. Forehead diaphoresis, or sweating, is a potential symptom of autonomic dysreflexia. However, it is more of a consequence rather than a precipitating factor. It occurs as a result of sympathetic nervous system activation in response to the triggering stimulus.
C. Skeletal traction misalignment is not a common precipitating factor for autonomic dysreflexia. Autonomic dysreflexia is typically triggered by stimuli related to visceral or autonomic reflexes, such as bladder distention or bowel impaction, rather than mechanical issues like traction misalignment.
D. A severe pounding headache can occur as a symptom of autonomic dysreflexia, but it is not the primary precipitating factor. The headache is a result of the sudden increase in blood pressure that occurs during autonomic dysreflexia.

A. Auscultate lungs for unequal breath sounds. B. Continue to monitor the drainage system. C. Lift and clear drainage from the chest tube. D. Inspect the tube insertion site for leaking.

Correct Answer is B

Explanation

B. Tidaling is an expected finding in a functioning chest drainage system and indicates proper drainage of air or fluid from the pleural space. Continuously monitoring the drainage system allows the nurse to assess the volume, color, and consistency of drainage.
A. Rising water levels during inspiration and falling during expiration are indicative of proper chest tube function, therefore, auscultation for breath sounds may not provide additional relevant information related to the functioning of the chest tube.
C. Performing this action unnecessarily may disrupt the functioning of the drainage system and should only be done if specifically instructed by the healthcare provider.
D. While it is important to monitor for leaks, the observation of tidaling in the water-seal chamber does not necessarily indicate a leak at the insertion site.

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Naxlex Comprehensive Predictor Exams

A client with a cervical spinal injury (C7) is experiencing autonomic dysreflexia. The nurse should first assess the client for which precipitating factor?

Correct Answer is A

Explanation

Correct Answer is B

Explanation

While caring for a client with full thickness burns covering 40% of the body, the nurse observes purulent drainage from the wounds. Before reporting this finding to the healthcare provider, the nurse should evaluate which laboratory value?

The healthcare provider prescribes regular insulin 10 units/hr IV. The IV solution contains 100 units of regular insulin in 100 mL of 0.9% normal saline. How many mL/hr should the nurse program the infusion pump? (Enter numerical value only.)

A client who fractured the right femur from a fall at home is placed in traction while awaiting surgery. When the client informs the nurse of the need to urinate, which intervention should the nurse implement?

While completing a health assessment for a young adult female with acute appendicitis, the client informs the nurse that there is a chance that she may be pregnant. The operating team is preparing to take the client to surgery. Which intervention should the nurse implement immediately?

The nurse is admitting a client with possible tuberculosis (TB). The client is placed in a private room with airborne precautions pending diagnostic test results. Which diagnostic test should the nurse review to confirm the diagnosis of TB?

A client presents with the onset of a severe headache, fever, nuchal rigidity, and a petechial rash on arms and legs. The nurse recognizes the client is exhibiting symptoms of which condition?

A client who had a biliopancreatic diversion procedure (BDP) 3 months ago is admitted with severe dehydration. Which assessment finding warrants immediate intervention by the nurse?

The nurse calls the healthcare provider because a client diagnosed with an abdominal aortic aneurysm (AAA) is reporting low back pain. Which additional information about the client would be important for the nurse to tell the healthcare provider?