A client is scheduled for a spiral computed tomography (CT) scan with contrast to evaluate for pulmonary embolism. Which information in the client’s history requires follow up by the nurse?
CT scan that was performed six months earlier.
Takes metformin hydrochloride for type 2 diabetes mellitus.
Report of client’s sobriety for the last five years.
Metal hip prosthesis was placed twenty years ago.
The Correct Answer is B
A) CT scan that was performed six months earlier: A previous CT scan performed six months earlier does not necessarily require follow-up by the nurse. However, it would be important to review the results of the previous CT scan to compare findings and assess for any changes over time.
B) Takes metformin hydrochloride for type 2 diabetes mellitus: This is the correct answer. Metformin is excreted by the kidneys, and contrast media used in CT scans can potentially cause kidney damage, particularly in clients with pre-existing renal impairment. Therefore, clients taking metformin may be at increased risk of developing lactic acidosis if renal function is compromised. It is essential for the nurse to follow up on this information and coordinate with the healthcare provider to determine whether metformin should be temporarily discontinued before the CT scan and when it can be safely resumed.
C) Report of client’s sobriety for the last five years: The client’s sobriety status for the last five years is not directly relevant to the CT scan with contrast for evaluating pulmonary embolism. While substance use history is important for overall health assessment, it does not specifically require follow-up related to the CT scan.
D) Metal hip prosthesis was placed twenty years ago: The presence of a metal hip prosthesis placed twenty years ago may be relevant for certain imaging studies, such as magnetic resonance imaging (MRI) or metal artifact reduction sequence (MARS) MRI, but it is not directly related to the CT scan with contrast for pulmonary embolism evaluation. Therefore, it does not require immediate follow-up by the nurse in this context.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["100"]
Explanation
Since the client weighs 90 kg, let’s first convert their weight to pounds to determine the appropriate cefazolin dosage:
Conversion factor: 1 kg = 2.205 pounds
Client weight (pounds) = 90 kg x 2.205 pounds/kg = 198.45 pounds (rounded to two decimals)
Now, comparing the client’s weight (198.45 pounds) to the weight threshold (265.5 pounds):
Client weight is less than the threshold (198.45 pounds < 265.5 pounds).
Therefore, the appropriate dosage is:
Cefazolin 2 grams/100 mL 0.9% normal saline over 1 hour.
The pump rate is determined by the total volume of the IV fluid and the infusion time.
We are not given the specific bag size, but typically these come in 100 mL or 500 mL volumes.
Assuming a 100 mL bag (which aligns with the concentration provided):
Total volume of IV bag: 100 mL
Infusion time: 1 hour
Calculation:
Pump rate (mL/hr) = Total volume (mL) / Infusion time (hr)
Pump rate (mL/hr) = 100 mL / 1 hour = 100 mL/hr
Therefore, the nurse should program the pump to deliver 100 mL/hr.
Correct Answer is A
Explanation
A) Notify the healthcare provider of the passage of black stools: This is the correct response. Black stools can indicate gastrointestinal bleeding, which is a serious adverse effect of NSAID use. It's im’ortant for the client to report this symptom promptly to the healthcare provider for further evaluation and management.
B) Call the clinic if diarrhea or headache occur when taking esomeprazole: While it's im’ortant to report any adverse effects of medication to the healthcare provider, diarrhea and headache are not specific to esomeprazole and may not warrant immediate attention unless severe or persistent.
C) Once pain subsides, NSAID therapy can be resumed: This statement is incorrect. The client should avoid NSAIDs in the future, as they are likely the cause of the gastric pain and gastrointestinal bleeding. Resuming NSAID therapy would increase the risk of recurrent bleeding.
D) Resume a diet that consists of milk, cream, and bland foods: This statement is incorrect. While bland foods may be easier to tolerate during acute gastric pain, they do not address the underlying issue of gastrointestinal bleeding. Additionally, dairy products like milk and cream may exacerbate symptoms in some individuals.
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