A nurse is caring for a client who has recurrent kidney stones and a history of diabetes mellitus.
The client is scheduled for an intravenous Pyelogram (IVP). The nurse should collect additional data about which of the following statements made by the client?

“I haven’t had anything to eat or drink since last night.”

“The last time I voided it was painful.”

“I took my metformin before breakfast.”

“I took a laxative yesterday.”

Answer and Explanation

The Correct Answer is C

Choice A rationale:

The client stating, “I haven’t had anything to eat or drink since last night” is not a cause for concern. This is because patients are often advised to fast before undergoing certain medical procedures or tests, including an intravenous pyelogram (IVP).

Fasting helps to ensure that the test results are accurate and not influenced by recent food or drink consumption.

Choice B rationale:

The client expressing that “The last time I voided it was painful” could be related to their recurrent kidney stones. Kidney stones can cause discomfort or pain during urination. However, this statement does not necessarily require additional data collection in the context of an IVP. The pain could be a symptom of the kidney stones rather than a contraindication for the IVP1.

Choice C rationale:

The statement “I took my metformin before breakfast” is of concern. Metformin is a medication used to treat type 2 diabetes. It is important for the nurse to collect additional data about this statement because metformin can potentially interact with the iodine-based contrast dye used in an IVP. This interaction can increase the risk of lactic acidosis, a serious and potentially lifethreatening condition. Therefore, patients are often advised to stop taking metformin before and for a couple of days after having an IVP12. Choice D rationale:

The client mentioning, “I took a laxative yesterday” is not necessarily alarming. Laxatives are often used before an IVP to clear the bowels, which helps to ensure clear images during the procedure. Therefore, this statement does not require additional data collection in the context of an IVP1.

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Correct Answer is C

Explanation

Choice A rationale:

This choice suggests that the nurse is advising the patient to take the medication first and then check with the doctor. This is not a safe practice. The nurse should always verify any doubts or concerns before administering the medication. Administering an unfamiliar medication can lead to adverse effects if it turns out to be incorrect.

Choice B rationale:

This choice implies that if a medication is listed on the medication administration record (MAR), it must be correct. However, errors can occur when transcribing medication orders onto the MAR. Therefore, it’s crucial for the nurse to verify any concerns or doubts before administering the medication.

Choice C rationale:

This is the correct choice. If a patient expresses concern about a medication, the nurse should always check the order before administering it. This is a fundamental aspect of patient safety and medication administration. It ensures that the right patient receives the right medication at the right dose via the right route at the right time.

Choice D rationale:

This choice suggests that because the medication is listed on the medication sheet, the patient should take it. However, this does not address the patient’s concern about the unfamiliar medication. It’s important for the nurse to validate the patient’s concern and verify the medication order before administration.

A. I will shake the insulin vial vigorously to mix. B. I should inject the insulin into my abdominal area. C. I should increase my insulin when I exercise. D. I will freeze unopened insulin vials.

Correct Answer is B

Explanation

Choice A rationale:

Shaking the insulin vial vigorously is not recommended. It can lead to the formation of bubbles, which can affect the accuracy of the dose. Instead, insulin vials should be gently rolled between the hands to mix.

Choice B rationale:

Injecting insulin into the abdominal area is indeed a recommended practice. The abdomen is a preferred site for insulin injection because it has a faster absorption rate compared to other areas. This can help to more effectively regulate blood glucose levels.

Choice C rationale:

Exercise typically lowers blood glucose levels, so insulin doses may need to be reduced to prevent hypoglycemia. Clients should monitor their blood glucose closely and adjust insulin as directed by their healthcare provider.

Choice D rationale:

Freezing unopened insulin vials is not advised. Freezing can disrupt the insulin structure, rendering it ineffective. Insulin should be stored in a refrigerator at a temperature between 2°C and 8°C (36°F and 46°F). Once opened, it can be kept at room temperature for up to 28 days.

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A nurse is caring for a client who has recurrent kidney stones and a history of diabetes mellitus. The client is scheduled for an intravenous Pyelogram (IVP). The nurse should collect additional data about which of the following statements made by the client?

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Naxlex Comprehensive Predictor Exams

When given a scheduled morning medication, the patient states, “I haven’t seen that pill before. Are you sure it’s correct?” The nurse checks the medication administration record and verifies that it is listed. Which is the nurse’s best response?

Correct Answer is C

Explanation

A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus. Which statement from the client indicates that the teaching is effective?

Correct Answer is B

Explanation

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A nurse is caring for a client who has recurrent kidney stones and a history of diabetes mellitus.
The client is scheduled for an intravenous Pyelogram (IVP). The nurse should collect additional data about which of the following statements made by the client?