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.”
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Bounding peripheral pulses are not typically associated with diabetes insipidus. Diabetes insipidus is a condition characterized by excessive thirst and excretion of large amounts of severely dilute urine.
Choice B rationale:
Moist mucous membranes are not a common finding in diabetes insipidus. In fact, due to excessive urination, patients may experience dehydration which can lead to dry mucous membranes.
Choice C rationale:
Bradycardia, or a slower than normal heart rate, is not a typical symptom of diabetes insipidus. The condition does not directly affect the heart rate.
Choice D rationale:
Decreased urine specific gravity is a key finding in diabetes insipidus. The condition causes an imbalance of water in the body, leading to the production of large amounts of dilute (or low specific gravity) urine.
Please note that these rationales are based on general knowledge about diabetes insipidus and the specific symptoms mentioned in the choices. For a more detailed understanding, it’s recommended to refer to medical textbooks or consult with healthcare professionals.
Correct Answer is B
Explanation
Choice A rationale:
Providing written pamphlets for instruction can be a useful supplement, but it may not be the most effective method for teaching a skill like self-injection of insulin. This is because it lacks the hands-on practice and immediate feedback that can be crucial for learning a new physical skill.
Choice B rationale:
After demonstrating the procedure, allowing the patient to do several return demonstrations is considered one of the best methods for teaching a skill like self-injection of insulin. This approach, often referred to as “see one, do one, teach one,” allows the patient to observe the correct technique, practice it themselves, and then demonstrate their understanding by teaching it back. This method is particularly effective because it engages the patient in active learning and provides opportunities for immediate feedback and correction.
Choice C rationale:
Showing a video and allowing the patient to practice as needed on his own can be helpful, but it may not be as effective as other methods. This is because it lacks the immediate feedback and personalized instruction that can be provided in a one-onone teaching session. Additionally, practicing “as needed” may not provide the consistent repetition needed to master a new skill.
Choice D rationale:
Verbally explaining the procedure and providing written handouts for reinforcement can be effective, but it may not be sufficient for teaching a skill like self-injection of insulin. This is because it lacks the hands-on practice that is crucial for learning a new physical skill. Additionally, relying solely on verbal explanation and written handouts may not address all learning styles.
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