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:

Waiting to see if the fever gets worse is not the best course of action. Fever is a symptom that the body is fighting off an infection, and it can cause discomfort in children. However, the main concern with chickenpox and fever is not the fever itself, but the risk of complications from the chickenpox. Therefore, it’s important to manage the fever for the child’s comfort but also monitor for any signs of complications.

Choice B rationale:

Aspirin should not be given to children or teenagers who have chickenpox or flu symptoms before a doctor is consulted about Reye’s Syndrome, a rare but serious illness. Reye’s syndrome is a potentially life-threatening condition that has been associated with aspirin use in children and adolescents with viral illnesses, especially chickenpox or influenza.

Choice C rationale:

Acetaminophen (Tylenol) should be used to reduce his fever, not aspirin. This is because of the risk of Reye’s syndrome associated with aspirin use in children and adolescents who have viral illnesses. Acetaminophen is a safe and effective choice for fever reduction in children.

Choice D rationale:

While it’s important to always follow the instructions on the bottle when giving medication, aspirin should not be used in children or teenagers with chickenpox due to the risk of Reye’s syndrome. Therefore, this advice could potentially lead to a dangerous situation.

A. Take it with cheese and crackers or yogurt. B. Take an antacid with each dose as needed. C. Drink a full glass of water with each dose. D. Take each dose with a glass of milk.

Correct Answer is C

No 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?

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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?