A nurse is collecting a medication history from a client who is scheduled to have a cardiac catheterization. Which of the following medications taken by the client interacts with contrast material and places the client at risk for acute kidney injury?
Carvedilol
Nitroglycerin
Atorvastatin
Metformin
The Correct Answer is D
Choice A: Carvedilol is not a medication that interacts with contrast material and places the client at risk for acute kidney injury. Carvedilol is a beta-blocker that lowers blood pressure and heart rate by blocking the effects of adrenaline on the heart and blood vessels. Carvedilol does not affect kidney function or contrast excretion, but it can cause hypotension, bradycardia, or heart failure in some clients.
Choice B: Nitroglycerin is not a medication that interacts with contrast material and places the client at risk for acute kidney injury. Nitroglycerin is a vasodilator that relaxes the smooth muscles of the blood vessels and increases blood flow to the heart. Nitroglycerin does not affect kidney function or contrast excretion, but it can cause hypotension, headache, or flushing in some clients.
Choice C: Atorvastatin is not a medication that interacts with contrast material and places the client at risk for acute kidney injury. Atorvastatin is a statin that lowers cholesterol levels by inhibiting an enzyme that produces cholesterol in the liver. Atorvastatin does not affect kidney function or contrast excretion, but it can cause liver damage, muscle pain, or rhabdomyolysis in some clients.
Choice D: Metformin is a medication that interacts with contrast material and places the client at risk for acute kidney injury. Metformin is an oral antidiabetic drug that lowers blood glucose levels by decreasing hepatic glucose production and increasing insulin sensitivity. Metformin can accumulate in the kidneys and cause lactic acidosis, a life-threatening condition characterized by high levels of lactic acid in the blood. Contrast material can worsen kidney function and increase the risk of lactic acidosis in clients taking metformin. Therefore, metformin should be discontinued before and after the procedure as prescribed.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The correct answer is: B. Initiate oxygen therapy.
Choice A reason:
Attaching the leads for a 12-lead ECG is crucial for diagnosing a myocardial infarction. However, it is not the first priority. Ensuring the patient receives adequate oxygen is more critical to prevent further myocardial damage. The ECG can be performed immediately after oxygen therapy is initiated to confirm the diagnosis and guide further treatment.
Choice B reason:
Initiating oxygen therapy is the first priority because it ensures that the heart muscle receives adequate oxygen, which is essential to prevent further damage during a myocardial infarction. Oxygen therapy helps to maintain tissue oxygenation and can reduce the extent of myocardial injury. This immediate intervention is vital to stabilize the patient and improve outcomes.
Choice C reason:
Inserting the IV catheter is important for administering medications and fluids. However, it is not the first step. Oxygen therapy takes precedence to ensure the heart and other vital organs receive sufficient oxygen. Once oxygen is administered, IV access can be established to facilitate further treatment.
Choice D reason:
Obtaining a blood sample is necessary for confirming the diagnosis and assessing cardiac markers. However, it is not the immediate priority. Ensuring the patient is oxygenated is more urgent to prevent further myocardial damage. Blood samples can be drawn after oxygen therapy is initiated.
Correct Answer is ["A","B","D","E"]
Explanation
Choice a) is correct because copies of insurance cards can help clients access medical care and claim compensation in case of a disaster. Insurance cards can also serve as a form of identification if other documents are lost or damaged.
Choice b) is correct because a whistle can help clients signal for help or locate each other in case of an emergency. A whistle can also deter potential atackers or wild animals.
Choice c) is incorrect because antibiotics are not recommended to be included in a disaster readiness supply kit or “go bag”. Antibiotics are prescription drugs that should only be used under the guidance of a health care provider. Using antibiotics without proper indication, dosage, or duration can cause adverse effects, such as allergic reactions, resistance, or superinfection.
Choice d) is correct because household bleach can be used to disinfect water, surfaces, or wounds in case of a disaster. Household bleach can also be used to create chlorine gas, which can be used as a weapon or a deterrent.
Choice e) is correct because pencil and paper can be used to write down important information, such as contact numbers, medical history, or evacuation plans. Pencil and paper can also be used to communicate with others, especially if there is no access to phone or internet services.
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