An adult client is admitted for severe pain in his side and back and is sent for an intravenous pyelogram. Which report from the client is the earliest indication to the nurse that the client is experiencing an adverse reaction to this procedure?

Tingling on tongue or lips.

Episodes of shivering.

Salty taste in the mouth.

Difficulty breathing.

Answer and Explanation

The Correct Answer is A

A. Tingling on the tongue or lips is an early sign of an allergic reaction to the contrast dye used during an intravenous pyelogram. This type of reaction can quickly progress to more severe symptoms, such as difficulty breathing and anaphylaxis, so it is crucial to recognize and respond to it promptly.

B. Episodes of shivering: Shivering is not typically an early sign of an allergic reaction to contrast dye. It might indicate a reaction to temperature or anxiety but is not as immediately concerning as symptoms of an allergic reaction.

C. Salty taste in the mouth: A salty or metallic taste is a common and benign side effect of the contrast dye and is not indicative of an adverse reaction.

D. Difficulty breathing: Difficulty breathing is a severe and later sign of an allergic reaction. By the time this symptom appears, the reaction has progressed and immediate intervention is necessary.

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Correct Answer is ["A","B","D"]

Explanation

A. Prolonged standing or sitting can worsen venous insufficiency and increase the risk of blood pooling in the legs. Encouraging the client to move around and avoid prolonged periods of immobility can help improve circulation.

B. Compression stockings help improve blood flow by applying pressure to the legs, reducing swelling and preventing blood from pooling. The client should be instructed to continue wearing them as prescribed by their healthcare provider.

C.Crossing the legs can impede blood flow and should be avoided altogether.

D. Sitting for extended periods can also contribute to blood pooling. Using a recliner allows the client to elevate their legs, promoting better circulation and reducing the risk of complications. The nurse should recommend using a recliner when sitting for long periods of time.

E.Elevating legs during sleep is generally advised to reduce venous pressure.

A. Repeat information to the client. B. Write information on a whiteboard. C. Talk loudly into the affected ear. D. Speak directly facing the client. E. None F. None

Correct Answer is D

Explanation

The correct answer is Choice D

Choice A rationale: Repeating information may reinforce understanding but does not address the core barrier in unilateral hearing loss, which is sound localization and clarity. Auditory input from one ear limits binaural processing, making it harder to distinguish speech from background noise. Repetition without visual cues or proper orientation may still result in misinterpretation. Effective communication requires compensating for the sensory deficit, not merely reiterating content. Thus, repetition alone is insufficient for optimal education delivery.

Choice B rationale: Writing on a whiteboard provides visual support but lacks the dynamic interaction necessary for patient education. While visual aids help reinforce concepts, they do not allow for immediate clarification or emotional engagement. Pain management education involves nuanced discussion of pharmacologic options, side effects, and patient preferences. Relying solely on written communication may hinder comprehension, especially if literacy or cognitive load is a concern. It should supplement, not replace, direct verbal and visual interaction.

Choice C rationale: Speaking loudly into the affected ear is counterproductive and may distort sound further. In unilateral hearing loss, the affected ear has reduced or absent auditory function, and increasing volume does not restore clarity. Loud speech can also be perceived as aggressive or uncomfortable. Effective communication requires engaging the functional ear and using visual cues to enhance comprehension. Loudness does not compensate for neural deficits in auditory processing and may worsen patient experience.

Choice D rationale: Facing the client allows for optimal use of visual cues such as lip reading, facial expressions, and gestures, which are critical in compensating for unilateral auditory deficits. This technique engages the functional ear while supporting multimodal communication. It respects the neurophysiological limitations of monaural hearing and enhances speech perception through visual-auditory integration. Direct face-to-face interaction also fosters trust and allows for immediate feedback, making it the most scientifically sound approach for patient education.

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An adult client is admitted for severe pain in his side and back and is sent for an intravenous pyelogram. Which report from the client is the earliest indication to the nurse that the client is experiencing an adverse reaction to this procedure?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The home care nurse provided self-care instructions for a client with chronic venous insufficiency caused by deep vein thrombosis. Which instruction(s) should the nurse include in the client's discharge teaching plan? (Select all that apply.)

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Explanation

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Correct Answer is D

Explanation

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