The nurse is caring for a client who is taking metformin (Glucophage) for hyperglycemia prior to admission. The nurse would question the following order for this client:
CT scan with contrast
Chest X-ray 1 view
V/Q scan
Bilateral lower extremity ultrasound
The Correct Answer is A
Choice A reason: CT scan with contrast is an order that the nurse should question for the client who is taking metformin for hyperglycemia. Metformin is a medication that lowers the blood glucose level by decreasing the hepatic glucose production and increasing the insulin sensitivity¹. Metformin can cause a rare but serious complication called lactic acidosis, which is a buildup of lactic acid in the blood that can cause symptoms such as weakness, nausea, vomiting, or breathing problems. CT scan with contrast involves injecting iodinated contrast material into the bloodstream, which can affect the kidney function and increase the risk of lactic acidosis in patients taking metformin. The nurse should consult with the prescriber and the pharmacist about the need to stop metformin before and after the CT scan with contrast, and to monitor the kidney function and the blood glucose level of the client.
Choice B reason: Chest X-ray 1 view is not an order that the nurse should question for the client who is taking metformin for hyperglycemia. Chest X-ray is a diagnostic test that uses a small amount of radiation to produce images of the lungs, heart, and chest wall. Chest X-ray does not involve any contrast material or affect the kidney function or the blood glucose level. The nurse should follow the standard precautions and procedures for performing a chest X-ray, such as verifying the client's identity, checking for pregnancy, removing any metal objects, and positioning the client properly.
Choice C reason: V/Q scan is not an order that the nurse should question for the client who is taking metformin for hyperglycemia. V/Q scan is a diagnostic test that measures the ventilation and perfusion of the lungs, and can detect any abnormalities such as pulmonary embolism or chronic obstructive pulmonary disease. V/Q scan involves injecting a radioactive tracer into the bloodstream and inhaling a radioactive gas, which are then detected by a special camera. V/Q scan does not affect the kidney function or the blood glucose level. The nurse should follow the standard precautions and procedures for performing a V/Q scan, such as verifying the client's identity, checking for allergies, explaining the procedure, and monitoring the vital signs.
Choice D reason: Bilateral lower extremity ultrasound is not an order that the nurse should question for the client who is taking metformin for hyperglycemia. Bilateral lower extremity ultrasound is a diagnostic test that uses sound waves to produce images of the blood vessels in the legs, and can detect any abnormalities such as deep vein thrombosis or peripheral arterial disease. Bilateral lower extremity ultrasound does not involve any contrast material or affect the kidney function or the blood glucose level. The nurse should follow the standard precautions and procedures for performing a bilateral lower extremity ultrasound, such as verifying the client's identity, explaining the procedure, and applying a gel and a probe to the legs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Administering half of the scheduled dose of Colace is not the correct action for the nurse who is caring for a patient who had two loose stools during the night shift. Colace is the brand name of docusate, which is a stool softener that works by increasing the amount of water and fat in the stool, making it easier to pass. Colace is used to treat and prevent constipation, which is a condition of infrequent or hard bowel movements. Colace is not indicated for diarrhea, which is a condition of frequent and loose bowel movements. Administering half of the scheduled dose of Colace may not be enough to prevent constipation, and it may also worsen diarrhea by adding more water and fat to the stool.
Choice B reason: Administering the scheduled dose of Colace is not the correct action for the nurse who is caring for a patient who had two loose stools during the night shift. Colace is the brand name of docusate, which is a stool softener that works by increasing the amount of water and fat in the stool, making it easier to pass. Colace is used to treat and prevent constipation, which is a condition of infrequent or hard bowel movements. Colace is not indicated for diarrhea, which is a condition of frequent and loose bowel movements. Administering the scheduled dose of Colace may not be necessary to prevent constipation, and it may also worsen diarrhea by adding more water and fat to the stool.
Choice C reason: Inserting a rectal tube to prevent excoriation is not the correct action for the nurse who is caring for a patient who had two loose stools during the night shift. A rectal tube is a device that is inserted into the rectum and connected to a drainage bag, which collects the stool and prevents leakage and skin irritation. A rectal tube is used for patients who have fecal incontinence, which is the inability to control bowel movements. A rectal tube is not indicated for patients who have diarrhea, which is a condition of frequent and loose bowel movements. Inserting a rectal tube may not be effective to prevent excoriation, and it may also cause complications such as infection, bleeding, or perforation.
Choice D reason: Holding the scheduled dose of Colace and notifying the ordering physician is the correct action for the nurse who is caring for a patient who had two loose stools during the night shift. Colace is the brand name of docusate, which is a stool softener that works by increasing the amount of water and fat in the stool, making it easier to pass. Colace is used to treat and prevent constipation, which is a condition of infrequent or hard bowel movements. Colace is not indicated for diarrhea, which is a condition of frequent and loose bowel movements. Holding the scheduled dose of Colace may be appropriate to avoid further diarrhea, and notifying the ordering physician may be necessary to determine the cause and the treatment of diarrhea
Correct Answer is C
Explanation
Choice A reason: "Antibiotics are administered to treat viral infections." is an incorrect statement for the nurse to make when providing teaching for a client who has a new prescription for an antibiotic. Antibiotics are medicines that fight bacterial infections in people and animals. They work by killing the bacteria or by making it hard for the bacteria to grow and multiply. Antibiotics do not work against viruses, such as those that cause colds, flu, or COVID19. Taking antibiotics when they are not needed can cause harm and increase the risk of antibiotic resistance¹.
Choice B reason: "Bloody stools are expected while taking antibiotics." is an incorrect statement for the nurse to make when providing teaching for a client who has a new prescription for an antibiotic. Bloody stools are not a normal or expected side effect of antibiotics. They can indicate a serious condition, such as intestinal bleeding, ulcerative colitis, or Clostridioides difficile infection. C. diff is a type of bacteria that can cause severe diarrhea, abdominal pain, and bloody stools. It can occur when antibiotics disrupt the normal balance of bacteria in the gut and allow C. diff to grow and produce toxins. The nurse should instruct the client to report any signs of bloody stools or severe diarrhea to the health care provider immediately.
Choice C reason: "Take the entire course of antibiotics as prescribed." is a correct statement for the nurse to make when providing teaching for a client who has a new prescription for an antibiotic. Taking the entire course of antibiotics as prescribed is important to ensure that the infection is completely treated and to prevent the bacteria from becoming resistant to the antibiotic. Stopping the antibiotic too soon or skipping doses can allow some bacteria to survive and multiply, which can cause the infection to come back or spread to other parts of the body. The nurse should also remind the client to follow the instructions on the medication label or the prescriber's order regarding the dosage, frequency, and duration of the antibiotic therapy.
Choice D reason: "Discontinue the medication when you feel better." is an incorrect statement for the nurse to make when providing teaching for a client who has a new prescription for an antibiotic. Discontinuing the medication when the client feels better is not advisable, as it can lead to incomplete treatment and antibiotic resistance. Feeling better does not mean that the infection is gone or that the bacteria are all killed. The client should continue to take the antibiotic until the end of the prescribed course, even if they have no symptoms or feel better. The nurse should also advise the client to contact the health care provider if they have any questions or concerns about the antibiotic or if they experience any side effects or allergic reactions.
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