The nurse is preparing an older adult client for a magnetic resonance imaging (MRI) with contrast. Which laboratory value should the nurse report to the healthcare provider before the scan is performed?

Reference Range:

Glycosylated Hemoglobin (4% to 5.9% ]

Creatinine 10.6 to 1.2 mg/dL (53 to 106 μmol/L)]

Glucose [74 to 106 mg/dL (4.1 to 5.9 mmol/L)]

Blood Urea Nitrogen [10 to 20 mg/dL (3.6 to 7.1 mmol/L)]

Fasting blood sugar of 200 mg/dl. (11.1 mmol/L).

Serum creatinine of 1.9 mg/dl. (168 μmol/l)

Glycosylated hemoglobin of 8%.

Blood urea nitrogen of 22 mg/dL (7.9 mmol/L)

Answer and Explanation

The Correct Answer is B

B. Creatinine is a waste product of muscle metabolism that is filtered by the kidneys. Elevated serum creatinine levels may indicate impaired kidney function. Since contrast agents can affect renal function, a serum creatinine level above the reference range should be reported to the healthcare provider before the MRI with contrast.

A. While elevated blood sugar levels may indicate diabetes or poor glycemic control, they are not directly related to kidney function or the risk of contrast-induced nephropathy. Therefore, this value is not the most pertinent for reporting before an MRI with contrast.
C. Glycosylated hemoglobin (HbA1c) reflects average blood glucose levels over the past two to three months and is used to assess long-term glycemic control in diabetes. While elevated HbA1c levels suggest poor diabetes management, they do not directly assess kidney function or the risk of contrast-induced nephropathy.
D. Blood urea nitrogen (BUN) levels reflect the amount of urea nitrogen in the blood and can indicate kidney function. Elevated BUN levels may suggest impaired renal function. However, an elevated serum creatinine is a more reliable marker for renal excretion.

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Correct Answer is ["A","C","E"]

Explanation

A. Standard precautions should always be followed when caring for any patient to prevent the transmission of infectious agents. Additionally, wearing a mask can provide further protection, especially if there is a risk of respiratory droplet transmission.
C. Culturing the wound drainage allows for the identification of the specific bacteria causing the infection, including whether it is methicillin-resistant Staphylococcus aureus (MRSA). Sensitivity testing helps determine which antibiotics are effective against the bacteria, guiding appropriate antibiotic therapy.
E. Contact precautions are necessary for preventing the transmission of MRSA to other patients, staff, and visitors. This includes wearing gloves and gowns when providing care, as well as ensuring proper hand hygiene practices. Visitors may also need to follow specific precautions to prevent the spread of infection.
B. While monitoring the client's white blood cell count may be important for assessing the body's response to infection, it is not specific to MRSA infection. MRSA infection is typically diagnosed based on clinical presentation and confirmed through laboratory tests such as wound cultures.
D. A low bacteria diet is not typically indicated for MRSA infection. MRSA is primarily treated with antibiotics, and dietary modifications are not a standard part of its management.

A. Jogging or running are excellent aerobic exercises. B. Limit your exercise to just your daily activities. C. Tennis or racquetball will increase your muscle strength. D. Swimming is an excellent exercise for you.

Correct Answer is D

Explanation

D. Swimming is a low-impact exercise that is gentle on the joints and can provide numerous benefits for individuals with osteoarthritis. The buoyancy of water reduces stress on the joints while allowing for a full range of motion, making swimming an ideal exercise for improving joint flexibility, muscle strength, and cardiovascular fitness without exacerbating symptoms of osteoarthritis. Additionally, swimming can help relieve joint pain and stiffness and improve overall physical function in older adults with osteoarthritis.
A. Jogging or running can place significant stress on the joints, particularly the knees and hips, which may exacerbate symptoms of osteoarthritis and increase the risk of joint injury. High- impact activities like jogging or running are generally not recommended for individuals with osteoarthritis, especially in weight-bearing joints.
B. While engaging in daily activities can provide some level of physical activity, it may not be sufficient for managing osteoarthritis symptoms or improving joint function. Older adults with osteoarthritis can benefit from structured exercise programs tailored to their needs, which may include a variety of exercises aimed at improving joint flexibility, strength, and overall physical function.
C. Tennis or racquetball are high-impact sports that involve repetitive movements and may exacerbate joint pain and stiffness in individuals with osteoarthritis, particularly in the wrists, elbows, and shoulders. Engaging in these activities can increase the risk of joint injury and may not be suitable for older adults with osteoarthritis.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with draining skin lesions of the lower extremity is admitted with possible methicillin resistant Staphylococcus aureus (MRSA). What nursing intervention (s) should the nurse include in the plan of care? Select all that apply.

Correct Answer is ["A","C","E"]

Explanation

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Correct Answer is D

Explanation

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