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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Free Nursing Study Resources

Correct Answer is A

Explanation

A. Changes in sputum color can indicate exacerbations of COPD, such as infection or increased inflammation in the airways. Darker or greenish sputum may suggest the presence of infection, while changes in consistency or volume can also indicate worsening respiratory status. Promptly notifying the healthcare provider of any change in sputum color allows for timely assessment and appropriate management.
B. Staying indoors during hot and humid temperature is relevant for minimizing exposure to environmental triggers that can exacerbate COPD symptoms, but it may not be as immediately critical
C. Avoiding allergens is important for clients with asthma who are sensitive to allergens but not COPD
D. Foods taken are more relevant in asthmatic patients as opposed to those with COPD.

A. High-pitched sound heard upon inspiration. B. Apical heart rate of 100 to 110 beats/minute. C. Redness and edema noted at the incision site. D. Pain rating of 8 on a scale of 0 to 10.

Correct Answer is A

Explanation

A. A high-pitched sound heard upon inspiration, known as a "stridor," can indicate airway obstruction or respiratory distress. In the postoperative period following an appendectomy, airway patency and adequate ventilation are essential for the client's oxygenation and recovery.
B. While a slightly elevated heart rate may be expected in the immediate postoperative period due to stress or pain, it does not typically require immediate action unless accompanied by other concerning symptoms.
C. Redness and edema at the incision site can be normal inflammatory responses following surgery.
D. Pain is common after surgery, and a pain rating of 8 on a scale of 0 to 10 indicates moderate to severe pain.

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Naxlex Comprehensive Predictor Exams

In providing discharge teaching to a client with chronic obstructive pulmonary disease (COPD), which instruction is most important for the nurse to emphasize?

Correct Answer is A

Explanation

The nurse is caring for a client who had an appendectomy 4 hours ago. Which finding requires immediate action by the nurse?

Correct Answer is A

Explanation

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