Question

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?

Answer 1

Correct Answers:

Metformin

Rationale :

✅ Metformin interacts with iodine-based contrast used during procedures like cardiac catheterization, increasing the risk of lactic acidosis and acute kidney injury. ✅ It is crucial to withhold metformin before and after contrast administration until renal function is re-evaluated. ✅ Impaired renal clearance caused by contrast can lead to metformin accumulation, posing life-threatening risks. ✅ Monitoring renal function is a top priority for clients on metformin undergoing procedures involving contrast agents.

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Answer 2

Correct Answers:

An international normalized ratio (INR)

Rationale :

🔷 INR is a critical test for clients taking warfarin because it measures the blood’s clotting tendency and helps prevent perioperative bleeding complications. 🔷 Warfarin therapy affects the extrinsic coagulation pathway, making INR the most accurate and relevant test to monitor anticoagulation levels preoperatively. 🔷 A normal INR is typically around 1.0; therapeutic ranges vary depending on the reason for anticoagulation, but elevated INRs must be managed before surgery. 🔷 Ensuring an appropriate INR level reduces the risk of serious hemorrhage during invasive procedures.

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Answer 3

Correct Answers:

Spontaneous bleeding

Rationale :

💠 A platelet count of 9,000/mm³ is critically low and puts the client at a severe risk for spontaneous bleeding, including internal bleeding. 💠 Normal platelet ranges are 150,000 to 450,000/mm³, and anything below 20,000/mm³ is dangerously low. 💠 Immediate nursing actions include monitoring for bleeding, minimizing invasive procedures, and preparing for possible platelet transfusion. 💠 Prompt identification and intervention can prevent life-threatening hemorrhagic complications in thrombocytopenic clients.

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Answer 4

Correct Answers:

Potassium: 2.9 mEq/L (2.9 mm)

Rationale :

💎 A potassium level of 2.9 mEq/L is significantly below the normal range (3.5–5.0 mEq/L) and can lead to dangerous cardiac arrhythmias during surgery. 💎 Hypokalemia alters myocardial conduction, predisposing the client to dysrhythmias under anesthesia. 💎 It is critical to correct low potassium levels before surgery to stabilize cardiac function. 💎 Immediate notification of the surgical team and electrolyte replacement are essential steps before proceeding.

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Answer 5

Correct Answers:

A client who has diarrhea

Rationale :

⬖ Diarrhea causes the loss of large amounts of bicarbonate from the gastrointestinal tract, leading to metabolic acidosis. ⬖ Metabolic acidosis is characterized by decreased pH and bicarbonate levels, resulting in compensatory hyperventilation. ⬖ Clients with diarrhea are at particular risk due to persistent bicarbonate depletion. ⬖ Early identification allows nurses to monitor acid-base status and initiate fluid and electrolyte replacement.

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Answer 6

Correct Answers:

Give the client a back massage.
Teach the client relaxation techniques.
Assist the client to cough and deep breathe
Administer PRN analgesics as needed.

Rationale :

🔴Give the client a back massage

⬗ Promotes relaxation and comfort, enhancing postoperative recovery.

⬗ Reduces muscular tension and improves blood circulation, indirectly preventing complications like venous stasis.

⬗ Non-pharmacological interventions like massage complement pain management protocols.

🔴Teach the client relaxation techniques

⬗ Helps control postoperative anxiety and promotes emotional well-being.

⬗ Assists in reducing pain perception and supports better respiratory effort during recovery.

⬗ Stress management is a critical component of holistic postoperative care.

🔴Assist the client to cough and deep breathe

⬗ Prevents postoperative pulmonary complications such as atelectasis and pneumonia.

⬗ Encourages lung expansion and mobilizes secretions to maintain adequate oxygenation.

⬗ Essential part of respiratory therapy post-surgery, especially within the first few hours.

🔴 Administer PRN analgesics as needed

⬗ Managing pain effectively encourages early mobilization and breathing exercises.

⬗ Adequate analgesia prevents complications linked to immobility and respiratory issues.

⬗ Pain control is a cornerstone of postoperative nursing care to enhance healing.

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Answer 7

Correct Answers:

pH below 3.5

Rationale :

✍️ A pH below 7.35 indicates acidosis, and when the primary problem is metabolic, it reflects an accumulation of acid or loss of bicarbonate. ✍️ In metabolic acidosis, the HCO₃⁻ level will also be decreased (<22 mEq/L), but the primary indicator is the low pH. ✍️ Causes include renal failure, diarrhea, and diabetic ketoacidosis, all of which lead to acid buildup or base loss. ✍️ Nurses must act promptly to correct the underlying cause and monitor for signs of compensation through respiratory changes.

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Answer 8

Correct Answers:

Albumin

Rationale :

👉 Albumin is a plasma protein synthesized by the liver and is a key indicator of protein nutritional status. 👉 Normal albumin levels (3.5–5.0 g/dL) reflect adequate protein intake and synthesis abilities. 👉 Clients who are well-hydrated and non-anemic but have low albumin may still suffer from malnutrition or liver dysfunction. 👉 Monitoring albumin helps evaluate long-term nutrition and chronic illness impacts on protein metabolism.

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Answer 9

Correct Answers:

Potassium

Rationale :

✳️ Potassium must be reviewed before administering digoxin because hypokalemia increases the risk of digoxin toxicity. ✳️ Digoxin toxicity can cause life-threatening arrhythmias, especially if potassium is low. ✳️ The therapeutic potassium range is critical (3.5–5.0 mEq/L) to maintain safe cardiac function with digoxin use. ✳️ Nurses should prioritize correcting potassium imbalances before administering cardiac glycosides like digoxin.

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Answer 10

Correct Answers:

"l eat two eggs for breakfast each morning

Rationale :

✔️ Eggs are high in cholesterol, especially in the yolk, and daily consumption can raise serum cholesterol levels. ✔️ Clients with atherosclerosis should be educated to limit dietary cholesterol to under 200 mg/day. ✔️ Substituting egg whites or plant-based protein sources can help reduce cholesterol intake. ✔️ Nutritional counseling is essential in preventing further cardiovascular complications in clients with elevated cholesterol.

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QLexNursing

1 :
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?

2 :
A nurse is assessing a preoperative client. The client has a history of atrial fibrillation and is taking warfarin daily. Which test order will the nurse request from the provider?

3 :
A nurse is reviewing a client's CBC findings and discovers that the client's platelet count is 9,000/mm3. The nurse should monitor the client for which of the following conditions?

4 :
A nurse is reviewing laboratory results for a client who is scheduled for surgery this morning. Which of the following results will cause the nurse to place a call to the surgical team?

5 :
A nurse is reviewing the medical records of four clients who have an acid-base imbalance. The nurse should recognize that which of the following clients is at risk for metabolic acidosis?

6 :
A nurse is planning care for a client who is 4 hr postoperative. Which of the following actions should the nurse include in the plan of care? (Select all that apply.)

7 :
A nurse is reviewing the arterial blood gas (ABG) results of a client who the provider suspects has metabolic acidosis. Which of the following results should the nurse expect to see?

8 :
A nurse is caring for a client who is well-hydrated and who demonstrates no evidence of anemia. Which of the following laboratory values gives the nurse an assessment of the adequacy of the client's protein uptake and synthesis?

9 :
A nurse is planning to administer digoxin to a client who has heart failure. Which of the following laboratory results is the priority for the nurse to review prior to administering the medication?

10 :
A nurse is reviewing the laboratory results for a client who has a history of atherosclerosis and notes elevated cholesterol levels. Which of the following statements by the client indicates the nurse should plan follow-up teaching on a low-cholesterol diet?

QLexNursing

1 : 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?

2 : A nurse is assessing a preoperative client. The client has a history of atrial fibrillation and is taking warfarin daily. Which test order will the nurse request from the provider?

3 : A nurse is reviewing a client's CBC findings and discovers that the client's platelet count is 9,000/mm3. The nurse should monitor the client for which of the following conditions?

4 : A nurse is reviewing laboratory results for a client who is scheduled for surgery this morning. Which of the following results will cause the nurse to place a call to the surgical team?

5 : A nurse is reviewing the medical records of four clients who have an acid-base imbalance. The nurse should recognize that which of the following clients is at risk for metabolic acidosis?

6 : A nurse is planning care for a client who is 4 hr postoperative. Which of the following actions should the nurse include in the plan of care? (Select all that apply.)

7 : A nurse is reviewing the arterial blood gas (ABG) results of a client who the provider suspects has metabolic acidosis. Which of the following results should the nurse expect to see?

8 : A nurse is caring for a client who is well-hydrated and who demonstrates no evidence of anemia. Which of the following laboratory values gives the nurse an assessment of the adequacy of the client's protein uptake and synthesis?

9 : A nurse is planning to administer digoxin to a client who has heart failure. Which of the following laboratory results is the priority for the nurse to review prior to administering the medication?

10 : A nurse is reviewing the laboratory results for a client who has a history of atherosclerosis and notes elevated cholesterol levels. Which of the following statements by the client indicates the nurse should plan follow-up teaching on a low-cholesterol diet?

1 :
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?

2 :
A nurse is assessing a preoperative client. The client has a history of atrial fibrillation and is taking warfarin daily. Which test order will the nurse request from the provider?

3 :
A nurse is reviewing a client's CBC findings and discovers that the client's platelet count is 9,000/mm3. The nurse should monitor the client for which of the following conditions?

4 :
A nurse is reviewing laboratory results for a client who is scheduled for surgery this morning. Which of the following results will cause the nurse to place a call to the surgical team?

5 :
A nurse is reviewing the medical records of four clients who have an acid-base imbalance. The nurse should recognize that which of the following clients is at risk for metabolic acidosis?

6 :
A nurse is planning care for a client who is 4 hr postoperative. Which of the following actions should the nurse include in the plan of care? (Select all that apply.)

7 :
A nurse is reviewing the arterial blood gas (ABG) results of a client who the provider suspects has metabolic acidosis. Which of the following results should the nurse expect to see?

8 :
A nurse is caring for a client who is well-hydrated and who demonstrates no evidence of anemia. Which of the following laboratory values gives the nurse an assessment of the adequacy of the client's protein uptake and synthesis?

9 :
A nurse is planning to administer digoxin to a client who has heart failure. Which of the following laboratory results is the priority for the nurse to review prior to administering the medication?

10 :
A nurse is reviewing the laboratory results for a client who has a history of atherosclerosis and notes elevated cholesterol levels. Which of the following statements by the client indicates the nurse should plan follow-up teaching on a low-cholesterol diet?