Nursing Elites

1. A client has been scheduled for magnetic resonance imaging (MRI). For which of the following conditions, a contraindication to MRI, does the nurse check the client’s medical history?

• A. Pancreatitis
• B. Pacemaker insertion
• C. Type 1 diabetes mellitus
• D. Chronic airway limitation

Correct answer: B

Rationale: The correct answer is B: Pacemaker insertion. Patients with metal devices or implants are contraindicated for MRI. These include pacemakers, orthopedic hardware, artificial heart valves, aneurysm clips, and intrauterine devices. These metal objects can be affected by the strong magnetic field of the MRI, leading to serious risks for the patient. Pancreatitis (choice A), Type 1 diabetes mellitus (choice C), and chronic airway limitation (choice D) are not contraindications to MRI based on the presence of metal objects. Therefore, the nurse should be particularly concerned about pacemaker insertion when reviewing the client's medical history prior to an MRI.

2. The nurse is teaching a patient who will be discharged home from the hospital to take amoxicillin (Amoxil) twice daily for 10 days. Which statement by the nurse is correct?

• A. Discontinue the antibiotic when your temperature returns to normal and your symptoms have improved.
• B. If diarrhea occurs, stop taking the drug immediately and contact your provider.
• C. Stop taking the drug and notify your provider if you develop a rash while taking this drug.
• D. You may save any unused antibiotic to use if your symptoms recur.

Correct answer: C

Rationale: Patients who develop signs of allergy, such as rash, should notify their provider before continuing medication therapy. Patients should be counseled to continue taking their antibiotics until completion of the prescribed regimen even when they feel well. Diarrhea is an adverse effect but does not warrant cessation of the drug. Before deciding to stop taking a medication due to a side effect, encourage the patient to contact the provider first. Patients should discard any unused antibiotic.

3. A nurse reviews laboratory results for a client with glomerulonephritis. The client’s glomerular filtration rate (GFR) is 40 mL/min as measured by a 24-hour creatinine clearance. How should the nurse interpret this finding? (Select all that apply.)

• A. Excessive GFR
• B. Reduced GFR
• C. Fluid retention and risks for hypertension
• D. Pulmonary edema

Correct answer: B

Rationale: A GFR of 40 mL/min indicates a reduced glomerular filtration rate. In a healthy adult, the normal GFR ranges between 100 and 120 mL/min. A GFR of 40 mL/min signifies a significant reduction, leading to fluid retention and risks for hypertension and pulmonary edema due to excess vascular fluid. Choices A, C, and D are incorrect. Choice A is incorrect as a GFR of 40 mL/min is not excessive but rather reduced. Choices C and D do not directly address the interpretation of GFR but instead describe potential consequences of a reduced GFR.

4. A healthcare professional is reviewing the results of serum laboratory studies of a client with suspected hepatitis. Which increased parameter is interpreted as the most specific indicator of this disease?

• A. Hemoglobin
• B. Serum bilirubin
• C. Blood urea nitrogen (BUN)
• D. Erythrocyte sedimentation rate (ESR)

Correct answer: B

Rationale: Serum bilirubin is the most specific indicator of hepatitis as it reflects liver dysfunction. Hemoglobin, blood urea nitrogen (BUN), and erythrocyte sedimentation rate (ESR) are not specific to hepatitis. Hemoglobin measures the oxygen-carrying capacity of red blood cells, BUN evaluates kidney function, and ESR is a nonspecific marker of inflammation or infection.

5. A young female client prescribed amoxicillin (Amoxil) for a urinary tract infection is being taught by a nurse. Which statement should the nurse include in this client’s teaching?

• A. Use a second form of birth control while taking this medication.
• B. You will experience increased menstrual bleeding while on this medication.
• C. You may experience an irregular heartbeat while on this medication.
• D. Watch for blood in your urine while taking this drug.

Correct answer: A

Rationale: The correct statement for the nurse to include in the teaching is to advise the client to use a second form of birth control while taking amoxicillin. Penicillin, like amoxicillin, may reduce the effectiveness of estrogen-containing contraceptives, making it important to use additional contraceptive measures. The incorrect choices are B, C, and D. Increased menstrual bleeding, irregular heartbeat, or blood in the urine are not common side effects associated with amoxicillin use for a urinary tract infection.

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