Page 54 - Saunders Comprehensive Review For NCLEX-RN

Facial pain, personality changes, and ocular disturbances (photophobia, diplopia,
light flashes, halos around bright objects, yellow or green color perception) are also
signs of toxicity, but are not early signs.

Reduction of Risk Potential
A magnetic resonance imaging (MRI) study is prescribed for a client with a
suspected brain tumor. The nurse should implement which action to prepare the
client for this test?

1. Shave the groin for insertion of a femoral catheter.
2. Remove all metal-containing objects from the client.
3. Keep the client NPO (nothing by mouth) for 6 hours before the test.
4. Instruct the client in inhalation techniques for the administration of the
radioisotope.

Answer: 2
This question addresses the subcategory Reduction of Risk Potential in the Client
Needs category Physiological Integrity, and the nurse’s responsibilities in preparing
the client for the diagnostic test. Focus on the subject, preparing a client for an MRI.
In an MRI study, radiofrequency pulses in a magnetic field are converted into
pictures. All metal objects, such as rings, bracelets, hairpins, and watches, should be
removed. In addition, a history should be taken to ascertain whether the client has
any internal metallic devices, such as orthopedic hardware, pacemakers, or
shrapnel. A femoral catheter is not used for this diagnostic test. An intravenous (IV)
catheter may be inserted if a contrast agent is prescribed. Additionally, shaving is
not a common practice because of the risk for microabrasions and infection. If
needed, hair may be clipped away from a surgical or insertion site. NPO status is
not necessary for an MRI study of the head. Inhalation of the radioisotope may be
prescribed with other types of scans but is not a part of the procedures for an MRI.

Physiological Adaptation
A client with renal insufficiency has a magnesium level of 3.5 mEq/L 1.44 mmol/L).
On the basis of this laboratory result, the nurse interprets which sign as significant?

1. Hyperpnea
2. Drowsiness
3. Hypertension
4. Physical hyperactivity

Answer: 2
This question addresses the subcategory Physiological Adaptation in the Client
Needs category Physiological Integrity. It addresses an alteration in body systems.
Focus on the data in the question. The normal magnesium level is 1.8 to 2.6 mEq/L
(0.74 to 1.07 mmol/L). A magnesium level of 3.5 mEq/L (1.44 mmol/L). indicates
hypermagnesemia. Neurological manifestations begin to occur when magnesium
levels are elevated and are noted as symptoms of neurological depression, such as
drowsiness, sedation, lethargy, respiratory depression, muscle weakness, and
areflexia. Bradycardia and hypotension also occur.

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