In which of the ff clients will an MRI scan be contraindicated?

Correct Answer: B

Rationale: The correct answer is B: Clients with metal implants in their body. An MRI uses strong magnetic fields, which can interact with metal implants, causing movement or heating of the metal and potential harm to the client. This could lead to serious injuries or complications during the scan. Overweight clients (choice A), clients over the age of 60 (choice C), and clients with brain tumors (choice D) do not have contraindications for an MRI scan.

Correct Answer: B

Rationale: The correct answer is B: Ask the patient to describe the type of reaction. This is the first action the nurse should take to assess the severity of the latex allergy and determine appropriate interventions. By gathering more information about the reaction, the nurse can better understand the potential risks and provide safe care. Summary of other choices: A: Immediately placing the patient in isolation is unnecessary and not indicated based solely on the patient's latex allergy. C: Proceeding to the termination phase of the interview is premature without fully assessing the patient's allergy. D: Documenting the allergy is important but should not be the first action without assessing the reaction itself.

Correct Answer: B

Rationale: The correct answer is B: Ask the patient to describe the type of reaction. This is the first action the nurse should take because it helps determine the severity of the allergy and how to best proceed with care. By understanding the specific type of reaction the patient experiences, the nurse can implement appropriate precautions and interventions to prevent any adverse reactions during the patient's stay. Choice A is incorrect because placing the patient in isolation is not necessary for a latex allergy. Choice C is incorrect as terminating the interview is premature and does not address the patient's allergy. Choice D is also incorrect as documenting the allergy is important but not the first action to take when assessing a patient's allergic reaction.

Correct Answer: B

Rationale: The correct answer is B because hyperkalemia presents with symptoms such as muscle weakness, diarrhea, and ECG changes. Muscle weakness is a common sign due to potassium's effect on neuromuscular function. Diarrhea can lead to potassium loss. ECG changes, such as peaked T waves and widened QRS complexes, indicate cardiac involvement. Assessing for these symptoms helps monitor the severity of hyperkalemia and guide treatment. Other choices are incorrect because assessing for fever and chest pain (choice A) are not specific to hyperkalemia. Encouraging fluid restriction (choice C) may not directly address hyperkalemia. Preparing for a cardiac ultrasound (choice D) is not an immediate intervention for hyperkalemia.

Correct Answer: C

Rationale: The correct answer is C because it acknowledges the client's value as an individual by directly addressing them and asking about their own self-care practices, which respects their autonomy and personhood. Choice A focuses on the client's father rather than the client themselves. Choice B addresses the daughter, not the client, and implies a lack of prioritization of the client's needs. Choice D is dismissive and does not recognize the client's capacity to communicate, undermining their dignity.

Correct Answer: C

Rationale: Rationale: - A: Diuretics are not necessary before the test and may affect test results. - B: Dehydration is not recommended before the test as it can impact cardiac function. - C: Medication to relieve cough is necessary to reduce any potential interference with the scan. - D: Administering analgesics is not required for the test and may not be relevant to the client's condition.

Correct Answer: A

Rationale: The correct answer is A because shampooing the hair thoroughly helps remove oil and dirt, which can interfere with the CT scan results. By having clean hair, the scan can produce clearer images. Choice B is incorrect because some preparation is needed for a CT scan, especially regarding cleanliness. Choice C is incorrect as giving a cleansing enema and fluids until 8 AM is not necessary for a CT scan of the head. Choice D is incorrect as shaving the scalp and attaching electrodes are not part of routine preparation for a CT scan.

Correct Answer: C

Rationale: The correct answer is C: Human, T-cell lymphotrophic virus, as it is the causative agent for HIV/AIDS. This virus specifically targets and infects the body's T-cells, weakening the immune system. Trichomonas vaginalis, Treponema pallidum, and Chlamydia trachomatis are all different pathogens that do not cause HIV/AIDS. Trichomonas vaginalis is a protozoan parasite that causes trichomoniasis, Treponema pallidum causes syphilis, and Chlamydia trachomatis causes chlamydia. Therefore, the correct answer is C based on the specific viral agent responsible for HIV/AIDS.

Correct Answer: D

Rationale: The correct answer is D: Ankylosing spondylitis. This disease process is characterized by chronic progressive inflammation of the sacroiliac and costovertebral joints and adjacent soft tissue. Ankylosing spondylitis specifically affects the spine and large joints. Rheumatoid arthritis (A) is characterized by joint inflammation and primarily affects small joints. Scoliosis (B) is a condition characterized by an abnormal lateral curvature of the spine, not inflammation of the sacroiliac and costovertebral joints. Kyphosis (C) is an excessive outward curvature of the spine, not related to inflammation of the sacroiliac and costovertebral joints.