Diagnostic Tests And Contrast Allergy Precautions - NCLEX-RN
Card 1 of 25
What instruction should be given after iodinated contrast if no fluid restriction exists?
What instruction should be given after iodinated contrast if no fluid restriction exists?
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Increase oral fluids to help excrete contrast. Enhanced hydration promotes renal clearance, reducing retention and potential toxicity.
Increase oral fluids to help excrete contrast. Enhanced hydration promotes renal clearance, reducing retention and potential toxicity.
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What is the priority assessment immediately after IV contrast administration during CT?
What is the priority assessment immediately after IV contrast administration during CT?
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Airway and breathing for early hypersensitivity reaction. Contrast can trigger rapid anaphylactoid reactions, necessitating vigilant monitoring for airway compromise.
Airway and breathing for early hypersensitivity reaction. Contrast can trigger rapid anaphylactoid reactions, necessitating vigilant monitoring for airway compromise.
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Which complication is a priority to monitor for after a barium enema, especially in older adults?
Which complication is a priority to monitor for after a barium enema, especially in older adults?
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Constipation or fecal impaction. Retained barium can harden, leading to obstruction, particularly in those with reduced motility.
Constipation or fecal impaction. Retained barium can harden, leading to obstruction, particularly in those with reduced motility.
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What is the key post-procedure nursing instruction after a barium study?
What is the key post-procedure nursing instruction after a barium study?
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Increase fluids and fiber; expect light/white stools. This promotes barium excretion to prevent constipation and informs about temporary stool discoloration from residual contrast.
Increase fluids and fiber; expect light/white stools. This promotes barium excretion to prevent constipation and informs about temporary stool discoloration from residual contrast.
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Which imaging study commonly uses barium sulfate as oral or rectal contrast?
Which imaging study commonly uses barium sulfate as oral or rectal contrast?
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Upper GI series or barium enema (lower GI series). Barium's high atomic number provides radiopacity for detailed GI tract visualization under fluoroscopy.
Upper GI series or barium enema (lower GI series). Barium's high atomic number provides radiopacity for detailed GI tract visualization under fluoroscopy.
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Which patient history finding is the strongest predictor of iodinated contrast reaction risk?
Which patient history finding is the strongest predictor of iodinated contrast reaction risk?
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Prior allergic-like reaction to iodinated contrast. A prior reaction indicates sensitization, making recurrence up to 60% more likely without premedication.
Prior allergic-like reaction to iodinated contrast. A prior reaction indicates sensitization, making recurrence up to 60% more likely without premedication.
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What is the key nursing action when a patient reports a prior contrast reaction before a CT with contrast?
What is the key nursing action when a patient reports a prior contrast reaction before a CT with contrast?
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Notify provider and radiology; do not administer until evaluated. This allows for risk assessment, potential premedication with steroids/antihistamines, or alternative imaging to ensure safety.
Notify provider and radiology; do not administer until evaluated. This allows for risk assessment, potential premedication with steroids/antihistamines, or alternative imaging to ensure safety.
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Which symptom indicates a severe contrast reaction requiring emergency response?
Which symptom indicates a severe contrast reaction requiring emergency response?
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Stridor with respiratory distress. Stridor signals laryngeal edema or bronchospasm, escalating to potential airway obstruction in anaphylaxis.
Stridor with respiratory distress. Stridor signals laryngeal edema or bronchospasm, escalating to potential airway obstruction in anaphylaxis.
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Which symptom is most consistent with a mild iodinated contrast reaction?
Which symptom is most consistent with a mild iodinated contrast reaction?
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Limited urticaria or pruritus. Mild reactions often involve histamine-mediated skin symptoms without systemic involvement.
Limited urticaria or pruritus. Mild reactions often involve histamine-mediated skin symptoms without systemic involvement.
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What is the immediate nursing action for suspected contrast extravasation at an IV site?
What is the immediate nursing action for suspected contrast extravasation at an IV site?
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Stop injection, elevate limb, and notify radiology/provider. Immediate cessation and elevation reduce tissue exposure to hyperosmolar contrast, minimizing necrosis risk.
Stop injection, elevate limb, and notify radiology/provider. Immediate cessation and elevation reduce tissue exposure to hyperosmolar contrast, minimizing necrosis risk.
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Which allergy history does NOT reliably predict iodinated contrast allergy and should not be treated as equivalent?
Which allergy history does NOT reliably predict iodinated contrast allergy and should not be treated as equivalent?
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Shellfish allergy. Shellfish reactions stem from proteins like tropomyosin, not iodine, lacking correlation with contrast hypersensitivity.
Shellfish allergy. Shellfish reactions stem from proteins like tropomyosin, not iodine, lacking correlation with contrast hypersensitivity.
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What is the main renal risk associated with iodinated IV contrast in CT imaging?
What is the main renal risk associated with iodinated IV contrast in CT imaging?
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Contrast-associated acute kidney injury. Iodinated agents can induce tubular toxicity and vasoconstriction, impairing renal function in at-risk patients.
Contrast-associated acute kidney injury. Iodinated agents can induce tubular toxicity and vasoconstriction, impairing renal function in at-risk patients.
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Which baseline lab is most important to review before iodinated contrast in a patient with kidney disease?
Which baseline lab is most important to review before iodinated contrast in a patient with kidney disease?
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Serum creatinine or estimated glomerular filtration rate (eGFR). These metrics evaluate renal function to stratify risk for contrast-induced nephropathy before administration.
Serum creatinine or estimated glomerular filtration rate (eGFR). These metrics evaluate renal function to stratify risk for contrast-induced nephropathy before administration.
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Which patient condition increases risk for contrast-associated kidney injury and requires extra precautions?
Which patient condition increases risk for contrast-associated kidney injury and requires extra precautions?
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Chronic kidney disease (reduced eGFR). Reduced clearance prolongs contrast exposure, heightening nephrotoxic effects on tubules and vasculature.
Chronic kidney disease (reduced eGFR). Reduced clearance prolongs contrast exposure, heightening nephrotoxic effects on tubules and vasculature.
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What is the priority nursing intervention to reduce kidney injury risk with iodinated contrast when ordered?
What is the priority nursing intervention to reduce kidney injury risk with iodinated contrast when ordered?
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Ensure adequate hydration as prescribed. Pre- and post-procedure hydration dilutes contrast and enhances renal perfusion, mitigating nephrotoxicity.
Ensure adequate hydration as prescribed. Pre- and post-procedure hydration dilutes contrast and enhances renal perfusion, mitigating nephrotoxicity.
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Which medication should be held around iodinated contrast administration due to lactic acidosis risk if AKI occurs?
Which medication should be held around iodinated contrast administration due to lactic acidosis risk if AKI occurs?
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Metformin. Contrast-induced AKI can cause metformin accumulation, increasing lactic acidosis risk in diabetic patients.
Metformin. Contrast-induced AKI can cause metformin accumulation, increasing lactic acidosis risk in diabetic patients.
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Which contrast agent is typically used for MRI enhancement instead of iodinated contrast?
Which contrast agent is typically used for MRI enhancement instead of iodinated contrast?
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Gadolinium-based contrast. Gadolinium shortens T1 relaxation times, enhancing signal intensity in vascular and pathological tissues on MRI.
Gadolinium-based contrast. Gadolinium shortens T1 relaxation times, enhancing signal intensity in vascular and pathological tissues on MRI.
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Which action should the nurse take first when a patient with prior contrast anaphylaxis arrives for a contrast CT without premedication orders?
Which action should the nurse take first when a patient with prior contrast anaphylaxis arrives for a contrast CT without premedication orders?
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Hold the study and notify provider/radiology for an alternative or premedication plan. History of anaphylaxis necessitates premedication or non-contrast options to avoid life-threatening recurrence.
Hold the study and notify provider/radiology for an alternative or premedication plan. History of anaphylaxis necessitates premedication or non-contrast options to avoid life-threatening recurrence.
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Which instruction is most appropriate for a patient who had a barium swallow this morning and has not had a bowel movement?
Which instruction is most appropriate for a patient who had a barium swallow this morning and has not had a bowel movement?
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Increase fluids and fiber; use laxative if prescribed. These measures facilitate barium passage through the GI tract, averting impaction from delayed elimination.
Increase fluids and fiber; use laxative if prescribed. These measures facilitate barium passage through the GI tract, averting impaction from delayed elimination.
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Identify the best nursing response when a patient says, "I cannot have contrast because I am allergic to shellfish."
Identify the best nursing response when a patient says, "I cannot have contrast because I am allergic to shellfish."
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Shellfish allergy alone does not predict contrast reaction; assess prior contrast reaction. This educates on the iodine myth and refocuses on true predictors like prior contrast exposure.
Shellfish allergy alone does not predict contrast reaction; assess prior contrast reaction. This educates on the iodine myth and refocuses on true predictors like prior contrast exposure.
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Which order should the nurse question for a CT with iodinated contrast in a patient with eGFR $20$ mL/min/1.73 m$^2$?
Which order should the nurse question for a CT with iodinated contrast in a patient with eGFR $20$ mL/min/1.73 m$^2$?
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Proceeding with iodinated contrast without renal-risk mitigation plan. Severely reduced eGFR heightens AKI risk, requiring hydration, low-osmolar contrast, or alternatives.
Proceeding with iodinated contrast without renal-risk mitigation plan. Severely reduced eGFR heightens AKI risk, requiring hydration, low-osmolar contrast, or alternatives.
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Identify the correct action when a patient reports wheezing and facial swelling during contrast injection.
Identify the correct action when a patient reports wheezing and facial swelling during contrast injection.
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Stop contrast, call rapid response, maintain airway, give O2. These signs indicate anaphylaxis, demanding prompt intervention to prevent respiratory failure.
Stop contrast, call rapid response, maintain airway, give O2. These signs indicate anaphylaxis, demanding prompt intervention to prevent respiratory failure.
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Which pre-procedure action is essential before any contrast study to prevent wrong-patient or wrong-allergy errors?
Which pre-procedure action is essential before any contrast study to prevent wrong-patient or wrong-allergy errors?
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Verify patient identity and documented allergies. Accurate verification upholds safety protocols, preventing administration errors and allergic complications.
Verify patient identity and documented allergies. Accurate verification upholds safety protocols, preventing administration errors and allergic complications.
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What is the priority screening question before MRI to prevent device-related injury?
What is the priority screening question before MRI to prevent device-related injury?
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Presence of implanted ferromagnetic metal or pacemaker/ICD. Strong magnetic fields can torque metals or interfere with device function, risking burns or malfunctions.
Presence of implanted ferromagnetic metal or pacemaker/ICD. Strong magnetic fields can torque metals or interfere with device function, risking burns or malfunctions.
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Which patient is at highest risk for nephrogenic systemic fibrosis with gadolinium contrast?
Which patient is at highest risk for nephrogenic systemic fibrosis with gadolinium contrast?
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Patient with severe renal failure (very low eGFR). Impaired excretion in renal failure allows gadolinium deposition, triggering fibrotic skin and organ changes.
Patient with severe renal failure (very low eGFR). Impaired excretion in renal failure allows gadolinium deposition, triggering fibrotic skin and organ changes.
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