Hives, wheezing, throat tightness or low blood pressure during contrast may be anaphylaxis — stop the infusion and call for help.
Before you read
Test yourself first: 5 questions
Question 1 of 5
A client is scheduled for a colonoscopy. Which preparation teaching is correct?
Answer: B. Bowel prep: follow a clear-liquid diet and complete the bowel-cleansing prep the day before (avoid red/purple liquids), remain NPO after midnight, and arrange a ride home (sedation). Eating solid food the morning of the test invalidates it.
Question 2 of 5
During a nonstress test, the nurse observes two accelerations of the fetal heart rate of at least 15 beats per minute above baseline, each lasting at least 15 seconds, within a 20-minute period. How should the nurse interpret this result?
Answer: A. A reactive nonstress test, defined by at least two qualifying accelerations in 20 minutes, indicates adequate fetal oxygenation and is a reassuring finding. A nonreactive result lacks sufficient accelerations. A positive contraction stress test and late decelerations are different, concerning findings.
Question 3 of 5
During labor, a client suddenly becomes dyspneic, hypotensive, and cyanotic, then develops bleeding. The nurse suspects amniotic fluid embolism. What is the priority action?
Answer: B. Amniotic fluid embolism is a life-threatening emergency. The priority is to maintain oxygenation and circulation: call for emergency help, administer oxygen, prepare for intubation and CPR, and support cardiopulmonary function while preparing for emergent delivery.
Question 4 of 5
A client with multiple myeloma reports new, severe back pain, lower-extremity weakness, and difficulty urinating. What is the nurse's priority action?
Answer: A. These findings suggest spinal cord compression, an oncologic emergency that can cause permanent paralysis if untreated. The nurse must notify the provider immediately so that diagnostic imaging and treatment (such as corticosteroids and radiation) can begin promptly. Encouraging ambulation, applying heat, or simply documenting would delay urgent care.
Question 5 of 5
A client's cardiac monitor shows a rhythm with a regular rate of 38 and the client is dizzy and hypotensive. The nurse:
Answer: B. Symptomatic bradycardia (dizzy, hypotensive) needs intervention — apply oxygen, prepare atropine, and notify the provider/rapid response; transcutaneous pacing may be needed. Doing nothing risks deterioration.
Keep the streak going with more questions like these, each with a full rationale.
What is diagnostic test prep?
Tests that use iodinated contrast, moderate sedation or arterial access carry the most risk, so most questions ask what to check before, what to watch after, and what to teach.
Key points to remember
- Contrast: ask about any previous contrast reaction and check creatinine or eGFR; contrast can injure the kidneys, especially with dehydration or diabetes.
- A seafood allergy is not a specific risk for contrast, but a previous reaction to contrast is — report it so premedication can be ordered.
- Metformin is often held around iodinated contrast in patients with poor kidney function and restarted after about 48 hours once kidney function is stable, per policy.
- Sedation and scopes: NPO for the ordered time, consent signed before sedation, and an adult to drive the patient home.
- After an upper endoscopy, confirm the gag reflex has returned before giving food or fluids.
- MRI: screen for metal — pacemakers, implants, clips, and medication patches with metal backing.
Nursing priorities
- Verify consent, allergies, NPO status and pre-procedure labs (creatinine, coagulation studies) before the test.
- Review which medications to hold, such as anticoagulants or metformin, as ordered.
- After sedation, monitor airway, oxygen saturation and level of consciousness until the patient is back to baseline.
- After a femoral arterial procedure, keep the leg straight and check the site, distal pulses, color and temperature per protocol.
- Encourage fluids after contrast unless restricted.
Labs & values
Patient teaching
- Follow the NPO and medication instructions exactly, and ask which home medicines to take with a sip of water.
- After sedation, do not drive, sign legal papers or make major decisions for 24 hours.
- After a femoral cardiac cath, avoid heavy lifting for several days and report bleeding, swelling, or a cold or numb leg.
Red flags: report now
- Hives, wheezing, throat tightness or low blood pressure during contrast may be anaphylaxis — stop the infusion and call for help.
- Bleeding, a growing hematoma or a lost distal pulse after cardiac catheterization — apply pressure above the site and notify the provider.
- Severe abdominal or chest pain, fever, or vomiting blood after an endoscopy may mean perforation.
- Falling urine output or rising creatinine in the days after contrast suggests kidney injury.
References
Clinical references for this topic
