All of the following instructions related to investigation of a patient who has to undergo bone densitometry are correct EXCEPT

Appeared in: ESIC Nursing Officer-7July 2024

Explanation

A bone densitometry (DXA) scan is a non-invasive X-ray procedure that does not require the patient to be fasting.
Patients can eat and drink normally before the test, so an instruction to remain 'nil per orally' (NPO) is incorrect.
The purpose of the scan is to measure bone mineral density, which is not affected by recent food or fluid intake (other than calcium supplements).

Option A: This is a correct and necessary instruction for the procedure. Therefore, it is not the answer to the 'EXCEPT' question.
Option C: This is a correct and necessary instruction for the procedure. Therefore, it is not the answer to the 'EXCEPT' question.
Option D: This is a correct and necessary instruction for the procedure. Therefore, it is not the answer to the 'EXCEPT' question.

Visual 1: Diagram - Showing the correct patient positioning for a DXA scan, with the patient lying supine on the table and a support block under their legs to flex the hips and knees. This helps visualize the procedure described in the options.

Clinical Relevance

Nursing practice connection: Use the key finding related to Patient preparation and instructions for a bone densitometry (DXA) scan to guide bedside assessment, documentation, and the next nursing action.
A nurse's primary role includes patient education. Providing accurate pre-procedure instructions ensures test validity, prevents the need for rescheduling, and reduces patient anxiety.
It is crucial to screen for contraindications. Ask the patient if they have had any recent imaging with contrast material (e.g., barium study, CT with contrast) as this can interfere with the DXA scan, requiring it to be postponed.
What if? If a patient is unable to lie flat or hold the required position due to severe pain or deformity (like kyphosis), alternative sites like the forearm may be scanned, or a different type of bone density test might be considered.

How to Approach the Question

First, identify that this is a negative-stem question because of the word 'EXCEPT'. This means you are looking for the one option that is an INCORRECT statement.
Read the question stem carefully to understand the context: pre-procedure instructions for a 'bone densitometry' scan.
Evaluate each option's validity as an instruction for this specific test.
Consider Option A (avoid calcium): This is plausible, as supplements could temporarily alter measurements.
Consider Option B (NPO/fasting): This is a significant restriction. Ask yourself if a simple, non-invasive X-ray test typically requires fasting. It usually doesn't unless sedation or contrast is involved, which is not standard for DXA.
Consider Option C (remove metal) and D (lie still): These are standard instructions for almost all imaging procedures to ensure image quality and safety.

Concept Tested & Keywords

Concept Tested: Patient preparation and instructions for a bone densitometry (DXA) scan.
Stem keywords: bone densitometry, investigation, instructions
Lead-in keywords: EXCEPT
Negative lead-in flag: The question asks for the INCORRECT instruction.

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Practise the full ESIC Nursing Officer-7July 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.