Saunders Comprehensive Review for the NCLEX-RN Examination Silvestri 5th Edition Test Bank


18. The nurse is caring for a client with a nasogastric tube (NGT) who has a prescription for NGT irrigation once every 8 hours. The nurse plans to irrigate the NGT with which of the following solutions to maintain homeostasis? 1. Tap water 2. Sterile water 3. 0.9% sodium chloride 4. 0.45% sodium chloride


ANS: 3


Rationale: Homeostasis is maintained by irrigating with an isotonic solution, such as 0.9% sodium chloride. Tap water, sterile water, and sodium chloride are hypotonic solutions.


Test-Taking Strategy: Use the process of elimination to answer the question. Knowing that options that are comparable or alike are not likely to be correct, eliminate “tap water” and “sterile water” because they include water. Irrigating with solutions that contain water increases the risk for fluid and electrolyte imbalance. Select between the last two options, knowing that an isotonic irrigating solution helps maintain homeostasis; thus, “0.45% sodium chloride” can be eliminated. Review the tonicity of these solutions if you had difficulty with these questions.


PTS: 1 DIF: Level of Cognitive Ability: Applying REF: Ignatavicius, D., &Workman, M. (2010). Medical-surgical nursing: patient- centered collaborative care (6th ed.). St. Louis: Saunders. OBJ: Client Needs: Physiological Integrity TOP: Content Area: Nursing Sciences MSC: Integrated Process: Nursing Process—Planning


19. The nurse is caring for a client with Paget’s disease who has an elevated serum calcium level of 12.3 mEq/L. The nurse checks to see that which of the following medications is available in the stock medication supply for possible use to reverse this elevation? 1. Vitamin D 2. Calcium chloride 3. Calcium gluconate 4. Calcitonin


ANS: 4


Rationale: The normal serum calcium level is 4.5 to 5.5 mEq/L or 9 to 11 mg/dL. Calcitonin, a thyroid hormone, decreases the plasma calcium level by increasing the incorporation of calcium into the bones, thus keeping it out of the serum. In hypercalcemia, large doses of vitamin D should be avoided. Calcium gluconate and calcium chloride would be used to treat tetany that results from acute hypocalcemia.


Saunders Comprehensive Review for the NCLEX-RN Examination Silvestri 5th Edition Test Bank


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