Page 882 - Saunders Comprehensive Review For NCLEX-RN

finding. Therapeutic serum levels of magnesium are 4 to 7.5 mEq/L (2 to 3.75
mmol/L).
Test-Taking Strategy: Focus on the subject, magnesium toxicity. Eliminate option
3 first because it is a normal finding. Next, eliminate option 5, knowing that the
therapeutic serum level of magnesium is 4 to 7.5 mEq/L (2 to 3.75 mmol/L). From the
remaining options, recalling that proteinuria of 3 + would be noted and expected in a
client with preeclampsia will direct you to the correct options.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Pharmacology: Maternity/Newborn: Tocolytics
Health Problem: Maternity: Gestational hypertension/preeclampsia and eclampsia
Priority Concepts: Perfusion; Reproduction
Reference: McKinney et al. (2018), pp. 539, 544.

286. Answer: 1

Rationale: Eye prophylaxis protects the newborn against Neisseria gonorrhoeae and
Chlamydia trachomatis. The eyes are not flushed after instillation of the medication
because the flush would wash away the administered medication. Options 2, 3, and
4 are correct statements regarding the procedure for administering eye medication to
the newborn.
Test-Taking Strategy: Note the strategic words, further teaching is needed. These
words indicate a negative event query and ask you to select an option that is an
incorrect statement. Eliminate options 3 and 4 first because they are comparable or
alike and relate to instilling the eye medication. From the remaining options,
visualize the effect of each. This will direct you to the correct option.
Level of Cognitive Ability: Evaluating
Client Needs: Health Promotion and Maintenance
Integrated Process: Teaching and Learning
Content Area: Pharmacology: Maternity/Newborn: Eye Prophylaxis for the
newborn
Health Problem: Newborn: Infections
Priority Concepts: Health Promotion; Infection
Reference: McKinney et al. (2018), p. 463.

287. Answer: 2

Rationale: Betamethasone, a glucocorticoid, is given to increase the production of
surfactant to stimulate fetal lung maturation. It is administered to clients in preterm
labor at 28 to 32 weeks of gestation if the labor can be inhibited for 48 hours.
Nalbuphine is an opioid analgesic. Rh (D) immune globulin is given to Rh-negative
o
clients to prevent sensitization. Dinoprostone vaginal insert is a prostaglandin given
to ripen and soften the cervix and to stimulate uterine contractions.
Test-Taking Strategy: Focus on the subject, a client at 31 weeks’ gestation. Recall
that the preterm infant is at risk for respiratory distress syndrome because of
immaturity and the inability to produce surfactant. Next, recalling the actions of the

882