NCLEX review discrepancies?

[It's Alisa]

Hello everybody,

So I've been reviewing for the NCLEX using a variety of books, and am confused on some questions...

1. In Saunders Q & A review for PN 3rd edition, there is a question " A client arrives in the ER after a chemical splash into the eye. The client tells the nurse that the eye was irrigated w/ tap water for 5 minutes before coming to the ER. The nurse proceeds with the irrigation with normal saline and tests the pH of eye w/ litmus paper. The nurse should resume the normal saline wash until the pH test reads: 7.0 7.5 7.8 8.0 "

The book says it should be irrigated until 7.0.... but I've read in different books that its 7.45 (so 7.5 here)....so I'm officially confused....irrigate until 7 or 7.5?

2. Also, in Lippincott's review for PN (7th edition) there is a question that says: "The nurse inserts a gastric sump tube in the client with a perforated ulcer and asks the LPN to check its placement. Which is the most appropriate technique for determining if the distal end of the tube is in the stomach?

a. requesting a portable x-ray of stomach

b. listening over the stomach as air is instilled

c. adding 100mL of tap water into the tube

d. feeling for air at the proximal end of the tube."

The book says the answer is B, w/ the rationale being that an x-ray is too expensive and unnecessary radiation to pt. Now I know in the clinical setting, we do B...but I've always been told that for nclex, it's the IDEAL setting, and the BEST way to check is w/ an x-ray. So to x-ray or not x-ray? That is the question

[IrishIzCPNP, MSN, RN, APRN, NP]

2. Also, in Lippincott's review for PN (7th edition) there is a question that says: "The nurse inserts a gastric sump tube in the client with a perforated ulcer and asks the LPN to check its placement. Which is the most appropriate technique for determining if the distal end of the tube is in the stomach?

a. requesting a portable x-ray of stomach

b. listening over the stomach as air is instilled

c. adding 100mL of tap water into the tube

d. feeling for air at the proximal end of the tube."

The book says the answer is B, w/ the rationale being that an x-ray is too expensive and unnecessary radiation to pt. Now I know in the clinical setting, we do B...but I've always been told that for nclex, it's the IDEAL setting, and the BEST way to check is w/ an x-ray. So to x-ray or not x-ray? That is the question

Real simple...the LPN isn't about to do an xray.

I personally wouldn't pick x-ray. There's no guarantee that you would really be able to see the end unless it's weighed. The radiation isn't needed. Evidence base is pH residual and not x-ray. So I don't know that there's anything out there that says x-ray is best.

So then looking at the options...

LPN isn't going to x-ray a patient.

If the LPN adds water and the tube is misplaced you could have some problems.

I'm not sure why anyone would feel for air at the proximal end.

So that leaves...listening for air.