 Hi and thank you for watching Nursing School Explained. Today I'm going to review this book called Prioritization and Clinical Judgment for NCLEX-RN and I'm going to go over a example question and then show you how FA Davis presents the rationale for correct and incorrect answers. So I've chosen a question here from the Respiratory Management chapter and the question goes like this. The client diagnosed with abdominal pain of unknown ideology has a nasogastric tube draining green bile and reports abdominal pain of 8 on a 10 scale. The client's ABG values are reported in the accompanying table, which intervention should the nurse implement based on the client's ABGs? And the nice thing is here you have the client value as well as the normal range, although you should be memorizing these according to your books and whatever NCLEX review that you've taken. So now right away before even looking at the question, I highly recommend that you look at those ABGs and try to interpret them and if you want to learn more about how to do that, I have a video that goes into all the details. In this case this patient is in metabolic alkalosis. So and we know that the patient has an NG tube in place meaning that too much acid has left the body, which probably has something to do with that NG tube. So right away you don't even have to look at the answer questions. You know the answer probably has something to do with the NG tube. So let's look at that. Assess the client to rule out any complications secondary to the client's pain. Okay, but the patient has pain. Is that a priority right now? Probably not. Determined the last time the client was medicated for abdominal pain? Yes, important, but is not really related to those ABGs. Check the amount of suction on the client's and his gastric tube. Remember we said this probably has something to do with the NG tube. And then administer intravenous sodium bicarbonate to the client. Sodium bicarbonate is a buffer that we give to patient in acidosis to make them more alkaline. So in this case this would be contraindicated because the sodium bicarbonate is an alkaline agent and would make the alkalosis worse. So in this case we're going to go with option number three. And then I'm going to show you what the rationales look like over here. Number 19. So first of all it tells you here the client is a metabolic alkalosis so this intervention is not appropriate for the client's ABG. This was the pain. Second one tells you the same exact thing is a metabolic alkalosis so this intervention is not appropriate for the client's ABG because pain has nothing to do with ABGs. And then here it goes into the ABG indicates metabolic alkalosis which could be caused by too much hydrochloric acid being removed via the NG tube therefore the nurse would check the NG wall suction. Number four. Sodium bicarbonate is administered for metabolic acidosis not metabolic alkalosis. So this is also has a clinical judgment guide so it says here the nurse must be knowledgeable regarding normal lab values. These values must be memorized and the nurse must be able to determine if the lab values are normal for the client's disease process or medication or the medications the client is taking. So again this goes back into knowing your basic lab values and being able to interpret those. The book goes into the different body systems as you can see here so it goes in from anything to cardiovascular peripheral respiratory GI, GU, RENOM all the different body systems and then at the end here we'll have some case studies for different medical surgical but also ICU case studies, outpatient clinic, home health, mental health and maternal newborn case studies and then a comprehensive exam at the end and remember you have rationales for all of those. Best here is that you get 20% with coupon code Petra20 so make sure when you head over to FEDavis to order this book to help you with your NCLEX exam to use the code so that you get that discount and get ready for your studies. Thanks for watching.