Decision Tree:
This walk-through provides test-taking strategies to determine the correct answer for the different types of questions you will encounter on the NCLEX-RN exam. These strategies are based on the Kaplan Decision Tree (DT) algorithm, a technique that provides a process to determine the correct answer for NCLEX-style questions.
This is an Evaluation Question.
For this type of question, you are looking for something correct/incorrect, right/wrong, safe/unsafe, or true/false. Use these steps, based on the Kaplan Decision Tree, to determine the correct answer.
STEP 1: Can you identify the topic of the question?
- Expected IV fluid when TPN is discontinued.
STEPS 2-4: These steps are not relevant to this type of question because you do not need to use the rules for Evaluation questions. Move to Step 5.
STEP 5: What is the outcome of each of the remaining answer choices?
Evaluate the outcome(s)
1. Ringer lactate. This IV fluid contains electrolytes and does not contain any dextrose and therefore, would not be a good choice when discontinuing TPN. Eliminate.
2. 0.9% sodium chloride. This IV fluid contains electrolytes in an isotonic solution without dextrose. Because of the potential of hypoglycemia when discontinuing TPN, it is not a good choice. Eliminate.
3. 10% dextrose in water.This solution is similar to TPN in regard to dextrose concentrations so it is the best choice of fluid to hang so that the client's blood glucose does not drop quickly after TPN is discontinued.
4. 0.45% sodium chloride. This IV fluid contains a hypotonic salt solution without dextrose and would not be a good choice when discontinuing TPN. Eliminate.
Select the best choice:
Is #3 the correct answer? Yes, 10% dextrose solution is the best IV fluid to hang to prevent hypoglycemia in a client whose TPN has been discontinued.
Does #3 make sense? Yes, hanging 10% dextrose as the IV fluid after discontinuation of TPN makes sense to prevent hypoglycemia.
