Questions 151

NCLEX-RN

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Question 1 of 5

A client with a history of stroke is prescribed clopidogrel (Plavix). The nurse should monitor the client for which of the following adverse effects?

Correct Answer: A

Rationale: Clopidogrel, an antiplatelet, increases bleeding risk, requiring monitoring.

Question 2 of 5

Which tool or scale would you use for a focused neurological assessment of your client?

Correct Answer: D

Rationale: The Rancho Los Amigos Scale is used for assessing levels of consciousness and cognitive recovery in patients with brain injuries, ideal for a focused neurological assessment.

Question 3 of 5

An adolescent with type 1 diabetes mellitus is hospitalized for appendicitis. He is weak and nauseated with poor skin turgor. The nurse notes a fruity odor to the client's breath. The client uses insulin. The nurse should suspect:

Correct Answer: A

Rationale: Fruity breath, weakness, nausea, and poor skin turgor in a type 1 diabetic suggest diabetic ketoacidosis, a complication of uncontrolled hyperglycemia. Hypoglycemia would present with shakiness or sweating, not fruity breath.

Question 4 of 5

A client with chronic kidney disease is on a fluid restriction. How should the nurse calculate the client's daily fluid intake?

Correct Answer: A

Rationale: Fluid intake in chronic kidney disease is typically calculated as urine output plus 500 mL to replace insensible losses while preventing fluid overload.

Question 5 of 5

The nurse is assessing a client with a suspected cholecystitis. Which of the following findings is most indicative of this condition?

Correct Answer: A

Rationale: Right upper quadrant pain is a hallmark sign of cholecystitis due to gallbladder inflammation.

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