Questions 150

NCLEX-RN

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Question 1 of 5

Your client has a doctor's order for the antihistamine medication diphenhydramine for sleep. What should you do?

Correct Answer: D

Rationale: Diphenhydramine (Benadryl) is commonly used off-label for sleep due to its sedative effects, making it an appropriate choice if ordered for this purpose.

Question 2 of 5

A 4-year-old child is admitted with dehydration due to gastroenteritis. Which assessment finding indicates severe dehydration?

Correct Answer: C

Rationale: Sunken fontanelles in a young child are a sign of severe dehydration, indicating significant fluid loss requiring urgent rehydration.

Question 3 of 5

The nurse is caring for a client who has just received a diagnosis of terminal cancer. The client says, 'I don't want to tell my family yet.' Which of the following responses by the nurse is most appropriate?

Correct Answer: B

Rationale: Respecting the client's autonomy while offering support is the most appropriate response, honoring their decision about disclosure.

Question 4 of 5

The nurse is delivering care to a client who is diagnosed with toxic shock syndrome (TSS). Which complication of this syndrome should the nurse monitor the client for?

Correct Answer: D

Rationale: TSS is caused by infection and is often associated with tampon use. DIC is a complication of TSS. The nurse monitors the client for signs of this complication, and notifies the primary health care provider promptly if signs and symptoms are noted. The other options are not complications of TSS.

Question 5 of 5

A client with cirrhosis is admitted with ascites. The nurse should monitor the client for which of the following complications?

Correct Answer: A

Rationale: Ascites can cause diaphragmatic compression, leading to respiratory distress, which requires monitoring.

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