NCLEX-RN Health Promotion and Maintenance practice questions

Question 1

A nurse in a community health screening clinic is assessing four adult clients. Which finding requires the nurse to obtain further assessment before allowing the client to leave the clinic?

1. A A 30-year-old client with a blood pressure of 122/78 mmHg and a seasonal cough
2. B A 60-year-old client with a blood pressure of 118/76 mmHg and an irregular pulse
3. C A 45-year-old client with a blood pressure of 138/86 mmHg and mild fatigue
4. D A 55-year-old client with a blood pressure of 130/82 mmHg and occasional heartburn

Question 2

A nurse is reviewing current recommended health screening guidelines with a group of clients at a community health fair. Which statement by the nurse about screening for colorectal cancer is accurate?

1. A Adults with average risk should begin screening at age 65.
2. B Adults with average risk should begin screening at age 30.
3. C Adults with average risk should begin screening at age 50, only if male.
4. D Adults with average risk should begin screening at age 45.

Question 3

A 24-year-old primigravida at 39 weeks gestation is admitted in active labor. Cervical exam shows 5 cm dilation, 80% effacement, and station -1. The fetal heart rate tracing is Category I with moderate variability. The client requests an epidural for pain management. Which nursing action is most appropriate at this time?

1. A Administer a bolus of 500 mL lactated Ringer’s solution before the anesthesiologist arrives.
2. B Check the client’s platelet count from the admission labs and document the result.
3. C Call the anesthesiologist immediately and obtain a signed consent form for the epidural.
4. D Position the client in left lateral and encourage breathing techniques until the epidural is placed.

Question 4

A 50-year-old male client with no significant medical history comes to a health fair. He reports that his father had a myocardial infarction at age 55. Which health screening should the nurse recommend as a priority for this client?

1. A A fasting lipid panel to assess cholesterol levels.
2. B A bone density scan to screen for osteoporosis.
3. C A prostate-specific antigen (PSA) test to screen for prostate cancer.
4. D A colonoscopy to screen for colorectal cancer.

Question 5

A 55-year-old male client with no known cardiac history comes to the clinic for a routine physical. The nurse uses a stethoscope to auscultate the heart. Which technique is correct for assessing the apical pulse?

1. A Place the diaphragm of the stethoscope at the left midclavicular line in the fifth intercostal space
2. B Place the bell of the stethoscope at the right sternal border in the second intercostal space
3. C Place the diaphragm of the stethoscope at the left sternal border in the fourth intercostal space
4. D Place the bell of the stethoscope at the left midclavicular line in the fifth intercostal space

Question 6

A 28-year-old G1P0 at 39 weeks gestation is in active labor with contractions every 3 minutes. Cervical exam is 6 cm, 80% effaced, and 0 station. The fetal heart rate shows moderate variability with accelerations and no decelerations. The client asks for pain relief. Which nonpharmacologic comfort measure is most appropriate to suggest at this time?

1. A Recommend deep breathing with a prolonged exhale through pursed lips
2. B Encourage the client to lie supine with a pillow under the knees
3. C Advise the client to hold her breath during each contraction
4. D Suggest using a birthing ball with upright positioning between contractions

Question 7

A 45-year-old female client at a community health fair asks which cancer screening is most important for her age group. She has no family history of cancer and no current symptoms. Which screening should the nurse recommend?

1. A Low-dose CT chest scan every year for smokers
2. B Pap smear every 3 years until age 65
3. C Mammography every 2 years starting at age 40
4. D Colonoscopy every 10 years starting at age 45

Question 8

A 4-year-old child is brought to the pediatric clinic for a well-child visit. The mother reports that the child sometimes refuses to share toys and has frequent temper tantrums. Which statement by the nurse best reflects normal development for this age?

1. A A 4-year-old should be able to share consistently and tantrums suggest a developmental delay
2. B Refusing to share at age 4 may indicate a need for behavioral intervention and social skills training
3. C Temper tantrums and difficulty sharing are typical for a 4-year-old who is developing autonomy
4. D Frequent tantrums at this age are usually caused by inadequate limit-setting by the parents

Question 9

An 80-year-old female client in a long-term care facility tells the nurse she feels tired and has lost interest in meals. She has a history of osteoarthritis and takes ibuprofen as needed. Vital signs are normal. Which age-related change should the nurse consider first?

1. A Possible adverse effect of ibuprofen causing gastric irritation
2. B Normal age-related decline in basal metabolic rate and appetite
3. C Increased need for protein due to muscle loss from sarcopenia
4. D Reduced taste bud sensitivity and decreased gastric motility

Question 10

A 30-year-old client who gave birth vaginally 12 hours ago has a fundus firm at the umbilicus and moderate lochia rubra with no clots. The client's vital signs are temperature 37.2°C, heart rate 72/min, blood pressure 118/74 mm Hg. The client reports perineal pain rated 6 out of 10. Which nursing intervention is most appropriate?

1. A Insert an indwelling urinary catheter to empty the bladder
2. B Apply an ice pack to the perineum and offer ibuprofen 600 mg orally
3. C Massage the fundus firmly until it becomes boggy
4. D Notify the provider about possible retained placental fragments