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NCLEX-RN category

NCLEX Health Promotion and Maintenance Practice Questions

Quick answer

Health Promotion and Maintenance makes up 6 to 12 percent of the NCLEX-RN. It covers screening schedules, immunizations, lifestyle teaching, physical assessment technique, newborn care, growth and development and pregnancy, and most items ask which client statement proves the teaching worked.

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Students tend to treat this category as the easy one and then lose points on it because the facts are small and exact. The exam will ask the age a colonoscopy starts, which way to pull the ear on a toddler, or what to do when a client nods along but has not understood a word. There is rarely a crashing client here, so the trap is different: you pick the answer that sounds caring instead of the one that matches the guideline or the correct technique. Read for numbers, ages and sequence, and remember that "shows understanding" questions want the one statement that is fully correct, not the one that is close. The questions below sample the whole category. Maternity, pediatrics and growth and development each have their own page linked at the bottom.

Practice questions

1

A 45-year-old client with no family history of cancer asks the nurse which routine screenings are due this year. Which statement by the client shows a correct understanding of current adult screening guidelines?

  1. A"I can wait until I am 50 to have my first colonoscopy."
  2. B"I should schedule a colonoscopy now, and repeat it every 10 years if it is normal."
  3. C"I need a bone density scan this year because I am over 40."
  4. D"A PSA blood test is required every year starting at 45."
Show answer

Answer: B

Average-risk adults start colorectal cancer screening at age 45, and a normal colonoscopy is repeated every 10 years.

Why the others are wrong

Waiting until 50 follows an older guideline that has been replaced. Routine bone density screening begins at 65 for women without risk factors, not at 40. PSA testing is a shared decision between the client and the provider, usually discussed from 50 to 55 for average-risk men, and it is not a required yearly test.

2

A 66-year-old client who had chickenpox as a child and a shingles outbreak two years ago tells the nurse, "I already had shingles, so I do not need that vaccine." Which response by the nurse is correct?

  1. A"You are right, a prior shingles infection gives lifelong immunity."
  2. B"The shingles vaccine is still recommended for you. It is a two-dose series given 2 to 6 months apart."
  3. C"You only need the vaccine if you never had chickenpox."
  4. D"You can skip shingles, but you will need the pneumococcal vaccine every 5 years."
Show answer

Answer: B

The recombinant zoster vaccine is recommended for adults 50 and older, including those who have already had shingles, because the virus can reactivate again. It is two doses, 2 to 6 months apart.

Why the others are wrong

Shingles can recur, so a past episode does not protect the client. Having had chickenpox is the reason the client is at risk, not a reason to skip the vaccine. Pneumococcal vaccination for most older adults is a single dose of a conjugate vaccine, not a 5-year repeat.

3

A client who smokes one pack of cigarettes a day comes to the clinic for a routine visit. Which action should the nurse take first?

  1. AGive the client a pamphlet on nicotine replacement products
  2. BTell the client that smoking will shorten their life
  3. CAsk the client whether they are interested in quitting and how ready they feel
  4. DRefer the client to a telephone quit line
Show answer

Answer: C

Cessation counseling follows the 5 A's: ask, advise, assess, assist, arrange. After confirming tobacco use, the nurse assesses readiness to quit, because the plan depends on which stage of change the client is in.

Why the others are wrong

Pamphlets, warnings and referrals are "assist" and "arrange" steps. Offered before readiness is known, they are wasted on a client who is not ready and come across as lecturing.

4

The nurse is teaching a 20-year-old male client how to perform a testicular self-examination. Which statement indicates the teaching was effective?

  1. A"I will do the exam once a month after a warm shower."
  2. B"I should check my testicles first thing in the morning before I get out of bed."
  3. C"A hard, painless lump is normal as long as it does not grow."
  4. D"I only need to do this if someone in my family has had testicular cancer."
Show answer

Answer: A

The exam is done monthly, after a warm bath or shower when the scrotal skin is relaxed, rolling each testicle gently between the thumb and fingers.

Why the others are wrong

A cold or tense scrotum makes the testicles harder to feel, so morning before a shower is a poor time. Any painless lump or change in size must be reported, not watched. Testicular cancer is most common between 15 and 35 and can occur with no family history, so all young men are taught the exam.

5

A client newly diagnosed with hypertension is started on the DASH eating plan. Which food choice by the client shows that the diet teaching was understood?

  1. ACanned vegetable soup with crackers and a slice of cheddar cheese
  2. BDeli turkey sandwich on white bread with pickles
  3. CGrilled chicken, brown rice, steamed broccoli and a banana
  4. DFrozen pepperoni pizza with a diet cola
Show answer

Answer: C

The DASH plan is high in fruits, vegetables, whole grains and lean protein, and low in sodium and saturated fat. This plate also supplies potassium from the banana and broccoli, which helps lower blood pressure.

Why the others are wrong

Canned soup, crackers, cheese, deli meat, pickles and frozen pizza are all heavily salted. Each of those meals can run well over 1,000 mg of sodium when the daily goal on DASH is 1,500 to 2,300 mg.

6

A nurse preceptor is observing a new graduate perform physical assessments. Which action by the graduate requires the preceptor to intervene?

  1. APulling the pinna up and back to straighten the ear canal of an adult client
  2. BPalpating all four quadrants of the abdomen and then listening for bowel sounds
  3. CUsing the diaphragm of the stethoscope to listen for bowel sounds
  4. DPulling the pinna down and back before inserting the otoscope in a 2-year-old
Show answer

Answer: B

The abdomen is assessed in the order inspect, auscultate, percuss, palpate. Pressing on the abdomen before listening stirs up bowel sounds and gives a false picture of motility.

Why the others are wrong

Up and back is correct for adults and older children, and down and back is correct for children under 3 because the canal angles differently. Bowel sounds are high pitched, so the diaphragm is the right side of the stethoscope.

7

A client with a new prescription for an inhaler nods and says "Yes, I understand" after every sentence of the nurse's teaching. The nurse notices the client did not read the consent form before signing it. Which action should the nurse take first?

  1. AGive the client the written instructions to take home and review
  2. BAsk the client to show how they would use the inhaler and explain when to use it
  3. CDocument that teaching was completed and the client verbalized understanding
  4. DAsk a family member to come in and listen to the teaching instead
Show answer

Answer: B

The signs point to limited health literacy. Teach-back asks the client to demonstrate or explain in their own words, which shows the nurse what was actually learned and lets the nurse fix gaps on the spot.

Why the others are wrong

Written material does not help a client who may not read well. Documenting "verbalized understanding" when the client only nodded is inaccurate charting. Bringing in a family member bypasses the client and should only happen with the client's agreement after an assessment.

8

During a health history, the nurse screens a 52-year-old client for alcohol use. Which client response should prompt the nurse to assess further for an alcohol use problem?

  1. A"I have a glass of wine with dinner a couple of nights a week."
  2. B"My wife keeps getting on me about how much I drink, and it annoys me."
  3. C"I stopped drinking beer because it gave me heartburn."
  4. D"I have never had a drink before noon."
Show answer

Answer: B

Being annoyed by others criticizing your drinking is one of the four CAGE screening questions (cut down, annoyed, guilty, eye-opener). A yes to any one of them calls for a fuller assessment.

Why the others are wrong

One drink a few nights a week is within low-risk limits. Stopping a drink because of a side effect is not a sign of dependence. Never drinking in the morning is a negative answer to the eye-opener question.

9

The nurse is preparing a mother and her 2-day-old newborn for discharge. Which statement by the mother shows she understands newborn care?

  1. A"I will put the baby to sleep on his back in his own crib with a firm mattress and no blankets."
  2. B"I will fold the diaper over the cord stump to keep it covered and protected."
  3. C"I will put rubbing alcohol on the cord stump twice a day until it falls off."
  4. D"He can sleep in bed with me as long as I stay on my side."
Show answer

Answer: A

Supine sleep on a firm surface with no loose bedding, pillows or bumpers is the single biggest protection against sudden infant death. Room sharing is encouraged, bed sharing is not.

Why the others are wrong

The diaper is folded below the cord so air can reach it; covering it keeps it moist and slows separation. Current practice is to keep the stump clean and dry and let it fall off on its own in 1 to 3 weeks, without routine alcohol. Bed sharing raises the risk of suffocation regardless of the parent's position.

10

A 24-year-old client has just started a combined estrogen and progestin oral contraceptive. Which statement indicates the client needs more teaching?

  1. A"If I miss one pill, I will take it as soon as I remember and then take the next one at the usual time."
  2. B"I will call the clinic right away if I get a severe headache or pain and swelling in my calf."
  3. C"Since I am on the pill, I do not need to use condoms with a new partner."
  4. D"I will take the pill at the same time every day."
Show answer

Answer: C

Oral contraceptives prevent pregnancy but give no protection against sexually transmitted infections, so condoms are still needed with any new or untested partner.

Why the others are wrong

Taking a missed pill as soon as it is remembered, reporting the ACHES warning signs (abdominal pain, chest pain, headache, eye changes, severe leg pain) and taking the pill at a consistent time are all correct and show the teaching worked.

Quick tips

  • Memorize the current screening ages as numbers, not as ideas: colonoscopy 45, routine bone density 65, shingles vaccine 50, Pap test 21. The exam will offer an older age as a distractor.
  • For adult vaccines, know the dose count: shingles is two doses, Tdap is one dose then a tetanus booster every 10 years, flu is every year.
  • Any "shows understanding" question about diet, self-exams or contraception has three options that are each wrong in one small detail. Find the detail.
  • Assessment technique questions reward sequence. Abdomen goes inspect, auscultate, percuss, palpate. Ears go up and back for adults, down and back for children under 3.
  • When a client agrees with everything and asks no questions, the exam wants teach-back, not more handouts.

Related topics

FAQ

What does Health Promotion and Maintenance cover on the NCLEX?

It is the client-need category for keeping healthy people healthy: screening and immunization schedules, lifestyle and self-care teaching, physical assessment techniques, prenatal and postpartum care, newborn care, and growth and development across the lifespan.

How many Health Promotion and Maintenance questions are on the NCLEX-RN?

The test plan sets it at 6 to 12 percent. On an 85-question exam that is about 5 to 10 questions, and on a 150-question exam it can be up to 18.

Is Health Promotion the easiest NCLEX category?

It has fewer emergencies, but it is not easy to score well on because it tests exact facts: ages, dose counts, techniques and sequences. Most misses come from remembering an outdated guideline or choosing the kind-sounding option over the correct one.

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