NCLEX-RN: Health Promotion practice questions questions 1-25

Answer: C. Family history of seizures

Topic: Febrile Seizure Risk Factors

A family history of febrile or unprovoked seizures is a major risk factor for febrile seizures, indicating a strong genetic predisposition. Other risk factors include a high peak temperature, young age, and certain viral infections.

Why the others are wrong

• A – Delayed vaccinations increase the risk of vaccine-preventable infections that cause high fevers.
• B – A maternal diet rich in fruits and vegetables does not cause febrile seizures.
• D – Zinc and iron deficiencies, rather than high levels, are associated with febrile seizures.

Remember: Febrile seizures: Family history is the strongest spark.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: C. Rigid family expectations

Topic: Family Dynamics and Autonomy

The family's insistence that all members follow identical religious practices creates inflexible, controlling expectations that suppress individual belief exploration, which is defined as rigid family expectations—a maladaptive dynamic limiting autonomy.

Why the others are wrong

• A – Role inadequacy refers to mismatched responsibilities, not imposed belief conformity.
• B – Privacy and autonomy are affected, yet the core issue is expectation rigidity.
• D – Communication may be limited but not the primary unhealthy factor here.

Remember: Rigid expectations choke personal belief freedom.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: A. "I should avoid exercise during my period because movement worsens the pain."

Topic: Primary Dysmenorrhea Management

Regular physical activity and exercise actually help alleviate primary dysmenorrhea by releasing endorphins, improving pelvic blood flow, and reducing stress. Advising a client to avoid movement during their period is incorrect and indicates a need for further teaching.

Why the others are wrong

• B – Local heat application relaxes pelvic muscles and effectively reduces cramping and discomfort.
• C – Hormonal contraceptives suppress ovulation and thin the endometrium, successfully reducing menstrual pain.
• D – NSAIDs are first-line therapies best started before menses to block prostaglandin synthesis.

Remember: Keep moving to beat the cramping pain.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: D. Reflective Observation

Topic: Kolb Experiential Learning Theory

Reflective observation requires the learner to consciously step back from a task to review and assess the experience. During this phase, individuals reflect on what occurred and consider how it aligns with their prior understanding.

Why the others are wrong

• A – Concrete experience involves actively participating in a new event rather than reflecting on it.
• B – Abstract conceptualization focuses on developing new theories and general concepts from reflections.
• C – Active experimentation involves testing newly formed concepts and skills in practical scenarios.

Remember: Reflective observation means looking back before building new abstract theories.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: D. Engage in open discussions and use multimedia resources for health education

Topic: Adolescent Health Education

Adolescents benefit from interactive, collaborative learning that respects their autonomy. Engaging them in open discussions and utilizing multimedia resources aligns with their developmental stage, promoting active participation and better retention of health information.

Why the others are wrong

• A – Complex medical jargon causes confusion; plain, age-appropriate language should always be used.
• B – Holistic adolescent care must integrate both physical and mental health topics.
• C – Sensitive topics like sexuality and substance use must be addressed openly to ensure safety.

Remember: For teens, keep it open, interactive, and holistic.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: B. It can imply that the victim is at fault for the abuse.

Topic: Intimate Partner Violence

The term “cycle of violence” frames abuse as a repeating pattern, which can be interpreted as the victim’s behavior contributing to the abuse, leading courts to assign blame to the victim rather than the perpetrator.

Why the others are wrong

• A – Predictability is accurate; the issue is victim blaming, not predictability.
• C – The model describes patterns; it does not inflate abuse severity.
• D – The term relates to abuse dynamics, not clinical diagnosis accuracy.

Remember: Cycle language can blame victims, not perpetrators.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: A. Enmeshment and overinvolvement

Topic: Family Dynamics and Anxiety

Enmeshment and overinvolvement describe families that blur boundaries, expecting the adolescent to prioritize family wishes over personal needs, which creates significant chronic pressure and anxiety.

Why the others are wrong

• B – Lack of emotional warmth reflects neglect, not the over‑involvement described.
• C – Isolation indicates distance, whereas Lily experiences intrusive family pressure.
• D – Supportive relationships are healthy, not a source of anxiety.

Remember: Enmeshment = family over‑involvement, eroding teen’s personal boundaries.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: D. Use of accessory muscles for breathing

Topic: RSV Respiratory Distress

Respiratory syncytial virus (RSV) causes bronchiolitis in infants, leading to airway obstruction. To compensate for decreased oxygenation, infants exhibit increased work of breathing, which characteristically presents as the use of accessory muscles, such as intercostal and subcostal retractions.

Why the others are wrong

• A – Respiratory distress causes tachypnea (increased respiratory rate), not a decreased rate.
• B – Hypertension is not a typical sign of acute respiratory distress in infants.
• C – Dehydration from poor feeding in RSV leads to decreased, not increased, urination.

Remember: Distress in RSV makes the chest cave in (retractions).

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: A. Malassezia fungus disturbance

Topic: Seborrheic Dermatitis in Infants

Seborrheic dermatitis (cradle cap) in infants is primarily linked to an inflammatory reaction to Malassezia yeast, which thrives in sebum-rich areas stimulated by maternal hormones.

Why the others are wrong

• B – Seborrheic dermatitis is an inflammatory/fungal response, not an allergic reaction.
• C – Candida albicans causes diaper dermatitis and thrush, not seborrheic dermatitis.
• D – Staphylococcus aureus causes bacterial infections like impetigo, not seborrheic dermatitis.

Remember: Malassezia makes a mess of baby's scalp.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: A. Stiff neck, elevated temperature, and altered mental status

Topic: Meningitis Classic Triad

The classic clinical triad of bacterial meningitis consists of fever (elevated temperature), nuchal rigidity (stiff neck), and altered mental status. Most patients present with at least two of these key diagnostic findings.

Why the others are wrong

• B – Headache, photophobia, and vomiting are common but not the classic triad.
• C – Cough and muscle weakness are not classic symptoms of meningitis.
• D – Petechial rash is a sign of meningococcemia, not the classic triad.

Remember: Meningitis triad: Fever, stiff neck, and altered mind.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: A. Autonomy vs. shame and doubt

Topic: Erikson Psychosocial Stages

A toddler insisting on dressing alone reflects the developmental conflict of autonomy versus shame and doubt, where children seek independence and control over personal tasks.

Why the others are wrong

• B – Trust vs. mistrust addresses infant reliance on caregivers, not independence.
• C – Industry vs. inferiority pertains to school-age competence, unrelated to toddler self‑dressing.
• D – Initiative vs. guilt involves preschoolers planning activities, not dressing autonomy.

Remember: Toddlers want to do it themselves—autonomy stage.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: C. Health literacy

Topic: Social Determinants of Health

Health literacy influences a person's ability to understand medical information, navigate the health system, and follow treatment plans, making it a social determinant that directly affects access to healthcare services.

Why the others are wrong

• A – Genetic predisposition is a biological factor, not a social determinant of health.
• B – Environmental pollution affects health outcomes, but not immediate healthcare access.
• D – Access to healthy food influences nutrition, not direct healthcare service utilization.

Remember: Understanding health info opens doors to care.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: B. Create

Topic: Bloom's Taxonomy Levels

In Bloom's revised taxonomy, the highest level is Create, which requires learners to synthesize information to produce novel products, designs, or solutions, reflecting original thinking beyond application.

Why the others are wrong

• A – Interpret information; still not generating new concepts.
• C – Recall of facts; no new ideas.
• D – Use knowledge in familiar situations; not creating.

Remember: Create = make something brand‑new.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: A. Low-resource family with high resiliency

Topic: Family Resilience Assessment

The family experiences financial strain, indicating limited material resources, yet they demonstrate strong emotional cohesion and mutual support, reflecting high resiliency. Therefore they are best described as a low‑resource family with high resiliency.

Why the others are wrong

• B – They lack financial resources, so they are not high‑resource.
• C – They have strong emotional bonds, not poor support.
• D – Classification emphasizes resource level and resiliency, not just temporary instability.

Remember: Stressful wallet, strong heart: low resources, high resilience.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: B. Developing a nonjudgmental rapport

Topic: Readiness To Learn

Establishing a nonjudgmental rapport allows the nurse to gauge the client's motivation, cultural beliefs, and learning preferences, which are essential first steps in assessing readiness to learn.

Why the others are wrong

• A – Scheduling follow‑up occurs after readiness is determined.
• C – Medication administration does not evaluate learning readiness.
• D – Physical exam assesses health status, not learning readiness.

Remember: Build trust first; learning follows.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: B. Encouraging skin-to-skin contact and breastfeeding

Topic: Maternal Role Attainment Theory

Ramona Mercer’s Maternal Role Attainment Theory emphasizes that early, close physical contact and active caregiving, such as skin-to-skin contact and breastfeeding, foster maternal-infant bonding and help the parent successfully transition into and assume their maternal role.

Why the others are wrong

• A – Limiting contact hinders bonding and delays the parent's transition into the maternal role.
• C – Nurses must actively facilitate bonding and role attainment rather than remaining completely hands-off.
• D – Delaying caregiving delays maternal role attainment; early hands-on care builds maternal confidence.

Remember: Mercer means maternal bonding: skin-to-skin and feeding build the mothering role.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: A. Lack of pulmonary surfactant

Topic: Neonatal Respiratory Distress Syndrome

Respiratory distress syndrome in preterm infants is primarily caused by developmental deficiency of pulmonary surfactant. Surfactant reduces alveolar surface tension, preventing atelectasis and maintaining end-expiratory lung volume, which immature type II pneumocytes cannot adequately produce.

Why the others are wrong

• B – Meconium aspiration typically affects post-term or term infants experiencing perinatal distress, not preterm RDS.
• C – Congenital diaphragmatic hernia is a structural defect causing lung hypoplasia, not primary neonatal RDS.
• D – Neonatal pneumonia is an infectious process that mimics RDS but is not its primary cause.

Remember: Preemies lack surfactant, causing their tiny alveoli to collapse.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: B. Recommend wearing a supportive bra and applying warm compresses

Topic: Fibrocystic Breast Changes

Conservative measures are the first-line management for fibrocystic breast changes. Wearing a supportive, well-fitting bra minimizes breast movement and tension on Cooper ligaments, while applying warm compresses promotes local blood flow to relieve discomfort.

Why the others are wrong

• A – Oral contraceptives may be considered later, but nonpharmacologic conservative measures are the initial approach.
• C – Caffeine can exacerbate breast pain and swelling; reducing intake is typically advised.
• D – Fibrocystic changes are benign; routine surgical excision is unnecessary and does not prevent cancer.

Remember: Support the breasts and soothe with heat to beat cyclic pain.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: C. Encouraging the child to drink warm fluids

Topic: Pediatric Upper Respiratory Infection

Warm fluids help liquefy thick nasal secretions, soothe irritated airways, and maintain hydration in a child with an upper respiratory infection. This non-pharmacological intervention safely eases congestion and promotes comfort.

Why the others are wrong

• A – A supine position worsens nasal congestion; elevating the head of the bed is preferred.
• B – URIs are primarily viral; antibiotics are ineffective and not routinely prescribed.
• D – Cool-mist humidifiers are recommended to help loosen secretions and ease breathing.

Remember: Warm fluids and elevation ease congestion; avoid antibiotics for viral URIs.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: C. Vitamin B3 (Niacin)

Topic: Niacin Deficiency

Pellagra results from niacin (vitamin B3) deficiency, presenting with the 3 D's: dermatitis, diarrhea, dementia, plus glossitis and abdominal pain. If untreated, the condition can progress to severe neurological impairment and death.

Why the others are wrong

• A – Cobalamin deficiency presents with megaloblastic anemia and neurologic signs, not pellagra.
• B – Pyridoxine deficiency leads to peripheral neuropathy and sideroblastic anemia, not skin lesions.
• D – Riboflavin deficiency causes cheilosis and corneal vascularization, not pellagra.

Remember: Pellagra = 3 D's, think 'Niacin'.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: B. To defuse stress responses

Topic: Crisis Intervention Communication

Therapeutic communication allows nurses to actively listen, validate feelings, and provide calm reassurance, which reduces the client’s physiological stress response and facilitates coping during a crisis.

Why the others are wrong

• A – Minimizing emotion hinders therapeutic rapport.
• C – Regulations are unrelated to client emotional needs.
• D – Ending quickly prevents needed support.

Remember: Calm listening eases stress in crisis.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: A. Iron

Topic: Iron and Hemoglobin Production

Iron is a vital trace mineral required for the synthesis of hemoglobin, the protein in red blood cells that transports oxygen. Excellent dietary sources include heme iron from red meat and non-heme iron from spinach.

Why the others are wrong

• B – Zinc supports immune function, wound healing, and DNA synthesis, but does not form hemoglobin.
• C – Manganese is involved in bone formation and nutrient metabolism, not oxygen transport or hemoglobin production.
• D – Chromium regulates blood glucose levels by enhancing insulin action, rather than producing hemoglobin.

Remember: Iron builds hemoglobin to pump oxygen through your blood.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: C. Discuss adding complementary therapies such as heat therapy or acupuncture.

Topic: Chronic Pelvic Pain Management

When first-line NSAIDs provide incomplete relief for chronic pelvic pain, a multimodal approach is recommended. Discussing complementary therapies like heat or acupuncture empowers the client and safely enhances pain management without replacing prescribed medical treatments.

Why the others are wrong

• A – Recommending surgery is outside the nursing scope and prematurely dismisses conservative management options.
• B – Advising clients to stop prescribed medications for unproven herbal supplements is unsafe and inappropriate.
• D – False reassurance is non-therapeutic and ignores the client's current ineffective pain control.

Remember: For chronic pelvic pain, combine prescribed meds with complementary therapies for relief.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: A. Axillary temperature of 96.8°F (36°C)

Topic: Small For Gestational Age Assessment

Small for gestational age infants have limited subcutaneous fat and depleted brown fat stores, increasing vulnerability to cold stress. An axillary temperature below 97.7°F indicates hypothermia, which demands prompt rewarming to prevent severe metabolic acidosis and hypoxia.

Why the others are wrong

• B – Weight below the 10th percentile defines small for gestational age and is expected.
• C – Mild, transient tremors during feeding are common and usually benign in neonates.
• D – A glucose level of 45 mg/dL is within acceptable neonatal parameters after birth.

Remember: SGA lacks fat insulation, making cold stress the top priority.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: D. Higher rates of chronic health problems and mental illness in adulthood

Topic: Adverse Childhood Experiences

Adverse childhood experiences are linked to a dose‑response increase in adult chronic conditions such as heart disease, diabetes, and cancer, as well as higher prevalence of depression, anxiety, and substance‑use disorders, per CDC data.

Why the others are wrong

• A – Physical activity is not a documented outcome of ACE exposure.
• B – ACE exposure does not enhance cognition or academic achievement.
• C – ACE exposure actually raises, not reduces, mental illness risk.

Remember: ACE = early trauma, later health trouble.

Question adapted from Nursing Health Promotion, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.