Nursing Exam Prep

NCLEX-RN: Health Promotion practice questions questions 26-50

185 questions, page 2 of 8. Try each one first, then open the answer.

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26Question

What is the most common presenting symptom of nasolacrimal duct obstruction (NLDO) in newborns?

  1. Visual acuity issues
  2. Epiphora (excessive eye watering)
  3. Conjunctival hemorrhage
  4. Eye pain and redness
Show the answer and explanation

Answer: B. Epiphora (excessive eye watering)

Topic: Nasolacrimal Duct Obstruction

Nasolacrimal duct obstruction in newborns prevents normal tear drainage, most commonly presenting as persistent epiphora (excessive tearing) and crusting or mucoid discharge in the affected eye, typically resolving spontaneously within the first year.

Why the others are wrong

  • A – Does not affect the internal structures of the eye or visual development.
  • C – Typically results from birth trauma and presents as bright red patches, not tearing.
  • D – Suggests infection like conjunctivitis or corneal abrasion rather than simple obstruction.

Remember: Blocked tear duct: tears overflow (epiphora) but the eye stays calm.

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.

27Question

Which of the following is a potential complication of severe croup?

  1. Appendicitis
  2. Meningitis
  3. Pneumonia
  4. Peptic ulcers
Show the answer and explanation

Answer: C. Pneumonia

Topic: Severe Croup Complications

Severe croup, primarily a viral upper airway infection, can lead to complications like secondary bacterial tracheitis or pneumonia as the infection spreads downward into the lower respiratory tract or due to aspiration from respiratory distress.

Why the others are wrong

  • A – Appendicitis is an acute inflammation of the appendix, unrelated to respiratory croup infections.
  • B – Meningitis is an infection of the meninges, not a typical complication of croup.
  • D – Peptic ulcers are gastrointestinal lesions, unrelated to upper respiratory tract infections like croup.

Remember: Croup goes down: upper airway stridor can descend into lower airway pneumonia.

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.

28Question

What does the "ABCDE" criteria for melanoma screening stand for?

  1. Appearance, Bleeding, Color, Depth, Erosion
  2. Asymmetry, Bruising, Consistency, Discoloration, Edema
  3. Alignment, Border, Consistency, Depth, Enlargement
  4. Asymmetry, Border, Color, Diameter, Evolving
Show the answer and explanation

Answer: D. Asymmetry, Border, Color, Diameter, Evolving

Topic: Melanoma Skin Assessment

The ABCDE mnemonic identifies early warning signs of melanoma: Asymmetry, irregular Border, varied Color, Diameter greater than 6 mm, and Evolving characteristics over time. Recognizing these features enables early detection, prompt biopsy, and improved patient outcomes.

Why the others are wrong

  • A – Bleeding, depth, and erosion describe advanced complications rather than the standard screening mnemonic.
  • B – Bruising, consistency, discoloration, and edema are incorrect terms not included in the criteria.
  • C – Alignment, consistency, and depth are not components of the standard ABCDE screening mnemonic.

Remember: ABCDE: Asymmetrical Border, Colorful Diameter, Evolving over time.

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.

29Question

What is the primary goal of trauma-informed care (TIC)?

  1. To provide the fastest possible treatment to clients.
  2. To adhere strictly to traditional medical procedures without alteration.
  3. To avoid retraumatization and promote empowerment and recovery.
  4. To limit the amount of personal interaction between healthcare providers and clients.
Show the answer and explanation

Answer: C. To avoid retraumatization and promote empowerment and recovery.

Topic: Trauma-Informed Care

Trauma‑informed care centers on recognizing past trauma, preventing re‑traumatization, and fostering a safe environment that empowers patients and supports their recovery, rather than focusing solely on speed or rigid protocols.

Why the others are wrong

  • A – Speed of treatment does not address trauma’s psychological impact.
  • B – Rigid adherence ignores individual trauma histories.
  • D – Limiting interaction undermines trust and healing.

Remember: Avoid re‑trauma; empower and heal.

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.

30Question

Which of the following statements by a parent indicates a need for further teaching about managing a child's regression during hospitalization?

  1. "I will try to keep our normal routines as much as possible."
  2. "I should encourage my child to express feelings through play."
  3. "I will be patient and provide extra comfort and reassurance."
  4. "I will punish my child for using baby talk to encourage proper speech."
Show the answer and explanation

Answer: D. "I will punish my child for using baby talk to encourage proper speech."

Topic: Child Regression Management

Punishing a child for using baby talk is inappropriate because regression during hospitalization is a normal stress response; children need comfort, reassurance, play, and routine maintenance, not punitive measures.

Why the others are wrong

  • A – Maintaining routines supports stability; this is proper guidance.
  • B – Encourages healthy emotional expression through play; correct approach.
  • C – Shows appropriate patience and reassurance; not a teaching deficit.

Remember: Never punish regression; always support with comfort and routine.

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.

31Question

According to Knowles’ Theory of Adult Learning, which of the following best describes how adults prefer to learn?

  1. Adults are more self-directed and take responsibility for their own learning.
  2. Adults prefer learning through rote memorization and repetition.
  3. Adults are less likely to connect new information to their life experiences.
  4. Adults prefer to be passive recipients of information without questioning it.
Show the answer and explanation

Answer: A. Adults are more self-directed and take responsibility for their own learning.

Topic: Knowles' Theory of Andragogy

Knowles' Theory of Andragogy states that adult learners are self-directed, internally motivated, and take responsibility for their own learning. They prefer active involvement in the learning process and want to apply new knowledge immediately to solve real-world problems.

Why the others are wrong

  • B – Adults prefer problem-centered learning over rote memorization and repetition.
  • C – Adults rely heavily on their rich life experiences to anchor and connect new information.
  • D – Adults prefer active, collaborative engagement rather than being passive recipients of information.

Remember: Adults are self-directed drivers of their own learning journey.

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.

32Question

Which sign is commonly associated with a person experiencing a crisis?

  1. Calm and composed demeanor.
  2. Euphoria
  3. Escalating anxiety and confusion.
  4. High levels of productivity and efficiency
Show the answer and explanation

Answer: C. Escalating anxiety and confusion.

Topic: Crisis Signs Identification

Escalating anxiety and confusion indicate loss of coping ability, a hallmark of crisis; the individual shows heightened emotional distress, disorganized thinking, and inability to function normally, distinguishing crisis from calm, euphoria, or high productivity.

Why the others are wrong

  • A – Calm and composed demeanor reflects effective coping, not a crisis state.
  • B – Euphoria suggests mania or elation, which is opposite of crisis distress.
  • D – High productivity indicates stable functioning, inconsistent with crisis‑related disorganization.

Remember: Crisis = rising anxiety, confusion; calm, euphoria, productivity are not crisis signs.

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.

33Question

Several children have been brought to the clinic with cold-like symptoms. Which child has symptoms most consistent with acute sinusitis?

  1. A child who exhibits coughing and sneezing.
  2. A child with bad breath and thick, green nasal discharge.
  3. A child with nasal discharge that is thin and watery.
  4. A child with congestion and a sore throat.
Show the answer and explanation

Answer: B. A child with bad breath and thick, green nasal discharge.

Topic: Pediatric Acute Sinusitis

Acute sinusitis in children is characterized by thick, purulent nasal discharge, persistent daytime cough, and halitosis (bad breath) resulting from bacterial accumulation in the nasal and sinus passages.

Why the others are wrong

  • A – Coughing and sneezing are non-specific symptoms typical of a common viral upper respiratory infection.
  • C – Thin, watery nasal discharge is characteristic of allergic rhinitis or early viral rhinovirus infections.
  • D – Congestion and a sore throat are classic symptoms of a standard viral cold or pharyngitis.

Remember: Sinusitis: Thick green snot and smelly breath.

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.

34Question

A nurse is educating parents about feeding strategies for their SGA infant. Which statement by the parent indicates a need for further teaching?

  1. "I will work with a lactation consultant to improve my baby's latch."
  2. "I will keep track of the number of wet diapers to ensure my baby is getting enough milk."
  3. "Since my baby is small, I should wait until they cry before offering a feeding."
  4. "My baby may need tube feeding if they have trouble sucking effectively."
Show the answer and explanation

Answer: C. "Since my baby is small, I should wait until they cry before offering a feeding."

Topic: SGA Infant Feeding

Crying is a late hunger cue that wastes vital energy. Small-for-gestational-age infants have minimal glycogen stores and high metabolic demands, placing them at risk for hypoglycemia. Feedings should be offered on early hunger cues or a regular schedule.

Why the others are wrong

  • A – Lactation consultants provide essential guidance to improve latch and promote effective milk transfer.
  • B – Tracking wet diapers accurately monitors hydration status and the adequacy of oral intake.
  • D – SGA infants easily fatigue, so gavage feedings may be necessary to ensure sufficient calories.

Remember: Feed on early cues, not cries, to conserve energy and prevent hypoglycemia.

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.

35Question

A client experiencing a spontaneous abortion is found to have retained pregnancy tissue on ultrasound. The nurse anticipates which medical intervention?

  1. Bed rest with serial hCG monitoring
  2. Immediate induction of labor
  3. Administration of misoprostol
  4. Administration of oxytocin
Show the answer and explanation

Answer: C. Administration of misoprostol

Topic: Spontaneous Abortion Management

For an incomplete spontaneous abortion with retained tissue, misoprostol (a prostaglandin analogue) is administered to stimulate uterine contractions and facilitate the expulsion of the remaining products of conception, preventing infection and hemorrhage.

Why the others are wrong

  • A – Expectant management is inappropriate once retained tissue is confirmed due to infection risk.
  • B – Induction of labor is used for late-term pregnancies, not early spontaneous abortions.
  • D – Oxytocin is ineffective for expelling early pregnancy tissue and is used postpartum.

Remember: Misoprostol clears the womb when tissue is left behind.

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.

36Question

A client with CPP related to interstitial cystitis asks the nurse why she is being referred to physical therapy. What is the best response by the nurse?

  1. "Physical therapy can help improve your posture, which may reduce bladder pressure."
  2. "Strengthening the pelvic floor muscles may decrease pain and improve bladder function."
  3. "Physical therapy can cure interstitial cystitis by realigning the pelvic organs."
  4. "Therapy will teach you how to avoid certain exercises that might worsen your condition."
Show the answer and explanation

Answer: B. "Strengthening the pelvic floor muscles may decrease pain and improve bladder function."

Topic: Interstitial Cystitis Physical Therapy

Pelvic floor physical therapy helps clients with interstitial cystitis by training and strengthening the pelvic floor muscles, which supports bladder function, reduces spasms, and alleviates chronic pelvic pain.

Why the others are wrong

  • A – Posture improvement is not the primary mechanism for relieving interstitial cystitis pain.
  • C – Physical therapy manages symptoms but cannot cure interstitial cystitis or realign organs.
  • D – Therapy focuses on active rehabilitation and muscle training, not just avoiding exercises.

Remember: Pelvic floor therapy strengthens muscles to ease interstitial cystitis 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.

37Question

A nurse wants to encourage a child to take their medication daily. Based on B.F. Skinner’s operant conditioning theory, which of the following would be the most effective strategy?

  1. Scolding the child when they refuse to take the medication
  2. Ignoring the child’s refusal and waiting for them to take it on their own
  3. Offering a small reward, such as a sticker, each time the child takes their medication
  4. Forcing the child to take the medication, regardless of their willingness
Show the answer and explanation

Answer: C. Offering a small reward, such as a sticker, each time the child takes their medication

Topic: Operant Conditioning in Pediatrics

Offering a small reward each time the child takes medication provides positive reinforcement, increasing the likelihood of the desired behavior recurring, which aligns with Skinner’s operant conditioning principle of reinforcing desired actions.

Why the others are wrong

  • A – Scolding uses punishment, which may create fear and reduce cooperation.
  • B – Ignoring the refusal provides no feedback, so behavior is unlikely to change.
  • D – Forcing ignores autonomy and may cause resistance, not effective reinforcement.

Remember: Reward good behavior, not punish, to shape habits.

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.

38Question

A neonate is born with a gastroschisis, where the intestines are protruding from a hole in the abdominal wall. What is the most important initial action in managing this condition?

  1. Perform corrective surgery immediately
  2. Place the infant on parenteral nutrition
  3. Initiate antibiotic therapy to prevent infection
  4. Cover the exposed intestines with a sterile, moist dressing
Show the answer and explanation

Answer: D. Cover the exposed intestines with a sterile, moist dressing

Topic: Gastroschisis Immediate Nursing Care

Covering the exposed bowel with a sterile, saline-moistened dressing or bowel bag is the immediate priority. This protects the delicate intestines from trauma, prevents drying and necrosis, and minimizes significant fluid and heat loss.

Why the others are wrong

  • A – Surgical reduction is required, but immediate bedside stabilization and bowel protection come first.
  • B – Parenteral nutrition is required later, but immediate physical bowel protection takes precedence.
  • C – Antibiotics are administered early, but physical coverage immediately prevents severe hypothermia and dehydration.

Remember: Cover and moisten the bowel immediately to prevent drying and heat loss.

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.

39Question

The nurse is preparing a six-year-old client for discharge home after a tonsillectomy. Which of the following should be included in their discharge instructions?

  1. The client should lay flat on their back for 24 hours.
  2. The client can eat a regular diet as soon as they are alert.
  3. The client should drink milk to ensure optimal nutrition.
  4. Coughing, throat clearing, and nose blowing are discouraged.
Show the answer and explanation

Answer: D. Coughing, throat clearing, and nose blowing are discouraged.

Topic: Post-Tonsillectomy Discharge Care

Post-tonsillectomy care focuses on preventing hemorrhage. Activities that increase pressure on the surgical site, such as coughing, throat clearing, and nose blowing, must be avoided to prevent disruption of the healing clots.

Why the others are wrong

  • A – Lying flat increases swelling and aspiration risk; elevate the head of the bed.
  • B – A soft, cool diet is required initially; rough foods can cause bleeding.
  • C – Milk coats the throat, prompting clearing and coughing, which increases bleeding risks.

Remember: Post-tonsillectomy: Keep it cool, soft, and quiet to prevent bleeding.

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.

40Question

What is the most common causative virus of croup?

  1. Adenovirus
  2. Parainfluenza virus
  3. Respiratory syncytial virus
  4. Influenza virus
Show the answer and explanation

Answer: B. Parainfluenza virus

Topic: Croup Etiology

Parainfluenza virus (specifically type 1) is the most common cause of croup (laryngotracheobronchitis), accounting for the majority of cases. It typically presents with a characteristic barking cough, inspiratory stridor, and hoarseness in young children.

Why the others are wrong

  • A – Adenovirus commonly causes pharyngitis and upper respiratory infections, rarely croup.
  • C – Respiratory syncytial virus is the primary cause of bronchiolitis, not croup.
  • D – Influenza virus can cause croup but is a much less common cause than parainfluenza.

Remember: Parainfluenza causes the barking seal of croup.

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.

41Question

What is the most common causative organism of an upper respiratory tract infection (URI)?

  1. Streptococcus pneumoniae
  2. Influenza virus
  3. Respiratory syncytial virus (RSV)
  4. Rhinovirus
Show the answer and explanation

Answer: D. Rhinovirus

Topic: Upper Respiratory Infections

Rhinoviruses are the most common viral infective agents in humans and are the predominant cause of the common cold, which is the most frequent type of upper respiratory tract infection.

Why the others are wrong

  • A – Streptococcus pneumoniae is a bacterium; most URIs are viral.
  • B – Influenza causes the flu, which is less common than the common cold.
  • C – RSV typically causes lower respiratory tract infections, especially in infants.

Remember: Rhino means nose; rhinovirus is the top cause of runny noses.

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.

42Question

Copper is essential for the production of which of the following?

  1. Fluoride
  2. Glucose
  3. Hemoglobin
  4. Iodine
Show the answer and explanation

Answer: C. Hemoglobin

Topic: Copper and Hemoglobin Synthesis

Copper is a crucial trace mineral that works closely with iron to facilitate the synthesis of hemoglobin, the oxygen-carrying protein in red blood cells. A deficiency in copper can impair iron absorption and lead to anemia.

Why the others are wrong

  • A – Fluoride is a distinct mineral element, not a product synthesized by copper.
  • B – Glucose is a simple carbohydrate synthesized from carbon, hydrogen, and oxygen, not copper.
  • D – Iodine is an independent chemical element required for thyroid hormone synthesis, not copper.

Remember: Copper and iron work together to build hemoglobin.

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.

43Question

Which of the following is a modifiable risk factor for developing metabolic syndrome?

  1. Increased age
  2. Poor quality sleep
  3. Male gender
  4. Low socioeconomic status
Show the answer and explanation

Answer: B. Poor quality sleep

Topic: Metabolic Syndrome Risk Factors

Poor quality sleep can increase insulin resistance, blood pressure, and abdominal obesity, all components of metabolic syndrome, and can be improved through behavioral changes, making it a modifiable risk factor.

Why the others are wrong

  • A – Age cannot be changed; it is a non‑modifiable factor.
  • C – Gender is innate and cannot be modified.
  • D – Socioeconomic status is largely fixed and not directly alterable.

Remember: Sleep quality tweaks insulin; age and gender stay the same.

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.

44Question

Which trace mineral is necessary for glucose metabolism?

  1. Chromium
  2. Manganese
  3. Zinc
  4. Fluorine
Show the answer and explanation

Answer: A. Chromium

Topic: Trace Minerals Metabolism

Chromium is a trace mineral that enhances insulin receptor activity, facilitating glucose uptake into cells and supporting normal carbohydrate metabolism; deficiency can impair glucose tolerance, making it essential for proper glucose handling.

Why the others are wrong

  • B – Manganese acts as an enzyme cofactor but does not directly regulate glucose metabolism.
  • C – Zinc supports many enzymes, yet it is not the primary mineral for glucose metabolism.
  • D – Fluorine is involved in dental enamel formation, not glucose metabolism.

Remember: Chromium boosts insulin, helping glucose enter cells.

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.

45Question

What is the primary goal during the care of a child experiencing a febrile seizure?

  1. Ensure safety and prevent injury during the seizure
  2. Administer antibiotics to prevent infection
  3. Reduce fever immediately with antipyretics
  4. Restrain the child to prevent excessive movement
Show the answer and explanation

Answer: A. Ensure safety and prevent injury during the seizure

Topic: Febrile Seizure Management

The immediate priority is to protect the child from harm while the seizure occurs, maintaining airway, positioning, and preventing trauma; fever control can be addressed after the event.

Why the others are wrong

  • B – Antibiotics do not treat seizures and are unnecessary without bacterial infection.
  • C – Antipyretics are given after the seizure; immediate fever reduction is not priority.
  • D – Restraint can cause injury and airway obstruction; gentle positioning is preferred.

Remember: First protect the child, then treat the fever.

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.

46Question

Which vitamin deficiency may lead to pernicious anemia?

  1. Vitamin B1 (Thiamine)
  2. Vitamin B6 (Pyridoxine)
  3. Vitamin B12 (Cyanocobalamin)
  4. Vitamin B9 (Folic Acid)
Show the answer and explanation

Answer: C. Vitamin B12 (Cyanocobalamin)

Topic: Vitamin B12 Deficiency

Pernicious anemia results from an inability to absorb vitamin B12 due to intrinsic factor deficiency, causing a megaloblastic anemia characterized by large, immature red cells and neurologic symptoms.

Why the others are wrong

  • A – Thiamine deficiency causes beriberi, not anemia.
  • B – Pyridoxine deficiency may cause sideroblastic anemia, not pernicious.
  • D – Folic acid deficiency leads to megaloblastic anemia, but not pernicious.

Remember: Pernicious anemia = missing B12 absorption.

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.

47Question

During a home visit, you observe that Mr. and Mrs. Ramirez communicate openly and respect each other’s opinions, even when they disagree. However, their teenage son often feels isolated from the family due to his strict academic expectations. Which of the following best describes the family's overall dynamics?

  1. Low-resource family with poor communication
  2. Dysfunctional due to emotional detachment
  3. High-resource family with flexible expectations
  4. Healthy communication but rigid expectations
Show the answer and explanation

Answer: D. Healthy communication but rigid expectations

Topic: Family Dynamics Assessment

The parents demonstrate healthy communication through open, respectful dialogue. However, the family exhibits rigid expectations, as evidenced by the strict academic pressure that leaves their teenage son feeling isolated and disconnected from the family unit.

Why the others are wrong

  • A – The parents communicate openly and respectfully, and resource level is not mentioned in the scenario.
  • B – Open parental communication prevents the family from being classified as entirely dysfunctional or emotionally detached.
  • C – The strict academic expectations causing isolation indicate rigid, not flexible, family expectations.

Remember: Healthy talk meets rigid rules: open communication with unyielding expectations.

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.

48Question

A nurse is providing education to parents on toilet training. According to Freud, unsuccessful resolution of which stage may result in obsessive cleanliness or messiness in adulthood?

  1. Latency stage
  2. Oral Stage
  3. Genital stage
  4. Anal stage
Show the answer and explanation

Answer: D. Anal stage

Topic: Freud's Psychosexual Stages

According to Freud's psychosexual development theory, the anal stage (ages 1 to 3) focuses on toilet training. Conflict or fixation during this stage can lead to adult traits of extreme orderliness (anal-retentive) or extreme messiness (anal-expulsive).

Why the others are wrong

  • A – Latency stage involves dormant sexual feelings and focuses on social and academic peer interactions.
  • B – Oral stage fixation results in oral habits like smoking, overeating, or nail-biting.
  • C – Genital stage focuses on the maturation of sexual interests and relationships starting at puberty.

Remember: Anal stage is about control; fixation causes messy or obsessive control.

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.

49Question

A nurse is providing guidance to parents on how to manage their child’s stranger anxiety. Which of the following is an appropriate nursing intervention to help a child cope with stranger anxiety?

  1. Encourage frequent exposure to new people without the presence of the primary caregiver.
  2. Discourage the child from expressing fear and encourage them to interact with strangers.
  3. Allow the child to remain close to the primary caregiver when meeting new people.
  4. Avoid introducing the child to new people until they outgrow the anxiety.
Show the answer and explanation

Answer: C. Allow the child to remain close to the primary caregiver when meeting new people.

Topic: Child Development Anxiety

Allowing the child to stay near the primary caregiver during new social encounters provides a secure base, reduces fear, and supports gradual coping with stranger anxiety.

Why the others are wrong

  • A – Frequent exposure without caregiver can overwhelm and increase fear.
  • B – Discouraging fear invalidates emotions and may heighten anxiety.
  • D – Avoiding introductions delays normal social development.

Remember: Stay close to caregiver for safe, gradual social exposure.

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.

50Question

A client at six weeks postpartum reports feeling fatigued, overwhelmed, and uninterested in caring for her baby. What is the best nursing action?

  1. Suggest asking a family member for help with baby care.
  2. Screen the client for postpartum depression and refer to a provider.
  3. Encourage the client to get more sleep when the baby sleeps.
  4. Reassure the client that this is normal and will pass with time.
Show the answer and explanation

Answer: B. Screen the client for postpartum depression and refer to a provider.

Topic: Postpartum Depression Screening

Screening for postpartum depression and arranging a provider referral is essential, as early identification allows timely treatment, reduces maternal morbidity, and supports both mother and infant health during the vulnerable postpartum period.

Why the others are wrong

  • A – Asking family for help may help but does not screen for depression.
  • C – Suggesting more sleep alone does not address underlying mood disorder.
  • D – Reassuring normalcy ignores possible depression and delays needed assessment.

Remember: Screen, refer, treat: postpartum depression can't wait.

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.

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