Nursing Exam Prep

NCLEX-RN: Health Promotion practice questions questions 51-75

185 questions, page 3 of 8. Try each one first, then open the answer.

Practise these interactively

51Question

An infant is diagnosed with esophageal atresia (EA) and tracheoesophageal fistula (TEF). Which of the following clinical manifestations would the nurse expect to observe during feeding?

  1. Abdominal distention and vomiting
  2. Coughing, choking, and cyanosis
  3. Rapid breathing and poor feeding
  4. Excessive drooling and failure to thrive
Show the answer and explanation

Answer: B. Coughing, choking, and cyanosis

Topic: Tracheoesophageal Fistula Manifestations

Esophageal atresia with tracheoesophageal fistula classically presents during feeding with the three Cs: coughing, choking, and cyanosis. Oral fluids enter the blind pouch and aspirate into the trachea, causing acute airway compromise and respiratory distress.

Why the others are wrong

  • A – Abdominal distention may occur, but vomiting is not the primary hallmark during initial feeds.
  • C – These are vague, non-specific signs rather than the classic triad seen with feeding attempts.
  • D – Excessive drooling occurs at rest, but failure to thrive takes time to develop.

Remember: TEF feeding triad: The Three Cs—Coughing, Choking, and Cyanosis.

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.

52Question

A nurse is counseling parents who are going through a divorce. The parents frequently argue in front of their 8-year-old daughter, who has begun to show signs of anxiety and withdrawal. Which of the following actions would the nurse most likely recommend to minimize the impact of this Adverse Childhood Experience (ACE)?

  1. Limit the child's exposure to the other parent to reduce stress
  2. Reassure the child that the divorce is her fault and that she can fix the issues
  3. Keep the child’s routine as unchanged as possible and avoid involving her in conflicts
  4. Encourage the child to take sides to resolve the family conflict more quickly
Show the answer and explanation

Answer: C. Keep the child’s routine as unchanged as possible and avoid involving her in conflicts

Topic: Adverse Childhood Experiences

Maintaining a consistent daily routine and protecting the child from parental arguments provides stability, reduces anxiety, and promotes coping skills, which are evidence‑based strategies to mitigate the negative effects of adverse childhood experiences.

Why the others are wrong

  • A – Limiting exposure to one parent increases instability and may worsen stress.
  • B – Blaming the child harms self‑esteem and intensifies feelings of guilt.
  • D – Encouraging taking sides creates loyalty conflicts and heightens anxiety.

Remember: Stable routines protect kids from conflict stress.

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.

53Question

What does the concept of "psychological control" in parenting refer to?

  1. Providing warmth and emotional support to children.
  2. Physical discipline methods used to manage a child's behavior.
  3. Parenting practices like guilt induction, withdrawal of love, and shaming.
  4. Setting clear and consistent rules for children's behavior.
Show the answer and explanation

Answer: C. Parenting practices like guilt induction, withdrawal of love, and shaming.

Topic: Psychological Control In Parenting

Psychological control refers to parenting behaviors that intrude upon a child's emotional and psychological development. This is characterized by manipulative tactics such as guilt induction, shaming, and the withdrawal of love to influence the child's behavior.

Why the others are wrong

  • A – This describes parental warmth and responsiveness, which fosters secure attachment.
  • B – This describes corporal punishment or physical discipline, not psychological manipulation.
  • D – This describes behavioral control or authoritative parenting, which provides healthy structure.

Remember: Psychological control manipulates emotions using guilt, shame, and love withdrawal.

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.

54Question

A community is known for its high rates of violence, easy access to drugs and alcohol, and limited youth activities. Which of the following is the best strategy a public health nurse can implement to reduce the risk of ACEs in this community?

  1. Promote stricter laws against drug and alcohol use
  2. Provide financial incentives for families to move to safer neighborhoods
  3. Increase law enforcement presence to reduce crime rates
  4. Organize after-school programs that engage and support at-risk youth
Show the answer and explanation

Answer: D. Organize after-school programs that engage and support at-risk youth

Topic: Adverse Childhood Experiences

Organizing after‑school programs provides protective environments, mentorship, and structured activities that mitigate exposure to violence, substance use, and trauma, directly reducing the incidence of adverse childhood experiences.

Why the others are wrong

  • A – Stricter drug/alcohol laws target behavior without offering alternatives, limiting effectiveness in preventing ACEs.
  • B – Financial incentives to relocate families ignore community‑level determinants and may not be feasible for many residents.
  • C – Increasing police presence does not address underlying risk factors or provide supportive environments for youth.

Remember: Safe, engaging activities protect kids from trauma.

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.

55Question

A nurse is conducting a prenatal education session about preterm birth risk factors. Which statement by a pregnant patient requires further teaching?

  1. “As long as I’m eating a balanced diet, my stress levels won’t impact my pregnancy.”
  2. “I should avoid smoking and alcohol to reduce my risk of preterm birth.”
  3. “If I have symptoms of preterm labor, I should seek medical attention immediately.”
  4. “Since I had a preterm birth before, I am at higher risk this time.”
Show the answer and explanation

Answer: A. “As long as I’m eating a balanced diet, my stress levels won’t impact my pregnancy.”

Topic: Preterm Birth Risk Factors

High maternal stress increases the risk of preterm birth by triggering corticotropin-releasing hormone release. A balanced diet does not eliminate the physiological impact of stress, so this statement requires further teaching.

Why the others are wrong

  • B – Smoking and alcohol abuse are modifiable risk factors that significantly increase preterm birth risk.
  • C – Promptly seeking medical attention for preterm labor symptoms is critical for timely intervention.
  • D – A history of previous preterm birth is the strongest risk factor for recurrence.

Remember: Stress and distress can cause preterm birth, regardless of diet.

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.

56Question

In the transtheoretical model (TTM) of change theory, which stage involves the client actively making changes to their behavior?

  1. Contemplation
  2. Precontemplation
  3. Preparation
  4. Action
Show the answer and explanation

Answer: D. Action

Topic: Transtheoretical Model of Change

The action stage of the Transtheoretical Model involves the individual actively modifying their behavior, experiences, or environment to overcome their problems. This stage requires a commitment of time and energy to make visible, observable changes.

Why the others are wrong

  • A – Contemplation involves intending to change in the next six months but taking no action.
  • B – Precontemplation involves no intention to take action in the foreseeable future.
  • C – Preparation involves intending to take action in the immediate future with small steps.

Remember: Action is the active implementation of behavior change.

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.

57Question

During a prenatal visit at 41 weeks’ gestation, a pregnant patient asks why the provider is recommending fetal surveillance. What is the best response by the nurse?

  1. "This testing ensures your baby is growing at a normal rate."
  2. "There is an increased risk of fetal distress due to placental aging."
  3. "We need to monitor your baby's lung maturity before delivery."
  4. "Post-term infants are at risk for premature birth complications."
Show the answer and explanation

Answer: B. "There is an increased risk of fetal distress due to placental aging."

Topic: Post-Term Fetal Surveillance

At 41 weeks of gestation, placental function naturally begins to decline due to aging and calcification. Fetal surveillance, such as biophysical profiles, is indicated to detect uteroplacental insufficiency and prevent fetal distress, hypoxemia, or intrauterine demise.

Why the others are wrong

  • A – Surveillance evaluates immediate oxygenation and fetal well-being rather than long-term growth rate.
  • C – Fetal lung maturity is already well-established by 41 weeks of gestation.
  • D – Post-term infants face complications of prolonged pregnancy, not premature birth risks.

Remember: Aging placenta means less oxygen; surveillance catches distress early.

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.

58Question

A client three weeks postpartum calls the clinic stating she has flu-like symptoms, body aches, and tenderness in one breast. What should the nurse recommend first?

  1. "Continue breastfeeding frequently and call your provider, as this may be mastitis."
  2. "Monitor your temperature, and call back if it reaches 101°F or higher."
  3. "Stop breastfeeding until the symptoms resolve."
  4. "Try applying a cold compress to reduce swelling."
Show the answer and explanation

Answer: A. "Continue breastfeeding frequently and call your provider, as this may be mastitis."

Topic: Postpartum Mastitis Management

The client's symptoms of unilateral breast tenderness, body aches, and flu-like symptoms indicate mastitis. The nurse must advise continuing breastfeeding to empty the breast and prevent abscess formation, while promptly contacting the healthcare provider for evaluation and potential antibiotic therapy.

Why the others are wrong

  • B – Delaying care to monitor temperature is unsafe, as systemic symptoms already suggest mastitis.
  • C – Abruptly stopping breastfeeding worsens milk stasis, increasing the risk of breast abscess formation.
  • D – Cold compresses can soothe discomfort but do not address the underlying infection or breast emptying.

Remember: For mastitis, keep breastfeeding to empty the breast and call the provider.

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.

59Question

A nurse is caring for a 10-month-old infant who cries excessively when their parent leaves the room. According to Erikson’s stages of psychosocial development, which nursing intervention would best support the infant’s psychosocial needs?

  1. Limit holding and comforting to prevent overdependence
  2. Encourage consistent, responsive caregiving to build a sense of trust
  3. Encourage the parents to leave without saying goodbye to reduce distress
  4. Provide a variety of new toys to distract the infant from the absence of their parent
Show the answer and explanation

Answer: B. Encourage consistent, responsive caregiving to build a sense of trust

Topic: Infant Trust Development

Consistent, responsive caregiving fosters trust, the primary psychosocial need of infants in Erikson’s trust versus mistrust stage, promoting secure attachment, emotional stability, and overall healthy development.

Why the others are wrong

  • A – Limiting comfort can lead to insecure attachment and heightened distress.
  • C – Leaving without goodbye increases anxiety and undermines trust formation.
  • D – Distraction does not address the infant’s need for reliable caregiver responsiveness.

Remember: Trust grows when caregivers respond consistently to infant cues.

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.

60Question

A nurse is providing education to new parents about feeding their infant who has a cleft lip and palate. Which of the following statements by the parents indicates a need for further teaching?

  1. I will place my baby on their back immediately after feeding to prevent choking."
  2. "I should use a special bottle with a one-way valve to help my baby feed."
  3. "I will hold my baby in an upright position while feeding."
  4. "Breastfeeding may still be possible because my breast tissue can help close the gap."
Show the answer and explanation

Answer: A. I will place my baby on their back immediately after feeding to prevent choking."

Topic: Cleft Lip and Palate Feeding

Infants with a cleft lip and palate swallow excess air during feeds, increasing the risk of regurgitation and aspiration. Placing them flat on their back immediately after feeding is dangerous; they must be kept upright and burped frequently.

Why the others are wrong

  • B – Special bottles with one-way valves facilitate feeding by compensating for poor suction.
  • C – Upright feeding prevents liquid from entering the Eustachian tubes and reduces aspiration risk.
  • D – Breast tissue can naturally mold to seal the cleft, making breastfeeding possible.

Remember: Feed upright, burp often, and keep elevated after to prevent aspiration.

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.

61Question

A school nurse notices that a 9-year-old child is highly focused on school activities and forming friendships rather than showing interest in sexuality. This aligns with which of Freud’s stages?

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

Answer: C. Latency stage

Topic: Freud's Psychosexual Stages

Freud's latency stage occurs from about age six to puberty. During this period, sexual impulses are repressed, and children redirect their energy into developing social skills, forming peer relationships, and focusing on schoolwork and hobbies.

Why the others are wrong

  • A – The oral stage occurs in infancy, focusing on sucking, biting, and oral gratification.
  • B – The genital stage begins at puberty, marked by mature, active sexual interests and relationships.
  • D – The anal stage occurs in toddlers, focusing on toilet training and bowel control.

Remember: Latency means "latent" sexuality, focusing instead on learning and friendship.

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.

62Question

Fluorine is crucial for which function in the body?

  1. Retention of calcium in bones and teeth
  2. Vision
  3. Neurotransmitter production
  4. Immune function
Show the answer and explanation

Answer: A. Retention of calcium in bones and teeth

Topic: Fluoride Calcium Retention

Fluoride incorporates into hydroxyapatite, forming fluorapatite, which is more resistant to acid. This enhances calcium and phosphate retention in teeth and bone, preventing demineralization and cavities.

Why the others are wrong

  • B – Fluoride does not affect visual function.
  • C – Fluoride is not involved in neurotransmitter synthesis.
  • D – Fluoride is not essential for immune activity.

Remember: Fluoride = calcium keeper for teeth and bone.

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.

63Question

A nurse is advising a single mother with multiple children on how to handle their three-year-old child’s separation anxiety, which has intensified during a prolonged hospital stay. Which of the following strategies should the nurse recommend?

  1. Sneak away while the child is distracted to avoid a scene.
  2. Establish a consistent and quick goodbye routine.
  3. Encourage lengthy goodbyes to reassure the child.
  4. Avoid leaving the child with anyone other than a primary caregiver.
Show the answer and explanation

Answer: B. Establish a consistent and quick goodbye routine.

Topic: Separation Anxiety Management

A brief, consistent goodbye routine gives the child predictability and reduces the stress of separation, promoting a sense of security and helping the child transition more smoothly during hospital stays.

Why the others are wrong

  • A – Sneaking away breaks trust and heightens the child's anxiety.
  • C – Lengthy goodbyes prolong distress and reinforce separation fear.
  • D – Restricting caregivers limits the child's ability to adapt to necessary separations.

Remember: Quick, predictable goodbyes calm anxious toddlers.

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.

64Question

A nurse is providing care for a pediatric client from a family with cultural beliefs different from their own. Which of the following is the best approach for the nurse to ensure culturally competent care?

  1. Use family members as interpreters when language barriers exist
  2. Ask the family how staff can support their cultural and religious needs
  3. Avoid discussing cultural beliefs to maintain neutrality
  4. Assume the family's preferences based on general cultural knowledge
Show the answer and explanation

Answer: B. Ask the family how staff can support their cultural and religious needs

Topic: Cultural Competence in Nursing

Asking the family directly respects their autonomy, identifies specific cultural or religious needs, and guides individualized care planning, which is the core of culturally competent nursing practice.

Why the others are wrong

  • A – Family members may lack medical interpreting skills, leading to inaccurate communication.
  • C – Avoiding discussion prevents understanding and may lead to unmet cultural needs.
  • D – Assuming preferences risks stereotyping and may miss individual family needs.

Remember: Ask, don’t assume, to honor each family’s unique culture.

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.

65Question

In Piaget’s sensorimotor stage, infants primarily learn about their environment through:

  1. Trial and error with abstract concepts
  2. Logical reasoning and conservation principles
  3. Symbolic thought and imaginative play
  4. Their senses and motor skills
Show the answer and explanation

Answer: D. Their senses and motor skills

Topic: Piaget Sensorimotor Stage

During the sensorimotor stage (birth to ~2 years), infants acquire knowledge by interacting physically with the world, using their senses and motor actions to explore and form mental representations.

Why the others are wrong

  • A – Infants lack abstract reasoning; they use concrete sensory‑motor trial‑and‑error, not abstract concepts.
  • B – Logical reasoning and conservation appear much later, during concrete and formal operational stages.
  • C – Symbolic thought and imaginative play develop after the sensorimotor stage, not in infancy.

Remember: Infants learn by touching, seeing, moving—senses plus motor actions.

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.

66Question

What is considered a standard alcoholic drink according to the CDC?

  1. 1 ounce of liquor
  2. 8 ounces of beer
  3. 10 ounces of wine
  4. 5 ounces of wine
Show the answer and explanation

Answer: D. 5 ounces of wine

Topic: Standard Drink Measurements

According to the CDC, a standard alcoholic drink contains roughly 14 grams of pure alcohol. This equivalent amount is found in 5 ounces of wine at roughly 12 percent alcohol content, 12 ounces of beer, or 1.5 ounces of distilled spirits.

Why the others are wrong

  • A – A standard serving of 80-proof distilled spirits or liquor is 1.5 ounces, not 1 ounce.
  • B – A standard serving of beer is 12 ounces, not 8 ounces.
  • C – Ten ounces equals two standard servings of wine, as one standard drink is 5 ounces.

Remember: Standard drinks: 12 oz beer, 5 oz wine, 1.5 oz liquor.

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.

67Question

A five-year-old child has been brought to the emergency room with suspicions of epiglottitis. Which of the following should be included in their plan of care?

  1. Encourage the client to sit in the tripod position.
  2. Restrict the client’s fluid intake.
  3. Administer cough syrup to the client.
  4. Culture the client’s throat.
Show the answer and explanation

Answer: A. Encourage the client to sit in the tripod position.

Topic: Epiglottitis Nursing Care

The tripod position (sitting upright, leaning forward with chin out) helps maximize airway diameter and ease respiratory effort in a child with epiglottitis. Keeping the child comfortable in this preferred position is vital to prevent complete airway occlusion.

Why the others are wrong

  • B – Fluid restriction is unnecessary; IV hydration is typically maintained to support the child.
  • C – Cough syrup is ineffective for epiglottitis and does not address the emergency airway obstruction.
  • D – Throat cultures or inserting anything into the mouth can trigger sudden, fatal airway spasm.

Remember: Epiglottitis: Tripod position keeps the airway open; never probe the throat.

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.

68Question

A patient with an intraductal papilloma presents with nipple discharge. The nurse understands that which diagnostic test may be ordered to confirm the presence of a papilloma in the milk ducts?

  1. Fine-needle aspiration biopsy
  2. Core biopsy
  3. Ductogram (galactography)
  4. Breast MRI
Show the answer and explanation

Answer: C. Ductogram (galactography)

Topic: Intraductal Papilloma Diagnosis

A ductogram (galactography) involves injecting contrast dye into the discharging breast duct followed by mammography, making it the definitive imaging test to identify and locate an intraductal papilloma.

Why the others are wrong

  • A – Fine-needle aspiration is used to drain cysts, not to map ductal lesions.
  • B – Core biopsy targets solid breast masses but does not visualize the ductal system.
  • D – Breast MRI is costly and not the primary diagnostic test for ductal visualization.

Remember: Ductogram: Dye in the duct detects the papilloma.

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.

69Question

A nurse is assisting with the delivery of a post-term newborn weighing 4,300 grams. Which immediate complication should the nurse anticipate?

  1. Shoulder dystocia
  2. Neonatal hypothermia
  3. Hyperbilirubinemia
  4. Respiratory distress syndrome
Show the answer and explanation

Answer: A. Shoulder dystocia

Topic: Macrosomia Delivery Complications

A fetus weighing over 4,000 grams is macrosomic, commonly seen in post-term pregnancies. During delivery, the newborn's broad shoulders risk impaction behind the maternal symphysis pubis, making shoulder dystocia the most critical immediate intrapartum complication to anticipate.

Why the others are wrong

  • B – Hypothermia can occur post-delivery, but shoulder dystocia is the primary delivery complication anticipated.
  • C – Hyperbilirubinemia typically develops over subsequent hours or days, not immediately during delivery.
  • D – Respiratory distress syndrome from surfactant deficiency is primarily a concern for preterm infants.

Remember: Big baby at delivery: watch out for stuck shoulders.

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.

70Question

Which principle of health teaching emphasizes adapting the teaching content to the client's current physical and emotional state?

  1. Motivation
  2. Currency
  3. Timing
  4. Relevancy
Show the answer and explanation

Answer: C. Timing

Topic: Health Teaching Principles

Timing requires presenting information when the client is physically and emotionally ready, ensuring the material is understandable and retained at that moment.

Why the others are wrong

  • A – Motivation concerns encouraging behavior change, not state‑based content adaptation.
  • B – Currency refers to using up‑to‑date information, not client readiness.
  • D – Relevancy addresses relevance to needs, not timing with current condition.

Remember: Teach when they’re ready, not just when you’re prepared.

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.

71Question

Which trace mineral is primarily associated with immune function, healing, and vision?

  1. Selenium
  2. Zinc
  3. Iron
  4. Copper
Show the answer and explanation

Answer: B. Zinc

Topic: Essential Trace Minerals

Zinc is an essential trace mineral crucial for cellular metabolism, immune system function, wound healing, and maintaining healthy vision. It plays a key role in protein synthesis, DNA synthesis, and cell division.

Why the others are wrong

  • A – Selenium acts as an antioxidant and supports thyroid function, but is not primary for vision.
  • C – Iron is primarily responsible for oxygen transport via hemoglobin and myoglobin, not vision.
  • D – Copper aids in iron absorption, red blood cell formation, and maintaining healthy blood vessels.

Remember: Zinc helps you think, blink, and heal your skin.

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.

72Question

A nurse is assessing a newborn with suspected neonatal sepsis. Which finding is the most concerning and suggests the need for immediate intervention?

  1. Low-grade fever and irritability
  2. Mild jaundice and poor feeding
  3. Tachypnea, poor peripheral circulation, and a heart rate of 180 bpm
  4. Intermittent apnea with normal oxygen saturation levels
Show the answer and explanation

Answer: C. Tachypnea, poor peripheral circulation, and a heart rate of 180 bpm

Topic: Neonatal Sepsis Assessment

Tachypnea, tachycardia, and poor peripheral perfusion indicate septic shock and impending cardiovascular collapse. These signs reflect severe hemodynamic compromise requiring emergent resuscitation, supplemental oxygen, and intravenous antibiotics to prevent rapid clinical deterioration and death.

Why the others are wrong

  • A – Fever and irritability require evaluation, but signs of shock demand more urgent intervention.
  • B – These are non-specific signs of illness that do not indicate immediate cardiovascular collapse.
  • D – Brief periodic breathing without hypoxia is common and less urgent than hemodynamic compromise.

Remember: Tachycardia and poor perfusion in sepsis signal shock: act immediately.

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.

73Question

A deficiency in which vitamin can lead to night blindness and poor bone development?

  1. Vitamin D
  2. Vitamin E
  3. Vitamin A
  4. Vitamin K
Show the answer and explanation

Answer: C. Vitamin A

Topic: Vitamin A Deficiency

Vitamin A is essential for the formation of rhodopsin in the retina and for normal growth‑plate cartilage; deficiency therefore produces night blindness and compromises bone development.

Why the others are wrong

  • A – Vitamin D deficiency causes rickets, not night blindness.
  • B – Vitamin E acts as antioxidant; deficiency rarely affects eyesight or bone.
  • D – Vitamin K is needed for clotting, unrelated to vision or bone growth.

Remember: A for eyesight, A for growth.

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.

74Question

Which of the following is the recommended first-line treatment for congenital nasolacrimal duct obstruction (NLDO)?

  1. Systemic steroids
  2. Referral to an ophthalmologist immediately
  3. Antibiotic therapy and lacrimal duct massage
  4. Surgical intervention
Show the answer and explanation

Answer: C. Antibiotic therapy and lacrimal duct massage

Topic: Nasolacrimal Duct Obstruction Management

Congenital nasolacrimal duct obstruction typically resolves spontaneously. First-line conservative management consists of lacrimal duct (Crigler) massage to relieve the blockage, combined with topical antibiotic therapy if purulent discharge or secondary conjunctivitis is present.

Why the others are wrong

  • A – Systemic steroids are not indicated and do not resolve mechanical duct obstructions.
  • B – Immediate referral is unnecessary because most cases resolve spontaneously with conservative care.
  • D – Surgical probing is reserved for persistent cases, typically after 12 months of age.

Remember: Massage the duct first; probe only if it persists past age one.

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.

75Question

A nurse is preparing to assess a 12-month-old child in the hospital. The child starts crying and clings to the parent when the nurse enters the room. The nurse recognizes this behavior as:

  1. Stranger anxiety
  2. Regression
  3. Fear of medical equipment
  4. Separation anxiety
Show the answer and explanation

Answer: A. Stranger anxiety

Topic: Child Development Anxiety

Stranger anxiety appears in infants 6‑12 months when unfamiliar people enter, causing distress and clinging to the caregiver; this is a normal developmental stage, distinct from separation anxiety or regression.

Why the others are wrong

  • B – Regression is reverting to earlier behaviors, not a reaction to a stranger.
  • C – Fear of medical equipment involves objects, not a person entering the room.
  • D – Separation anxiety occurs when the child is left alone, not when a stranger arrives.

Remember: Infants fear strangers before they fear being left alone.

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.

Keep going

NurseSim: the full simulatorAll 20 nursing exams, timed mock exams, audio key points and a readiness score. Free: 5 questions a day, no card.Nursing questions on YouTubeShort videos and full timed tests with the rationale read aloud.Free printable NCLEX-RN set50 questions with answers and rationales, as a PDF.Spoken English@ShadowLingua: IELTS and PTE speaking practice, sentence by sentence.

NCLEX-RN is a registered trademark of the National Council of State Boards of Nursing, Inc. (NCSBN). This site is not affiliated with, sponsored by or endorsed by the owner of that mark.