NCLEX-RN: Health Promotion practice questions questions 76-100

Answer: C. A preterm infant born at 27 weeks weighing less than 3 pounds

Topic: Intraventricular Hemorrhage Risk

The infant born at 27 weeks gestation and weighing less than 3 pounds has a highly vulnerable germinal matrix and immature cerebral vessels, making extremely preterm infants the group at greatest risk for intraventricular hemorrhage.

Why the others are wrong

• A – Meconium aspiration affects lungs; it does not increase IVH risk.
• B – Full-term infants have mature cerebral vessels, low IVH incidence.
• D – Transient tachypnea is a respiratory issue, not linked to IVH.

Remember: Tiny, early brain vessels bleed most in <28‑week infants.

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. Mirror the family’s communication style and avoid direct eye contact

Topic: Cultural Communication in Pediatrics

Eye‑contact practices differ across cultures; many families view direct gaze as disrespectful. By mirroring their style and avoiding direct eye contact, the nurse shows cultural sensitivity, builds trust, and facilitates effective therapeutic communication.

Why the others are wrong

• A – Strong eye contact may be perceived as disrespectful in this cultural context.
• B – Requesting Western eye‑contact norms is culturally insensitive and harms rapport.
• D – Lack of eye contact does not necessarily indicate disinterest.

Remember: Match the family's communication style, not yours.

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. Fixation in that stage

Topic: Freud Psychosexual Development

Freud taught that each psychosexual stage requires successful conflict resolution; failure causes the individual to become fixated, remaining emotionally and behaviorally tied to that stage’s characteristics into later life.

Why the others are wrong

• A – A fully developed personality results from successful, not failed, stage resolution.
• B – Spontaneous adult resolution does not occur without revisiting the unresolved conflict.
• C – Psychosocial regression is an Erikson concept, not Freud’s fixation theory.

Remember: Unresolved stage = stuck, not moving forward.

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. Immunosuppression

Topic: Impetigo Risk Factors

Impetigo is a highly contagious bacterial skin infection. Immunosuppression compromises the body's natural defenses, making individuals more susceptible to bacterial invasion by Streptococcus pyogenes or Staphylococcus aureus through minor skin breaks.

Why the others are wrong

• A – Dietary habits, including dairy consumption, do not influence the risk of developing impetigo.
• B – Poor hygiene increases risk; high levels of personal hygiene help prevent infection.
• C – Impetigo thrives in warm, humid climates, not cold and dry environments.

Remember: Impetigo: compromised immunity invites bacterial skin invasion.

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. Fibroadenoma

Topic: Benign Breast Conditions

Fibroadenomas are benign, solid breast tumors characterized by a well-circumscribed, round, rubbery, and highly mobile mass. They are painless and often remain stable in size, commonly occurring in younger women.

Why the others are wrong

• A – Characterized by spontaneous, bloody or serous nipple discharge rather than a rubbery mass.
• C – Presents with subareolar inflammation, pain, erythema, and nipple retraction, often in smokers.
• D – Typically presents with bilateral, tender, fluctuating lumps that change with the menstrual cycle.

Remember: Fibroadenoma: Firm, free-slipping, and friendly (benign) breast lump.

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. Hemoglobin production

Topic: Physiological Role of Iron

Iron is an essential mineral primarily required for the synthesis of hemoglobin, a protein in red blood cells that transports oxygen from the lungs to the rest of the body.

Why the others are wrong

• A – Calcium and phosphorus are the primary minerals responsible for bone and teeth health.
• B – Iodine, not iron, is the essential mineral required for proper thyroid function.
• D – Chromium and zinc, not iron, are primarily involved in glucose metabolism and insulin regulation.

Remember: Iron pumps up hemoglobin to carry oxygen.

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. A preterm infant born at 25 weeks who required mechanical ventilation

Topic: Bronchopulmonary Dysplasia Risk

Bronchopulmonary dysplasia (BPD) primarily affects extremely premature infants. A neonate born at 25 weeks requiring mechanical ventilation is at the highest risk due to lung immaturity, oxygen toxicity, and ventilator-induced lung injury.

Why the others are wrong

• A – Full-term infants have mature lungs and are at extremely low risk for BPD.
• B – Transient tachypnea is a benign, self-limiting condition that resolves without causing BPD.
• C – Meconium aspiration is an acute condition and rarely leads to chronic BPD.

Remember: Prematurity plus mechanical ventilation equals high BPD risk.

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. Calm Phase

Topic: Cycle of Violence

The calm phase, also called the honeymoon phase, is the initial period of a seemingly peaceful relationship before any tension or abuse emerges and is often marked by affection and normal interaction.

Why the others are wrong

• A – Reconciliation Phase follows an abusive incident, not the initial peaceful period.
• B – Altercation Phase occurs after violence has begun, not before tension.
• C – Tension‑Building Phase is when stress and conflict start to rise.

Remember: Calm phase = peaceful start before any tension.

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. Discuss options for medical or surgical management

Topic: Missed Abortion Management

This client is experiencing a missed abortion. At 14 weeks gestation, expectant management carries a higher risk of complications like hemorrhage and infection, so the nurse must discuss medical and surgical options to safely evacuate the uterus.

Why the others are wrong

• A – Monitoring for labor at home is unsafe due to risks of severe bleeding and infection.
• C – Expectant management is generally not recommended in the second trimester due to high complication risks.
• D – Bed rest and hydration cannot resolve a missed abortion; active intervention is required.

Remember: For a missed abortion, discuss medical or surgical options, don't just 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.

Answer: A. Placing the infant under a radiant warmer

Topic: Premature Infant Thermoregulation

Premature infants have immature thermoregulation and minimal subcutaneous fat. A radiant warmer provides a highly controlled, neutral thermal environment that effectively prevents heat loss and cold stress in the acute NICU setting.

Why the others are wrong

• B – Warm formula does not provide systemic temperature regulation and poses feeding risks.
• C – Swaddling in blankets is insufficient to maintain temperature in premature infants with limited heat production.
• D – Kangaroo care is beneficial but cannot replace continuous, controlled incubator or radiant warmer thermoregulation.

Remember: Premature infants need radiant warmth to prevent cold 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.

Answer: B. Severe croup

Topic: Westley Croup Score

The Westley Croup Score classifies severity as mild (0–2), moderate (3–5), severe (6–11), and impending respiratory failure (12 or higher). A score of 7 falls into the severe category, requiring urgent medical intervention.

Why the others are wrong

• A – A score of 3 to 5 indicates moderate croup.
• C – A score of 12 or higher indicates impending respiratory failure.
• D – A score of 0 to 2 indicates mild croup.

Remember: Westley Croup: Mild <=2, Moderate 3-5, Severe 6-11, Failure >=12.

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. Double worsening

Topic: Double Sickening in Sinusitis

Double worsening, or double sickening, describes a clinical pattern where a patient initially improves from a viral upper respiratory infection but then suddenly deteriorates, strongly suggesting the development of a secondary bacterial sinusitis.

Why the others are wrong

• A – Recurrent sinusitis involves multiple distinct episodes of acute sinusitis per year with complete resolution between.
• C – Chronic sinusitis is defined by symptoms lasting twelve weeks or longer, not acute worsening.
• D – Nasal rebound effect is congestion caused by overuse of topical decongestant sprays.

Remember: Double worsening means getting better, then getting worse with bacterial sinusitis.

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. It boosts mood and reduces stress by increasing endorphin levels.

Topic: Stress Management Through Exercise

Regular physical exercise boosts mood and reduces stress by increasing endorphin levels, which act as natural analgesics and improve emotional well‑being, while also enhancing cardiovascular health and sleep quality.

Why the others are wrong

• A – It increases feelings of anxiety.
• B – It decreases the body’s production of endorphins.
• D – It leads to decreased energy and concentration.

Remember: Exercise boosts endorphins, lowering 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.

Answer: A. Scheduling medical procedures around daily prayer times

Topic: Cultural Competence in Pediatrics

Scheduling procedures around prayer times respects the family's religious practices, showing sensitivity to their spiritual needs while still providing safe care, which is core to culturally responsive nursing.

Why the others are wrong

• B – Neglects cultural needs, missing opportunities to integrate beliefs into care planning.
• C – May violate modesty preferences; fails to obtain family consent for gender-sensitive care.
• D – Assumes mother is sole decision-maker, ignoring family hierarchy and individual preferences.

Remember: Fit care into prayer times to show respect.

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. Preventing illness and injury before they occur

Topic: Levels of Prevention

Primary prevention aims to avert the onset of disease or injury entirely by reducing exposure to hazards and enhancing resistance. Interventions include immunizations, health education, and promoting healthy lifestyle habits before any pathological process begins.

Why the others are wrong

• A – Rehabilitation to restore function and prevent long-term disability is classified as tertiary prevention.
• B – Diagnosing and treating acute medical conditions falls under secondary prevention or acute curative care.
• D – Managing established chronic illnesses to prevent further complications represents tertiary prevention.

Remember: Primary prevents, secondary screens, tertiary treats and rehabilitates.

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. Primary infertility

Topic: Infertility Classifications

Primary infertility is defined as the inability to conceive after at least 12 months of regular, unprotected intercourse in a couple who has never achieved a pregnancy. This couple's 14-month struggle fits this classification.

Why the others are wrong

• A – Secondary infertility applies to couples who have previously conceived but now cannot.
• C – Hormonal infertility describes a potential cause of infertility, not a classification.
• D – Subfertility refers to a delay or difficulty in conceiving, not a standard classification.

Remember: Primary is the first try; secondary is after a prior pregnancy.

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. Stage 4: Authority and Social Order

Topic: Kohlberg Moral Development

The adolescent values maintaining social order, reflecting Kohlberg’s conventional level, specifically Stage 4 (Authority and Social Order), where behavior is guided by laws and societal expectations.

Why the others are wrong

• A – Stage 6 relies on universal ethical principles, beyond social order.
• B – Stage 2 is driven by personal gain, not societal rules.
• D – Stage 1 focuses on avoiding punishment, not social order.

Remember: Stage 4 = obey laws for society’s stability.

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. Superego

Topic: Freud's Structural Model

Freud defined the superego as the internalized moral standards that judge behavior; an overactive superego produces excessive guilt and rigid morality, matching the client’s presentation.

Why the others are wrong

• A – Id seeks pleasure, not moral judgment.
• B – Ego mediates reality, not internalized morals.
• C – Unconscious mind includes all structures, not specifically morality.

Remember: Overactive superego = guilt and strict morals.

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. Notify the provider immediately and prepare for emergency interventions.

Topic: Postpartum Pulmonary Embolism

Sudden dyspnea, tachycardia, and pleuritic chest pain postpartum suggest pulmonary embolism; immediate provider notification and preparation for emergency interventions are essential to prevent rapid deterioration.

Why the others are wrong

• A – Deep breathing delays urgent assessment and intervention.
• B – Leg elevation and ambulation can worsen a potential embolus.
• D – Pain meds may mask symptoms and delay critical treatment.

Remember: Suspect PE? Call provider, prep emergency now.

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. Decreasing sperm count due to increased scrotal temperature

Topic: Varicocele and Male Infertility

A varicocele is an abnormal dilation of veins in the scrotum. This pooling of blood increases scrotal temperature, which impairs spermatogenesis and reduces both sperm count and quality, leading to infertility.

Why the others are wrong

• A – Urethral obstruction is caused by conditions like benign prostatic hyperplasia, not a varicocele.
• C – Retrograde ejaculation is caused by nerve damage or medications, not scrotal venous dilation.
• D – Varicoceles primarily impair spermatogenesis through heat, typically leaving systemic testosterone levels unaffected.

Remember: Varicocele: Warm veins wilt sperm.

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. Irregular ovulation or anovulation

Topic: PCOS and Infertility

Polycystic ovary syndrome (PCOS) is characterized by hormonal imbalances, specifically elevated androgens, which disrupt the normal menstrual cycle. This hormonal disruption leads to irregular ovulation or a complete lack of ovulation (anovulation), making conception difficult.

Why the others are wrong

• A – Fallopian tube blockages are typically caused by pelvic inflammatory disease or endometriosis, not PCOS.
• C – Patients with PCOS have abundant eggs, but hormonal imbalances prevent their proper maturation and release.
• D – PCOS affects ovarian function and hormone levels, not uterine structure.

Remember: PCOS infertility: Hormones stall ovulation, not egg supply.

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 insurance coverage

Topic: Social Determinants of Health

Health insurance coverage directly dictates a patient's financial access to prescribed medications, therapies, and follow-up care. Without adequate coverage, patients are highly likely to ration or entirely skip their prescribed treatment plan due to cost.

Why the others are wrong

• A – Employment status affects income, but insurance coverage is the direct mechanism determining healthcare and prescription affordability.
• B – Transportation affects appointment attendance but has less direct impact on overall treatment adherence than medication cost.
• D – While culture influences health behaviors, it does not create the absolute financial barrier that lack of insurance does.

Remember: No coverage, no cure: insurance dictates treatment adherence.

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. Cognitive

Topic: Bloom's Taxonomy Domains

The cognitive domain of Bloom's Taxonomy encompasses mental processes such as remembering, understanding, applying, analyzing, evaluating, and creating, making it the category that addresses intellectual skills and the recall of information.

Why the others are wrong

• A – Psychomotor focuses on physical movement and coordination, not mental processes.
• B – Emotional is not a recognized Bloom taxonomy domain.
• D – Affective deals with feelings, attitudes, and values, not intellectual recall.

Remember: Cognitive = thinking; remember, understand, apply.

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. Anemia

Topic: Vitamin E Deficiency

Vitamin E protects cell membranes from oxidative damage; deficiency causes hemolytic anemia and neurologic deficits, not bone or eye disorders. It also impairs absorption of fat‑soluble vitamins, leading to peripheral neuropathy, but the hallmark is anemia.

Why the others are wrong

• A – Night blindness results from vitamin A deficiency, unrelated to vitamin E.
• C – Rickets is due to vitamin D deficiency, not vitamin E.
• D – Hypocalcemia is linked to vitamin D or parathyroid issues, not vitamin E.

Remember: Vitamin E protects red cells; lack = anemia.

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. Formal operational

Topic: Piaget Formal Operational Stage

Formal operational adolescents can think abstractly, reason hypothetically, and discuss moral dilemmas, which defines Piaget’s fourth stage of cognitive development.

Why the others are wrong

• A – Concrete operational thinkers handle concrete problems, not abstract ethics.
• B – Preoperational children lack logical reasoning and abstract thought.
• D – Sensorimotor stage involves only reflexes and basic motor actions.

Remember: Abstract debates signal formal operational thinking.

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.