NCLEX-RN: Health Promotion practice questions questions 126-150

Answer: B. To inform clients about what to expect and reduce anxiety related to unpredictability.

Topic: Trauma‑Informed Care

Anticipatory guidance prepares clients for upcoming procedures, clarifies what will happen, and reduces anxiety caused by uncertainty, which aligns with trauma‑informed principles of safety and empowerment.

Why the others are wrong

• A – Providing minimal information contradicts the goal of informed, supportive care.
• C – Consent requirements are unrelated to anticipatory guidance in trauma‑informed care.
• D – Speeding treatment is not the primary purpose of anticipatory guidance.

Remember: Explain ahead, calm nerves, empower patients.

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. Encourage the client to seek counseling and consider joining a support group.

Topic: Chronic Pelvic Pain Support

Chronic pelvic pain is strongly linked with anxiety and depression. Providing holistic care requires addressing these mental health comorbidities by recommending professional counseling and peer support groups, which offer coping strategies and reduce isolation.

Why the others are wrong

• A – Focuses solely on pharmacological management instead of addressing the client's psychological needs.
• C – Promotes avoidance, which prevents effective coping and can worsen emotional distress.
• D – Dismisses the client's feelings and falsely reassures that symptoms will resolve without intervention.

Remember: Treat chronic pain holistically: support the mind to help heal the body.

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. Demonstrating how to use new information in practical scenarios

Topic: Bloom's Taxonomy in Patient Education

The "Apply" level of Bloom's Taxonomy involves using acquired knowledge in new and concrete situations. Demonstrating how to use information in practical, real-world scenarios directly facilitates this active application of knowledge.

Why the others are wrong

• B – Explaining concepts and ideas aligns with the "Understand" level of Bloom's Taxonomy.
• C – Evaluating understanding corresponds to the higher-level "Evaluate" stage of Bloom's Taxonomy.
• D – Recall of specific facts corresponds to the lower-level "Remember" stage of Bloom's Taxonomy.

Remember: Apply means action: use the information in a practical situation.

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. Prepare for possible mechanical ventilation

Topic: Neonatal Respiratory Distress

Because the infant shows signs of respiratory distress with meconium aspiration, the immediate priority is to secure the airway and support breathing; preparing for mechanical ventilation ensures rapid intervention if oxygenation deteriorates.

Why the others are wrong

• B – Surfactant is indicated for premature lungs, not post‑term infants.
• C – Feeding can wait, but airway protection takes precedence.
• D – Trendelenburg may increase aspiration risk and does not improve ventilation.

Remember: Think airway first, then consider ventilation.

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. Investigating underlying chromosomal abnormalities

Topic: Recurrent Pregnancy Loss Evaluation

Recurrent pregnancy loss is most frequently linked to genetic factors. Investigating parental and embryonic chromosomal abnormalities is a priority assessment to identify the underlying etiology and guide future preconception counseling.

Why the others are wrong

• B – Routine physical activity does not cause miscarriage and is not a priority.
• C – Nutritional deficiencies are rarely the primary cause of recurrent pregnancy loss.
• D – These assessments are for an ongoing, viable pregnancy, not an evaluation for loss.

Remember: Recurrent pregnancy loss: check the genes first.

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. Whole grains

Topic: Molybdenum Dietary Sources

Molybdenum is an essential trace mineral that acts as a cofactor for enzymes involved in detoxifying sulfites and toxins. The richest dietary sources of molybdenum include whole grains, legumes, and nuts.

Why the others are wrong

• A – Dairy contains only trace amounts of molybdenum compared to plant-based sources like whole grains.
• C – Red meat is not a primary source of molybdenum, which is concentrated in plant foods.

Remember: Molybdenum: Whole grains help you detox.

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. Increased moisture and infrequent diaper changes

Topic: Diaper Dermatitis Prevention

Diaper dermatitis is primarily caused by prolonged exposure to wetness, urine, and feces. Increased moisture breaks down the skin's protective barrier, while infrequent diaper changes allow urea-splitting bacteria to increase skin pH, leading to severe irritation.

Why the others are wrong

• A – Frequent diaper changes keep the skin dry and clean, reducing the risk of dermatitis.
• C – Breastfed infants have lower stool pH, which actually decreases the risk of diaper dermatitis.
• D – A higher (alkaline) skin pH, not a low (acidic) pH, promotes skin breakdown.

Remember: Keep it dry to keep dermatitis away!

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. Grounding oneself by engaging the senses and focusing on the present moment

Topic: Stress Management Strategies

Grounding oneself by engaging the senses and focusing on the present moment is a WHO‑recommended stress‑reduction strategy that promotes mindfulness, reduces physiological arousal, and helps individuals manage anxiety effectively.

Why the others are wrong

• B – Ignoring emotional responses avoids processing stress and contradicts WHO guidance.
• C – Focusing on challenging thoughts is cognitive restructuring, not the WHO’s recommended grounding technique.
• D – Taking on new commitments adds stress rather than reduces it.

Remember: Mindfulness = senses + present moment.

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. Incomplete abortion

Topic: Types of Spontaneous Abortion

An incomplete abortion is characterized by vaginal bleeding, uterine cramping, cervical dilation, and the partial passage of products of conception, with some gestational tissue remaining inside the uterus.

Why the others are wrong

• A – Characterized by cramping and bleeding, but the cervix remains closed with no tissue passage.
• C – The cervix is dilated, but no products of conception have been expelled yet.
• D – All products of conception have been expelled, and the cervix is typically closed.

Remember: Incomplete: some tissue has passed, but some remains inside an open cervix.

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. Attending daycare

Topic: Pediatric Acute Diarrhea Risks

Attending daycare increases a child's exposure to infectious pathogens through close contact with other children and shared toys, making it a primary risk factor for acute infectious gastroenteritis and diarrhea.

Why the others are wrong

• A – High fiber diets promote healthy bowel movements and do not cause acute infectious diarrhea.
• B – Increased fluid intake prevents dehydration and does not cause acute diarrhea.
• D – Exclusive breastfeeding is protective against infectious diarrhea due to maternal antibodies.

Remember: Daycare sharing means germ sharing; close contact spreads acute diarrhea.

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. The client reports something dripping down her throat.

Topic: Post-Tonsillectomy Hemorrhage Assessment

Feeling something dripping down the throat or frequent swallowing after a tonsillectomy indicates active hemorrhage. This is a life-threatening complication that requires immediate medical intervention to prevent airway compromise and hypovolemia.

Why the others are wrong

• A – A single episode of vomiting is common after anesthesia and swallowed blood.
• C – Sore throat is an expected postoperative finding after a tonsillectomy.
• D – Dark brown blood indicates old, dried blood and is an expected finding.

Remember: Frequent swallowing or throat dripping means active bleeding after tonsillectomy.

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. A sense of autonomy and confidence in their abilities

Topic: Child Development Learning

The child observed the parent’s calm reaction, so no punishment followed the fall. Operant conditioning reinforces the behavior, leading the child to feel autonomous and confident in continuing activity.

Why the others are wrong

• B – No injury or attention occurred; the child did not associate falling with harm.
• C – No paired stimulus to create fear; classical conditioning not involved.
• D – The child was not discouraged from activity; no avoidance learned.

Remember: Calm response = reinforcement, child feels capable.

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. Progressive muscle relaxation

Topic: Stress Management Techniques

Progressive muscle relaxation involves sequentially tensing and releasing muscle groups, which activates the parasympathetic response, lowers heart rate, and promotes a relaxation state useful for self‑regulation of stress.

Why the others are wrong

• A – Rapid breathing typically heightens sympathetic activity rather than enhancing parasympathetic tone.
• B – Increasing muscle tension maintains sympathetic activation, counteracting parasympathetic stimulation.
• C – Ignoring symptoms of stress does not engage any physiological relaxation mechanisms.

Remember: Tense, then release muscles to trigger 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.

Answer: D. "Use a peri-bottle with warm water after urination and defecation."

Topic: Postpartum Perineal Care

Gentle irrigation with a peri‑bottle after voiding cleans the perineal area, reduces bacterial load, prevents irritation, and promotes healing without applying heat or restricting fluids, which are essential for optimal recovery.

Why the others are wrong

• A – Hot baths cause edema and maceration, worsening discomfort.
• B – Warm compresses can increase swelling and delay tissue healing.
• C – Fluid restriction risks urinary stasis and infection; hydration is needed.

Remember: Peri‑bottle rinses keep the wound clean without heat or fluid restriction.

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

Answer: B. To decrease the impact of unwanted thoughts or feelings

Topic: Stress Management Techniques

Unhooking is a cognitive defusion technique that helps individuals step back and detach from difficult thoughts and feelings. This reduces their emotional impact and prevents them from dictating behavior, promoting healthier coping.

Why the others are wrong

• A – Unhooking involves acknowledging thoughts mindfully, not ignoring or avoiding stressful situations.
• C – Enhancing stress intensity increases anxiety and physiological arousal, which is harmful.
• D – Increasing negative thoughts worsens distress and runs counter to stress management goals.

Remember: Unhook from negative thoughts to reduce their power.

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. "I should avoid using tampons and douching for at least two weeks."

Topic: Post-Abortion Discharge Care

Avoiding tampons, douching, and sexual intercourse for at least two weeks allows the dilated cervix to close and significantly reduces the risk of ascending reproductive tract infection. Bleeding should remain light, resembling a normal or light menstrual period.

Why the others are wrong

• A – Heavy bleeding with large clots signals hemorrhage or retained products, requiring immediate medical evaluation.
• B – Pelvic rest, including avoiding intercourse, is required for at least two weeks to prevent infection.
• C – Routine follow-up is essential to ensure complete healing, confirm uterine involution, and discuss contraception.

Remember: Nothing in the vagina for two weeks protects against pelvic infection.

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. Classical conditioning

Topic: Classical Conditioning in Children

The child's fear is linked to the painful shot, a neutral stimulus (medical exam) now elicits fear because it has been paired with pain, illustrating classical conditioning.

Why the others are wrong

• A – Based on modeling behavior, not direct stimulus association.
• B – Adds pleasant stimulus to increase behavior, not fear from pain.
• D – Focuses on rewards/punishments, not stimulus pairing.

Remember: Painful shot pairs fear with medical exams.

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. Topical antibiotics with crust removal

Topic: Nonbullous Impetigo Treatment

Nonbullous impetigo is a superficial bacterial skin infection. The primary treatment for localized lesions involves applying topical antibiotics after gently removing the overlying honey-colored crusts with warm compresses to ensure optimal drug penetration.

Why the others are wrong

• A – Reserved for widespread, severe, or systemic infections rather than localized lesions.
• B – Contraindicated because they suppress the immune system and can worsen bacterial infections.
• D – Only provide symptomatic relief for itching without treating the underlying bacterial infection.

Remember: Soak the crust, apply the cream, to keep impetigo clean.

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. Id

Topic: Freud Psychosexual Development

According to Freud, the Id is the unconscious, instinctual part of personality that seeks immediate pleasure and avoids pain, functioning solely on the pleasure principle without regard for reality or morality.

Why the others are wrong

• A – Superego represents internalized morals and standards, guiding behavior rather than seeking pleasure.
• C – Conscious mind involves awareness of thoughts, not the unconscious drive for instant pleasure.
• D – Ego mediates between Id and reality, using the reality principle, not immediate gratification.

Remember: Id = instant desire, pleasure principle.

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. Smoking

Topic: Osteoporosis Risk Factors

Smoking reduces bone density by impairing calcium absorption, increasing bone resorption, and decreasing estrogen levels, making it a preventable contributor to osteoporosis. Thus, cessation can improve bone health and lower fracture risk.

Why the others are wrong

• B – A prior diagnosis reflects existing disease, not a changeable behavior influencing risk.
• C – Age cannot be changed; it is a non‑modifiable risk factor.
• D – Sex is determined biologically and cannot be altered, so it is non‑modifiable.

Remember: Quit smoking, keep bones strong.

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. Administering antenatal corticosteroids as prescribed

Topic: Preterm Labor Management

In preterm labor before 34 weeks' gestation, administering antenatal corticosteroids is the priority to accelerate fetal lung maturity and reduce the risk of neonatal respiratory distress syndrome, intraventricular hemorrhage, and mortality.

Why the others are wrong

• A – Immediate delivery is avoided if possible to allow time for corticosteroid administration and tocolysis.
• B – Physical activity is contraindicated in preterm labor as it can stimulate further uterine contractions.
• D – Prenatal vitamins are a long-term health measure, not a priority during acute preterm labor.

Remember: Preterm labor under thirty-four weeks: give steroids to mature the lungs.

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. Oral catheter insertion to confirm non-passage to the stomach

Topic: Esophageal Atresia Diagnosis

Inability to pass a radiopaque catheter through the mouth into the stomach directly demonstrates the blind esophageal pouch. A follow-up radiograph confirms the catheter coiled in the upper pouch, definitively establishing the diagnosis of esophageal atresia.

Why the others are wrong

• A – Assesses for secondary aspiration pneumonia, not the anatomical blockage itself.
• C – Identifies infectious gastrointestinal pathogens, not congenital structural anomalies.
• D – Does not visualize proximal esophageal patency or establish the diagnosis.

Remember: Catheter stops short when the esophagus hits a dead end.

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. Weak Moro reflex and asymmetric arm movement

Topic: Newborn Birth Injuries

Infants with macrosomia are at high risk for birth trauma during difficult deliveries. A weak Moro reflex with asymmetric arm movement strongly indicates a fractured clavicle or brachial plexus injury, which requires prompt evaluation and immobilization.

Why the others are wrong

• B – A blood glucose level above 40 to 45 mg/dL is normal for a newborn.
• C – Caput succedaneum is benign scalp edema that resolves spontaneously within days.
• D – Jaundice appearing after 24 hours of life is typically benign physiological jaundice.

Remember: Asymmetric movement after macrosomic delivery screams nerve damage or bone fracture.

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. Drooling, dysphagia, and distress

Topic: Epiglottitis Clinical Presentation

Epiglottitis is a life-threatening medical emergency characterized by rapid airway obstruction. The classic '3 Ds' presentation includes drooling (due to inability to swallow saliva), dysphagia (difficulty swallowing), and respiratory distress (often accompanied by inspiratory stridor).

Why the others are wrong

• B – Dizziness and dry mouth are not classic signs of epiglottitis or respiratory distress.
• C – Dizziness and diarrhea are not associated with acute epiglottitis or airway obstruction.
• D – Diarrhea is a gastrointestinal symptom and is not related to epiglottitis.

Remember: Epiglottitis 3 Ds: Drooling, Dysphagia, Distress.

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. Through repeated associations between a stimulus and a response

Topic: Classical Conditioning Theory

Classical conditioning posits that fears develop when a neutral stimulus repeatedly pairs with an aversive event, creating an association that elicits anxiety and the learned response can be triggered by the stimulus alone, even without the original danger.

Why the others are wrong

• A – Punishment and reward describe operant conditioning, not classical conditioning.
• B – Genetic factors influence temperament but do not explain learned fear via conditioning.
• D – Observation and imitation are mechanisms of social learning, not classical conditioning.

Remember: Fear learns by pairing neutral cues with scary events.

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.