NCLEX-RN: Health Promotion practice questions questions 151-175

Answer: A. Separation anxiety

Topic: Child Development Anxiety

The toddler becomes extremely upset when the parents leave, which is typical separation anxiety—a normal developmental response in children 6‑24 months who fear being apart from primary caregivers.

Why the others are wrong

• B – Regression is a return to earlier behaviors, not distress over separation.
• C – Fear of hospitalization concerns the setting, not being left alone.
• D – Stranger anxiety involves fear of unfamiliar people, not parental departure.

Remember: Kids fear being left alone, not strangers.

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. Placing specially prepared sperm directly into the uterus

Topic: Intrauterine Insemination

Intrauterine insemination (IUI) involves washing and concentrating sperm, then placing it directly into the uterus using a catheter during ovulation to increase the chances of fertilization.

Why the others are wrong

• A – This describes in vitro fertilization (IVF), not intrauterine insemination.
• B – Sperm is placed in the uterus during IUI, not the Fallopian tubes.
• C – This describes gestational surrogacy, which uses a carrier to bear the pregnancy.

Remember: Intrauterine Insemination puts sperm directly Into the Uterus.

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. Aligning actions with long-term goals

Behavioral self-regulation is the process of monitoring, evaluating, and adjusting one's actions and thoughts so that behavior remains aligned with long‑term goals, personal values, and desired outcomes, rather than fleeting impulses.

Why the others are wrong

• A – It describes impulsive reactions, not deliberate alignment with goals.
• B – Self‑regulation involves balanced management, not total emotional suppression.
• D – Self‑regulation requires confronting, not evading, challenging tasks to achieve goals.

Remember: Self‑regulation = actions match your long‑term plan.

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 abuser prevents them from accessing medical care.

Topic: Intimate Partner Violence

Abusers often control victims' movements and resources, deliberately restricting access to health care to maintain power and prevent disclosure of the abuse.

Why the others are wrong

• A – Victims rarely delay care because they think injuries will self‑heal; safety concerns dominate.
• C – Reporting concerns are usually addressed confidentially; fear of mandatory reporting is not the main barrier.
• D – Embarrassment may occur but does not typically override the abuser's control over care.

Remember: Abuser blocks care to keep 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. Sore throat and body aches

Topic: Influenza Clinical Presentation

Influenza is a respiratory illness characterized by the sudden onset of systemic and respiratory symptoms. Classic presentations include fever, myalgia (body aches), headache, cough, and a sore throat.

Why the others are wrong

• A – Typically indicates complications like pneumonia or is more characteristic of COVID-19.
• B – A hallmark symptom of COVID-19, rarely associated with uncomplicated influenza.
• C – Associated with obstructive airway diseases like asthma or bronchitis, not typical influenza.

Remember: Flu is systemic: think fever, body aches, and sore 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.

Answer: B. Vitamin C

Topic: Wound Healing Nutrition

Vitamin C is essential for wound healing because it acts as a cofactor for the enzymes that hydroxylate proline and lysine, steps required to form stable collagen fibers, and it also supports immune function.

Why the others are wrong

• A – Vitamin E acts as an antioxidant; it does not directly participate in collagen production.
• C – Vitamin A supports epithelial health, not the enzymatic steps of collagen formation.
• D – Vitamin D regulates calcium and bone metabolism, not collagen synthesis in wound repair.

Remember: C for Collagen, the building block vitamin.

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. "Ground glass" appearance

Topic: Respiratory Distress Syndrome

Respiratory distress syndrome is caused by surfactant deficiency, leading to diffuse alveolar collapse. This presents classically on a chest X-ray as a diffuse, reticulogranular 'ground glass' appearance with air bronchograms.

Why the others are wrong

• A – Characteristic of meconium aspiration syndrome or neonatal pneumonia, not uncomplicated RDS.
• B – Typical of transient tachypnea of the newborn or meconium aspiration, which cause air trapping.
• C – Suggests transient tachypnea of the newborn or pulmonary edema rather than surfactant deficiency.

Remember: RDS: Surfactant loss brings ground glass gloss.

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. Identity vs. role confusion

Topic: Erikson Psychosocial Development

Erikson describes adolescence as the Identity versus Role Confusion stage, where individuals explore personal values, beliefs, and future roles, leading to concerns about career choices and family expectations.

Why the others are wrong

• A – Industry vs. inferiority applies to school-age children, not adolescents.
• B – Generativity vs. stagnation occurs in middle adulthood, not teenage years.
• D – Autonomy vs. shame and doubt is the toddler stage.

Remember: Teens grapple identity, not skills or legacy.

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. Use a trained medical interpreter

Topic: Cultural Competence Communication

A trained medical interpreter provides accurate, culturally appropriate translation, eliminates errors, complies with Joint Commission and Title VI requirements, and protects patient safety and informed consent.

Why the others are wrong

• A – Speaking slowly and loudly in English does not guarantee comprehension and may be perceived as condescending.
• B – Relying on a sibling risks inaccurate translation and breaches confidentiality.
• D – Communicating only with the child ignores parental rights and may lead to misunderstandings.

Remember: Professional interpreter = safe, accurate, legal communication.

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. Provide comfort and reassurance, allowing the child to express their feelings and needs.

Topic: Child Development Regression

Providing comfort and reassurance allows the child to process stress, supports emotional development, and meets developmental needs, thereby reducing regression during prolonged hospitalization and promotes a sense of safety.

Why the others are wrong

• B – Discouraging non‑age‑appropriate behavior ignores the child’s need for emotional expression.
• C – Enforcing age‑appropriate behavior increases anxiety and may worsen regression.
• D – Limiting parental visits removes essential support, increasing the child’s stress.

Remember: Comfort first; children regress when they feel unsafe.

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. PCR testing

Topic: Respiratory Viral Diagnostic Testing

Polymerase chain reaction (PCR) testing is the gold standard for detecting respiratory viral illnesses because it amplifies viral genetic material, offering significantly higher sensitivity and specificity compared to rapid antigen tests or imaging.

Why the others are wrong

• A – Shows structural changes or complications like pneumonia, but cannot identify the specific viral pathogen.
• B – Used to evaluate kidney function or urinary tract infections, not respiratory viral pathogens.
• C – Quicker but has lower sensitivity, leading to a higher rate of false-negative results.

Remember: PCR amplifies DNA and RNA for the most precise viral display.

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. Low income, financial stress, and isolation from support networks

Topic: Adverse Childhood Experiences

The situation highlights socioeconomic hardship and lack of social support, both recognized ACE risk factors that contribute to toxic stress and behavioral issues in children.

Why the others are wrong

• A – Strong support reduces risk; caregiver age alone is not an ACE.
• B – Inconsistent discipline is not a primary ACE risk in this scenario.
• D – Abuse history is a risk, but supervision is protective, not a risk factor.

Remember: Financial strain plus isolation equals key ACE 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: C. Preparing the client for a dilation and curettage (D&C)

Topic: Molar Pregnancy Management

A molar pregnancy carries a high risk of hemorrhage and choriocarcinoma. Immediate evacuation of the abnormal trophoblastic tissue via dilation and curettage (D&C) is the priority intervention to prevent life-threatening complications.

Why the others are wrong

• A – Education on future risks is important but is addressed after the acute crisis is resolved.
• B – Dietary changes for anemia are long-term interventions that do not address the acute surgical need.
• D – Monitoring for infection is a secondary, post-operative concern rather than the immediate priority.

Remember: Molar pregnancy: evacuate immediately with a D&C.

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 screen and identify early stages of disease before symptoms appear

Topic: Levels Of Prevention

Secondary prevention aims to detect disease early in asymptomatic individuals, allowing for prompt intervention to halt progression and minimize complications. Screening tests, such as mammograms and blood pressure checks, are hallmark examples of this prevention level.

Why the others are wrong

• A – Preventing the initial occurrence of disease describes primary prevention, such as immunizations.
• C – Managing existing chronic conditions to prevent further deterioration describes tertiary prevention.
• D – Curing existing disease reflects acute medical treatment rather than preventive health frameworks.

Remember: Primary prevents, secondary screens, tertiary treats chronic disease.

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. 10 days

Topic: Acute Bacterial Sinusitis Diagnosis

Acute bacterial sinusitis is clinically distinguished from viral rhinosinusitis by symptoms that persist for more than 10 days without clinical improvement, or worsen after initial improvement. Viral infections typically resolve within 7 to 10 days.

Why the others are wrong

• A – Seven days is common for viral sinusitis, which usually resolves within a week.
• C – Three days is too brief; viral upper respiratory infections typically peak and persist longer.
• D – Four weeks defines the transition from acute to subacute sinusitis, not the initial onset.

Remember: Bacterial lasts past ten; viral clears up by then.

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. "I feel frustrated when you do not make your bed every morning."

Topic: Child Self‑Esteem Communication

Option C uses an ‘I‑statement’ to express the adult’s feelings without blaming the child, encouraging open dialogue and supporting the child’s self‑esteem by focusing on behavior, not character.

Why the others are wrong

• A – Negative blanket statement; criticizes habit and damages self‑esteem.
• B – Labels child as lazy; attacks character and undermines confidence.
• D – Coercive threat; uses punishment rather than supportive communication.

Remember: Use ‘I‑statements’ to share feelings, not blame, to boost self‑esteem.

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

Answer: B. It is a viral illness that leads to swelling near the larynx and a barking cough.

Topic: Pediatric Croup Pathophysiology

Croup, or laryngotracheobronchitis, is a viral infection that causes swelling of the larynx and trachea. This upper airway inflammation leads to the classic clinical presentation of a barking, seal-like cough and inspiratory stridor.

Why the others are wrong

• A – This describes epiglottitis, a severe, life-threatening bacterial infection of the epiglottis.
• C – This describes asthma, which is a chronic inflammatory disease causing bronchospasm and wheezing.
• D – This describes bronchiolitis, a viral lower respiratory tract infection affecting the small airways.

Remember: Croup: viral swelling of the larynx causes a barking seal cough.

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

Answer: B. Encouraging the child to sit on the toilet for 5–10 minutes daily at the same time

Topic: Pediatric Functional Constipation Management

Establishing a regular toilet routine, such as sitting on the toilet for 5–10 minutes after meals, utilizes the gastrocolic reflex to promote regular bowel movements and helps overcome stool withholding behaviors in children with functional constipation.

Why the others are wrong

• A – High-fiber foods should be encouraged, not avoided, to increase stool bulk and facilitate passage.
• C – Daily enemas are invasive and reserved for severe impaction, not as first-line maintenance therapy.
• D – Restricting fluids worsens constipation by making stools harder and more difficult to pass.

Remember: Routine toilet time trains the bowel to shine.

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. Erythema migrans, a round, red rash with a bullseye appearance

Topic: Early Lyme Disease Signs

Erythema migrans, a characteristic expanding 'bullseye' rash, is the classic hallmark of early localized Lyme disease, occurring in approximately 70% to 80% of infected individuals within 3 to 30 days after a tick bite.

Why the others are wrong

• B – Fever with a purple rash suggests meningococcemia, not early localized Lyme disease.
• C – Severe joint pain and stiffness are signs of late disseminated Lyme disease.
• D – These are non-specific symptoms and not the primary diagnostic sign of early Lyme.

Remember: Lyme disease starts with a bullseye (erythema migrans).

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. Using open and nonthreatening body positioning.

Topic: Trauma-Informed Care

Open, relaxed posture signals safety, reduces perceived threat, and supports trauma‑informed communication, allowing survivors to feel respected and less defensive, and promotes therapeutic engagement.

Why the others are wrong

• A – Avoiding all touch may increase isolation and hinder therapeutic rapport.
• B – Medical jargon can feel intimidating and may retraumatize the client.
• D – Speaking quickly can heighten anxiety and reduce comprehension for trauma survivors.

Remember: Open posture = safety signal for trauma survivors.

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. Permissive

Topic: Parenting Styles

Permissive parenting offers high warmth with few rules, fostering children’s confidence and social ease, but the lack of structure often results in impulsive, disruptive behavior and weaker academic achievement.

Why the others are wrong

• A – Authoritarian is strict and low warmth, producing obedience but low self‑esteem and poor social skills.
• B – Authoritative balances limits and support, leading to competence and good grades, not typical problem behavior.
• C – Uninvolved provides little guidance or affection, resulting in low self‑esteem and overall poor outcomes.

Remember: Permissive = free‑range, confidence high, discipline low.

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. 6-8 months old

Topic: Infant Development

Stranger anxiety usually begins between six and eight months as infants develop object permanence and recognize familiar caregivers, leading to wariness of unfamiliar people and heightened emotional responses.

Why the others are wrong

• B – Infants at 2–4 months lack sufficient cognitive development for stranger anxiety.
• C – At 24–26 months, stranger anxiety resolved.
• D – At 12–18 months, stranger anxiety lessens.

Remember: Six‑to‑eight months: baby says ‘who’s that?’ to strangers.

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. Avoid alcohol, tobacco, and recreational drugs

Topic: Infertility Lifestyle Modifications

Avoiding alcohol, tobacco, and recreational drugs is a crucial lifestyle modification for both partners, as these substances impair reproductive health, decrease sperm and egg quality, and reduce overall conception rates.

Why the others are wrong

• A – High caffeine intake can impair fertility and increase miscarriage risks.
• B – Many standard lubricants are spermicidal and can hinder sperm motility.
• D – Extreme exercise and very low body fat disrupt ovulation and hormone levels.

Remember: Ditch toxins and standard lubes to protect the sperm and tubes.

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. Subcostal retractions and nasal flaring

Topic: Neonatal Respiratory Distress

Subcostal retractions and nasal flaring indicate respiratory distress syndrome, a life-threatening complication in premature infants due to surfactant deficiency. This requires immediate airway and breathing intervention, prioritizing it over expected premature findings.

Why the others are wrong

• B – Physiological jaundice is common and addressed after stabilizing the infant's respiratory status.
• C – A weak suck reflex is expected at 27 weeks and is not immediately life-threatening.
• D – Apnea under 20 seconds without bradycardia is common periodic breathing in premature infants.

Remember: Respiratory distress always takes priority over expected premature findings.

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. Functional constipation

Topic: Pediatric Functional Constipation

Functional constipation is the most common cause of pediatric constipation. It is typically triggered by a painful bowel movement, which prompts the child to withhold stool to avoid pain, reinforcing a cycle of retention.

Why the others are wrong

• B – Presents with abdominal pain, bloody diarrhea, and weight loss rather than withholding.
• C – Presents with chronic diarrhea, abdominal distension, and poor growth rather than withholding.
• D – Typically presents in infancy with delayed meconium passage and abdominal distension.

Remember: Painful stool leads to withholding: think functional constipation.

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.