a 25 year old client was seen in the clinic 2 weeks ago for symptoms of a cold and is now complaining of chest congestion and cough the nurse should a a 25 year old client was seen in the clinic 2 weeks ago for symptoms of a cold and is now complaining of chest congestion and cough the nurse should a
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NCLEX NCLEX-PN

Health Promotion and Maintenance NCLEX PN Questions

1. When a 25-year-old client complains of chest congestion and cough after previously presenting with cold symptoms, what data should the nurse collect?

Correct answer: C: Data related to the respiratory system

Rationale: In this case, the nurse should collect data related to the respiratory system since the client is presenting with symptoms like chest congestion and cough, indicating a respiratory issue. Focusing on the respiratory system will help gather pertinent information to assess the current problem comprehensively. A complete health database involves a detailed health history and full physical examination, which is beyond the immediate scope of the presenting issue. Data related to follow-up care is premature as the primary focus should be on assessing the current respiratory symptoms. Data related to the treatment for the cold is not the priority at this stage, as understanding the underlying respiratory problem is crucial for appropriate intervention.

2. Which type of exercises might be prescribed to strengthen the pelvic floor muscles of a client with urinary incontinence?

Correct answer: Kegel

Rationale: The correct answer is Kegel. Kegel exercises are specifically designed to strengthen the pelvic floor muscles, making them an effective treatment for urinary incontinence. These exercises involve contracting and relaxing the pelvic floor muscles, which helps to improve muscle tone and control. Choice B, resistance exercises, may not directly target the pelvic floor muscles as effectively as Kegel exercises. Passive exercises (Choice C) do not actively engage the muscles and are unlikely to strengthen the pelvic floor. Stretching exercises (Choice D) focus on increasing flexibility rather than muscle strength, so they are not the most appropriate for strengthening the pelvic floor muscles in the context of urinary incontinence.

3. A client is complaining of difficulty walking secondary to a mass in the foot. The nurse should document this finding as:

Correct answer: Morton’s neuroma.

Rationale: The correct answer is Morton’s neuroma. Morton’s neuroma is a small mass or tumor in a digital nerve of the foot, causing pain and difficulty walking. Hallux valgus is commonly known as a bunion, involving a bony bump at the base of the big toe. Hammertoe is a condition where one toe is bent abnormally at the middle joint, resembling a hammer. Plantar fasciitis is characterized by pain and inflammation in the arch of the foot, not by a mass causing difficulty walking. Therefore, options A, B, and C are incorrect as they do not describe a mass in the foot leading to difficulty walking, unlike Morton’s neuroma.

4. The licensed practical nurse is working with a registered nurse and a patient care assistant. Which of the following clients should be cared for by the registered nurse?

Correct answer: A client 2 days post-thoracotomy

Rationale: The correct answer is a client 2 days post-thoracotomy because this client is the most critical and requires the expertise of a registered nurse. Clients A and B are stable and ready for discharge after their respective surgeries (appendectomy and thyroidectomy). Client C, who is 3 days post-splenectomy, is also stable enough to be cared for by a licensed practical nurse as they are in a stable condition and do not have immediate critical needs. Therefore, the registered nurse should care for the client 2 days post-thoracotomy due to the critical nature of the procedure and the immediate postoperative care required.

5. The nurse is assessing the dental status of an 18-month-old child. How many teeth should the nurse expect to examine?

Correct answer: 12

Rationale: An 18-month-old child should have approximately 12 teeth. In general, children begin dentition around 6 months of age. During the first 2 years of life, a quick guide to the number of teeth a child should have is as follows: Subtract the number 6 from the number of months in the age of the child. In this example, the child is 18 months old, so the formula is 18 – 6 = 12. The correct answer is 12. Choice A (6) is incorrect as it does not consider the child's age. Choices B (8) and D (16) are incorrect as they do not align with the dental development timeline and the specific age of the child in question.

Similar Questions

While caring for the following clients, a pediatric nurse tells the charge nurse she must leave due to a family emergency. Which client would the charge nurse reassign to an LPN?
Client self-determination is the primary focus of:
A patient has experienced a severe third-degree burn to the trunk in the last 36 hours. Which phase of burn management is the patient in?
When a client informs the nurse that he is experiencing hypoglycemia, the nurse provides immediate intervention by offering:
A nurse assisting with data collection regarding the client’s eyes notes that the pupils get larger when the client looks at an object in the distance and become smaller when the client looks at a nearby object. How does the nurse document this finding?

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