NCLEX-PN
Health Promotion and Maintenance NCLEX PN Questions
1. A client who was given a diagnosis of hypertension 3 months ago is at the clinic for a checkup. Which type of database does the nurse use in performing an assessment?
- A. Emergency
- B. Follow-up
- C. Complete (total)
- D. Problem-centered
Correct answer: B
Rationale: The correct answer is 'Follow-up.' A follow-up database is used to assess the status of an identified problem at regular intervals. An emergency database is for urgent data collection during life-saving measures. A complete database involves a full health history and physical examination. A problem-centered (episodic) database focuses on a limited or short-term issue, typically centered around one problem or body system.
2. A nurse in the healthcare provider's office is checking the Babinski reflex in a 3-month-old infant. The nurse determines that the infant's response is normal if which finding is noted?
- A. The fingers curl tightly, and the toes curl forward.
- B. The toes flare, and the big toe is dorsiflexed.
- C. There is extension of the extremities on the side to which the head is turned, with flexion on the opposite side.
- D. The infant turns to the side that is touched.
Correct answer: B
Rationale: To elicit the Babinski reflex, the nurse strokes the lateral sole of the foot from the heel to across the base of the toes. In the expected response, the toes flare, and the big toe dorsiflexes. The Babinski reflex disappears at 12 months of age. Turning to the side that is touched is the expected response when the rooting reflex is elicited. Tight curling of the fingers and forward curling of the toes is the expected response when the grasp reflex (palmar and plantar) is elicited. Extension of the extremities on the side to which the head is turned with flexion on the opposite side is the expected response when the tonic neck reflex is elicited.
3. A nurse is providing information to a group of pregnant clients and their partners about the psychosocial development of an infant. Using Erikson's theory of psychosocial development, the nurse tells the group that infants have which developmental need?
- A. Must have needs ignored for short periods to develop a healthy personality
- B. Need to rely on the fact that their needs will be met
- C. Need to experience frustration, so it is best to allow an infant to cry for a while before meeting his or her needs
- D. Need to tolerate a great deal of frustration and discomfort to develop a healthy personality
Correct answer: B
Rationale: According to Erikson's theory of psychosocial development, infants struggle to establish a sense of basic trust rather than a sense of basic mistrust in their world, their caregivers, and themselves. If provided with consistent satisfying experiences that are delivered in a timely manner, infants come to rely on the fact that their needs are met and that, in turn, they will be able to tolerate some degree of frustration and discomfort until those needs are met. This sense of confidence is an early form of trust and provides the foundation for a healthy personality. Therefore, options A, C, and D are incorrect as they do not align with Erikson's theory that emphasizes the importance of infants trusting that their needs will be met.
4. When preparing to assist the healthcare provider in examining a client's skin with the use of a Wood light, what action should the nurse perform?
- A. Darken the room
- B. Obtain informed consent from the client
- C. Obtain a scalpel and a slide for diagnostic evaluation
- D. Obtain medication to anesthetize the skin area before proceeding with the examination
Correct answer: A
Rationale: When using a Wood light during a skin examination, the room should be darkened to enhance the visibility of fluorescence. The Wood light emits long-wavelength ultraviolet light, highlighting certain skin conditions. Darkening the room aids in better visualization. Obtaining informed consent is a crucial aspect of healthcare but not directly related to using a Wood light. Obtaining a scalpel and a slide is unnecessary for a noninvasive Wood light examination. Anesthetizing the skin area is not required as the procedure is painless and noninvasive.
5. A wrong committed by one person against another (or against the property of another) that might result in a civil trial is:
- A. a tort
- B. a crime
- C. a misdemeanor
- D. a felony
Correct answer: B
Rationale: A tort is a civil wrong committed by one person against another person (or against the property of another) that might result in civil trials. Unlike crimes, which are considered wrongs against the public, torts are personal wrongs. Misdemeanors are crimes punishable with fines or imprisonment for less than one year, whereas felonies are serious crimes punishable by imprisonment for more than one year in a State or Federal penitentiary. Therefore, the correct answer is a tort as it aligns with the definition of a civil wrong that leads to potential civil trials, distinguishing it from crimes, misdemeanors, and felonies.
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