NCLEX NCLEX-PN
Health Promotion and Maintenance NCLEX PN Questions
1. A community health nurse is instructing a group of female clients about breast self-examination (BSE). The nurse instructs the clients to perform the examination in which manner?
- A. At the onset of menstruation
- B. Every month during ovulation
- C. Weekly, at the same time of day
- D. One week after menstruation begins
Correct answer: One week after menstruation begins
Rationale: Breast self-examination (BSE) should be performed after the menstrual period, specifically on the seventh day of the menstrual cycle, when the breasts are smallest and least congested. This timing facilitates the easier detection of any abnormalities. Performing BSE at the onset of menstruation (Option A) can lead to false results due to hormonal changes affecting breast tissue. Performing it every month during ovulation (Option B) is not recommended as breast tissue may be more tender and lumpy during this time. Conducting weekly examinations at the same time of day (Option C) is unnecessary and can lead to unnecessary anxiety for the client.
2. Mr. H. is upset about being in the hospital for another day because he states it costs too much. The rights he is likely to demand include all of the following except:
- A. the right to examine and question the bill
- B. the right to reasonable response to requests
- C. the right to refuse treatment
- D. the right to confidentiality
Correct answer: the right to confidentiality
Rationale: Confidentiality is the maintenance of privacy of information, which is not directly related to the issue Mr. H. is facing. The question indicates that Mr. H. is concerned about the cost of staying in the hospital, which pertains more to financial aspects and the right to examine and question the bill. The right to a reasonable response to requests and the right to refuse treatment are also crucial patient rights that Mr. H. may demand in his current situation. Therefore, the correct answer is the right to confidentiality, as it is not specifically relevant to the scenario presented.
3. A nurse is reading the report from the registered nurse for an initial home visit to a client with chronic obstructive pulmonary disease. The client was recently discharged from the hospital. Which type of database does the nurse read that contains this information from the client?
- A. Episodic
- B. Follow-up
- C. Emergency
- D. Complete
Correct answer: Complete
Rationale: The correct answer is 'Complete.' A complete database includes a full health history and physical examination, providing a comprehensive overview of the client's current and past health status. This type of database establishes a baseline for future assessments, making it essential for the nurse's initial home visit to understand the client's health needs thoroughly post-hospital discharge. It is typically gathered in primary care settings like clinics, private practices, college health services, women's health care agencies, visiting nurse agencies, or community health agencies. An episodic database focuses on a specific short-term issue or body system, which is not comprehensive enough for the initial home visit after hospital discharge. A follow-up database is used to monitor a known problem at regular intervals, not suitable for an initial assessment. An emergency database is swiftly collected during urgent situations, often while lifesaving measures are being carried out, and is not relevant for a post-hospital discharge home visit.
4. The nurse manager of a quality improvement program asks a nurse in the neurological unit to conduct a retrospective audit. Which action should the auditing nurse plan to perform in this type of audit?
- A. Checking the crash cart to ensure that all needed supplies are readily available in case of an emergency
- B. Checking the documentation written by a new nursing graduate on her assigned clients at the end of the shift
- C. Reviewing neurological assessment checklists for all clients on the unit to ensure that these assessments are being conducted as prescribed
- D. Obtaining the assigned medical record from the hospital’s medical record room to review documentation made during a client’s hospital stay
Correct answer: Obtaining the assigned medical record from the hospital’s medical record room to review documentation made during a client’s hospital stay
Rationale: Quality improvement, also known as performance improvement, focuses on processes contributing to client safety and care outcomes. Retrospective audits involve reviewing medical records after discharge for compliance with standards. Concurrent audits assess staff compliance during a client's stay. Therefore, obtaining the medical record from the hospital’s record room for review is crucial in a retrospective audit. Options A, B, and C are more suited for concurrent audits as they involve real-time assessment during a client’s stay.
5. Quality is defined as a combination of all of the following except:
- A. conforming to standards.
- B. performing at the minimally acceptable level.
- C. meeting or exceeding customer requirements.
- D. exceeding customer expectations.
Correct answer: performing at the minimally acceptable level.
Rationale: The correct answer is 'performing at the minimally acceptable level.' Quality is about meeting or exceeding customer requirements and expectations, as well as conforming to standards. The term 'performing at the minimally acceptable level' implies just meeting the minimum requirements, which falls short of the comprehensive definition of quality in terms of customer satisfaction and excellence. Therefore, this choice is the exception when defining quality. Choices A, C, and D align with the definition of quality as they all involve meeting or surpassing certain criteria for customer satisfaction and product excellence, which are essential components of quality management.
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