NCLEX-PN
Health Promotion and Maintenance NCLEX Questions
1. After reviewing the child's immunization record, which scheduled vaccine should the nurse prepare to administer next?
- A. Hib
- B. IPV
- C. MMR
- D. DTaP
Correct answer: D
Rationale: The correct answer is DTaP. DTaP is administered at 2, 4, and 6 months of age; between 15 and 18 months of age; and between 4 and 6 years of age. Since the child has only received three doses of this vaccine, the next dose of DTaP should be administered. The other options are incorrect because Hib is administered at 2, 4, and 6 months of age and between 12 and 15 months; IPV is administered at 2, 4, and 6 months of age and between 4 and 6 years of age; MMR is administered between 12 and 15 months of age and again between 4 and 6 years of age.
2. When assessing the carotid artery of a client with cardiovascular disease, what action should a nurse perform?
- A. Palpating the carotid artery in the upper third of the neck
- B. Palpating both arteries simultaneously to compare amplitude
- C. Listening to the carotid artery, using the bell of the stethoscope to assess for bruits
- D. Instructing the client to take slow, deep breaths while the nurse listens to the carotid artery
Correct answer: C
Rationale: When assessing the carotid artery of a client with cardiovascular disease, the nurse should listen to the carotid artery using the bell of the stethoscope to assess for bruits. This is crucial in detecting abnormal sounds that may indicate underlying pathology. Palpating the carotid artery in the upper third of the neck can trigger a vagal response, leading to a decrease in heart rate, which is undesirable. Palpating both arteries simultaneously can disrupt blood flow to the brain. Instructing the client to take slow, deep breaths is unnecessary and not a standard practice during carotid artery assessment.
3. When caring for a patient who is hard-of-hearing, which of the following steps may be appropriate when communicating with the patient?
- A. Divide the verbal communication into smaller sections and address one at a time.
- B. Communicate only with written information.
- C. Ask multiple questions in a row quickly to make sure the patient is remaining engaged.
- D. Frequently communicate without assistive devices to help the patient improve their hearing.
Correct answer: A
Rationale: When caring for a patient who is hard-of-hearing, it is important to divide verbal communication into smaller sections and address them one at a time. This approach helps the patient follow along more easily and understand the information being conveyed. While using written information can also be beneficial, solely relying on written communication may not always be practical or feasible for effective interaction. Asking multiple questions quickly can overwhelm the patient and hinder their ability to process each question adequately. It is essential to give the patient sufficient time to comprehend and respond. Additionally, frequently communicating without assistive devices is not recommended. Using assistive devices can significantly enhance the patient's ability to hear and understand, promoting better communication and patient care.
4. A 65-year-old female client is experiencing postmenopausal bleeding. Which type of physician should this client be encouraged to see?
- A. a radiologist
- B. a gynecologist
- C. a physiatrist
- D. an oncologist
Correct answer: B
Rationale: A 65-year-old female experiencing postmenopausal bleeding should be encouraged to see a gynecologist. Gynecologists specialize in treating and managing diseases of the female reproductive organs, making them the most appropriate physician for this issue. Postmenopausal bleeding can indicate various gynecological conditions such as endometrial atrophy, endometrial hyperplasia, or endometrial cancer, highlighting the importance of consulting a gynecologist for proper diagnosis and management. Radiologists evaluate X-rays, physiatrists manage rehabilitation teams, and oncologists treat clients with cancer. Therefore, in this case, the symptoms point towards a gynecological problem, emphasizing the necessity of seeking care from a gynecologist.
5. During an interview, what action should a nurse conducting an interview with a client take to collect subjective data?
- A. Takes minimal notes to avoid impeding observation of the client's nonverbal behaviors
- B. Takes a great deal of notes to allow the client to continue at his or her own pace as the nurse records what he or she is saying
- C. Takes notes because this allows the nurse to break eye contact with the client, which may increase the client's level of comfort
- D. Takes notes to allow the nurse to shift attention away from the client, which may make the nurse more comfortable
Correct answer: A
Rationale: During an interview, a nurse should minimize note-taking to focus on the client and not impede the conversation. Taking minimal notes allows the nurse to effectively observe the client's nonverbal behaviors, which provide valuable subjective data. Option B, taking many notes, is incorrect as it can distract the nurse from the client's cues and hinder interaction. Option C, taking notes to break eye contact, is incorrect as it may decrease the client's comfort level and disrupt communication. Option D, taking notes to shift attention away from the client, is incorrect as it diminishes the client's importance and may make them uncomfortable during sensitive discussions. Therefore, the correct approach is for the nurse to take minimal notes, ensuring effective observation of the client's nonverbal behaviors while collecting subjective data.
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