NCLEX-PN
Health Promotion and Maintenance NCLEX PN Questions
1. While assisting with data collection, the client informs the nurse that he is having difficulty swallowing medications and food. The nurse gathers additional subjective data and documents that the client is experiencing which disorder?
- A. Pyrosis
- B. Anorexia
- C. Eructation
- D. Dysphagia
Correct answer: D
Rationale: The correct answer is 'Dysphagia.' Dysphagia is the term used to indicate difficulty swallowing, which can occur in disorders of the throat or esophagus. Anorexia refers to a loss of appetite, not difficulty swallowing. Eructation is the medical term for belching, not difficulty swallowing. Pyrosis is heartburn, a burning sensation in the esophagus and stomach caused by the reflux of gastric acid, not difficulty swallowing.
2. A nurse is reviewing the findings of a physical examination documented in a client's record. Which piece of information does the nurse recognize as objective data?
- A. The client is allergic to strawberries
- B. The last menstrual period was 30 days ago
- C. The client takes acetaminophen (Tylenol) for headaches
- D. A 1-2-inch scar is present on the lower right portion of the abdomen
Correct answer: D
Rationale: Objective data in a physical examination are findings that the healthcare provider observes or measures directly. In this case, a 1 � 2-inch scar present on the lower right portion of the abdomen is a physical observation. Subjective data are based on what the client reports, such as allergies (Choice A), the date of the last menstrual period (Choice B), and self-reported medication use for headaches (Choice C). While these pieces of information are important for assessing the client's health, they are considered subjective data because they rely on the client's self-report rather than direct observation by the healthcare provider.
3. Which of the following physical findings indicates that an 11-12-month-old child is at risk for developmental dysplasia of the hip?
- A. refusal to walk
- B. not pulling to a standing position
- C. negative Trendelenburg sign
- D. negative Ortolani sign
Correct answer: B
Rationale: The correct answer is 'not pulling to a standing position.' If an 11-12-month-old child is unable to pull to a standing position, it can indicate a risk for developmental dysplasia of the hip. By 15 months of age, children should be walking, so delayed standing can be a red flag. The Trendelenburg sign is associated with gluteus medius muscle weakness, not hip dysplasia, making choice C incorrect. The Ortolani sign is used to detect congenital hip subluxation or dislocation, not developmental dysplasia, making choice D incorrect.
4. What is the primary theory that explains a family's concept of health and illness?
- A. Health Belief Model
- B. Education-School-Completing Factor
- C. Family Health Expert Factor
- D. Disconnected Family Factor
Correct answer: A
Rationale: The correct answer is the Health Belief Model. This model explains a family's concept of health and illness by focusing on readiness factors, perceived susceptibility, and seriousness of health problems, and positive motivation for wellness. The Health Belief Model is widely used in healthcare to understand and predict health behaviors. Choices B, C, and D are incorrect as they do not specifically address how a family perceives health and illness. The Health Belief Model is the most appropriate choice as it is specifically designed to explain individual and family beliefs and behaviors related to health and illness.
5. While a client is on total parenteral nutrition, which of the following values should the nurse monitor closely?
- A. calcium
- B. magnesium
- C. glucose
- D. cholesterol
Correct answer: C
Rationale: Glucose should be monitored closely when a client is on total parenteral nutrition due to the high glucose concentration in the solutions. Monitoring glucose levels is crucial to prevent complications such as hyperglycemia or hypoglycemia. Calcium and magnesium are usually monitored to assess electrolyte imbalances, while cholesterol levels are not directly impacted by total parenteral nutrition. Therefore, choices A, B, and D are not the primary values that need close monitoring during total parenteral nutrition.
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