NCLEX-PN
Health Promotion and Maintenance NCLEX Questions
1. A nurse assisting with data collection plans to perform the Romberg test. After describing the test to the client, the nurse tells the client that it will help reveal which disorder?
- A. Loss of hearing acuity
- B. A problem with balance
- C. A problem with distant hearing
- D. A problem discriminating high-pitched and low-pitched sounds
Correct answer: B
Rationale: The Romberg test is a balance assessment that evaluates cerebellar function. During the test, the client stands with feet together and eyes closed, aiming to maintain balance for about 20 seconds. This test helps identify issues related to balance and proprioception, not hearing acuity or sound discrimination. Choices C and D are incorrect as the Romberg test focuses on balance, not distant hearing or sound discrimination.
2. A mother has come to the pediatric clinic concerned about the recent outbreak of West Nile Virus. The ages of her children are 5, 7, and 10. The mother has asked the nurse what she can do to prevent her children from contracting this illness. Which piece of information is best to provide the mother with?
- A. The children should wear long sleeves and long pants while outside.
- B. Apply insect repellent containing DEET when the children are outside.
- C. Remove standing water from the property.
- D. All of the above.
Correct answer: D
Rationale: The best advice to provide to the mother is 'All of the above.' It is recommended that the children wear insect repellent containing DEET and long-sleeved shirts and long pants when they are outside. This helps in preventing mosquito bites, which can transmit the West Nile Virus. Additionally, removing standing water from areas where the children play can help decrease the number of breeding mosquitoes, reducing the risk of contracting the virus. These methods work in combination to provide effective prevention against the West Nile Virus, making 'All of the above' the correct choice. Choices A, B, and C individually address important prevention measures, but a combination of all three strategies is the most comprehensive approach to protect the children from contracting the illness.
3. A 17-year-old female was raped by a young man in her neighborhood. She is in the Emergency Department for evaluation and tests. After the procedure is completed, a rape crisis counselor (nurse specialist) talks to the client in a conference room regarding the rape. Implementing counseling by the nurse specialist for the raped victim represents:
- A. assessment.
- B. crisis intervention.
- C. empathetic concern.
- D. unwarranted intrusion
Correct answer: B
Rationale: Crisis intervention is the correct choice. Counseling by a nurse specialist after a traumatic event like rape falls under the Crisis Intervention Model. This approach aims to provide immediate support to individuals facing a crisis to enhance coping mechanisms. In this scenario, the nurse specialist is offering specialized care tailored to rape victims, helping the client navigate through the emotional aftermath of the traumatic experience. Choices A, C, and D are incorrect: A is not the correct answer as the nurse specialist is providing emotional support rather than conducting an assessment; C, while important, does not fully capture the specialized intervention being provided; and D is inaccurate as the nurse specialist's intervention is warranted and essential for the victim's well-being.
4. When assessing the health-related physical fitness of a client as part of a health assessment, what aspect should be the focus?
- A. agility
- B. speed
- C. body composition
- D. risk factors
Correct answer: D
Rationale: When assessing the health-related physical fitness of a client, the primary focus should be on identifying risk factors that could predispose the client to illness or injury. Risk factors are crucial in determining an individual's overall health status and potential health outcomes. While agility, speed, and body composition are important components of physical fitness assessments, they are not the primary focus when assessing health-related physical fitness from a holistic perspective. Therefore, the correct choice is 'risk factors.'
5. Diagnostic genetic counseling, for procedures such as amniocentesis and chorionic villus sampling, allows clients to make all of the following choices except:
- A. terminating the pregnancy.
- B. preparing for the birth of a child with special needs.
- C. accessing support services before the birth.
- D. completing the grieving process before the birth.
Correct answer: D
Rationale: Diagnostic genetic counseling provides clients with important information to make informed decisions regarding their pregnancy. Clients can choose to terminate the pregnancy, prepare for the birth of a child with special needs, and access support services before the birth based on the genetic testing results. However, completing the grieving process before the birth is not a typical choice during genetic counseling. The grieving process, if needed, may extend beyond the prenatal period, especially if the findings are concerning or indicate potential issues. Therefore, completing the grieving process before the birth is the exception among the provided options.
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