NCLEX-PN
Health Promotion and Maintenance NCLEX PN Questions
1. Why is Kleinman's Explanatory Model of Health and Illness significant?
- A. it focuses on the health beliefs of a particular family.
- B. it highlights the impact of culture on health explanations.
- C. it discusses the significant role of popular and folk domains of influence.
- D. it is based on an educational approach.
Correct answer: C
Rationale: Kleinman's Explanatory Model of Health and Illness is significant because it emphasizes the influence of popular and folk domains on health perceptions. Kleinman distinguishes between disease, representing the biomedical view, and illness, reflecting individual understanding. The model underscores that cultural factors shape the significance of popular and folk influences on health beliefs. Choice A is incorrect as the model focuses on broader cultural influences, not individual family beliefs. Choice B is incorrect as it oversimplifies the model's emphasis on various cultural aspects. Choice D is incorrect as the model's significance lies in its cultural framework rather than an educational base.
2. When reviewing a client's medical notes to confirm pregnancy, a nurse should look for which finding to determine that pregnancy is confirmed?
- A. Amenorrhea
- B. Thinning of the cervix
- C. Palpable fetal movement
- D. Positive result on a home urine test for pregnancy
Correct answer: C
Rationale: To confirm pregnancy, the presence of palpable fetal movement is a positive indicator. Palpable fetal movement is a certain sign of pregnancy, known as a fetal movement felt by the examiner. Amenorrhea is a presumptive sign of pregnancy as it is reported by the woman but is not confirmatory. Thinning of the cervix (Hegar sign) is a probable sign of pregnancy, which is not confirmatory. A positive result on a home urine test for pregnancy is also a probable indicator. However, a positive pregnancy test result can sometimes yield false-positive results due to various factors like medication, recent pregnancy, or errors in reading.
3. A nurse is preparing to measure a client's calf circumference. The nurse performs this procedure by performing which action?
- A. Placing a tape measure around the widest point of the lower leg
- B. Measuring 2 inches above the knee and placing the tape measure around the client's leg at this point
- C. Measuring 2 inches above the ankle and placing the tape measure around the client's leg at this point
- D. Measuring 2 inches below the patella and placing the tape measure around the client's leg at this point
Correct answer: A
Rationale: To measure a client's calf circumference accurately, a nurse should place a non-stretchable tape measure around the widest point of the lower leg. It is crucial to ensure that the tape measure is positioned at the same number of centimeters down from a specific landmark, such as the patella, on both legs for consistency. Placing the tape measure 2 inches above the knee (Option B), 2 inches above the ankle (Option C), or 2 inches below the patella (Option D) would not provide an accurate measurement of the calf circumference. Therefore, these options are incorrect choices.
4. Which condition is associated with inadequate intake of vitamin C?
- A. rickets
- B. marasmus
- C. kwashiorkor
- D. scurvy
Correct answer: D
Rationale: Scurvy is indeed associated with inadequate intake of vitamin C. Vitamin C deficiency leads to scurvy, which is characterized by weakness, anemia, gum disease, and skin hemorrhages. Choices A, B, and C are incorrect because rickets is caused by vitamin D deficiency, marasmus is due to severe malnutrition leading to wasting, and kwashiorkor is a form of severe protein-energy malnutrition.
5. As part of a routine health screening, the nurse notes the play of a 2-year-old child. Which of the following is an example of age-appropriate play at this age?
- A. builds towers with several blocks
- B. tries to color within the lines
- C. says "Mine!"? when playing with toys
- D. tries to jump rope
Correct answer: C
Rationale: For a 2-year-old child, saying 'Mine!' when playing with toys is an example of age-appropriate play. Toddlers at this age are possessive and asserting their sense of ownership. Building towers with blocks and trying to color within the lines involve more advanced motor skills and cognitive abilities that are typically not fully developed in a 2-year-old. Jumping rope requires coordination and balance beyond what a 2-year-old can usually achieve. Therefore, choices A, B, and D are not considered age-appropriate plays for a 2-year-old child.
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