NCLEX-PN Health Promotion and Maintenance Practice Test

25 practice questions

Choose an answer, then check it under Show answer.

1. Question 1 of 25Hard

   A nurse in a clinic is collecting baseline physical data on a 78-year-old male client. Which finding should the nurse report to the health care provider first?

   1. AA. A gray-white ring around the edge of both corneas
   2. BB. Unintentional weight loss of 12 lb over the past 2 months
   3. CC. Decreased hearing for high-pitched sounds in both ears
   4. DD. Dry, thin skin with scattered brown age spots on the forearms
   Show answer to question 1

   Answer: B. Unintentional weight loss of 12 lb over the past 2 months

   Unintentional weight loss of this amount in a short time is not an expected age change and may signal cancer, depression, malnutrition or other illness. It needs prompt provider evaluation.

   Why the other options are wrong

   • AA ring around the cornea (arcus senilis) is a common, expected finding in older adults.
   • CHigh-frequency hearing loss (presbycusis) is an expected age-related change, though it may affect communication.
   • DThin, dry skin and age spots are expected with aging and need documentation and skin care, not urgent reporting.

2. Question 2 of 25Medium

   A 4-year-old child is scheduled for a blood draw and is crying and clinging to the parent. Which action by the nurse is most appropriate?

   1. AA. Let the child practice with a toy syringe on a doll first
   2. BB. Promise the child that the needle stick will not hurt at all
   3. CC. Explain blood circulation and laboratory testing in great detail
   4. DD. Do the draw quickly without explaining so the child worries less
   Show answer to question 2

   Answer: A. Let the child practice with a toy syringe on a doll first

   Preschoolers learn through play and concrete experience. Playing with safe equipment lets the child express fear and understand the procedure.

   Why the other options are wrong

   • BPromising there will be no pain is untrue and damages the child's trust in the nurse.
   • CA preschooler cannot grasp complex physiology, so a detailed explanation only increases confusion.
   • DSkipping an explanation increases the child's fear and removes any sense of control.

3. Question 3 of 25Hard

   A home health nurse visits a 64-year-old female client who retired from teaching 3 months ago. She says she feels restless and "without purpose," but she eats and sleeps well, enjoys her grandchildren and denies feeling sad. Which response by the nurse best assists her with this life transition?

   1. AA. "Those feelings mean you are depressed, so I will ask your provider about medication today."
   2. BB. "Most people adjust quickly to retirement, so try not to dwell on these feelings too much."
   3. CC. "Many retirees feel this way. What activities, like volunteering, might give you purpose?"
   4. DD. "You should start looking for a full-time job again as soon as possible to stay busy."
   Show answer to question 3

   Answer: C. "Many retirees feel this way. What activities, like volunteering, might give you purpose?"

   Restlessness and loss of role are common during retirement. Normalizing the feelings and exploring meaningful activities supports healthy adjustment, while the nurse stays alert for signs of depression.

   Why the other options are wrong

   • ANormal sleep, appetite and absence of sad mood do not support labeling this depression or requesting medication.
   • BTelling her not to dwell on her feelings dismisses them, blocks communication and offers no help adjusting to the role change.
   • DAdvising a quick return to full-time work ignores the client's own choice and is not a client-centered response.

4. Question 4 of 25Medium

   A nurse assesses a client 6 hours after a vaginal birth. The fundus is soft, two fingerbreadths above the umbilicus, and displaced to the right. Lochia is moderate. Which action should the nurse take first?

   1. AA. Massage the fundus firmly for several minutes.
   2. BB. Help the client walk to the bathroom to void.
   3. CC. Apply an ice pack to the perineal area now.
   4. DD. Give the prescribed analgesic for cramping.
   Show answer to question 4

   Answer: B. Help the client walk to the bathroom to void.

   A high fundus displaced to the side suggests a full bladder, which prevents the uterus from contracting. Helping the client void is the first action, after which the nurse reassesses the fundus and lochia.

   Why the other options are wrong

   • AProlonged firm massage is painful and does not address the likely cause, a distended bladder pushing the uterus upward and aside.
   • CAn ice pack eases perineal swelling and discomfort but does not correct the displaced fundus or its cause.
   • DAnalgesia may improve comfort later but does not treat the underlying problem, a full bladder preventing uterine contraction.

5. Question 5 of 25Easy

   An 82-year-old client at a clinic says, "I wake up more often at night and my sleep is lighter than it used to be. Is something wrong with me?" Which response by the nurse is best?

   1. AA. "Waking at night means your medications must be stopped right away."
   2. BB. "You should nap longer during the day to make up for lost sleep."
   3. CC. "You should ask for a sleep medication so you can sleep through the night."
   4. DD. "Lighter sleep and more awakenings are common, expected changes with aging."
   Show answer to question 5

   Answer: D. "Lighter sleep and more awakenings are common, expected changes with aging."

   Older adults commonly have lighter sleep, less deep sleep and more night awakenings. Reinforcing this as an expected change reduces worry.

   Why the other options are wrong

   • AMedications are not always the cause, and they should never be stopped without a provider's order.
   • BLonger daytime naps can further disrupt nighttime sleep.
   • CSleep medications raise fall and confusion risk in older adults and are not the first response to an expected change.

6. Question 6 of 25Medium

   A nurse is reviewing preventive health screening recommendations with an asymptomatic 65-year-old female client. Which screening examination should the nurse identify as routinely recommended for this client?

   1. AA. Transthoracic echocardiogram every three years to assess heart valves
   2. BB. Diagnostic colonoscopy every year to detect intestinal polyps
   3. CC. Dual-energy x-ray absorptiometry scan to evaluate bone density
   4. DD. Abdominal ultrasonography every two years to check liver size
   Show answer to question 6

   Answer: C. Dual-energy x-ray absorptiometry scan to evaluate bone density

   Bone mineral density testing via dual-energy x-ray absorptiometry (DXA) is routinely recommended for women aged 65 and older to screen for osteoporosis and guide fracture prevention. Routine screening colonoscopy for average-risk individuals is performed every 10 years, not annually. Routine abdominal ultrasonography and echocardiography are diagnostic tests reserved for specific symptoms or risk factors rather than universal preventive screenings.

7. Question 7 of 25Medium

   A client contacts the clinic asking about emergency contraception after barrier method failure occurred 24 hours ago. Which information should the nurse provide?

   1. AA. Barrier methods must be avoided for the next complete cycle.
   2. BB. A negative serum pregnancy test is required before purchase.
   3. CC. The pills act by terminating an already established pregnancy.
   4. DD. The medication is most effective when taken within 72 hours.
   Show answer to question 7

   Answer: D. The medication is most effective when taken within 72 hours.

   Levonorgestrel emergency contraceptive pills work primarily by delaying or inhibiting ovulation and are most effective when taken as soon as possible within 72 hours of unprotected intercourse. Emergency contraception does not disrupt or terminate an already implanted pregnancy and is not an abortifacient. Levonorgestrel is available over the counter without a prescription or serum pregnancy testing, and barrier methods should be continued immediately for subsequent sexual acts.

8. Question 8 of 25Medium

   A nurse in a high school wellness clinic is speaking with a 17-year-old student who reports feeling completely hopeless, has started giving away prized possessions, and stopped attending team practices. Which action should the nurse take first?

   1. AA. Encourage the student to join a peer-led extracurricular study circle.
   2. BB. Schedule an appointment for a counseling intake in two weeks.
   3. CC. Contact the athletic coach to inquire about recent team conflicts.
   4. DD. Ask the student directly if they are having thoughts of suicide.
   Show answer to question 8

   Answer: D. Ask the student directly if they are having thoughts of suicide.

   Giving away valued belongings, withdrawal from activities, and expressions of hopelessness are strong indicators of suicide risk, requiring the nurse to directly and immediately assess for suicidal ideation, intent, and plans. Delaying assessment by making future appointments or contacting coaches leaves the student in immediate danger.

9. Question 9 of 25Medium

   The practical nurse is assisting with a developmental screening of a 2-year-old child. Which behavior observed by the nurse indicates typical development for this age?

   1. AA. Engaging in cooperative board games with peers
   2. BB. Building a tower consisting of six to seven blocks
   3. CC. Tying shoelaces without adult assistance
   4. DD. Riding a tricycle smoothly using pedals
   Show answer to question 9

   Answer: B. Building a tower consisting of six to seven blocks

   A 2-year-old toddler typically has the fine motor ability to build a tower of 6 to 7 blocks and turn individual book pages. Riding a tricycle is a milestone expected of a 3-year-old preschooler, while tying shoelaces and cooperative rule-based games emerge in older children.

10. Question 10 of 25Hard

    In a long-term care facility, a resident with Parkinson disease takes about 40 minutes to dress each morning. At a care meeting, a team member suggests that the assistive personnel dress him to save time. What should the nurse recommend?

    1. AA. Encourage self-dressing, allow extra time, and provide hook-and-loop clothing.
    2. BB. Dress him on busy mornings and encourage independence when staffing allows.
    3. CC. Have assistive personnel dress him fully each day because the effort tires him.
    4. DD. Switch him to a hospital gown each day so that dressing is no longer needed.
    Show answer to question 10

    Answer: A. Encourage self-dressing, allow extra time, and provide hook-and-loop clothing.

    Care plan changes should be based on the client's self-care abilities and needs, not on staffing convenience. Extra time and adaptive clothing preserve independence, function and dignity.

    Why the other options are wrong

    • BBasing independence on staffing puts convenience ahead of the resident's needs and weakens his abilities.
    • CFully dressing him takes away a skill he still has and speeds the loss of function.
    • DA hospital gown removes his dignity and personal choice and does not address the dressing difficulty.

11. Question 11 of 25Medium

    A client is being treated for chlamydia at a clinic, and the nurse reinforces teaching about preventing reinfection. Which statement by the client indicates a need for further teaching?

    1. AA. "My partner should be tested and treated, too."
    2. BB. "I can have sex again as soon as my symptoms go away."
    3. CC. "Using a condom every time lowers my risk of another infection."
    4. DD. "I should return for retesting when my provider tells me to."
    Show answer to question 11

    Answer: B. "I can have sex again as soon as my symptoms go away."

    Symptoms may fade before the infection is cleared. The client should avoid sex until treatment is complete as the provider directs and partners have been treated, so this statement shows a need for further teaching.

    Why the other options are wrong

    • ATreating partners prevents passing the infection back and forth, so this statement is correct.
    • CConsistent condom use reduces the risk of acquiring sexually transmitted infections, so this is correct.
    • DFollow-up retesting is recommended because reinfection is common, so this statement is correct.

12. Question 12 of 25Hard

    A nurse at a neighborhood clinic serves a community where most homes were built before 1950 and many have peeling paint. A parent of a healthy 18-month-old asks how to keep the child healthy. Which teaching is most appropriate to reinforce based on this community's characteristics?

    1. AA. Limit the toddler's outdoor play to prevent insect bites and sun exposure.
    2. BB. Switch the toddler to a low-fat diet to prevent obesity later in life.
    3. CC. Keep the toddler away from peeling paint and ask about lead screening.
    4. DD. Delay routine immunizations until the toddler is at least two years old.
    Show answer to question 12

    Answer: C. Keep the toddler away from peeling paint and ask about lead screening.

    Older housing often contains lead-based paint, and toddlers are at high risk from hand-to-mouth behavior. Reducing exposure to paint chips and dust and arranging blood lead screening addresses the community's main risk.

    Why the other options are wrong

    • AInsect bites and sun exposure are not the main risk identified in this community, and limiting outdoor play is unnecessary.
    • BToddlers need adequate dietary fat for brain growth, and obesity is not the community's identified risk.
    • DDelaying immunizations leaves the child unprotected and is not recommended for healthy toddlers.

13. Question 13 of 25Easy

    A nurse is preparing a 45-year-old female client for an abdominal examination by the health care provider. Which action should the nurse take?

    1. AA. Position the client prone with both arms raised above the head
    2. BB. Leave the client fully undraped so the abdomen can be observed
    3. CC. Instruct the client to hold the breath during the whole exam
    4. DD. Have the client void, then lie supine with the knees bent
    Show answer to question 13

    Answer: D. Have the client void, then lie supine with the knees bent

    An empty bladder improves comfort and accuracy, and the supine position with flexed knees relaxes the abdominal muscles. Draping the client also protects privacy.

    Why the other options are wrong

    • AThe prone position blocks access to the abdomen, so it is not used for an abdominal examination.
    • BLeaving the client fully undraped violates privacy and dignity, and only the area being examined should be uncovered.
    • CHolding the breath for the whole exam is impossible and increases muscle tension, which makes the examination harder.

14. Question 14 of 25Easy

    The nurse in a pediatric clinic is comparing an 18-month-old client's development with expected milestones. Which finding should the nurse report to the RN or provider?

    1. AA. Walks with a wide-based gait and often falls
    2. BB. Says three or four single words with meaning
    3. CC. Cannot walk without holding onto furniture
    4. DD. Scribbles on paper with a large crayon
    Show answer to question 14

    Answer: C. Cannot walk without holding onto furniture

    Most children walk without support by about 18 months. Needing to hold on to take steps is a possible gross motor delay and should be reported for further evaluation.

    Why the other options are wrong

    • AA wide-based, somewhat unsteady gait with frequent falls is expected in toddlers who have only recently started walking independently.
    • BUsing a few single words with meaning is an expected language skill at this age.
    • DScribbling with a crayon is an expected fine motor skill for an 18-month-old.

15. Question 15 of 25Medium

    A client in a long-term care facility has hearing loss and is not wearing hearing aids. The nurse needs to explain the plan for the afternoon. Which approach is best?

    1. AA. Reduce noise, face the client, and speak in a low pitch at a normal pace
    2. BB. Move close to the client's ear and speak loudly in a high pitch to be heard
    3. CC. Exaggerate lip movements and shout each word separately so nothing is missed
    4. DD. Stand beside the client and speak quickly so the explanation stays brief
    Show answer to question 15

    Answer: A. Reduce noise, face the client, and speak in a low pitch at a normal pace

    Reducing noise, facing the client so lips and expressions are visible, and using a clear, low-pitched voice at a normal pace give the client the best chance of understanding.

    Why the other options are wrong

    • BHigh-pitched sounds are the hardest to hear with age-related hearing loss, and loud speech close to the ear can distort sound.
    • CShouting and exaggerated lip movements distort speech, make lip reading harder, and can feel demeaning to the client.
    • DStanding beside the client prevents lip reading and visual cues, and fast speech makes understanding even harder.

16. Question 16 of 25Hard

    A 55-year-old client who has smoked one pack of cigarettes daily for 30 years tells the clinic nurse, "I enjoy smoking and I'm not interested in quitting." Which response by the nurse is best?

    1. AA. "Smoking will give you lung cancer, so you need to quit now."
    2. BB. "I will ask the provider to prescribe a nicotine patch for you today."
    3. CC. "What do you enjoy about smoking, and what worries you about it?"
    4. DD. "Let me know when you are ready, and I will not bring it up again."
    Show answer to question 16

    Answer: C. "What do you enjoy about smoking, and what worries you about it?"

    A client who is not ready to quit benefits from a nonjudgmental, open-ended question that explores values and concerns. This builds trust and can increase readiness for change.

    Why the other options are wrong

    • AFear-based warnings and commands often create resistance and do not match the client's current readiness.
    • BStarting medication for a client who has said he does not want to quit ignores his stated readiness.
    • DNever raising the topic again gives up the chance to support future readiness and later cessation efforts.

17. Question 17 of 25Easy

    A nurse at a senior center clinic is caring for a 76-year-old male client who recently stopped driving and now misses appointments and grocery trips. Which community resource should the nurse suggest first?

    1. AA. Area Agency on Aging for transportation and meal services
    2. BB. Hospice program for end-of-life comfort care and support
    3. CC. Rape crisis center for survivor counseling and advocacy
    4. DD. Early intervention program for infant developmental delays
    Show answer to question 17

    Answer: A. Area Agency on Aging for transportation and meal services

    Area Agencies on Aging coordinate transportation, home-delivered meals and other services for older adults. This directly addresses the client's lost mobility and difficulty getting food and care.

    Why the other options are wrong

    • BHospice provides comfort care for clients with a terminal prognosis, and nothing in the scenario suggests the client is at the end of life.
    • CRape crisis centers serve survivors of sexual assault, which does not match the client's transportation and food needs.
    • DEarly intervention programs serve infants and toddlers with developmental delays, so they do not apply to an older adult.

18. Question 18 of 25Medium

    A 22-year-old client at 9 weeks of gestation tells the nurse in a prenatal clinic, "I did not plan this, my boyfriend says he is not ready, and I do not know who will help me." Which action by the nurse is best?

    1. AA. Reassure the client that most women feel happy about the baby once it is born
    2. BB. Let the client voice her feelings, explore her supports, and notify the RN
    3. CC. Tell the client that her boyfriend will probably change his mind in a few weeks
    4. DD. Advise the client to make a final decision about the pregnancy before she leaves
    Show answer to question 18

    Answer: B. Let the client voice her feelings, explore her supports, and notify the RN

    The client shows mixed feelings and limited support. Listening, exploring supports and reporting allow the team to plan counseling and referrals.

    Why the other options are wrong

    • APremature reassurance dismisses the client's concerns and blocks further communication.
    • CPredicting the partner's behavior is false reassurance and gives the client no real support.
    • DPressuring the client to decide immediately is not supportive and ignores her need for information and time.

19. Question 19 of 25Medium

    A 62-year-old client reports having an episode of shingles three years ago and asks the practical nurse if the shingles vaccine is still needed. Which response by the nurse is best?

    1. AA. The shingles vaccine is only approved for individuals who have never had chickenpox.
    2. BB. Receiving the recombinant shingles vaccine is recommended because recurrence is possible.
    3. CC. Having a documented shingles episode provides lifelong immunity against future outbreaks.
    4. DD. Vaccination is only indicated if chronic postherpetic neuralgia develops after the infection.
    Show answer to question 19

    Answer: B. Receiving the recombinant shingles vaccine is recommended because recurrence is possible.

    The recombinant zoster vaccine is recommended for immunocompetent adults aged 50 years and older regardless of whether they have had a prior episode of herpes zoster, because immunity wanes over time and recurrence can occur. Having a prior episode of shingles does not confer permanent immunity. Postherpetic neuralgia is a complication of shingles, not a prerequisite for vaccination, and the vaccine is specifically indicated to prevent both initial episodes and complications.

20. Question 20 of 25Hard

    A nurse is assisting with monitoring a client in active labor. The fetal heart rate tracing shows late decelerations after several consecutive contractions. Which action should the nurse take first?

    1. AA. Reposition the client to her left side and notify the RN or provider
    2. BB. Continue routine monitoring and recheck the fetal tracing in 30 minutes
    3. CC. Encourage the client to begin pushing with each contraction right away
    4. DD. Place the client in a supine position so the tracing is easier to read
    Show answer to question 20

    Answer: A. Reposition the client to her left side and notify the RN or provider

    Recurrent late decelerations suggest reduced placental perfusion. Left lateral positioning improves blood flow, and the RN or provider must be told right away.

    Why the other options are wrong

    • BWaiting 30 minutes delays treatment of possible fetal hypoxemia while the abnormal pattern continues.
    • CPushing can worsen fetal oxygenation, and nothing shows the client is fully dilated or ready to push.
    • DThe supine position can compress the vena cava and further reduce uteroplacental blood flow.

21. Question 21 of 25Easy

    A nurse is assisting with a nonstress test for a client who is at 36 weeks of gestation. Which finding indicates a reactive result?

    1. AA. Late decelerations after each uterine contraction
    2. BB. Absent variability with a flat baseline heart rate
    3. CC. A baseline fetal heart rate below the normal range
    4. DD. Fetal heart rate accelerations with movement
    Show answer to question 21

    Answer: D. Fetal heart rate accelerations with movement

    A reactive nonstress test shows fetal heart rate accelerations with fetal movement, indicating an intact fetal nervous system and adequate oxygenation.

    Why the other options are wrong

    • ALate decelerations suggest uteroplacental insufficiency and are a concerning finding, not a reactive result.
    • BAbsent variability with a flat baseline is a nonreassuring finding that must be reported, not a reactive result.
    • CA baseline rate below the normal range (bradycardia) is abnormal and does not indicate a reactive test.

22. Question 22 of 25Medium

    The nurse is collecting data from the parent of an 18-month-old toddler during a routine clinic visit. Which parental statement indicates a developmental milestone concern that requires further evaluation?

    1. AA. My child does not say any recognizable single words yet.
    2. BB. My child is unable to draw a recognizable circle on paper.
    3. CC. My child cannot pedal a small three-wheeled tricycle outside.
    4. DD. My child still needs hands-on help to dress and undress.
    Show answer to question 22

    Answer: A. My child does not say any recognizable single words yet.

    An 18-month-old toddler is expected to say at least 3 to 10 single words and use simple gestures to communicate; the absence of any spoken words is a major developmental delay warranting further speech and hearing screening. Pedaling a tricycle and drawing a circle are expected closer to 3 years of age, and independent dressing is a preschool skill.

23. Question 23 of 25Hard

    On the second day after colostomy surgery, a 45-year-old woman looks away and tells the nurse, "My husband will never look at me the same way." Which response by the nurse is best?

    1. AA. "Most husbands adjust quickly, so there is really no need to worry about that."
    2. BB. "Concerns about intimacy are usually better saved until after you go home."
    3. CC. "I will ask the surgeon to speak with your husband about how he feels."
    4. DD. "You seem worried about how intimacy may change. Tell me more about your concerns."
    Show answer to question 23

    Answer: D. "You seem worried about how intimacy may change. Tell me more about your concerns."

    An open-ended, nonjudgmental response acknowledges the cue, invites the client to discuss a sensitive sexuality concern, and lets the nurse gather data to report to the team.

    Why the other options are wrong

    • AFalse reassurance dismisses the feeling and closes communication.
    • BPostponing the topic tells the client that her concern is unimportant and misses the opportunity to listen now.
    • CArranging for someone else to talk to the husband avoids the client's own stated feelings and assumes his view.

24. Question 24 of 25Easy

    A nurse is reinforcing nutritional safety with the parent of an 8-month-old infant who is starting finger foods. Which food item should the nurse instruct the parent to avoid to prevent choking?

    1. AA. Whole uncut grapes
    2. BB. Small slices of ripe banana
    3. CC. Well-cooked soft carrot pieces
    4. DD. Toasted whole-grain oat cereal rings
    Show answer to question 24

    Answer: A. Whole uncut grapes

    Whole uncut grapes are round, smooth, and firm, making them a high-risk choking hazard that can completely occlude an infant's airway; they must be sliced lengthwise and quartered before serving. Well-cooked, soft carrot pieces and ripe banana slices can be easily mashed by an infant's gums and are appropriate finger foods. Dry cereal rings dissolve quickly with saliva and are considered safe introductory finger foods.

25. Question 25 of 25Easy

    A term newborn has just been born and is wet with amniotic fluid. Which nursing action best prevents heat loss by evaporation?

    1. AA. Bathe the newborn right away in warm water to remove all blood and vernix.
    2. BB. Place the newborn in an open crib in the nursery and observe the skin color.
    3. CC. Dry the newborn, remove wet linens, and place skin to skin under a blanket.
    4. DD. Wrap the newborn in a damp warm blanket to keep the skin moist and soft.
    Show answer to question 25

    Answer: C. Dry the newborn, remove wet linens, and place skin to skin under a blanket.

    Drying the newborn and removing wet linens stops evaporative loss, and skin-to-skin contact under a blanket keeps the newborn warm.

    Why the other options are wrong

    • AAn immediate bath leaves the newborn wet and exposed, increasing evaporation and cold stress; bathing is delayed until the temperature is stable.
    • BAn open crib in a cool nursery allows heat loss by convection while the newborn is still wet.
    • DA damp blanket keeps moisture on the skin, which promotes evaporative and conductive heat loss rather than preventing it.

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