NCLEX-RN Health Promotion and Maintenance Practice Test

25 practice questions

Choose an answer, then check it under Show answer.

1. Question 1 of 25Medium

   A nurse evaluates the primitive reflexes of a full-term newborn during a 24-hour physical assessment. When the infant's head and trunk are allowed to fall backward slightly in a supported, controlled manner, the infant abducts and extends the arms with fingers flared into a C-shape, followed by adduction. How should the nurse document this finding?

   1. AA. Abnormal startle response indicating clavicular fracture
   2. BB. Normal asymmetric tonic neck reflex
   3. CC. Normal Moro reflex
   4. DD. Normal Babinski reflex
   Show answer to question 1

   Answer: C. Normal Moro reflex

   The Moro reflex is elicited by allowing the infant's head to drop back about 30 degrees, resulting in symmetrical arm abduction and extension followed by flexion and adduction; this is an expected normal neurologic response in a term infant. The asymmetric tonic neck reflex involves turning the head to one side, which produces extension of the extremities on that side and flexion of the extremities on the opposite side.

2. Question 2 of 25Medium

   An 8-year-old child will be hospitalized for 2 weeks in skeletal traction. Which activity should the nurse plan to best support the child's developmental needs?

   1. AA. A model kit to build and display at the bedside
   2. BB. A set of hand puppets for acting out pretend stories
   3. CC. A large-piece wooden puzzle with six shapes
   4. DD. A cartoon video playlist to watch for most of the day
   Show answer to question 2

   Answer: A. A model kit to build and display at the bedside

   School-age children are in Erikson's stage of industry versus inferiority. Completing a project such as a model provides a sense of accomplishment and can be done within the limits of traction.

   Why the other options are wrong

   • BPretend play with puppets best matches the imaginative play of preschool children.
   • CA six-piece wooden puzzle suits a toddler and would not challenge an 8-year-old.
   • DWatching videos for most of the day is passive and offers little sense of mastery or accomplishment.

3. Question 3 of 25Easy

   A nurse is preparing to give an intramuscular vaccine to a 4-month-old infant at a well-child visit. Which action should the nurse take?

   1. AA. Inject into the dorsogluteal muscle using a 1-inch needle
   2. BB. Aspirate for 5 to 10 seconds before injecting the vaccine
   3. CC. Use a 5/8-inch needle at a 45-degree angle in the deltoid
   4. DD. Inject into the anterolateral thigh at a 90-degree angle
   Show answer to question 3

   Answer: D. Inject into the anterolateral thigh at a 90-degree angle

   The vastus lateralis muscle in the anterolateral thigh is the preferred site for intramuscular vaccines in infants, using a 1-inch needle inserted at a 90-degree angle to reach the muscle.

   Why the other options are wrong

   • AThe dorsogluteal site is not used for infant vaccines because of the risk of sciatic nerve injury and its poorly developed muscle.
   • BAspiration is not recommended for vaccine injections because it prolongs the injection and increases pain.
   • CThe infant deltoid is too small for intramuscular vaccines, and a short needle at 45 degrees may deposit vaccine in subcutaneous tissue.

4. Question 4 of 25Easy

   A nurse is teaching a community health class about primary prevention strategies for skin cancer. Which recommendation should the nurse include in the teaching?

   1. AA. Apply a broad-spectrum sunscreen with an SPF of at least 30 thirty minutes before sun exposure.
   2. BB. Limit outdoor activities between the peak UV radiation hours of 8:00 AM and 11:00 AM.
   3. CC. Reapply water-resistant sunscreen every four to six hours while engaging in outdoor swimming.
   4. DD. Avoid using commercial sunscreen products on overcast days when cloud cover blocks UV rays.
   Show answer to question 4

   Answer: A. Apply a broad-spectrum sunscreen with an SPF of at least 30 thirty minutes before sun exposure.

   Primary prevention of skin cancer includes applying a broad-spectrum, water-resistant sunscreen with a sun protection factor (SPF) of at least 30 approximately 15 to 30 minutes before going outside, with reapplication every two hours or after swimming or sweating. Limiting outdoor exposure between 8:00 AM and 11:00 AM is incorrect because the peak ultraviolet radiation window requiring avoidance is between 10:00 AM and 4:00 PM.

5. Question 5 of 25Hard

   A nurse in an outpatient pediatric clinic receives a telephone call from a parent stating that an exploratory 2-year-old child just ingested an unknown amount of liquid drain cleaner. The child is crying, drooling, and has oral mucosal burns. Which instruction should the nurse provide immediately?

   1. AA. Give two glasses of whole milk to neutralize the ingested caustic chemicals.
   2. BB. Have the child swallow activated charcoal mixed with juice right away.
   3. CC. Call emergency medical services immediately or go to the nearest emergency department.
   4. DD. Administer syrup of ipecac to induce vomiting before the chemical is absorbed.
   Show answer to question 5

   Answer: C. Call emergency medical services immediately or go to the nearest emergency department.

   Liquid drain cleaners are strong caustic agents that cause extensive liquefactive or coagulative necrosis of the esophagus, pharynx, and airway; immediate emergency medical evaluation is critical to ensure airway patency. Inducing vomiting with syrup of ipecac is strictly contraindicated because re-exposure of corrosive liquid to the esophagus and pharynx causes secondary chemical burns and risks airway compromise. Neutralizing agents cause exothermic reactions that worsen tissue injury, and activated charcoal is ineffective against caustic alkalis and impairs future endoscopic visualization.

6. Question 6 of 25Medium

   A 67-year-old male client attends an annual wellness visit. The client smoked one pack of cigarettes daily from age 20 to age 42 and has no symptoms of vascular disease. Which one-time screening test should the nurse anticipate for this client?

   1. AA. Abdominal ultrasonography for abdominal aortic aneurysm
   2. BB. Resting 12-lead electrocardiogram for occult ischemia
   3. CC. Serum alpha-fetoprotein level for hepatocellular carcinoma
   4. DD. Contrast-enhanced abdominal computed tomography scan
   Show answer to question 6

   Answer: A. Abdominal ultrasonography for abdominal aortic aneurysm

   A one-time screening for abdominal aortic aneurysm (AAA) using ultrasonography is recommended for men aged 65 to 75 years who have ever smoked (defined as 100 or more cigarettes in a lifetime). Contrast-enhanced CT exposes the client to unnecessary radiation and contrast dye, while routine screening ECGs and alpha-fetoprotein levels are not recommended in asymptomatic adults without specific indications.

7. Question 7 of 25Medium

   A home health nurse visits a 70-year-old client who had a stroke 6 weeks ago and has mild left-sided weakness. The client's daughter dresses the client every morning because it is faster, although the client can put on a shirt and pants without help when not rushed. Which instruction should the nurse plan to give the daughter?

   1. AA. Continue dressing the client to save energy for physical therapy
   2. BB. Let the client dress independently and help only when needed
   3. CC. Choose clothing with small buttons to build the client's hand coordination
   4. DD. Dress the client in loose hospital gowns until full strength returns
   Show answer to question 7

   Answer: B. Let the client dress independently and help only when needed

   Letting the client perform self-care at the client's own pace supports independence, self-esteem, and rehabilitation. The caregiver should step in only for tasks the client cannot complete safely.

   Why the other options are wrong

   • ADoing tasks the client can perform fosters dependence and slows recovery of function.
   • CSmall buttons frustrate a client with one-sided weakness; large buttons, hook-and-loop closures, or elastic waistbands support independence.
   • DHospital gowns do not promote independence and may reduce the client's sense of normalcy and dignity.

8. Question 8 of 25Medium

   A client with right-sided hemiparesis following an ischemic stroke is working with the nurse to regain independence in dressing. Which instruction should the nurse provide when teaching the client how to put on a button-front shirt?

   1. AA. Fasten the buttons from top to bottom while keeping both arms fully extended.
   2. BB. Place the unaffected left arm into the sleeve first, then pull the shirt over the right arm.
   3. CC. Place the affected right arm into the sleeve first, then pull the shirt around to the left arm.
   4. DD. Button the shirt completely while it is on the bed and pull it overhead like a t-shirt.
   Show answer to question 8

   Answer: C. Place the affected right arm into the sleeve first, then pull the shirt around to the left arm.

   When dressing with hemiparesis, the client should dress the affected extremity first because manipulating fabric around a paretic limb is much easier while the unaffected arm is completely free. Dressing the unaffected limb first restricts mobility and makes maneuvering the affected arm into its sleeve difficult or painful. Pulling a pre-buttoned shirt overhead requires bilateral coordination and increases the risk of arm entrapment.

9. Question 9 of 25Easy

   A nurse in an outpatient clinic is reviewing the health maintenance records of a 66-year-old client. Which immunization should the nurse recommend as a routine age-based preventative measure?

   1. AA. Meningococcal conjugate vaccine
   2. BB. Rotavirus vaccine
   3. CC. Recombinant zoster vaccine
   4. DD. Human papillomavirus vaccine
   Show answer to question 9

   Answer: C. Recombinant zoster vaccine

   The recombinant zoster vaccine is recommended for all immunocompetent adults aged 50 years and older to prevent herpes zoster and postherpetic neuralgia. The human papillomavirus vaccine is routinely administered up to age 26, rotavirus is given exclusively in infancy, and meningococcal conjugate is targeted to adolescents and specific high-risk groups rather than universal older adult populations.

10. Question 10 of 25Easy

    A client at 16 weeks of gestation undergoes maternal serum alpha-fetoprotein (MSAFP) screening. The laboratory report indicates an elevated MSAFP level. Which condition is most strongly associated with this finding?

    1. AA. Gestational trophoblastic disease
    2. BB. Open neural tube defect
    3. CC. Fetal growth restriction
    4. DD. Trisomy 21 (Down syndrome)
    Show answer to question 10

    Answer: B. Open neural tube defect

    Elevated maternal serum alpha-fetoprotein levels are associated with open neural tube defects, such as spina bifida or anencephaly, as well as abdominal wall defects or multiple gestation. Low, rather than elevated, levels of MSAFP are typically linked with chromosomal abnormalities such as trisomy 21. Further diagnostic testing, including high-resolution ultrasound, is typically indicated to determine the underlying cause.

11. Question 11 of 25Easy

    A nurse is assessing a 4-month-old infant during a routine well-child visit. Which developmental milestone should the nurse expect the infant to demonstrate?

    1. AA. Sitting unsupported on the examination table for several seconds
    2. BB. Rolling over completely from the back to the abdomen
    3. CC. Holding the head steady and erect when held in a sitting position
    4. DD. Transferring a small rattle from one hand to the other
    Show answer to question 11

    Answer: C. Holding the head steady and erect when held in a sitting position

    By 4 months of age, infants develop head control and should be able to hold their head steady and erect when supported in a sitting position. Transferring objects hand-to-hand and rolling completely from back to abdomen typically occur around 6 to 7 months of age, while sitting independently without support is expected between 6 and 8 months of age.

12. Question 12 of 25Medium

    A 29-year-old client with chronic hypertension managed with lisinopril reports planning to conceive within the next six months. Which action should the nurse anticipate?

    1. AA. Discontinuing all antihypertensive medications and relying solely on sodium restriction
    2. BB. Reducing the lisinopril dosage by half and initiating high-dose calcium supplementation
    3. CC. Continuing lisinopril until an intrauterine pregnancy is confirmed by ultrasound
    4. DD. Switching the client to a pregnancy-safe antihypertensive agent prior to conception
    Show answer to question 12

    Answer: D. Switching the client to a pregnancy-safe antihypertensive agent prior to conception

    Angiotensin-converting enzyme (ACE) inhibitors such as lisinopril are teratogenic, causing fetal renal dysgenesis, oligohydramnios, and skeletal hypoplasia. The client should be transitioned to a pregnancy-compatible antihypertensive medication (such as labetalol or nifedipine) before conception occurs. Stopping medication entirely in chronic hypertension can lead to maternal and fetal complications, while maintaining lisinopril into early pregnancy risks teratogenic exposure.

13. Question 13 of 25Easy

    A nurse provides anticipatory guidance to the guardian of a 9-month-old infant who is beginning to crawl and pull up to stand. To prevent tap water scald burns, what is the maximum temperature setting the nurse should instruct the guardian to maintain on the home water heater?

    1. AA. 150°F (65.6°C)
    2. BB. 120°F (48.9°C)
    3. CC. 100°F (37.8°C)
    4. DD. 135°F (57.2°C)
    Show answer to question 13

    Answer: B. 120°F (48.9°C)

    Household water heaters should be set to a maximum of 120°F (48.9°C) to prevent severe scald injuries in infants and young children, whose skin is thinner and burns more quickly than adult skin. At 135°F to 150°F, water can cause full-thickness scald burns within two to ten seconds of exposure. Lowering the thermostat to 100°F is unnecessary to avoid burns and may permit bacterial growth, such as Legionella, in the water tank.

14. Question 14 of 25Hard

    A 72-year-old client in a senior living center tells the nurse, "I feel dizzy when I stand up quickly, and I'm afraid I will fall." The client's blood pressure is 128/76 mm Hg supine and 104/62 mm Hg standing. Which intervention should the nurse implement first?

    1. AA. Teach the client to rise slowly from a sitting or lying position and dangle legs before standing.
    2. BB. Notify the healthcare provider of the orthostatic blood pressure change and request a medication review.
    3. CC. Apply compression stockings to both legs and recheck blood pressure in 30 minutes.
    4. DD. Increase the client's oral fluid intake to 2 liters per day and monitor for dehydration.
    Show answer to question 14

    Answer: A. Teach the client to rise slowly from a sitting or lying position and dangle legs before standing.

    A systolic drop of 24 mm Hg on standing confirms orthostatic hypotension. Teaching the client to change positions slowly and dangle the legs before standing is an immediate safety measure the nurse can implement to prevent falls.

    Why the other options are wrong

    • BA medication review is appropriate, but immediate safety teaching comes first.
    • CCompression stockings may help later but require evaluation and are not the first step.
    • DFluids help only if dehydration is the cause, which is not yet known, and they do not prevent an immediate fall.

15. Question 15 of 25Medium

    A nurse cares for a client receiving chemotherapy who developed Grade 2 oral mucositis. Which oral hygiene intervention should the nurse include in the client's care plan?

    1. AA. Rinse the mouth every 2 to 4 hours with a warm saline and sodium bicarbonate solution.
    2. BB. Debride the oral lesions using lemon-glycerin swabs after every meal.
    3. CC. Floss teeth firmly after each meal to prevent plaque accumulation around the gingiva.
    4. DD. Swish with an alcohol-based antimicrobial mouthwash twice daily to eradicate oral bacteria.
    Show answer to question 15

    Answer: A. Rinse the mouth every 2 to 4 hours with a warm saline and sodium bicarbonate solution.

    Rinsing with a mild solution of warm normal saline and sodium bicarbonate soothes inflamed oral mucosa, removes debris, and neutralizes acids without causing pain or cellular damage. Alcohol-based mouthwashes irritate damaged mucosa and cause intense burning and excessive dryness. Lemon-glycerin swabs are contraindicated because they erode tooth enamel and dry oral tissues, and vigorous flossing can cause tissue trauma and bleeding in myelosuppressed clients.

16. Question 16 of 25Easy

    A nurse provides discharge teaching about umbilical cord care to the parent of a 2-day-old newborn. Which statement by the parent indicates understanding of the teaching?

    1. AA. I will wipe the cord stump with rubbing alcohol at every diaper change.
    2. BB. I will give the baby a tub bath each day so the stump stays clean.
    3. CC. I will fold the top of the diaper down so it stays below the stump.
    4. DD. I will call the clinic if the stump has not fallen off in 3 days.
    Show answer to question 16

    Answer: C. I will fold the top of the diaper down so it stays below the stump.

    Dry cord care, which keeps the stump clean, dry, and open to air, promotes drying and separation. Folding the diaper below the stump keeps urine off the area and lets air reach it.

    Why the other options are wrong

    • ARoutine alcohol application is not recommended; natural drying works as well, and alcohol may delay separation.
    • BSponge baths are used until the stump falls off and the area heals, so the stump can stay dry.
    • DThe stump usually falls off within 1 to 3 weeks, so separation is not expected by day 3.

17. Question 17 of 25Medium

    A nurse is providing education to the parent of an 11-year-old child who is receiving the first dose of the human papillomavirus (HPV) vaccine. Which statement by the nurse accurately describes the recommended dosing schedule?

    1. AA. A second dose should be administered 6 to 12 months after the initial dose.
    2. BB. Two additional doses will be required at 2 months and 6 months following today's visit.
    3. CC. Annual booster doses will be needed until the child reaches 18 years of age.
    4. DD. A single dose provides lifetime immunity when given before the onset of sexual activity.
    Show answer to question 17

    Answer: A. A second dose should be administered 6 to 12 months after the initial dose.

    For children initiating the HPV vaccination series between ages 9 and 14, the standard schedule consists of two doses given 6 to 12 months apart. A three-dose schedule at 0, 1 to 2, and 6 months is only indicated if the vaccine series is started at age 15 or older or if the client is immunocompromised.

18. Question 18 of 25Medium

    A full-term newborn does not pass the initial hearing screening using automated auditory brainstem response testing before discharge. Which action should the nurse take based on national early hearing detection guidelines?

    1. AA. Instruct the parents to observe whether the infant turns toward loud noises over 6 months.
    2. BB. Schedule a comprehensive diagnostic audiological evaluation by 3 months of age.
    3. CC. Request an immediate prescription for oral antibiotics to treat suspected otitis media.
    4. DD. Reassure the parents that screening results will be re-evaluated at the 1-year well visit.
    Show answer to question 18

    Answer: B. Schedule a comprehensive diagnostic audiological evaluation by 3 months of age.

    National guidelines, such as the 1-3-6 benchmarks from the Joint Committee on Infant Hearing, recommend that infants who do not pass newborn hearing screening receive a comprehensive diagnostic audiological evaluation no later than 3 months of age so that intervention can begin by 6 months if hearing loss is present. Waiting until the 1-year visit or relying solely on behavioral observation misses the critical period for auditory brain development and language acquisition. Prescriptions for antibiotics are unwarranted without an examination confirming acute otitis media.

19. Question 19 of 25Medium

    A nurse is reviewing the health maintenance schedule for a 42-year-old female client who has no personal or family history of breast cancer. Which instruction regarding breast cancer screening aligns with current United States Preventive Services Task Force recommendations?

    1. AA. Delay screening mammography until reaching 50 years of age
    2. BB. Schedule a screening breast magnetic resonance imaging scan annually
    3. CC. Obtain an annual clinical breast examination and breast ultrasound
    4. DD. Undergo a screening mammogram every 2 years
    Show answer to question 19

    Answer: D. Undergo a screening mammogram every 2 years

    Current guidelines recommend biennial (every 2 years) screening mammography for average-risk women starting at age 40 and continuing through age 74. Delaying screening until age 50 reflects outdated recommendations, and screening breast MRI is reserved for high-risk individuals such as those with confirmed BRCA mutations or significant lifetime risk calculations.

20. Question 20 of 25Hard

    A 25-year-old client at 40 weeks of gestation has been in labor for 16 hours, and the membranes ruptured 22 hours ago. The client's temperature is 101.3°F (38.5°C), the fetal heart rate baseline has risen from 140/min to 170/min, the uterus is tender between contractions, and the amniotic fluid has a foul odor. Which condition is most likely?

    1. AA. Dehydration from limited oral intake during labor
    2. BB. Placental abruption
    3. CC. Pyelonephritis
    4. DD. Intra-amniotic infection
    Show answer to question 20

    Answer: D. Intra-amniotic infection

    Maternal fever, fetal tachycardia, uterine tenderness, and foul-smelling amniotic fluid after prolonged rupture of membranes point to intra-amniotic infection (chorioamnionitis). The nurse reports these findings promptly because the infection threatens both the client and the fetus.

    Why the other options are wrong

    • ADehydration can raise the temperature and fetal heart rate, but it does not cause uterine tenderness or foul-smelling amniotic fluid.
    • BAbruption causes pain and a firm, tender uterus, often with bleeding, but not fever or foul-smelling fluid.
    • CPyelonephritis causes fever with flank pain and costovertebral angle tenderness rather than uterine tenderness and foul amniotic fluid.

21. Question 21 of 25Hard

    The nurse is assessing a 4-year-old child during a well-child visit. The child’s height is at the 10th percentile, weight is at the 25th percentile, and head circumference is at the 50th percentile. The child was born at term and has no chronic illnesses. Which finding should the nurse report to the healthcare provider?

    1. AA. The child’s weight percentile has increased from the 10th to the 25th over the past 12 months.
    2. BB. The child’s height percentile has decreased from the 25th to the 10th since the last visit 12 months ago.
    3. CC. The child’s mother reports that the child eats a balanced diet and is physically active.
    4. DD. The child’s head circumference has remained at the 50th percentile for the past two visits.
    Show answer to question 21

    Answer: B. The child’s height percentile has decreased from the 25th to the 10th since the last visit 12 months ago.

    A drop in height from the 25th to the 10th percentile over 12 months shows slowing of linear growth. Crossing percentile lines can signal an endocrine, nutritional, or chronic medical problem and should be reported for evaluation.

    Why the other options are wrong

    • AA rise in weight from the 10th to the 25th percentile is within normal variation and not concerning by itself.
    • CA balanced diet and regular activity are reassuring findings.
    • DA head circumference that stays at the 50th percentile shows normal, consistent growth.

22. Question 22 of 25Medium

    A nurse is providing discharge teaching to a 32-year-old client who delivered vaginally 2 days ago. The client asks about resuming sexual activity. Which instruction is most appropriate?

    1. AA. Sexual activity is safe immediately after the postpartum bleeding has decreased
    2. BB. The client can resume sexual activity once she stops breastfeeding
    3. CC. The client should wait until the 6-week postpartum checkup regardless of symptoms
    4. DD. Sexual activity can resume once lochia has stopped and perineal healing is complete
    Show answer to question 22

    Answer: D. Sexual activity can resume once lochia has stopped and perineal healing is complete

    Sexual activity can usually resume once lochia has stopped and the perineum has healed, which lowers the risk of infection and pain. Timing is individualized rather than fixed to a specific week.

    Why the other options are wrong

    • AWhile lochia continues, the placental site and cervix are still healing, so this is too early.
    • BBreastfeeding does not determine readiness for sexual activity.
    • CA fixed 6-week wait is not required when healing is complete earlier.

23. Question 23 of 25Hard

    A nurse reviews the arterial blood gas results for a client in the third trimester of pregnancy who is resting comfortably. Which set of findings reflects normal maternal respiratory adaptation?

    1. AA. pH 7.36, PaCO2 40 mm Hg, HCO3 24 mEq/L
    2. BB. pH 7.43, PaCO2 30 mm Hg, HCO3 20 mEq/L
    3. CC. pH 7.50, PaCO2 42 mm Hg, HCO3 32 mEq/L
    4. DD. pH 7.32, PaCO2 48 mm Hg, HCO3 24 mEq/L
    Show answer to question 23

    Answer: B. pH 7.43, PaCO2 30 mm Hg, HCO3 20 mEq/L

    Elevated progesterone levels increase the sensitivity of maternal respiratory centers to carbon dioxide, resulting in mild hyperventilation and a normal pregnant PaCO2 of approximately 27 to 32 mm Hg. The kidneys compensate by excreting bicarbonate, resulting in a state of fully compensated chronic respiratory alkalosis characterized by a normal pH (7.40 to 7.45), low PaCO2, and low HCO3. Values reflecting respiratory acidosis or uncompensated metabolic alkalosis indicate pathology rather than normal physiological adaptation.

24. Question 24 of 25Hard

    The nurse is evaluating the developmental readiness of a 26-month-old toddler for toilet training. Which parental observation confirms that the child is ready to begin this transition?

    1. AA. The child resists following simple verbal requests and displays oppositional behavior.
    2. BB. The child sits quietly on an adult toilet seat for 20 minutes without assistance.
    3. CC. The child consistently wakes up with a completely dry diaper after sleeping through the night.
    4. DD. The child remains dry for at least 2 hours during the day and communicates when wet.
    Show answer to question 24

    Answer: D. The child remains dry for at least 2 hours during the day and communicates when wet.

    Physiological and behavioral indicators of readiness for toilet training include voluntary sphincter control (demonstrated by staying dry for at least 2 hours during the day), the ability to communicate the urge or discomfort of a soiled diaper, and the ability to follow simple instructions. Consistent overnight continence is not expected at the beginning of training, as nocturnal bladder control typically develops years after daytime continence.

25. Question 25 of 25Hard

    A 34-year-old parent of a 5-year-old child with asthma smokes about 10 cigarettes a day and tells the clinic nurse, "I'm not ready to quit, but I want to protect my child from the smoke." Which plan should the nurse recommend?

    1. AA. Smoke only in the kitchen with an exhaust fan on while the child sleeps
    2. BB. Keep the home and car completely smoke-free, even when the child is away
    3. CC. Use an air purifier in the child's bedroom and keep the door closed
    4. DD. Smoke only in the car, with the windows open, before picking up the child
    Show answer to question 25

    Answer: B. Keep the home and car completely smoke-free, even when the child is away

    Ventilation, exhaust fans, and air cleaners cannot eliminate secondhand smoke, and smoke residue clings to surfaces long after a cigarette is out. A completely smoke-free home and car is the only way to protect the child, while the nurse continues to support quitting.

    Why the other options are wrong

    • AAn exhaust fan does not remove all smoke particles, which spread through the home and settle on surfaces the child touches.
    • CAn air purifier removes only part of the smoke and does not protect the child in the rest of the home.
    • DSmoke residue remains in the car's air and upholstery after smoking, so the child is still exposed on later rides.

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