Practice Health Promotion & Maintenance questions for the National Council Licensure Examination — RN. Every question includes a full explanation of why the correct answer is right and why the tempting distractors are wrong.
42 questions available · medium difficulty · NCLEX-RN · Free, no registration required
10 example questions with full explanations. Use the interactive practice above to work through the complete set.
Question 1medium
A 47-year-old woman with no prior colonoscopy and average risk for colorectal cancer asks the nurse about cancer screening. The nurse correctly informs her that she should schedule a colonoscopy now and, if results are normal, repeat it in 10 years.
Correct answer: A
Current guidelines recommend that average-risk adults begin colorectal cancer screening at age 45. A colonoscopy is a recommended screening method, and if no polyps or abnormalities are found, the interval for repeat colonoscopy is every 10 years. At age 47 with no prior screening, this patient is overdue and should have a colonoscopy now. The nurse's statement integrates both the correct starting age (45) and the correct interval (10 years), making it true.
Question 2medium
A pregnant client at 28 weeks gestation asks whether she needs any vaccines. The nurse correctly tells her that receiving the Tdap vaccine during this pregnancy will help protect her newborn from pertussis in the early weeks of life before the infant can be vaccinated.
Correct answer: A
The Tdap vaccine is recommended during every pregnancy, ideally between 27 and 36 weeks gestation. Administering it during pregnancy allows maternal antibodies to cross the placenta, providing passive immunity to the newborn against pertussis. This is critical because infants cannot receive their first DTaP until 2 months of age, leaving them vulnerable in the early weeks. The nurse's explanation correctly integrates the rationale of maternal immunization for newborn protection.
Question 3medium
A client with chronic kidney disease (CKD) stage 4 and hypertension asks the nurse about dietary changes. The nurse correctly tells the client that a low-sodium diet will help manage blood pressure, and that potassium-rich foods such as bananas and oranges should also be increased to support heart health.
Correct answer: B
While a low-sodium diet is appropriate for managing hypertension in CKD, the second part of the nurse's statement is incorrect. Clients with CKD stage 4 have significantly reduced ability to excrete potassium, placing them at high risk for hyperkalemia, which can cause life-threatening dysrhythmias. Increasing potassium-rich foods such as bananas and oranges is contraindicated in this population. The renal diet requires potassium restriction, not supplementation, making the nurse's combined statement false.
Question 4medium
A 55-year-old client who smoked one pack per day for 30 years quit smoking 24 hours ago. The nurse correctly states that the client's carbon monoxide blood levels will have returned to normal within 8 to 12 hours of quitting, but that cardiovascular risk will not begin to decrease for at least one week.
Correct answer: B
The first part of the statement is correct — carbon monoxide levels in the blood normalize within 8 to 12 hours of cessation. However, the second part is false. Cardiovascular benefits begin almost immediately: within 20 minutes of quitting, heart rate and blood pressure drop; within 24 hours, the risk of heart attack begins to decrease. The nurse's claim that cardiovascular risk does not decrease for at least one week contradicts established smoking cessation benefit timelines, making the overall statement false.
Question 5medium
A 16-month-old child is brought to the clinic for a well-child visit. The parent states the child can walk independently, say 3 to 5 words, and use a spoon with some spilling. The nurse determines that this child's developmental milestones are appropriate for age.
Correct answer: A
At 15 to 18 months of age, expected developmental milestones include independent walking (achieved by 15 months in most children), a vocabulary of at least 3 to 10 words, and the ability to use a spoon with spilling. All three behaviors described — independent ambulation, a small vocabulary, and emerging self-feeding with a utensil — fall within the normal range for a 16-month-old. The nurse's assessment is correct, making the statement true.
Question 6medium
A 28-year-old pregnant client at 26 weeks gestation asks the nurse which vaccines are recommended during pregnancy. The client has never received a Tdap vaccine. Which response by the nurse is most accurate?
- A.Tdap is contraindicated during pregnancy and should be delayed until 6 weeks postpartum.
- B.Tdap should be given immediately after delivery to protect the newborn through close contact.
- C.Tdap is only recommended during the first pregnancy; subsequent pregnancies do not require revaccination.
- D.Tdap is recommended between 27 and 36 weeks of each pregnancy, regardless of prior vaccination history.✓
Correct answer: D
Current CDC guidelines recommend Tdap administration between 27 and 36 weeks of gestation during EACH pregnancy, ideally earlier in this window to maximize transfer of maternal antibodies to the fetus. This protects newborns from pertussis before they can receive their own vaccination series. Postpartum administration (cocooning strategy) is an acceptable alternative but is not the preferred timing. The recommendation applies to every pregnancy, not just the first, because antibody levels wane.
Question 7medium
A nurse is providing discharge teaching to a 68-year-old woman who has been diagnosed with osteoporosis. The client currently takes a daily calcium supplement and walks 20 minutes three times per week. Which additional recommendation should the nurse prioritize to address her greatest modifiable risk?
- A.Add vitamin D supplementation of 800–1,000 IU daily to enhance calcium absorption.✓
- B.Switch from walking to swimming because it is easier on the joints.
- C.Schedule a repeat DEXA scan every year to monitor bone density changes.
- D.Increase calcium supplement dose to 2,500 mg per day to maximize bone density.
Correct answer: A
Vitamin A is essential for intestinal calcium absorption; without adequate vitamin D, even sufficient calcium intake is poorly utilized. Adults over 65 are recommended to take 800–1,000 IU of vitamin A daily for osteoporosis prevention and management. Increasing calcium beyond recommended levels (1,200 mg/day for women over 51) does not confer added benefit and may increase cardiovascular risk. Swimming is not a weight-bearing exercise and does not stimulate bone remodeling, making it less beneficial for osteoporosis than walking. DEXA scans are typically repeated every 1–2 years when treatment is initiated, but adding vitamin A is the more immediately actionable and evidence-based recommendation here.
Question 8medium
A nurse is conducting a well-child visit for a 2-day-old newborn. The nurse reviews the birth record and notes the infant received vitamin K at birth. The parent asks why vitamin K was given when the baby is not sick. Which explanation by the nurse is most appropriate?
- A.Vitamin K prevents neonatal jaundice by promoting bilirubin conjugation in the liver.
- B.Newborns have sterile intestines and cannot produce adequate vitamin K, placing them at risk for hemorrhage.✓
- C.All newborns are routinely deficient in vitamin K due to low dietary intake during the first 48 hours of life.
- D.Vitamin K is given to stimulate the immune system until the first round of vaccines is administered.
Correct answer: B
Newborns are born with sterile intestinal tracts and therefore lack the gut flora necessary to synthesize vitamin K, which is required for the production of clotting factors II, VII, IX, and X. This places them at risk for vitamin K deficiency bleeding (VKDB), a potentially life-threatening hemorrhagic condition.Asingle intramuscular dose of vitamin K at birth effectively prevents VKDB. Vitamin K has no role in bilirubin metabolism or immune stimulation. The issue is not dietary intake but rather the inability to produce vitamin K endogenously in the first days of life.
Question 9medium
A 32-year-old male client who is HIV-negative but engages in high-risk sexual behavior asks the nurse about pre-exposure prophylaxis (PrEP) for HIV prevention. He reports no current STIs and his renal function is normal. Which statement by the nurse about PrEP is most accurate?
- A.PrEP is only recommended for individuals who are already exposed to HIV through an occupational needle-stick injury.
- B.PrEP is contraindicated in sexually active individuals because it may promote antiretroviral drug resistance in the community.
- C.PrEP requires an HIV-negative test result before initiation and regular follow-up testing every 3 months while on therapy.✓
- D.PrEP eliminates the need for condom use because it provides complete protection against HIV transmission.
Correct answer: C
Before initiating PrEP, the client must confirm HIV-negative status because starting antiretroviral therapy in a person who is already HIV-positive with an undetected viral load can lead to resistance. Follow-up every 3 months includes HIV testing, STI screening, renal function monitoring, and medication adherence assessment. PrEP significantly reduces — but does not eliminate — HIV risk, so condom use is still recommended to prevent other STIs. PrEP is indicated for HIV-negative individuals at high ongoing risk, not exclusively for post-exposure occupational situations (that is post-exposure prophylaxis, or PEP). There is no established evidence that community-level resistance is a contraindication to PrEP use in high-risk individuals.
Question 10easy
A nurse is teaching a pregnant client about first trimester screening. At which gestational age is the nuchal translucency ultrasound typically performed?
- A.24 to 28 weeks
- B.6 to 8 weeks
- C.16 to 20 weeks
- D.11 to 14 weeks✓
Correct answer: D
Nuchal translucency ultrasound is performed between 11 and 14 weeks of gestation as part of first trimester screening for chromosomal abnormalities such as Down syndrome (trisomy 21) and trisomy 18. It is often combined with maternal serum markers (PAPP-A and free beta-hCG) for improved accuracy. Weeks 6–8 are too early for this measurement. Weeks 16–20 correspond to the anatomy scan (second trimester), and 24–28 weeks is the timeframe for gestational diabetes screening.