Free NCLEX-RN Health Promotion & Maintenance Questions
Free NCLEX-RN health promotion and maintenance practice questions with rationales — growth and development, screening, and prevention.
A 50-year-old client with no personal or family history of colorectal cancer asks the nurse when routine colorectal cancer screening should begin for average-risk adults. Which response by the nurse is most accurate?
- A."Routine screening for average-risk adults generally begins at age 45."
- B."You only need screening if you start having symptoms such as bleeding."
- C."Screening is not recommended until age 70 for most adults."
- D."A single test in your twenties covers you for the rest of your life."
Show answer & rationaleHide answer & rationale
Correct answer: A
Cancer screening targets disease before symptoms appear, so it starts at a defined age, not at symptom onset. For average-risk adults, routine colorectal cancer screening generally begins at age 45 and continues at intervals based on the test used. Waiting for bleeding defeats the purpose of early detection. Delaying until age 70 misses years of preventable disease. A one-time test in the twenties offers no ongoing protection, since risk rises with age and screening must repeat. Beginning at 45 reflects current average-risk guidance.
Why the other options are wrong
- B. Screening exists to find disease before symptoms; waiting for bleeding misses the early window.
- C. Age 70 is far too late to start; routine screening begins decades earlier for average-risk adults.
- D. A single test in early adulthood provides no lasting protection as risk rises and screening must repeat.
Key takeaway: Average-risk colorectal cancer screening starts at age 45, not when symptoms appear.
On day 2 postpartum, you assess a woman who delivered vaginally. Her fundus is firm, midline, and about 2 fingerbreadths below the umbilicus, and her lochia is dark red with a few small clots. She asks if this is normal. What is your best response?
- A."These findings are expected for day 2; involution and lochia are progressing normally."
- B."A firm fundus this high suggests a clot is being retained and needs urgent attention."
- C."Dark red lochia on day 2 is abnormal and should already be pale yellow."
- D."Your fundus should be at the umbilicus today, so this is a sign of delayed healing."
Show answer & rationaleHide answer & rationale
Correct answer: A
Use the normal timeline to judge postpartum findings. The fundus descends roughly one fingerbreadth per day after peaking at the umbilicus around 12 hours, so 2 fingerbreadths below by day 2 fits. Lochia rubra (dark red, with small clots) is expected through about days 1 to 3. A firm, midline fundus signals good tone, not retained clots. Lochia does not turn pale yellow (serosa to alba) until roughly day 4 and beyond, so dark red on day 2 is normal, not delayed.
Why the other options are wrong
- B. A firm, midline fundus is reassuring tone, not evidence of a retained clot.
- C. Lochia rubra is normal through about day 3; pale lochia by day 2 would be early.
- D. The fundus descends daily after 12 hours, so below-umbilicus on day 2 is expected.
Key takeaway: Expect the fundus to drop about one fingerbreadth daily and lochia rubra through roughly day 3.
A 52-year-old woman reports she has not had a menstrual period for 14 months and is having frequent hot flashes that disrupt her sleep. She asks what nonpharmacologic step might help. Which suggestion is most appropriate?
- A.Dress in layers and keep the bedroom cool, avoiding triggers like caffeine and alcohol
- B.Increase the room temperature at night to prevent chills after a flash
- C.Limit fluid intake throughout the day to reduce sweating
- D.Begin daily high-dose vitamin E injections to stop the flashes
Show answer & rationaleHide answer & rationale
Correct answer: A
For menopausal hot flashes, first-line self-care targets heat regulation and known triggers. Layered clothing lets her shed a layer fast, a cool bedroom blunts night sweats, and cutting caffeine, alcohol, and spicy foods removes common vasomotor triggers. Twelve months without a period confirms menopause, so these flashes are expected. Raising room temperature worsens flashes. Fluid restriction risks dehydration and does not stop vasomotor symptoms. Vitamin E injections are not standard therapy and high-dose use carries its own risks.
Why the other options are wrong
- B. A warmer room intensifies vasomotor symptoms rather than relieving them.
- C. Restricting fluids risks dehydration and does nothing for the flash mechanism.
- D. High-dose vitamin E injections are not evidence-based therapy and add risk.
Key takeaway: Trigger avoidance and a cool, layered environment are first-line self-care for hot flashes.
A parent brings a 4-year-old for a well-child checkup. Which findings would you expect as normal developmental and health milestones for a child this age? Select all that apply.
- A.Hops on one foot and climbs stairs with alternating feet
- B.Draws a person with two to four body parts
- C.Engages in associative play with other children
- D.Has begun losing primary teeth and getting permanent ones
- E.Speaks in sentences that are largely understandable to strangers
Show answer & rationaleHide answer & rationale
Correct answers: A, B, C, E
Anchor each skill to the preschool window (3 to 5 years). By 4, gross motor includes hopping on one foot and alternating-feet stair climbing; fine motor lets the child draw a person with two to four parts; play is associative; and speech is mostly intelligible to strangers. Losing primary teeth does not normally begin until about age 6, so dental shedding at 4 is the outlier. Knowing typical timing lets you separate expected progress from a finding that needs follow-up.
Why the other options are wrong
- D. Primary teeth typically begin shedding around age 6, not at 4, so this is not expected now.
Key takeaway: A 4-year-old hops, draws a simple person, plays associatively, and speaks intelligibly; tooth shedding starts later.
A parent brings a 12-month-old for a well-child visit. Which behavior would you expect this child to demonstrate at this age?
- A.Builds a tower of six blocks
- B.Pulls to stand and may take a few steps
- C.Speaks in two- to three-word sentences
- D.Rides a tricycle using the pedals
Show answer & rationaleHide answer & rationale
Correct answer: B
Match the skill to the age the milestone first appears, not a later age when it is polished. Around 12 months, gross motor skills peak for the first year: most infants pull to stand, cruise along furniture, and many take their first independent steps. Fine motor at this age is a neat pincer grasp, not block towers. A six-block tower (around 2 years), two- to three-word sentences (around 2 years), and pedaling a tricycle (around 3 years) all belong to the toddler and preschool periods.
Why the other options are wrong
- A. A six-block tower is a 2-year fine motor skill; a 12-month-old manages only one to two blocks.
- C. Two- to three-word sentences appear near age 2; a 1-year-old typically says a few single words.
- D. Pedaling a tricycle is a 3-year gross motor milestone, well beyond the first year.
Key takeaway: At about 12 months, expect the infant to pull to stand, cruise, and possibly take first steps.
During a routine postpartum visit on day 10, a woman who delivered vaginally describes several experiences. Which findings should prompt you to follow up rather than reassure her as normal? Select all that apply.
- A.Lochia that has returned to bright red and saturates a pad in under an hour
- B.A localized, hot, reddened, painful area on one breast with fever
- C.Calf pain, warmth, and swelling in one leg
- D.Lochia that is now pale and yellowish-white in small amounts
- E.Persistent sadness, hopelessness, and loss of interest in the baby
Show answer & rationaleHide answer & rationale
Correct answers: A, B, C, E
Separate expected recovery from red-flag deviations. By day 10, lochia should be light and serosa-to-alba; returning to bright red that soaks a pad in under an hour suggests late hemorrhage or retained tissue. A hot, red, painful breast with fever points to mastitis. Unilateral calf pain, warmth, and swelling suggest deep vein thrombosis, a postpartum thrombosis risk. Persistent sadness and loss of interest in the baby signal possible postpartum depression. Pale, scant lochia (alba) on day 10 is the only normal finding here.
Why the other options are wrong
- D. Pale, scant yellowish-white lochia (alba) is the expected stage by day 10 and needs no follow-up.
Key takeaway: Heavy bright-red lochia, mastitis signs, unilateral calf symptoms, and persistent depressed mood all warrant follow-up.