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NCLEX-RN · Health Promotion and Maintenance

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NCLEX-RN Health Screening and Disease Prevention Summary

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About 4 of 8 Health Promotion and Maintenance questions (50%)

Health screening, immunizations, health risk factors, health teaching, and self-care.

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Health Screening and Disease Prevention: must-know points

  • Routine immunization principles
  • Screening and risk reduction
  • Teaching and readiness to learn

Health Screening and Disease Prevention: 6 sample questions

Practice questionReviewedHealth Promotion and Maintenance › Health Screening and Disease Prevention★★★★☆

Question 1. A pregnant client asks which vaccines are safe during pregnancy. Which vaccine should NOT be given during pregnancy?

  1. ① Measles, mumps, and rubella (MMR)
  2. ② Hepatitis B
  3. ③ Tdap (tetanus, diphtheria, and pertussis)
  4. ④ Inactivated influenza (flu shot)
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Answer: ① Measles, mumps, and rubella (MMR)

Key point: Live vaccines such as MMR are not given during pregnancy

MMR is a live vaccine (it contains weakened live virus). Live vaccines are not given during pregnancy because of a possible risk to the baby. A client who is not immune to rubella is usually given MMR after the baby is born.

Wrong choices

  • "Tdap" is an inactivated vaccine and is recommended during each pregnancy to protect the newborn from whooping cough.
  • "Inactivated influenza (flu shot)" is recommended during pregnancy because flu can be serious for pregnant clients.
  • "Hepatitis B" is not a live vaccine; certain hepatitis B vaccine brands are recommended during pregnancy for clients at risk.
Practice questionReviewedHealth Promotion and Maintenance › Health Screening and Disease Prevention★★★★☆

Question 2. The nurse has taught a client how to draw up and inject insulin. Which action best shows that the client has learned the skill?

  1. ① The client says, "Yes, I understand."
  2. ② The client watches a video about insulin
  3. ③ The client takes home a printed handout
  4. ④ The client shows the nurse how to draw up and inject the insulin
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Answer: ④ The client shows the nurse how to draw up and inject the insulin

Key point: Return demonstration best confirms learning of a skill

For a hands-on skill, the best way to check learning is a return demonstration: the client does the skill while the nurse watches. The nurse can see mistakes and correct them before the client goes home.

Wrong choices

  • "Yes, I understand" does not prove the client can do the skill. Many people say yes even when they are unsure.
  • "Takes home a printed handout" is a helpful extra but does not show the client can do it.
  • "Watches a video about insulin" is a teaching method, not a way to check learning.
Practice questionReviewedHealth Promotion and Maintenance › Health Screening and Disease Prevention★★★★☆

Question 3. The nurse reviews foot care with a client who has diabetes. Which statement by the client requires further teaching?

  1. ① "I will dry well between my toes after washing."
  2. ② "I will soak my feet in hot water every night."
  3. ③ "I will look at my feet every day, using a mirror for the bottoms."
  4. ④ "I will wear shoes or slippers, even inside the house."
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Answer: ② "I will soak my feet in hot water every night."

Key point: Diabetes foot care: no hot soaks; check feet daily

Diabetes can cause nerve damage, so the client may not feel heat or injury in the feet. Hot water can burn the skin without the client noticing, and long soaking dries and cracks the skin, which lets infection in. Clients should wash feet in warm (not hot) water, test the water with an elbow or thermometer, and avoid long soaks. All the other statements are correct.

Wrong choices

  • "I will look at my feet every day" is correct. Daily checks find small cuts or sores early.
  • "I will dry well between my toes" is correct. Moisture between toes can lead to fungal infection and skin breakdown.
  • "I will wear shoes or slippers, even inside" is correct. This protects the feet from injuries the client may not feel.
Practice questionReviewedHealth Promotion and Maintenance › Health Screening and Disease Prevention★★★★☆

Question 4. A 46-year-old client with no symptoms and no family history of colon cancer asks about colon cancer screening. Which response by the nurse is correct?

  1. ① "Screening is not needed until age 60."
  2. ② "Screening is only needed if you have symptoms such as blood in the stool."
  3. ③ "Screening is only needed if a parent had colon cancer."
  4. ④ "Screening is recommended for adults at average risk starting at age 45."
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Answer: ④ "Screening is recommended for adults at average risk starting at age 45."

Key point: Average-risk colon cancer screening starts at age 45

National guidelines in the United States recommend colorectal cancer screening for adults at average risk starting at age 45. Screening can find polyps (small growths) before they turn into cancer, and it can find cancer early when it is easier to treat. There are several test options, such as stool tests and colonoscopy, which the client can discuss with the provider.

Wrong choices

  • "Screening is not needed until age 60" would miss many years of screening for this client.
  • "Screening is only needed if you have symptoms" is wrong. Screening is done in people without symptoms to find problems early.
  • "Screening is only needed if a parent had colon cancer" is wrong. Family history means starting earlier, but average-risk adults also need screening.
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Question 5. A client who is 28 weeks pregnant says, "I got the Tdap shot two years ago during my last pregnancy, so I don't need it now." Which response by the nurse is correct?

  1. ① "You should wait until after the baby is born to get Tdap."
  2. ② "Tdap is recommended during each pregnancy, ideally between 27 and 36 weeks."
  3. ③ "Tdap is not safe during pregnancy."
  4. ④ "You are right. Tdap protects you for 10 years."
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Answer: ② "Tdap is recommended during each pregnancy, ideally between 27 and 36 weeks."

Key point: Give Tdap in every pregnancy, ideally at 27 to 36 weeks

Tdap is recommended during every pregnancy, even if the client had it before. The best time is between 27 and 36 weeks. The mother makes antibodies that pass to the baby before birth. This protects the newborn from whooping cough (pertussis) in the first months of life, before the baby can be vaccinated.

Wrong choices

  • "Tdap protects you for 10 years" applies to routine adult boosters, not pregnancy. Antibody levels fall, so a new dose is needed each pregnancy to protect the baby.
  • "Wait until after the baby is born" gives the baby no antibodies at birth, when whooping cough is most dangerous.
  • "Tdap is not safe during pregnancy" is false. Tdap is an inactivated vaccine and is recommended in pregnancy.
Practice questionReviewedHealth Promotion and Maintenance › Health Screening and Disease Prevention★★★★☆

Question 6. The nurse teaches a client about preventing skin cancer. Which statement by the client shows that the teaching was understood?

  1. ① "I will use a broad-spectrum sunscreen of SPF 30 or higher and reapply it every 2 hours outdoors."
  2. ② "I only need sunscreen on sunny days."
  3. ③ "Using a tanning bed is safer than tanning in the sun."
  4. ④ "Getting a base tan will protect me from skin cancer."
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Answer: ① "I will use a broad-spectrum sunscreen of SPF 30 or higher and reapply it every 2 hours outdoors."

Key point: Use broad-spectrum SPF 30+ sunscreen and reapply every 2 hours

Broad-spectrum sunscreen protects against both UVA and UVB rays. SPF 30 or higher is recommended, and it should be reapplied about every 2 hours outdoors and after swimming or sweating. Shade, hats, and protective clothing also help.

Wrong choices

  • "Using a tanning bed is safer" is false. Tanning beds give off UV rays that raise the risk of skin cancer.
  • "I only need sunscreen on sunny days" is false. UV rays pass through clouds.
  • "A base tan will protect me" is false. A tan is a sign of skin damage and gives very little protection.

Test yourself.

Health Screening and Disease Prevention: 5 questions →Health Promotion and Maintenance: 5 questions →