NCLEX FINAL EXAM PRACTICE QUESTIONS

NCLEX FINAL EXAM PRACTICE QUESTIONS &

ANSWERS

The nurse is participating at a health fair at the local mall giving influenza vaccines to senior citizens. What level of prevention is the nurse practicing?

• Primary prevention
• Secondary prevention
• Tertiary prevention
• Quaternary prevention

(ANS- Primary prevention is aimed at health promotion and includes health- education programs, immunizations, and physical and nutritional fitness activities.It can be provided to an individual and includes activities that focus on maintaining or improving the general health of individuals, families, and communities. It also includes specific protection such as immunization for influenza.

A patient experienced a myocardial infarction 4 weeks ago and is currently participating in the daily cardiac rehabilitation sessions at the local fitness center.In what level of prevention is the patient participating?

• Primary prevention
• Secondary prevention
• Tertiary prevention
• Quaternary prevention

(ANS- Tertiary prevention involves minimizing the effects of long-term disease or disability by interventions directed at preventing complications and deterioration following the myocardial infarction. Tertiary-prevention activities are directed at rehabilitation rather than diagnosis and treatment. Care at this level aims to help patients achieve as high a level of functioning as possible, despite the limitations 1 / 4

caused by illness or impairment. This level of care is called preventive care because it involves preventing further disability or reduced functioning.

Based on the transtheoretical model of change, what is the most appropriate response to a patient who states: "Me, exercise? I haven't done that since junior high gym class, and I hated it then!"

• "That's fine. Exercise is bad for you anyway."
• "OK. I want you to walk 3 miles 4 times a week, and I'll see you in 1 month."
• "I understand. Can you think of one reason why being more active would be

helpful for you?"

• "I'd like you to ride your bike 3 times this week and eat at least four fruits and

vegetables every day." (ANS- The patient's response indicates that the patient is in the precontemplation stage and does not intend to change his behavior in the next 6 months. In this stage the patient is not interested in information about the behavior and may be defensive when confronted with it. Asking an open-ended question may stimulate the patient to identify a reason to begin a behavior change. Nurses are challenged to motivate and facilitate change in health behavior when working with individuals.

A patient comes to the local health clinic and states: "I've noticed how many people are out walking in my neighborhood. Is walking good for you?" What is the best response to help the patient through the stages of change for exercise?

• "Walking is OK. I really think running is better."
• "Yes, walking is great exercise. Do you think you could go for a 5-minute walk

next week?"

• "Yes, I want you to begin walking. Walk for 30 minutes every day and start to

eat more fruits and vegetables." 2 / 4

• "They probably aren't walking fast enough or far enough. You need to spend at

least 45 minutes if you are going to do any good." (ANS- The patient's response indicates that the patient is in the contemplative state, possibly intending to make a behavior change within the next 6 months. The nurse's statement reinforces the behavior and provides a specific goal for the patient to begin a walking plan.

A male patient has been laid off from his construction job and has many unpaid bills. He is going through a divorce from his marriage of 15 years and has been seeing his pastor to help him through this difficult time. He does not have a primary health care provider because he has never really been sick and his parents never took him to the physician when he was a child. Which external variables influence the patient's health practices? (Select all that apply.)

• Difficulty paying his bills
• Seeing his pastor as a means of support
• Family practice of not routinely seeing a health care provider
• Stress from the divorce and the loss of a job

(ANS- External factors impacting health practices include family beliefs and economic impact. How patients' families use health care services generally affects their health practices. Their perceptions of the serious nature of diseases and their history of preventive care behaviors (or lack of them) influence how patients will think about health. Economic variables may affect a patient's level of health by increasing the risk for disease and influencing how or at what point the patient enters the health care system.

The nurse is conducting a home visit with an older adult couple. She assesses that the lighting in the home is poor and there are throw rugs throughout the home and 3 / 4

a low footstool in the living room. She discusses removing the rugs and footstool and improving the lighting with the couple. The nurse is addressing which level of need according to Maslow?

• Physiological
• Safety and security
• Love and belonging
• Self-actualization

(ANS- The teaching addresses the need for safety and security. The throw rugs, low lighting, and low stool are hazards that can cause falls in the elderly.Preventing falls is a priority safety issue for older adults.

When taking care of patients, the nurse routinely asks them if they take any vitamins or herbal medications, encourages family members to bring in music that the patient likes to help the patient relax, and frequently prays with her patients if that is important to them. The nurse is practicing which model?

• Holistic
• Health belief
• Transtheoretical
• Health promotion

(ANS- The nurse is using a holistic model of care that considers emotional and spiritual well-being and other dimensions of an individual to be important aspects of physical wellness. The holistic health model of nursing attempts to create conditions that promote optimal health. Nurses using the holistic nursing model recognize the natural healing abilities of the body and incorporate complementary and alternative interventions such as music therapy, reminiscence, relaxation therapy, therapeutic touch, and guided imagery because they are effective,

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