Free NCLEX-RN practice questions with answers

Twenty-five original, source-verified NCLEX-RN questions with full answers and rationale below, free to read, no account required. A new set every day.

1. Question 1

   A patient taking cimetidine for peptic ulcer disease is newly prescribed warfarin. The nurse should recognize which risk from this combination?

   • Cimetidine reduces the metabolism of warfarin in the liver, which can raise warfarin blood levels and increase bleeding risk.Correct
   • Cimetidine has no effect on any other medications.
   • Cimetidine increases warfarin's excretion, reducing its effectiveness.
   • Cimetidine converts warfarin into an inactive form.

   Why: Cimetidine can increase the blood levels of oral anticoagulants such as warfarin, along with many other drugs including propranolol, benzodiazepines, tricyclic antidepressants, theophylline, phenytoin, and calcium channel blockers, by reducing their metabolism in the liver and subsequent excretion. This makes cimetidine one of the more clinically significant H2-receptor antagonists for drug interactions, unlike the claim that it has no effect on other medications, increases warfarin excretion, or inactivates the drug. Primary reference: Nursing Pharmacology Made Incredibly Easy (Lippincott Williams & Wilkins/Wolters Kluwer, 4th Edition), Chapter 7, Gastrointestinal Drugs, p. 366.

2. Question 2

   A nurse has just finished a routine blood pressure check on a client whose skin was intact and who has no known infection. The nurse's hands are not visibly soiled. According to standard hand-hygiene guidance, what should the nurse do before moving to the next task?

   • Wash hands with soap and water for a full 2 minutes
   • Apply an alcohol-based hand rub to all surfaces of the hands and fingers until dryCorrect
   • Rinse hands with plain water only
   • Proceed to the next task without performing hand hygiene since gloves were not used

   Why: When hands have not been in contact with blood, body fluids, or a client known to have a spore-forming or highly resistant organism, an alcohol-based hand rub is an acceptable and effective substitute for soap-and-water handwashing. The nurse applies enough product to cover all surfaces of the hands and fingers and rubs until the hands are dry, since the volume needed to reduce bacterial counts varies by product. Soap and water is reserved for visibly soiled hands or after known contact with spore-forming organisms. Skipping hand hygiene entirely is never appropriate between client contacts, even without glove use. Primary reference: Nursing Diagnosis Handbook (Ackley, Elsevier, 11th Edition), Risk for Infection, p. 530.

3. Question 3

   Ten minutes into a first dose of intravenous vancomycin, a client develops audible wheezing, swelling of the lips and tongue, urticaria, and a blood pressure of 80/46 mm Hg. The nurse stops the infusion and calls for help. What is the priority next action?

   • Administer epinephrine intramuscularlyCorrect
   • Administer diphenhydramine intravenously
   • Begin a rapid isotonic fluid bolus
   • Apply a nonrebreather mask at 100% oxygen

   Why: Anaphylaxis is a form of distributive shock, and the priority intervention beyond removing the trigger is epinephrine, which reverses the widespread vasodilation and capillary leak driving the hypotension and airway swelling. Fluid resuscitation and supplemental oxygen are important supportive measures but do not reverse the underlying mediator release the way epinephrine does. Diphenhydramine and other antihistamines are adjunctive treatments for itching and hives, not the definitive therapy for anaphylactic hypotension and airway compromise. Primary reference: Harrison's Principles of Internal Medicine (McGraw Hill, 21st Edition), Chapter 303 Approach to the Patient with Shock, p. 2241.

4. Question 4

   A patient taking digoxin is also prescribed a potassium-wasting (loop) diuretic. The nurse understands this combination places the patient at increased risk for digoxin toxicity primarily because of which effect?

   • The diuretic increases digoxin absorption from the GI tract.
   • The diuretic can cause hypokalemia, and low potassium levels increase the risk of digoxin toxicity even when digoxin levels are not elevated.Correct
   • The diuretic decreases renal excretion of digoxin, causing direct accumulation.
   • The diuretic converts digoxin to an active metabolite.

   Why: Digoxin has a narrow therapeutic index, and potassium-wasting diuretics taken with digoxin can cause hypokalemia, which increases the risk of digoxin toxicity; a patient with hypokalemia can develop digoxin toxicity even when the actual digoxin level is not elevated. This is why potassium levels are monitored closely in any patient on both digoxin and a diuretic that depletes potassium, rather than assuming the interaction is caused by altered absorption or metabolism of digoxin itself. Primary reference: Nursing Pharmacology Made Incredibly Easy (Lippincott Williams & Wilkins/Wolters Kluwer, 4th Edition), Chapter 5, Cardiovascular Drugs, p. 232.

5. Question 5

   A patient's blood sample was drawn after prolonged fist clenching during a difficult venipuncture, and the result shows a potassium of 6.4 mEq/L, but the patient has no symptoms and a prior level last month was normal. What should the nurse consider first?

   • Immediately initiate emergency hyperkalemia treatment based on this single value
   • Consider pseudohyperkalemia from the collection technique and repeat the test properlyCorrect
   • Assume the patient has developed new kidney failure
   • Document the result and take no further action

   Why: Pseudohyperkalemia can arise during specimen collection due to repeated fist clenching, prolonged tourniquet application, or use of small-bore needles during phlebotomy, causing cell lysis and falsely elevated potassium. Given the asymptomatic presentation, the difficult draw, and a previously normal level, the diagnosis of hyperkalemia should first be confirmed by repeat testing with proper technique rather than immediately initiating emergency treatment, assuming new renal failure, or ignoring the abnormal value entirely. Primary reference: Current Medical Diagnosis & Treatment 2024 (Papadakis & McPhee, McGraw Hill, 63rd Edition), Chapter 23: Electrolyte & Acid-Base Disorders, p. 890-891.

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7. Question 6

   An RN notices a subtle but concerning change in a client's condition overnight and needs to call the on-call provider. Which communication framework should the RN use to organize this call for maximum clarity and safety?

   • FOCUS charting format
   • SBAR (Situation, Background, Assessment, Recommendation)Correct
   • A narrative retelling of the entire shift
   • SOAP note format read verbatim over the phone

   Why: SBAR (Situation, Background, Assessment, Recommendation) was developed to give a brief, concise, and standardized structure for communicating critically important information, reducing the communication failures that are a leading cause of inadvertent patient harm. FOCUS and SOAP are documentation formats rather than telephone communication tools, and an unstructured narrative retelling does not provide the standardized critical-language structure shown to improve safety. Primary reference: Carpenito-Moyet, Nursing Care Plans: Transitional Patient & Family-Centered Care (Wolters Kluwer/LWW, 6th Edition), Communication: The Critical Key to Preventing Adverse Events, p. 13.

8. Question 7

   A client is started on phenytoin for seizure control. Which laboratory result should the RN recognize as within the therapeutic range?

   • Serum phenytoin level of 15 mcg/mLCorrect
   • Serum phenytoin level of 2 mcg/mL
   • Serum phenytoin level of 35 mcg/mL
   • Serum phenytoin level of 45 mcg/mL

   Why: The therapeutic serum range for phenytoin is generally 10 to 20 mcg/mL; levels below this range increase the risk of breakthrough seizures, and levels above 20 mcg/mL increase the risk of toxicity. The RN should also monitor long-term users for gingival hyperplasia and reduced bone density. Primary reference: Pharmacology for Nurses (OpenStax/Rice University, 2024), Ch. 12.1 Epilepsy and Anticonvulsant Drugs, p. 350.

9. Question 8

   A patient stabilized on lithium for bipolar disorder is placed on a strict low-sodium diet for an unrelated cardiac condition. The nurse should recognize this dietary change places the patient at risk for which complication?

   • Lithium toxicity, because severe sodium restriction increases susceptibility to toxic lithium levelsCorrect
   • Lithium becoming completely ineffective and requiring an immediate dose increase
   • No effect, since lithium excretion is unrelated to sodium intake
   • Rapid excretion of lithium requiring more frequent dosing

   Why: Lithium has a narrow therapeutic margin of safety, and a patient on a severely salt-restricted diet is susceptible to lithium toxicity, while increased sodium intake can instead reduce lithium's therapeutic effects. This relationship exists because sodium and lithium are handled similarly by the kidneys, so a nurse caring for a patient on lithium should flag any significant change in sodium intake for the prescriber rather than assume it has no effect or automatically requires a dose change on its own. Primary reference: Nursing Pharmacology Made Incredibly Easy (Lippincott Williams & Wilkins/Wolters Kluwer, 4th Edition), Chapter 11, Antidepressant and Mood Stabilizer Drugs, p. 578.

10. Question 9

    A 78-year-old woman with type 2 diabetes and dementia is brought in with several weeks of polyuria and poor oral intake, now profoundly confused. Blood glucose is 920 mg/dL, serum osmolality is 365 mOsm/L, and arterial pH is 7.32 with only mild ketonuria. Which condition does this presentation most likely represent?

    • Diabetic ketoacidosis
    • Hyperglycemic hyperosmolar stateCorrect
    • Euglycemic ketoacidosis from an SGLT2 inhibitor
    • Simple hyperglycemia without a hyperosmolar emergency

    Why: Hyperglycemic hyperosmolar state (HHS) typically develops over days to weeks in an older adult with type 2 diabetes and a condition that impairs fluid intake, presenting with marked hyperglycemia and profound hyperosmolality and altered mental status, but with absent or only mild ketosis and near-normal pH, unlike DKA. DKA usually develops more rapidly with significant acidosis and prominent ketonemia and is more common in type 1 diabetes. Euglycemic DKA, by definition, presents with a near-normal glucose, which does not match this presentation. This patient's severe hyperosmolality and mental status change clearly represent more than simple hyperglycemia. Primary reference: Harrison's Principles of Internal Medicine (McGraw Hill, 21st Edition), Chapter 404, Diabetes Mellitus: Management and Therapies, p. 3117.

11. Question 10

    A patient scheduled for elective cardiac surgery reports a recent episode of slurred speech and unilateral arm weakness that resolved within an hour, and carotid imaging confirms significant carotid artery stenosis on the same side. What should the nurse anticipate?

    • The carotid stenosis is incidental and requires no action before cardiac surgery
    • Correction of the symptomatic carotid stenosis should generally be addressed before the elective cardiac surgeryCorrect
    • Asymptomatic and symptomatic carotid stenosis carry identical perioperative stroke risk
    • The transient symptoms confirm the carotid stenosis does not need any intervention

    Why: Symptomatic carotid artery stenosis is associated with a high risk of stroke in patients undergoing cardiac surgery, and patients with independent indications for correction of carotid stenosis should generally have the procedure performed before elective surgery. This is in contrast to asymptomatic carotid bruits and asymptomatic carotid stenosis, which are associated with little or no increased perioperative stroke risk in most studies. The transient ischemic attack described here indicates symptomatic disease that needs to be addressed, not ignored. Primary reference: Current Medical Diagnosis & Treatment 2024 (Papadakis & McPhee, McGraw Hill, 63rd Edition), Chapter 3: Preoperative Evaluation & Perioperative Management, p. 50.

12. Question 11

    A client recovering from several days of nasogastric suction develops metabolic alkalosis. A urine chloride level is drawn and returns at 8 mEq/L.

    • Administration of IV normal saline to expand extracellular fluid volumeCorrect
    • Administration of a potassium-sparing diuretic
    • Restriction of sodium intake
    • Administration of acetazolamide alone as first-line therapy

    Why: A urine chloride below 20 mEq/L identifies chloride-responsive metabolic alkalosis, as occurs with vomiting or nasogastric suction, where chloride and volume depletion maintain the alkalosis. Therapy involves volume expansion with a chloride salt, typically intravenous normal saline, until an euvolemic state is achieved, which reduces proximal bicarbonate reabsorption. A potassium-sparing diuretic and sodium restriction would not correct the underlying volume and chloride deficit, and acetazolamide is reserved for edematous, chloride-unresponsive situations where volume expansion is contraindicated, not as first-line therapy here. Primary reference: Current Medical Diagnosis & Treatment 2024 (Papadakis & McPhee, McGraw Hill, 63rd Edition), Chapter 23: Electrolyte & Acid-Base Disorders, p. 905-906.

13. Question 12

    A newly licensed RN is orienting to a medical unit and asks the preceptor to explain the standardized medication reconciliation process required at every transition of care. Which sequence of steps correctly reflects this process as defined by accreditation standards?

    • Develop a list of the client's current medications, develop a list of medications to be prescribed, compare the two lists, make clinical decisions based on the comparison, and communicate the updated list to the client's ongoing caregiversCorrect
    • Ask the client to state medication allergies, order new medications, discontinue home medications automatically, and document the change in the chart
    • Obtain the client's insurance formulary, select covered medications, notify the pharmacy, and discharge the client
    • Collect medication bottles from home, discard any that are expired, write a new list, and give it only to the receiving facility

    Why: Medication reconciliation is a defined five-step process, not an informal comparison: (1) develop a list of current medications, (2) develop a list of medications to be prescribed, (3) compare the two lists, (4) make clinical decisions based on the comparison, and (5) communicate the new list to the client's ongoing caregivers. The distractor that automates discontinuation skips comparison and clinical decision-making, risking omission of medications that should continue. Substituting an insurance/formulary process, or omitting comparison against newly ordered medications and failing to communicate the reconciled list forward, both defeat the purpose of reconciling at a transition of care. Primary reference: Carpenito, Nursing Care Plans (Wolters Kluwer/LWW, 6th Edition), Chapter 3: Early Identification of High-Risk Individuals and/or Family, p. 17.

14. Question 13

    A client recovering from a stroke has significant new physical deficits requiring lifestyle changes. The client's adult child insists nothing is really wrong, continues planning the same demanding family events and travel the client used to host before the stroke, and becomes visibly irritated whenever the client's limitations are mentioned. Which nursing diagnosis best fits this family dynamic?

    • Disabled Family CopingCorrect
    • Readiness for Enhanced Family Coping
    • Ineffective Community Coping
    • Risk for Caregiver Role Strain

    Why: Disabled Family Coping is defined as behavior of a primary person that disables the client's (or the family member's own) capacity to adapt to a health challenge, and its defining characteristics specifically include distortion of reality regarding the client's health problem and carrying on usual routines without regard for the client's needs--both of which this adult child is demonstrating. This differs from Compromised Family Coping, where a usually supportive person gives insufficient support because of exhaustion or lack of understanding, and from Readiness for Enhanced Family Coping, which reflects a family actively seeking growth; Risk for Caregiver Role Strain concerns strain in a caregiving role, not denial of the client's condition. Primary reference: Ackley, Nursing Diagnosis Handbook (Elsevier, 11th Edition), Disabled Family Coping, p. 294.

15. Question 14

    A parent brings a toddler with acute diarrhea and mild dehydration (increased thirst, dry mouth, no other symptoms) to the clinic. The toddler vomited once after drinking fluid at home. What should the nurse recommend?

    • Give oral rehydration solution in small, frequent amounts, continuing even if the child vomits againCorrect
    • Withhold all oral fluids until the vomiting has completely stopped
    • Give the child flat soda to help settle the stomach
    • Switch immediately to intravenous fluids because the child vomited once

    Why: Oral rehydration therapy is effective for children with mild to moderate dehydration from diarrhea and should be continued in small frequent amounts even if the child vomits again, since most of the fluid is still absorbed and vomiting is not a contraindication to oral rehydration. Flat soda has a high carbohydrate osmolality and low sodium content that can worsen diarrhea, and intravenous fluids are not the first recommendation for mild dehydration when oral rehydration remains an option. Primary reference: Ackley, Nursing Diagnosis Handbook (Elsevier, 11th Edition), Diarrhea, p. 336.

16. Question 15

    A provider performs a Trendelenburg test on a client with visible leg varicosities: the leg is elevated, an elastic tourniquet is applied around the distal thigh, and the client then stands. The varicosities remain flat immediately after standing and fill only slowly from below. How should the nurse interpret this result?

    • The deep venous valves are competent, and the superficial veins are the primary source of the varicositiesCorrect
    • The deep venous valves are incompetent and are the primary cause of the varicosities
    • The test result indicates arterial rather than venous disease
    • The test is inconclusive and must be repeated with the tourniquet placed at the ankle instead

    Why: In the Trendelenburg test, after the leg is elevated and a tourniquet is applied to occlude the superficial veins, veins that remain flat when the client stands (filling only slowly from below) indicate that the deep venous valves are competent and that incompetent superficial valves are the cause of the varicosities; rapid distention of the varicosities on standing would instead indicate incompetent deep venous valves. This is a venous competency test, not an arterial assessment, and the described result does not indicate a need to repeat the test at a different tourniquet location. Primary reference: LeMone & Burke, Medical-Surgical Nursing (Pearson, 7th ed.), Chapter 32, p. (Trendelenburg test).

17. Question 16

    A teenager who has experienced repeated exposure to community violence and inconsistent parenting shows a declining ability to sustain positive coping after a recent crisis, with worsening academic disengagement and social withdrawal. This presentation is most consistent with which nursing diagnosis?

    • Impaired ResilienceCorrect
    • Readiness for Enhanced Coping
    • Chronic Sorrow
    • Ineffective Role Performance

    Why: Impaired Resilience is defined as a decreased ability to sustain a pattern of positive responses to an adverse situation or crisis, with defining characteristics including decreased interest in academic activities and social isolation, and related factors including community violence and inconsistent parenting. Readiness for Enhanced Coping describes a desire to strengthen already-adequate coping, Chronic Sorrow involves recurring grief over an ongoing loss, and Ineffective Role Performance concerns a mismatch between behavior and role expectations — none of which fit this crisis-response presentation as precisely. Primary reference: Ackley, Ladwig, & Makic, Nursing Diagnosis Handbook (Elsevier, 11th Edition), Impaired Resilience, p. 721.

18. Question 17

    A cognitively intact older adult is being transferred from home to an assisted living facility due to safety concerns. The family has already selected the facility and finalized arrangements without the client's input. According to the recommended nursing approach to prevent relocation stress syndrome, what should the RN do?

    • Support the family's decision as already final and focus only on physical comfort during the move
    • Identify the extent to which the client can participate in relocation decisions and advocate for that participationCorrect
    • Avoid discussing the move with the client to prevent added distress
    • Recommend the client be sedated during the transition to minimize anxiety

    Why: To reduce relocation stress syndrome, the nurse should identify the extent to which the client can participate in relocation decisions and advocate for this participation, since engaging older adults in decision-making increases the level of adjustment following relocation and promotes psychological well-being. Simply accepting a family-made decision as final, avoiding the topic, or sedating the client to suppress a normal stress response does not reflect this evidence-based, client-advocacy approach. Primary reference: Ackley, Ladwig, & Makic, Nursing Diagnosis Handbook (Elsevier, 11th Edition), Relocation Stress Syndrome, p. 713.

19. Question 18

    A wife tells the nurse, "My husband is so worried about being discharged home." When the nurse later speaks privately with the husband, he denies any worry and states he feels ready to go home. The wife's statement most likely illustrates which defense mechanism?

    • Displacement
    • ProjectionCorrect
    • Reaction formation
    • Sublimation

    Why: Projection is attributing one's own unacceptable feelings or impulses to someone else. The wife's own worry about the discharge is being expressed as if it belongs to her husband, matching the textbook example of a spouse who says the patient is worried when it is really the spouse who is worried. Primary reference: Gorman & Anwar, Neeb's Fundamentals of Mental Health Nursing (F.A. Davis, 4th Edition), Chapter 7 — Coping and Defense Mechanisms, p. 109.

20. Question 19

    While off duty at a shopping mall, a nurse recognizes a man having what appears to be a panic attack and stops to help him breathe through it until paramedics arrive. Which statement about legal protection for this action is accurate?

    • The Good Samaritan law protects the nurse only while she is on duty at her assigned facility.
    • The Good Samaritan law generally protects a nurse who, in good faith, assists in an emergency or crisis situation outside the scope of her employment.Correct
    • Nurses have no legal protection for assisting outside of their employer's premises.
    • The nurse must first obtain the patient's written consent before the Good Samaritan law applies.

    Why: The Good Samaritan law generally protects nurses who, acting in good faith and within their scope of licensure, assist in a crisis or emergency situation; it typically does not cover actions within the confines of paid employment, which is the opposite of option 1. Primary reference: Gorman & Anwar, Neeb's Fundamentals of Mental Health Nursing (F.A. Davis, 4th Edition), Chapter 8 — Mental Health Treatments, p. 137.

21. Question 20

    A nurse is preparing to insert a nasogastric tube for an adult client. Which method should the nurse use to determine the correct length of tube to insert?

    • Measure from the tip of the nose to the earlobe, then to the point midway between the umbilicus and the xiphoid processCorrect
    • Insert the tube exactly 25 cm regardless of the client's height
    • Measure from the corner of the mouth to the sternal notch only
    • Ask the client to estimate the length based on prior nasogastric tube experience

    Why: The standard method for estimating nasogastric tube insertion length measures from the tip of the client's nose to the tip of the earlobe, and then from the earlobe to the point midway between the umbilicus and the xiphoid process; this individualizes the length to the client's body size rather than using a fixed measurement or the client's recollection, which are not reliable methods. Primary reference: Kozier & Erb's Fundamentals of Nursing (Pearson, 11th Ed. Global), Chapter 46 Nutrition, p. 1217.

22. Question 21

    A newborn passes the routine CCHD pulse oximetry screen before discharge at 30 hours of age. On day 6, the parent brings the infant to the clinic because the infant seems unusually tired with feeding. The nurse palpates weak, delayed femoral pulses compared with strong brachial pulses. Which statement best reflects the nurse's understanding of this presentation?

    • A normal CCHD screen before discharge reliably rules out coarctation of the aorta, so a cardiac cause is unlikely
    • Coarctation of the aorta may not be detected by CCHD screening before discharge, since femoral pulses can be normal initially and diminish only as the ductus arteriosus closes over the following daysCorrect
    • Weak femoral pulses with strong brachial pulses in a newborn are a normal variant that requires no further evaluation
    • This presentation is diagnostic of tricuspid atresia rather than any other congenital heart defect

    Why: In coarctation of the aorta, femoral pulses may be palpable on initial newborn examinations but then become diminished, delayed, or absent as the ductus arteriosus closes over the following days, and CCHD screening prior to hospital discharge may not identify newborns with this lesion. A normal screen at 30 hours therefore does not reliably rule out coarctation later in the first week of life, making option A incorrect, and this pulse discrepancy is a recognized abnormal finding requiring prompt cardiology evaluation rather than a normal variant. This presentation is specific to a left-sided obstructive lesion like coarctation and is not the classic presentation of tricuspid atresia, which more typically involves cyanosis from a right-sided obstructive lesion. Primary reference: ACoRN: Acute Care of At-Risk Newborns (Oxford University Press/Canadian Paediatric Society, 2nd Edition), Chapter 4, Cardiovascular, p. 112-113.

23. Question 22

    A client is being discharged after a hospital stay during which several new medications were started and one home medication was discontinued. Which action reflects correct medication safety practice at this transition point?

    • Reconcile all medications at discharge and provide an updated list to the clientCorrect
    • Assume the client's pharmacy will automatically update the medication list
    • Discharge the client without reviewing medications since the provider already wrote the prescriptions
    • Only discuss the new medications and skip mentioning the discontinued one

    Why: Medications should be reconciled at both admission and discharge, with an accurate, complete list provided to the client, so that new medications, changed doses, and discontinued medications are all clearly communicated and the risk of the client continuing a discontinued medication or missing a new one is minimized. Assuming a pharmacy will independently catch these changes, skipping medication review at discharge, or omitting discussion of discontinued medications each leave gaps that can lead to a medication error after discharge. Primary reference: Nursing Diagnosis Handbook (Ackley, Elsevier, 11th Edition), Risk for Injury, p. 534.

24. Question 23

    A client who recently completed a 10-day course of clindamycin for a dental infection develops profuse watery diarrhea. The health care provider suspects Clostridioides difficile infection. Which class of antibiotics, along with clindamycin, is most strongly associated with triggering this infection?

    • FluoroquinolonesCorrect
    • Topical antifungals
    • Intranasal corticosteroids
    • Short courses of acetaminophen with an opioid

    Why: Clindamycin, ampicillin, and cephalosporins were the antibiotics first associated with Clostridioides difficile infection, and fluoroquinolones such as ciprofloxacin, levofloxacin, and moxifloxacin later emerged as the most recent drug class implicated in hospital outbreaks because they further disrupt the normal colonic microbiota that normally suppresses C. difficile overgrowth. Topical antifungals, intranasal corticosteroids, and short-term analgesic combinations are not systemic antibiotics and do not carry this same risk of disrupting gut flora. Recognizing this antibiotic-exposure pattern helps the nurse anticipate which clients are at elevated risk for CDI. Primary reference: Harrison's Principles of Internal Medicine (McGraw Hill, 21st Edition), Chapter 134 Clostridioides difficile Infection, p. 1066.

25. Question 24

    The parent of a 14-month-old asks the nurse when it is safe to turn the car seat to face forward. What is the nurse's best response?

    • The child should remain rear-facing until at least age 2 or until reaching the car seat's height/weight limit, whichever comes firstCorrect
    • The child can be turned forward-facing as soon as they can sit up unassisted
    • The child should be turned forward-facing at 12 months regardless of size
    • Car seat direction does not affect injury risk once the child is walking

    Why: Primary-prevention injury guidance for toddlers recommends keeping children rear-facing until they are at least 2 years old, or until they reach the highest height or weight allowed by the car seat manufacturer, because rear-facing seats better protect the head, neck, and spine in a crash. Turning the seat forward based only on sitting ability or a fixed 12-month cutoff ignores the actual criteria (age and manufacturer limits) and would expose a still-developing toddler to unnecessary injury risk; car seat orientation directly affects crash injury risk regardless of whether the child can walk. Primary reference: Population Health for Nurses (Ochs, Roper & Schwartz, OpenStax, 1st Edition, 2024), Chapter 26.2 Newborn, Infant, and Toddler Health, p. 681.

26. Question 25

    A client with a strong family history of colon cancer tells the nurse, "I know I'm at high risk, and I know a colonoscopy could catch a problem early, but I just don't feel confident I could get through the bowel prep and the procedure itself." Using the Health Belief Model, which construct is the primary barrier to this client completing screening?

    • Low self-efficacyCorrect
    • Low perceived susceptibility
    • Low perceived severity
    • Low perceived benefit

    Why: Self-efficacy in the Health Belief Model refers to a person's confidence in their own ability to successfully take a recommended health action, and this client's statement expresses doubt specifically about being able to get through the bowel prep and procedure, not doubt about their risk or the test's value. The client has already articulated high perceived susceptibility (knows they are at high risk) and high perceived benefit (knows the test could catch a problem early), so those constructs are not the barrier here, and the client has not expressed any belief that colon cancer itself would be a mild or inconsequential diagnosis, which rules out low perceived severity. Primary reference: Population Health for Nurses (Ochs, Roper & Schwartz, OpenStax, 1st Edition, 2024), Chapter 15.3 Theories and Models, p. 405.