6–12% of the NCLEX-RN

NCLEX Health Promotion and Maintenance

Care across the lifespan: growth and development, pregnancy, birth and the newborn, screening and immunizations, and teaching people to stay well.

Practice Health Promotion free10 questions a day free, no card

What it covers

  • Growth and development milestones
  • Antepartum, intrapartum and postpartum care
  • Newborn care
  • Health screening and immunizations
  • Aging and the older adult
  • Health teaching and lifestyle choices

Three ways candidates lose points

  • Calling a normal finding abnormal. Ankle swelling late in pregnancy, physiologic jaundice after the first day, or an infant who sits but does not yet walk can all be expected.
  • Missing the one finding that is not normal. New hypertension with protein in the urine after 20 weeks is preeclampsia until proven otherwise.
  • Giving a live vaccine where it does not belong. Live vaccines (MMR, varicella, the nasal influenza vaccine) are avoided in pregnancy and severe immunosuppression.

How to approach it

First decide whether the finding is expected for this age or this stage of pregnancy. Most of these questions are won by knowing the normal range well enough to spot the one finding outside it. For teaching questions, look for the answer that shows the client understood, not the one that repeats the instruction.

Free chapters to read

Openly licensed textbooks written by nursing faculty, free to read online. Read the sections your misses point to, not the whole book.

Try three real questions

From WriteSpan’s own bank, the same questions students practice with. Answer first; the explanation opens after.

Question 1Developmental Milestones: Preschool

A nurse is performing a developmental assessment on a 4-year-old. Which finding indicates the child is meeting expected developmental milestones?

The answer is D

Correct! At 4 years of age, expected milestones include: hopping on one foot (gross motor), dressing with minimal assistance (fine motor and self-care), and drawing a person with four or more body parts (fine motor and cognitive). These are the key benchmarks assessed at the 4-year well visit.

Clinical pearl: Clinical Pearl: Drawing milestones by age: 12 months — scribbles. 2 years — horizontal and vertical lines. 3 years — copies a circle, draws a person with 2 to 3 body parts. 4 years — copies a square, draws a person with 4 or more parts. 5 years — copies a triangle, draws a person with 6 body parts. These drawing milestones reflect fine motor development and also indicate cognitive development.

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Question 2Physical Assessment: Techniques

A nurse is performing a physical assessment and needs to assess for tactile fremitus in a client with suspected pneumonia. Which technique is correct?

The answer is C

Correct! Tactile (vocal) fremitus is assessed by placing the ulnar surface of the hand on the posterior thorax while asking the client to say "ninety-nine." The vibrations of the voice are transmitted through the lung tissue to the chest wall.

Clinical pearl: Clinical Pearl: Tactile fremitus interpretation: INCREASED fremitus — consolidation (pneumonia, atelectasis) — solid tissue transmits vibrations better than air. DECREASED or absent fremitus — fluid (pleural effusion) or air (pneumothorax) between lung and chest wall. These findings complement percussion: consolidation — increased fremitus plus dullness. Effusion — decreased fremitus plus dullness. Pneumothorax — decreased fremitus plus hyperresonance.

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Question 3Newborn Safety: Feeding

A nurse is teaching a new parent about formula preparation. The parent asks if they can use well water to mix formula. Which response is most accurate?

The answer is D

Correct! Well water is not regulated by municipal water treatment standards and may contain nitrates (causing methemoglobinemia in infants), bacteria, heavy metals, and fluoride in unknown concentrations.

Clinical pearl: Clinical Pearl: Formula preparation safety: use the correct water-to-formula ratio (never dilute or concentrate). Store prepared formula in the refrigerator for no more than 24 hours. Discard unfinished formula after one hour at room temperature. Never microwave formula — creates hot spots. Always test temperature on the inner wrist before feeding.

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