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Section 1: Ethical, Legal, and Reporting Responsibilities
1. A school-age child with muscular dystrophy confides in a nurse during
a home visit that he was struck by his parents. Which action should the
nurse take FIRST?
• A. Report the incident to local authorities
• B. Check the child for injuries
• C. Refer the parents to a social service agency
• D. Enroll the parents in anger management classes
Answer: B. Check the child for injuries
Rationale: The nurse’s first priority is to ensure the child’s immediate safety
and assess for injuries. After confirming physical harm, the nurse must report
suspected abuse to authorities (A) and involve social services (C). Anger
management (D) is a long-term intervention.
Key Concept: Mandatory Reporting + Immediate Safety Assessment
NCLEX Tip: Always prioritize physical assessment before legal or social
interventions in suspected abuse cases.
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2. A nurse discovers a client with active tuberculosis (TB) refuses to take
medications. What is the nurse’s BEST action?
• A. Respect the client’s autonomy and document the refusal
• B. Notify the public health department for involuntary isolation
• C. Educate the client about TB transmission risks
• D. Arrange for directly observed therapy (DOT)**
Answer: B. Notify the public health department
Rationale: TB is a public health threat. If a client refuses treatment, the
nurse must follow legal protocols to protect community health, including
involuntary isolation. Education (C) and DOT (D) are preventive but not
immediate actions.
Key Concept: Public Health Laws + Ethical Dilemmas
NCLEX Tip: Prioritize community safety over individual autonomy in
contagious disease cases.
Section 2: Health Promotion and Disease Prevention
3. A nurse plans a program about healthy eating at an elementary school
where students primarily eat pizza and fries. Which action should the
nurse take FIRST?
• A. Provide resources about wise food choices
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• B. Determine students’ motivation to learn
• C. Give positive feedback for healthy choices
• D. Help students recognize the value of healthy eating
Answer: B. Determine students’ motivation to learn
Rationale: The first step in health education is assessing the audience’s
readiness to learn. Without motivation, interventions like education (A) or
feedback (C) will be ineffective.
Key Concept: Health Education Principles
NCLEX Tip: Use the PRECEDE-PROCEED model to assess predisposing,
reinforcing, and enabling factors before planning interventions.
4. A nurse is educating postmenopausal women. Which outcome is MOST
appropriate?
• A. Clients will schedule bone density screenings
• B. Clients will start hormone replacement therapy
• C. Clients will reduce caloric intake by 50%
• D. Clients will perform breast self-exams weekly
Answer: A. Schedule bone density screenings
Rationale: Postmenopausal women are at high risk for osteoporosis. Bone
density screenings (DEXA scans) are evidence-based secondary prevention.