Free NCLEX-RN Basic Care & Comfort Questions
Free NCLEX-RN basic care and comfort practice questions with rationales — mobility, nutrition, hygiene, rest, and comfort measures.
A nurse is providing perineal care for a female client who has an indwelling urinary catheter and is on bed rest. Which technique best reduces the client's risk of a catheter-associated urinary tract infection?
- A.Clean the perineum from front to back and keep the drainage bag below bladder level
- B.Clean from back to front to remove drainage away from the urethra
- C.Coil the tubing and rest the drainage bag on the client's abdomen
- D.Routinely irrigate the catheter with sterile saline every shift
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Correct answer: A
Infection control for a catheter rests on two principles: move contaminants away from the urethra and keep urine flowing downhill into a closed system. Cleaning front to back carries perineal flora away from the urethral meatus, and keeping the bag below bladder level prevents urine from refluxing back toward the bladder. Back-to-front wiping drags rectal bacteria toward the urethra. Resting the bag on the abdomen raises it above the bladder and promotes reflux. Routine irrigation breaks the closed system and is not done without an order.
Why the other options are wrong
- B. Wiping back to front pulls rectal bacteria toward the urethral opening, raising infection risk.
- C. Placing the bag on the abdomen lifts it above bladder level and lets urine reflux backward.
- D. Routine irrigation breaks the sterile closed system and is not standard practice without an order.
Key takeaway: Prevent CAUTI by cleaning front to back and keeping the closed drainage bag below the bladder.
A nurse is planning care for a client who reports chronic difficulty falling asleep in the hospital. Which non-pharmacological intervention should the nurse implement first to promote sleep?
- A.Offer a cup of regular coffee in the evening so the client relaxes before bed
- B.Cluster nighttime care and dim lights to provide an uninterrupted rest period
- C.Encourage a long afternoon nap to make up for lost nighttime sleep
- D.Keep the television on to provide background noise through the night
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Correct answer: B
Sleep depends on protecting the body's circadian cues and minimizing arousals, so the first nursing move is to reduce stimulation and bundle care into fewer interruptions. Clustering nighttime tasks and dimming lights gives the client a longer uninterrupted window to cycle through sleep stages. Evening caffeine in coffee is a stimulant that blocks sleep onset. Long daytime naps reduce nighttime sleep drive, and a television running all night adds light and noise that fragment sleep.
Why the other options are wrong
- A. Coffee contains caffeine, a stimulant that delays sleep onset rather than promoting it.
- C. A long afternoon nap lowers the homeostatic sleep drive needed at night.
- D. Constant television light and sound fragment sleep and prevent deep sleep stages.
Key takeaway: Promote sleep first by reducing stimulation and clustering care for uninterrupted rest.
A nurse is helping an older adult client use a standard cane for the first time after a left knee strain. The client asks which hand should hold the cane. What is the nurse's best response?
- A."Hold the cane in your right hand, on the side opposite your weaker leg."
- B."Hold the cane in your left hand, on the same side as your weaker leg."
- C."Hold the cane in whichever hand feels more comfortable to you."
- D."Hold the cane in front of you with both hands for the most stability."
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Correct answer: A
A cane goes in the hand on the side opposite the weaker or injured leg, and it advances together with that weaker leg. Holding it opposite widens the base of support and lets the cane share the load the moment the injured limb bears weight, mimicking a normal arm-leg swing. The client's weak leg is the left, so the cane belongs in the right hand. Same-side use narrows the base and offers little support. Comfort alone ignores biomechanics, and a single cane is not held with both hands.
Why the other options are wrong
- B. Same-side placement narrows the base of support and fails to offload the injured leg.
- C. Personal comfort does not ensure a stable, weight-sharing gait pattern.
- D. A single cane is held in one hand; two-handed use is neither intended nor stable.
Key takeaway: Hold a cane on the side opposite the weaker leg and move them together.
A nurse is preparing to transfer a client from the bed to a wheelchair using a gait belt. Which actions should the nurse take to perform the transfer safely? Select all that apply.
- A.Lock the wheels of both the bed and the wheelchair before the transfer
- B.Position the wheelchair on the client's stronger side
- C.Apply the gait belt snugly around the client's waist over clothing
- D.Have the client sit at the edge of the bed for a moment before standing
- E.Bend at the waist and lift the client with your back straight and knees locked
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Correct answers: A, B, C, D
Safe transfers protect both the client and the nurse: stabilize the equipment, lead with the client's strength, secure a hand-hold, and pace the move. Locking both sets of wheels prevents rolling, placing the chair on the strong side lets the client pivot toward stability, a snug gait belt gives a secure grip, and dangling at the bed edge first lets blood pressure adjust to prevent orthostatic dizziness. Bending at the waist with locked knees strains the back; proper body mechanics use bent knees and the leg muscles to lift.
Why the other options are wrong
- E. Bending at the waist with locked knees strains the back; lift with bent knees using the legs instead.
Key takeaway: Lock wheels, transfer toward the strong side, secure the gait belt, and let the client sit before standing.
A nurse is feeding an older adult client who has dysphagia after a stroke. Which finding during the meal requires the nurse to stop feeding immediately?
- A.The client takes small, slow sips between bites of pureed food
- B.The client develops a wet, gurgling voice and starts coughing
- C.The client requests that the meal tray be placed closer
- D.The client tucks the chin slightly while swallowing
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Correct answer: B
A wet or gurgling voice plus coughing during a meal signals that food or liquid is entering the airway, the classic warning of aspiration in a client with dysphagia. Stop feeding at once to protect the airway. Small, slow sips and a chin tuck are correct safe-swallow techniques you want to see, not problems. Wanting the tray closer is an ordinary preference. The skill is sorting protective behaviors from airway danger signs and acting on the danger sign first.
Why the other options are wrong
- A. Small, slow sips are a recommended safe-swallow strategy, not a red flag.
- C. Repositioning the tray is a comfort request unrelated to airway safety.
- D. A chin tuck protects the airway during swallowing and is encouraged.
Key takeaway: A wet, gurgling voice with coughing during meals means aspiration; stop feeding immediately.
A nurse is teaching a client with chronic constipation about non-pharmacological ways to promote regular bowel elimination. Which instructions should the nurse include? Select all that apply.
- A.Increase intake of high-fiber foods such as fruits, vegetables, and whole grains
- B.Drink more water and fluids throughout the day unless fluids are restricted
- C.Engage in regular physical activity such as daily walking
- D.Respond promptly to the urge to defecate rather than delaying
- E.Routinely use stimulant laxatives every day to ensure a bowel movement
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Correct answers: A, B, C, D
Healthy bowel function comes from softening and moving stool naturally and honoring the body's signals. Fiber adds bulk, fluids soften stool, and activity stimulates peristalsis, so all three work together. Answering the urge promptly preserves the normal defecation reflex; delaying lets the colon reabsorb water and harden the stool. Daily stimulant laxatives are not a first-line lifestyle measure: chronic use can create dependence and weaken natural colon tone, so they belong to medication management, not routine teaching.
Why the other options are wrong
- E. Daily stimulant laxative use can cause dependence and reduce natural colon tone; it is not a routine lifestyle measure.
Key takeaway: Fiber, fluids, activity, and responding to the urge promote bowel regularity without routine laxatives.
A nurse is teaching an older adult with chronic insomnia about nonpharmacologic sleep hygiene. Which statement by the client indicates the teaching was effective?
- A."I'll have a cup of coffee in the early evening so I'm relaxed by bedtime."
- B."If I can't fall asleep within 20 minutes, I'll get up and do something quiet until I feel drowsy."
- C."I'll take a long nap every afternoon to make up for the sleep I lose at night."
- D."I'll watch television in bed each night until I drift off."
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Correct answer: B
Good sleep hygiene keeps the bed paired with sleep, so getting up when you cannot fall asleep within about 20 minutes prevents the bed from becoming a place of frustrated wakefulness. Returning only when drowsy strengthens the sleep association. Evening caffeine is a stimulant that delays sleep onset, long daytime naps reduce nighttime sleep drive, and screen time in bed exposes the client to alerting light and breaks the bed-sleep link. The effective statement is the one that protects the conditioned association between bed and sleep.
Why the other options are wrong
- A. Caffeine is a stimulant; evening coffee delays sleep onset rather than relaxing the client.
- C. Long afternoon naps reduce homeostatic sleep drive and worsen nighttime insomnia.
- D. Screen light is alerting and watching TV in bed weakens the bed-sleep association.
Key takeaway: Leaving the bed when unable to sleep and returning only when drowsy preserves the conditioned link between bed and sleep.