NCLEX-PN Basic Care and Comfort Practice Test

25 practice questions

Choose an answer, then check it under Show answer.

1. Question 1 of 25Easy

   A client in a clinic reports difficulty falling asleep at night. Which bedtime snack should the nurse suggest?

   1. AA. A cup of warm milk and crackers
   2. BB. A small glass of cola with ice
   3. CC. A large cup of strong black tea
   4. DD. A large bowl of spicy beef chili
   Show answer to question 1

   Answer: A. A cup of warm milk and crackers

   Warm milk with a light carbohydrate is a commonly recommended bedtime snack that may promote relaxation and sleep without stimulating or upsetting the stomach.

   Why the other options are wrong

   • BCola usually contains caffeine, a stimulant that interferes with falling asleep.
   • CStrong black tea contains caffeine and can delay sleep onset.
   • DLarge, spicy meals at bedtime can cause heartburn and discomfort that disrupt sleep.

2. Question 2 of 25Medium

   The licensed practical nurse (LPN) is assisting a client with dysphagia after a stroke to eat lunch. Which instruction should the nurse reinforce with the client to decrease the risk of aspiration during swallowing?

   1. AA. Inhale deeply through the mouth immediately after swallowing.
   2. BB. Hyperextend the neck backward while swallowing liquids.
   3. CC. Turn the head toward the unaffected side during each bite.
   4. DD. Tilt the chin downward toward the chest when swallowing.
   Show answer to question 2

   Answer: D. Tilt the chin downward toward the chest when swallowing.

   Tucking the chin downward toward the chest widens the vallecular space and narrows the laryngeal entrance, which helps direct the bolus safely into the esophagus and protects the airway. Hyperextending the neck backward opens the laryngeal vestibule and significantly increases the risk of food or liquid entering the trachea.

3. Question 3 of 25Hard

   A client died 30 minutes ago in an acute care unit. The transport team arrives to take the body to the morgue, but the client's wife is at the bedside, crying quietly, and says she is not ready for him to be taken. Which action should the nurse take?

   1. AA. Escort the wife to the waiting room so postmortem care can start on schedule
   2. BB. Tell the wife that facility policy requires the body to be moved right away
   3. CC. Ask transport to wait and give the wife private time, offering to stay nearby
   4. DD. Hand the wife the release paperwork to complete while transport prepares him
   Show answer to question 3

   Answer: C. Ask transport to wait and give the wife private time, offering to stay nearby

   Allowing the family unhurried time with the body supports grieving and shows compassion, and transport can usually wait briefly. The nurse can stay if the wife wants company.

   Why the other options are wrong

   • ARemoving the wife from the bedside denies her time with her husband and adds to her distress.
   • BCiting policy rushes her and feels uncaring when a short delay is usually acceptable.
   • DPaperwork can wait and would distract her from grieving at an emotionally painful moment.

4. Question 4 of 25Medium

   A client with metastatic bone disease reports persistent, severe cancer pain. The client is prescribed scheduled extended-release morphine and immediate-release morphine for breakthrough pain. Which principle should guide the practical nurse's reinforcement of the client's pain plan?

   1. AA. Withhold the extended-release dose whenever the client reports zero pain at scheduled times.
   2. BB. Rely entirely on as-needed medications to minimize the development of drug tolerance.
   3. CC. Administer the scheduled opioid regularly to maintain steady therapeutic blood levels.
   4. DD. Avoid giving breakthrough medication within four hours of receiving a scheduled dose.
   Show answer to question 4

   Answer: C. Administer the scheduled opioid regularly to maintain steady therapeutic blood levels.

   Continuous, severe chronic pain in palliative care is best controlled by administering long-acting opioids on a regular around-the-clock schedule to maintain consistent analgesic levels and prevent pain recurrence. Withholding scheduled doses because the client is currently pain-free causes drug levels to drop and precipitates severe breakthrough pain.

5. Question 5 of 25Easy

   An 82-year-old resident of a long-term care facility tells the nurse that it takes a long time to fall asleep at night. Which action by the nurse is most likely to promote sleep?

   1. AA. Offer a cup of coffee after the evening meal so the resident can relax before bed
   2. BB. Encourage a long nap in the late afternoon so the resident feels more tired at night
   3. CC. Offer a warm, caffeine-free drink and help the resident follow the usual bedtime routine
   4. DD. Leave the bright overhead light and television news on until the resident falls asleep
   Show answer to question 5

   Answer: C. Offer a warm, caffeine-free drink and help the resident follow the usual bedtime routine

   A warm, caffeine-free drink and a familiar bedtime routine support relaxation and the client's usual sleep pattern, which are standard measures to promote sleep.

   Why the other options are wrong

   • ACoffee contains caffeine, a stimulant that delays sleep onset.
   • BLong late-afternoon naps reduce sleep drive and make nighttime sleep harder.
   • DBright light and stimulating news interfere with melatonin release and relaxation.

6. Question 6 of 25Medium

   A client in a long-term care facility has a reddened area on the sacrum that does not blanch when pressed, and the skin is intact. Which action by the assistive personnel requires the nurse to intervene?

   1. AA. Positioning the client in a 30-degree side-lying position
   2. BB. Placing a pillow between the client's knees when turned on the side
   3. CC. Using a lift sheet to move the client up in bed
   4. DD. Massaging the reddened area with lotion to increase circulation
   Show answer to question 6

   Answer: D. Massaging the reddened area with lotion to increase circulation

   Massaging reddened skin over a bony prominence can damage tissue already injured by pressure. The area should be kept free of pressure and the finding reported.

   Why the other options are wrong

   • AA 30-degree side-lying position keeps pressure off the sacrum and the trochanter, so it is appropriate.
   • BA pillow between the knees prevents skin-on-skin contact and supports alignment, so it is appropriate.
   • CA lift sheet reduces friction and shearing during repositioning, so it is appropriate.

7. Question 7 of 25Easy

   A client recovering from a stroke has weakness of the left leg and will use a cane. Which statement by the client shows correct understanding of cane use?

   1. AA. "I will hold the cane in my right hand and move it forward with my left foot."
   2. BB. "I will hold the cane in my left hand and move it forward with my right foot."
   3. CC. "I will hold the cane in my right hand and move it forward with my right foot."
   4. DD. "I will hold the cane in my left hand and move it forward with my left foot."
   Show answer to question 7

   Answer: A. "I will hold the cane in my right hand and move it forward with my left foot."

   The cane is held on the stronger side and moved forward with the weaker leg, so the cane and weak leg share the load together.

   Why the other options are wrong

   • BThe cane is held on the weak side, and it moves opposite the weak leg, which gives no support.
   • CMoving the cane with the strong leg leaves the weak leg unsupported when it bears weight.
   • DHolding the cane on the weak side does not support the weak leg and reduces stability.

8. Question 8 of 25Medium

   A 68-year-old man has left-sided weakness after a stroke. The nurse is helping him transfer from the bed to a chair. Which approach is best?

   1. AA. Place the chair on his left side and pull gently on his left arm
   2. BB. Place the chair on his left side and have him lead with the left leg
   3. CC. Place the chair on his right side and have him pivot on the stronger leg
   4. DD. Place the chair at the foot of the bed and lift under both armpits
   Show answer to question 8

   Answer: C. Place the chair on his right side and have him pivot on the stronger leg

   The chair is placed on the stronger (unaffected) side so the client can bear weight and pivot on the strong leg. This is safer for the client and the nurse.

   Why the other options are wrong

   • APulling on a weak, flaccid arm can dislocate or injure the shoulder, and moving toward the weak side is unsafe.
   • BLeading with the weak leg gives poor support and raises the risk of a fall.
   • DLifting under the armpits can injure the affected shoulder and strain the nurse, and it does not use the client's strength.

9. Question 9 of 25Hard

   In a long-term care facility, the nurse finds intact skin over the sacrum of a bedbound 82-year-old woman. The area is red and does not blanch with light pressure. The client receives tube feedings that require her head to be raised. Which intervention should the nurse include in the plan of care?

   1. AA. Massage the reddened sacral area firmly with lotion at the start of every shift
   2. BB. Place a ring cushion under the buttocks to relieve pressure directly on the sacrum
   3. CC. Keep the head of the bed elevated at 60 degrees at all times to aid digestion
   4. DD. Use 30-degree side-lying repositioning on a pressure-redistributing mattress
   Show answer to question 9

   Answer: D. Use 30-degree side-lying repositioning on a pressure-redistributing mattress

   Non-blanchable redness indicates a stage 1 pressure injury. Scheduled repositioning, a side-lying tilt that keeps weight off the sacrum, and a pressure-redistributing surface reduce pressure and shear.

   Why the other options are wrong

   • AMassaging reddened skin over a pressure area can damage fragile tissue and worsen the injury.
   • BRing or donut cushions concentrate pressure on surrounding tissue and reduce blood flow to the area.
   • CKeeping the head raised at a steep angle all the time increases sacral pressure and shear, so it should be raised only as needed for feedings.

10. Question 10 of 25Easy

    A client on the surgical unit has a prescription for knee-high graduated compression stockings. Which action by the nurse is correct when applying them?

    1. AA. Fold the top band down once so the stocking does not slip
    2. BB. Apply them while the legs are elevated and smooth out wrinkles
    3. CC. Apply them while the client stands so the legs are fully dependent
    4. DD. Leave them on continuously and skip skin checks until discharge
    Show answer to question 10

    Answer: B. Apply them while the legs are elevated and smooth out wrinkles

    Stockings are applied when the legs are elevated and venous blood has drained, and they must be smooth. This promotes venous return and prevents pressure areas from wrinkles.

    Why the other options are wrong

    • AA folded or rolled band acts like a tourniquet, restricts circulation and can injure the skin.
    • CApplying stockings over legs that are dependent and swollen traps blood and makes them less effective.
    • DStockings are removed periodically so the nurse can inspect the skin and circulation for problems.

11. Question 11 of 25Medium

    The practical nurse is caring for a client who is receiving continuous enteral nutrition through a small-bore nasogastric tube. To prevent tube occlusion, which action should the nurse take?

    1. AA. Flush the tube with 30 mL of sterile normal saline every 12 hours
    2. BB. Flush the tube with 30 mL of water every 4 hours during the infusion
    3. CC. Mix warm cranberry juice with the formula bag before hanging
    4. DD. Instill 15 mL of carbonated cola into the tube once per shift
    Show answer to question 11

    Answer: B. Flush the tube with 30 mL of water every 4 hours during the infusion

    Routine flushing with 30 mL of water every 4 to 6 hours maintains tube patency and clears formula residue that could cause clogging. Using carbonated soda or acidic cranberry juice is contraindicated because acidic fluids can curdle formula proteins and worsen obstructions. Flushing only every 12 hours is insufficient to maintain small-bore tube patency.

12. Question 12 of 25Medium

    The practical nurse is reinforcing teaching for a client newly prescribed a continuous positive airway pressure (CPAP) machine for obstructive sleep apnea. Which statement by the client indicates understanding of the instructions?

    1. AA. I must wear the mask every time I sleep, including during naps.
    2. BB. I will wash the mask cushion once a month using bleach.
    3. CC. I should adjust the air pressure setting if I still feel tired.
    4. DD. I will use the machine only on nights when I feel congested.
    Show answer to question 12

    Answer: A. I must wear the mask every time I sleep, including during naps.

    For continuous positive airway pressure therapy to be effective, the client must use the device consistently during all sleep episodes, including daytime naps, to maintain upper airway patency. Adjusting pressure settings should only be done by a healthcare provider after evaluation, and masks should be cleaned regularly with mild soap and warm water rather than harsh chemicals like bleach.

13. Question 13 of 25Medium

    A 59-year-old client of the Muslim faith has died in the hospital. The spouse tells the nurse that family members of the same sex traditionally wash the body. Which response by the nurse is best?

    1. AA. Explain that only licensed nursing staff may perform postmortem care
    2. BB. Ask the chaplain to decide which rituals are appropriate for the family
    3. CC. Complete routine postmortem care first, then tell the family what was done
    4. DD. Ask about the family's wishes and arrange their participation per policy
    Show answer to question 13

    Answer: D. Ask about the family's wishes and arrange their participation per policy

    Asking the family about their practices and helping them participate, while following infection control and facility policy, honors cultural and religious beliefs.

    Why the other options are wrong

    • AThis statement is inaccurate and dismisses a reasonable cultural request from the family.
    • BThe family knows their own traditions, so the chaplain may offer support but should not decide for them.
    • CCompleting care first removes the family's opportunity to perform their own rituals for the deceased.

14. Question 14 of 25Hard

    The licensed practical nurse (LPN) is monitoring a client who is using a continuous passive motion (CPM) device following a right total knee arthroplasty. Which action should the nurse take to ensure safe operation?

    1. AA. Place thick pillows under the frame to keep the machine tilted sideways.
    2. BB. Deactivate the device during scheduled periods of bed rest.
    3. CC. Confirm that the hinge of the machine is aligned with the client's knee joint.
    4. DD. Increase the programmed flexion angle whenever the client is resting.
    Show answer to question 14

    Answer: C. Confirm that the hinge of the machine is aligned with the client's knee joint.

    Proper alignment between the anatomical joint line and the mechanical hinge of the CPM machine is essential to prevent shearing forces and excessive strain on the surgical repair. The flexion and extension angles must follow the healthcare provider's specific orders rather than being changed arbitrarily, and the machine frame should remain flat and stable on the mattress.

15. Question 15 of 25Medium

    In a clinic, a 66-year-old man with chronic obstructive pulmonary disease reports that shortness of breath makes him too tired to finish meals, and he has lost weight. Which intervention should the nurse reinforce?

    1. AA. Eat three large meals a day so that fewer eating periods are needed
    2. BB. Eat small, frequent, nutrient-dense meals and rest before eating
    3. CC. Drink large amounts of fluid before and during meals to stay hydrated
    4. DD. Avoid snacks between meals so that appetite stays strong at mealtimes
    Show answer to question 15

    Answer: B. Eat small, frequent, nutrient-dense meals and rest before eating

    Small, frequent, nutrient-dense meals reduce the energy needed to eat and the pressure on the diaphragm, and resting first lessens dyspnea during meals. This supports weight maintenance.

    Why the other options are wrong

    • ALarge meals cause fullness and worsen dyspnea by pressing on the diaphragm.
    • CFluids with meals cause early fullness and reduce food intake.
    • DAvoiding snacks reduces total calories, which is harmful for a client who is losing weight.

16. Question 16 of 25Medium

    A nurse has completed postmortem care for a client who will be taken to the morgue. Which action best ensures proper identification of the body?

    1. AA. Verify the identification band and attach tags per policy to the body and outer wrap
    2. BB. Remove the client's identification band so it is not confused with the new tags
    3. CC. Write the client's name on the outer sheet with a marker and send the body to the morgue
    4. DD. Leave identification of the body to the morgue or funeral home staff on arrival
    Show answer to question 16

    Answer: A. Verify the identification band and attach tags per policy to the body and outer wrap

    The nurse verifies the client's identity and attaches identification, as policy directs, to the body and the outer covering so the body cannot be misidentified.

    Why the other options are wrong

    • BThe original identification band should stay on the body, and removing it eliminates a key identifier.
    • CA name written on the outer sheet alone can be separated from the body and is not an accepted identification method.
    • DThe nurse is responsible for completing identification before the body leaves the unit, not the receiving staff.

17. Question 17 of 25Easy

    A 24-year-old woman comes to an urgent care clinic one hour after twisting her ankle. The ankle is swollen and tender. Which intervention should the nurse implement?

    1. AA. Apply a cloth-covered cold pack for intervals and elevate the ankle
    2. BB. Apply a heating pad on a low setting and keep the ankle dependent
    3. CC. Have her soak the ankle in warm water for an extended period
    4. DD. Place ice directly on the skin continuously until the swelling resolves
    Show answer to question 17

    Answer: A. Apply a cloth-covered cold pack for intervals and elevate the ankle

    Cold applied intermittently with elevation constricts vessels and limits swelling and pain in the first period after an acute injury. A cloth barrier protects the skin.

    Why the other options are wrong

    • BHeat dilates vessels and increases swelling early after an injury, and a dependent limb adds to edema.
    • CA prolonged warm soak increases blood flow and swelling in an acute sprain.
    • DIce directly on skin for a continuous period can cause tissue damage such as frostbite.

18. Question 18 of 25Medium

    A home health nurse is reinforcing teaching with a 68-year-old woman who is 1 week past a total hip replacement. Which equipment should the nurse recommend to help her bathe and use the toilet safely?

    1. AA. A low shower stool and a short-handled brush for washing her feet
    2. BB. A shower chair with a handheld sprayer and a raised toilet seat
    3. CC. A low bathtub for soaking and a standard-height toilet seat
    4. DD. A step stool so she can reach items on the bathroom floor
    Show answer to question 18

    Answer: B. A shower chair with a handheld sprayer and a raised toilet seat

    A shower chair with a handheld sprayer and a raised toilet seat limit deep hip flexion and reduce the risk of falls and dislocation after hip replacement.

    Why the other options are wrong

    • AA low stool and short brush require bending the hip too far to reach the feet.
    • CGetting into and out of a low tub and sitting on a low toilet seat strain the new hip.
    • DStepping and reaching toward the floor increase the risks of falls and excessive hip flexion.

19. Question 19 of 25Hard

    A client on the first day after hip surgery is wearing sequential compression devices. While checking them, the nurse notes that the left calf is swollen, warm and painful. What is the nurse's best action?

    1. AA. Remove the device and massage the calf to improve circulation
    2. BB. Reapply the device more snugly and help the client to walk
    3. CC. Stop the device, keep the client at rest, and notify the RN
    4. DD. Apply a warm compress to the calf and recheck it in an hour
    Show answer to question 19

    Answer: C. Stop the device, keep the client at rest, and notify the RN

    Unilateral calf swelling, warmth and pain are cues for a possible deep vein thrombosis. Compression and activity could dislodge a clot, so the nurse stops them and reports to the RN or provider.

    Why the other options are wrong

    • AMassaging a calf with a possible clot can dislodge it and cause a pulmonary embolism.
    • BTighter compression and walking can move a clot, and the finding needs reporting rather than continued treatment.
    • DApplying warmth and waiting an hour delays reporting, and the finding needs prompt evaluation.

20. Question 20 of 25Easy

    A licensed practical nurse (LPN) is providing a back massage to promote sleep for a client on bed rest. Which massage stroke should the nurse use to begin and end the massage?

    1. AA. Long, smooth gliding strokes along the spine
    2. BB. Vigorous tapotement with cupped hands
    3. CC. Rapid friction rubs over bony prominences
    4. DD. Deep kneading of the subcutaneous tissue
    Show answer to question 20

    Answer: A. Long, smooth gliding strokes along the spine

    Effleurage involves long, smooth, gliding strokes that help relax muscles and distribute lotion, making it ideal for beginning and concluding a back massage. Kneading, also known as petrissage, is a deeper technique used during the middle of a massage rather than at the beginning or end. Vigorous tapotement and friction rubs can stimulate the nervous system rather than promote relaxation and rest.

21. Question 21 of 25Hard

    A nurse and an assistive personnel are helping a client who had a stroke to sit on the edge of the bed for the first time. The client becomes pale and diaphoretic and reports dizziness. The blood pressure is 86/50 mm Hg, down from 128/76 mm Hg when lying flat. Which action should the nurse take first?

    1. AA. Keep the client sitting upright and encourage slow deep breaths
    2. BB. Help the client lie flat, then recheck vital signs and report
    3. CC. Stand the client at the bedside to see if blood pressure improves
    4. DD. Ask the assistive personnel to move the client to the chair quickly
    Show answer to question 21

    Answer: B. Help the client lie flat, then recheck vital signs and report

    The findings indicate orthostatic hypotension with reduced cerebral perfusion. Lying the client flat restores blood flow to the brain and prevents fainting or a fall. The nurse then rechecks vital signs and reports the change.

    Why the other options are wrong

    • AStaying upright keeps blood pooled in the legs and risks fainting while the client has weakness from the stroke.
    • CStanding would further lower blood pressure and greatly increase the risk of a fall.
    • DMoving to the chair would extend the time upright with a low blood pressure and risk collapse during the transfer.

22. Question 22 of 25Hard

    A client dies at 0300 in a long-term care facility. The nurse has called the client's daughter, who is driving to the facility, and the nurse is the only licensed nurse on the unit. Which plan is best?

    1. AA. Escort the daughter to the room at once, before any preparation of the body
    2. BB. Prepare the body and the room, then greet the daughter, accompany her, and allow privacy
    3. CC. Have an assistive staff member meet the daughter and take her to the room alone
    4. DD. Ask the daughter to wait in the lobby until the funeral home has taken the body
    Show answer to question 22

    Answer: B. Prepare the body and the room, then greet the daughter, accompany her, and allow privacy

    Preparing the body and creating a calm, clean room before the family arrives promotes dignity. The nurse then offers presence, listens, and allows private time, which supports the grieving daughter.

    Why the other options are wrong

    • AShowing the daughter an unprepared body and room can add distress and does not respect the client's dignity.
    • CLeaving a newly bereaved family member without a nurse withholds emotional support and is not appropriate to delegate.
    • DKeeping the daughter away from the body denies her the opportunity to say goodbye.

23. Question 23 of 25Medium

    A client with expressive aphasia after a stroke uses a picture communication board in the long-term care facility. Which approach by the nurse is best?

    1. AA. Speak loudly and quickly so the client can follow each message
    2. BB. Finish the client's sentences to reduce the client's frustration
    3. CC. Keep the board with family and bring it out during visits only
    4. DD. Keep the board within reach and give the client time to point
    Show answer to question 23

    Answer: D. Keep the board within reach and give the client time to point

    Keeping the board within reach and allowing unhurried time supports independence and dignity. It also lets the client express needs accurately.

    Why the other options are wrong

    • AClients with expressive aphasia usually hear normally, and loud, fast speech adds stress and makes it harder to process the message.
    • BFinishing the client's sentences takes away the chance to communicate independently and can lead to wrong assumptions about the client's needs.
    • CThe client needs the board available at all times to express needs, so limiting it to family visits restricts communication with staff.

24. Question 24 of 25Hard

    During lunch in a long-term care facility, the nurse reviews the needs of four residents and plans to assign feeding help to an assistive personnel. Which resident should the nurse feed personally instead of assigning the task?

    1. AA. A resident with diabetes who needs the tray opened and the food cut up
    2. BB. A resident with mild dementia who eats without help but very slowly
    3. CC. A resident with arthritis who uses built-up utensils to feed himself
    4. DD. A resident with a recent stroke who coughs on thickened liquids
    Show answer to question 24

    Answer: D. A resident with a recent stroke who coughs on thickened liquids

    Coughing during intake signals an active risk of aspiration in a client whose condition may change. The nurse should do the feeding, observe swallowing, and report concerns to the RN or provider.

    Why the other options are wrong

    • AOpening the tray and cutting up food is a routine, stable task that assistive personnel can perform.
    • BStaying with a slow but independent eater is within the role of assistive personnel.
    • CHelping a stable client who self-feeds with adaptive utensils is a routine task suitable for assistive personnel.

25. Question 25 of 25Easy

    A nurse is applying a condom catheter to an uncircumcised male client who has urinary incontinence. Which action should the nurse take?

    1. AA. Secure the catheter sheath firmly to the shaft of the penis with non-elastic tape.
    2. BB. Leave the foreskin retracted behind the glans penis before unrolling the sheath.
    3. CC. Shave all pubic hair around the base of the penis before placing the sheath.
    4. DD. Leave 1 to 2 inches of space between the tip of the glans and the sheath end.
    Show answer to question 25

    Answer: D. Leave 1 to 2 inches of space between the tip of the glans and the sheath end.

    Leaving 1 to 2 inches (2.5 to 5 cm) of space between the tip of the glans and the end of the condom catheter allows adequate drainage of urine into the tubing and prevents moisture accumulation and skin breakdown on the glans. Leaving the foreskin retracted can cause severe swelling, constriction, and paraphimosis; the foreskin must remain in its natural anatomical position. Non-elastic tape must never be used because it can restrict blood flow and cause penile ischemia, and hair should be clipped rather than shaved to prevent skin micro-abrasions.

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