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NCLEX-RN category

NCLEX Basic Care and Comfort Practice Questions

Quick answer

Basic Care and Comfort is 6 to 12% of the NCLEX-RN, so expect somewhere between 5 and 18 questions. It covers the hands-on daily care a nurse gives or supervises: comfort measures, rest, elimination, hygiene, assistive devices, complementary therapies and care at the end of life.

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Most students skim this category because it sounds like nursing fundamentals from the first semester, and then they get caught by questions that look easy but have a clear best answer only if you know the standard. Enema position, water temperature for an older adult's bath, where a catheter bag hangs, how to position an unconscious client for mouth care. None of it is dramatic, but the exam writers like it because the answers are specific. The trap on this section is reaching for a medication or a provider call when the question is asking what the nurse can do with their own hands first. If an option is a simple, safe nursing measure that fits the situation, it usually beats the option that escalates. The ten questions below cover the parts of the category outside the nutrition and mobility pages, which each have their own set.

Practice questions

1

A client with a sprained ankle from a fall 6 hours ago asks the nurse what will help the pain and swelling. Which measure should the nurse recommend?

  1. AA warm compress applied for 20 minutes every 2 hours
  2. BAn ice pack wrapped in a towel for 20 minutes at a time
  3. CA heating pad kept on the ankle overnight
  4. DGentle range of motion exercises every hour
Show answer

Answer: B

Cold is the right choice in the first 24 to 48 hours after an acute injury. It constricts blood vessels, limits swelling and bleeding into the tissue, and numbs the area. The pack is wrapped and limited to about 20 minutes to protect the skin.

Why the others are wrong

Heat dilates vessels and increases swelling in a fresh injury, so it is saved for later when stiffness is the main problem. A heating pad left on overnight risks a burn on top of making the swelling worse. Moving a newly sprained joint every hour works against rest and can extend the injury.

2

An adult client on a medical unit says, "I have not slept well since I got here." Which suggestion by the nurse is most likely to improve the client's sleep?

  1. ATake a nap in the afternoon to make up the lost hours
  2. BKeep the same bedtime each night and limit caffeine after lunch
  3. CWatch television in bed until drowsy
  4. DAsk for a sleeping pill every night during the stay
Show answer

Answer: B

Sleep hygiene starts with a consistent schedule and removing stimulants late in the day. These are the measures with the best evidence and no side effects, and they are the first thing a nurse should try before medication.

Why the others are wrong

Daytime napping makes it harder to fall asleep at night and reinforces the cycle. Screens in bed delay sleep onset and tie the bed to wakefulness rather than sleep. Routine hypnotics carry fall and confusion risks and treat the symptom, not the cause.

3

A client who had a vaginal delivery 8 hours ago has not voided since the birth. The bladder is palpable above the symphysis pubis and the fundus is displaced to the right. What should the nurse do first?

  1. AInsert a straight catheter
  2. BNotify the provider
  3. CAssist the client to the bathroom and run warm water over the perineum
  4. DEncourage the client to drink 500 mL of water
Show answer

Answer: C

Urinary retention after delivery is common, and the first response is non-invasive. Sitting upright on the toilet, running water, and pouring warm water over the perineum relax the sphincter and often trigger voiding. Catheterization comes only if these fail.

Why the others are wrong

A straight catheter is invasive and carries infection risk, so it is not the first step when simpler measures have not been tried. The provider does not need a call before the nurse uses standard nursing measures. Adding fluid to an already full bladder makes the retention worse.

4

A home health nurse is teaching an 82 year old client about skin care. The client's skin is dry and flaky and the client reports soaking in a hot bath every evening for 30 minutes. Which teaching is correct?

  1. A"Keep the hot soaks but add a cup of bath oil to the water."
  2. B"Switch to short baths or showers in tepid water, pat dry, and apply a moisturizer while the skin is still damp."
  3. C"Use an antibacterial soap over the whole body every day to prevent skin infection."
  4. D"Rub the skin briskly with a towel to improve circulation."
Show answer

Answer: B

Aging skin has less oil and thinner layers, so long hot soaks strip it further. Tepid water, a shorter wash, patting dry and sealing in moisture with an emollient on damp skin is the standard advice.

Why the others are wrong

Bath oil does not undo the drying effect of prolonged hot water and makes the tub a fall hazard. Antibacterial soap is harsh and unnecessary on intact skin. Brisk rubbing creates friction damage on fragile skin and can cause tears.

5

The nurse is providing oral care for an unconscious client who has no artificial airway. Which action is correct?

  1. APlace the client in a side lying position with the head turned toward the mattress and have suction ready
  2. BRaise the head of the bed to 90 degrees and pour water into the mouth to rinse
  3. CUse a large amount of water on the toothbrush so the mouth is well rinsed
  4. DSkip brushing and use lemon-glycerin swabs only
Show answer

Answer: A

An unconscious client cannot protect the airway, so the mouth is cleaned with the client on the side, head turned so fluid drains out by gravity, with suction at the bedside. A small amount of water or oral rinse on a soft brush or swab is enough.

Why the others are wrong

Pouring water into the mouth of a client who cannot swallow invites aspiration, no matter how upright they are. Soaking the brush does the same thing. Lemon-glycerin swabs dry and irritate the mucosa and do not remove plaque, so brushing with a soft brush is still needed.

6

A client with a new hearing aid tells the nurse it whistles and the sound keeps fading. Which teaching is most appropriate?

  1. ATurn the volume all the way up to overcome the fading
  2. BCheck that the earmold is seated properly and the battery is fresh, and clean the device with a dry cloth
  3. CWash the hearing aid under running water each night
  4. DStore the hearing aid in the bathroom so it is handy in the morning
Show answer

Answer: B

Whistling (feedback) usually means the earmold is not fitted snugly or the volume is set too high, and fading sound usually means a dying battery or wax in the device. Checking fit, battery and cleanliness fixes most problems.

Why the others are wrong

Maximum volume increases feedback and can damage hearing. Water ruins the electronics. Bathrooms are humid, and moisture is one of the main reasons hearing aids fail.

7

A client with mild depression tells the nurse she takes St. John's wort "because it is natural" and has just been prescribed a daily oral contraceptive and a selective serotonin reuptake inhibitor. What is the nurse's best response?

  1. A"Natural products are safe to combine with prescription medications."
  2. B"St. John's wort can reduce the effect of your contraceptive and, combined with the antidepressant, raise your risk of serotonin syndrome, so we need to tell your provider before you take them together."
  3. C"Stop all three medications until you can see your provider."
  4. D"Take the St. John's wort at a different time of day from the other two."
Show answer

Answer: B

St. John's wort induces liver enzymes, which lowers blood levels of many drugs including oral contraceptives, and it has serotonergic activity that stacks with an SSRI. The nurse's job is to catch the interaction and get the provider involved before the combination is started.

Why the others are wrong

"Natural" does not mean free of interactions. Stopping prescribed medications without provider input is outside the nurse's role and could harm the client. Spacing the doses by a few hours does not change an enzyme-induction interaction or a serotonergic one.

8

The nurse is caring for a client with an indwelling urinary catheter. Which finding during rounds needs to be corrected?

  1. AThe drainage bag is hanging on the bed frame below the level of the bladder
  2. BThe catheter tubing is secured to the client's thigh with a securement device
  3. CThe drainage bag is resting on the client's abdomen while the client is turned
  4. DThe nurse cleans the perineal area and the catheter at the meatus with soap and water daily
Show answer

Answer: C

A bag above the level of the bladder lets urine flow back into the bladder, which is a direct route for infection. The bag must stay below the bladder at all times, including during turning and transport.

Why the others are wrong

Bag on the frame below the bladder is correct, as long as it is off the floor. Securing the tubing prevents tugging on the urethra and is expected. Routine perineal and meatal cleaning with soap and water is standard catheter care and reduces infection risk.

9

A hospitalized client is legally blind and newly admitted. Which nursing action best supports communication and safety for this client?

  1. ASpeak loudly and slowly so the client can follow
  2. BAnnounce yourself when entering, explain what you are about to do, and describe the room layout and where the call light is
  3. CRearrange the furniture so the path to the bathroom is shorter
  4. DKeep the room dark so the client is not bothered by glare
Show answer

Answer: B

A client with vision loss relies on verbal cues and a stable environment. Identifying yourself, narrating care before you touch the client, and orienting them to the room and call light reduces fear and prevents falls.

Why the others are wrong

Vision loss is not hearing loss, so raising your voice is unnecessary and can feel patronizing. Moving furniture after the client has learned the layout creates a fall hazard. Many clients with low vision use what sight they have, and adequate lighting helps rather than hurts.

10

A client with end stage cancer is receiving comfort care and is expected to die within days. The client is unresponsive, breathing is irregular, and the mouth is dry. The family asks what they can do. Which response by the nurse is best?

  1. A"There is nothing to do now except wait. We will call you when it is close."
  2. B"You can sit with him, talk to him, and help us moisten his lips and mouth. We will turn him every couple of hours to keep him comfortable."
  3. C"It is best to leave the room so he can rest without being disturbed."
  4. D"We will stop turning him now, since repositioning only causes discomfort at this stage."
Show answer

Answer: B

Comfort care continues right up to death: frequent mouth care, lip moisturizing, gentle repositioning to protect skin and ease breathing, and the presence of family. Hearing is thought to remain, so inviting family to talk and touch supports both the client and the people who love him.

Why the others are wrong

"Nothing to do" abandons the family and is untrue. Sending the family away removes the comfort of presence that most dying clients and families want. Repositioning is still done, gently and with analgesia timed before it, to prevent pressure injury and pooling of secretions.

Quick tips

  • Cold for the first 24 to 48 hours after an acute injury, heat for stiffness and chronic muscle pain. Both are wrapped and timed, never left on overnight.
  • Retention gets the simple measures first: upright position, running water, warm water over the perineum, privacy. A catheter is the fallback, not the opener.
  • Unconscious client and anything near the mouth means side lying, head turned, suction ready, and small amounts of fluid only.
  • Catheter bag below the bladder, off the floor, tubing secured, no dependent loops. If the question shows the bag above the bladder, that is the answer.
  • "Natural" supplements are still drugs on the exam. St. John's wort, ginkgo, garlic and ginseng all have interactions worth knowing.

Related topics

FAQ

What is covered in basic care and comfort on the NCLEX?

Non-pharmacological comfort measures, rest and sleep, elimination (including catheters, enemas and bladder or bowel retraining), personal hygiene and skin care, mobility and positioning, nutrition and hydration, assistive devices, complementary therapies and end of life comfort care.

How many basic care and comfort questions are on the NCLEX?

The category is 6 to 12% of the exam. On the minimum 85 question test that is roughly 5 to 10 questions, and on a longer test it can be up to 18. It is one of the smaller categories, but the questions tend to be ones you can get right with a little review.

Is basic care and comfort easy on the NCLEX?

The content is not hard, but the questions are specific. You need to know the exact standard (left Sims for an enema, bag below the bladder, tepid not hot water for older skin) rather than a general idea. Students lose these questions by guessing from common sense instead of from the standard.

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