NCLEX Basic Care and Comfort

Question 1 of 5

Following the change of shift report, the nurse should analyze the information and set priorities accordingly. When the plan has been formulated, at what point during the shift can or should the nurse's plan be altered or modified?

A. halfway through the shiftB. at the end of the shift before the nurse reports offC. when needs changeD. after the top-priority tasks have been completed

Correct Answer: C

Rationale: The nurse should modify the care plan whenever the client's needs change to ensure responsive and effective care, rather than at fixed times or only after completing tasks.

Question 2 of 5

The hydraulic lift (Hoyer lift) is:

A. used for all clients who've had orthopedic surgery.B. used for all clients who are not able to stand and for extremely obese clients.C. used for all clients, both old and young, in a hospital setting.D. not an assistive device for special needs.

Correct Answer: B

Rationale: The hydraulic lift is used for safe transfer when a client is not able to stand or is too heavy for the health care workers to lift safely.

Question 3 of 5

Hazards of improper splinting include:

A. aggravation of a bone or joint injuryB. reduced distal circulationC. delay in transport of a client with a life-threatening injuryD. all of the above

Correct Answer: D

Rationale: Improper splinting can worsen injuries, impair circulation, and delay critical transport, posing significant risks to the client.

Question 4 of 5

The client has dentures, including both upper and lower plates. Which technique should the nurse use to correctly perform oral hygiene for this client?

A. Wear sterile gloves to remove the lower plate first and then the upper plate.B. Use a foam swab to pry the upper and lower plates loose before removing these.C. Grasp the upper plate at the front teeth with a piece of gauze and move it prior to removal.D. Leave the dentures in the client's mouth and use a toothbrush to brush both denture plates.

Correct Answer: C

Rationale: C: Grasping the upper plate and moving it breaks the suction that holds the plate on the roof of the client's mouth. A: Removing denture plates is a clean procedure, and sterile gloves are not necessary. B: Removing the denture plates with a foam swab to pry the plate could injure the client. D: Dentures must be removed to properly clean the client's mouth and the dentures.

Question 5 of 5

The postoperative male client has been unable to urinate into the urinal while lying in bed. Which interventions are appropriate to promote voiding for this client who is to be discharged home within a few hours? Select all that apply.

A. Have the client apply an external condom catheter while lying flat in bedB. Assist the client to stand at the bedside to attempt to urinate in a urinal.C. Administer a prescribed analgesic if the client is experiencing pain.D. Turn on running water so it is heard while the client attempts to void.E. Ask the client to imagine being at home and voiding in his own bathroom.

Correct Answer: B,C,D,E

Rationale: B: Standing mimics normal voiding position. C: Pain relief aids relaxation for voiding. D: Running water stimulates the voiding reflex. E: Guided imagery promotes relaxation. A: Condom catheters manage incontinence, not promote voiding.

NCLEX Basic Care and Comfort | Nurselytic

Nurselytic

NCLEX-PN

NCLEX-PN