A client being admitted tells the nurse, "I'm transgender. My name is Alex and I use he/him pronouns," although the chart shows a different legal name. What should the nurse do?

Use the name Alex and he/him, and record this in the chart

Avoid using any name or pronouns when speaking with him

Ask the family which name they would like the staff to use for him

Use the legal name on the chart to avoid any mistakes

A 34-year-old client on a ventilator in the ICU has died after a traumatic brain injury. The family is at the bedside. Which action by the nurse is required first under US hospital rules on organ and tissue donation?

Notify the organ procurement organization per policy

Wait for the family to raise the subject of donation

Ask the family right away whether they will donate his organs

Remove the ventilator so the family can say goodbye

At 2200 on a surgical unit, four clients each have a comfort-related concern. Whose concern needs the nurse's attention first?

A client given IV hydromorphone 30 minutes ago, hard to rouse, RR 8/min

A client who says he could not sleep at all last night

A client with chronic back pain who asks for a heating pad

A client 1 day after knee surgery who rates pain 8/10 and asks for medicine

A client died unexpectedly 6 hours after a fall on the unit. The death has been referred to the medical examiner. How should the nurse prepare the body?

Leave all tubes, lines and dressings in place

Remove all tubes and replace them with dressings

Wash the body fully before the family's visit

Remove the IV catheters but leave the urinary catheter

For a client who is alert and able to communicate, the most reliable indicator of the presence and intensity of pain is the:

Client's own report of the pain

Change in heart rate and blood pressure

Nurse's observation of facial grimacing

Type of surgery the client has had

Pain, rest, nonpharmacological and complementary comfort

50 NCLEX-RN practice questions on Pain, rest, nonpharmacological and complementary comfort, part of Basic Care and Comfort. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Medium
A client being admitted tells the nurse, "I'm transgender. My name is Alex and I use he/him pronouns," although the chart shows a different legal name. What should the nurse do?
1. AUse the name Alex and he/him, and record this in the chart
2. BAvoid using any name or pronouns when speaking with him
3. CAsk the family which name they would like the staff to use for him
4. DUse the legal name on the chart to avoid any mistakes
Show answerHide answer
Answer: A · Use the name Alex and he/him, and record this in the chart
Unbiased, respectful care regardless of gender identity is part of the NCLEX test plan. Using the client's stated name and pronouns respects his dignity and builds trust. The nurse records the preferred name and pronouns so all staff use them, while two identifiers are still used for safety checks. This item tests taking action.
- B: Avoiding his name is impersonal and does not respect his request.
- C: The adult client, not the family, decides how he is addressed.
- D: Using the legal name against his wishes is disrespectful; identifiers are checked separately.
Question 2 · Hard
A 34-year-old client on a ventilator in the ICU has died after a traumatic brain injury. The family is at the bedside. Which action by the nurse is required first under US hospital rules on organ and tissue donation?
1. ANotify the organ procurement organization per policy
2. BWait for the family to raise the subject of donation
3. CAsk the family right away whether they will donate his organs
4. DRemove the ventilator so the family can say goodbye
Show answerHide answer
Answer: A · Notify the organ procurement organization per policy
Federal Medicare conditions of participation require hospitals to refer every death and imminent death promptly to the organ procurement organization (OPO). The OPO decides suitability, and a trained requester approaches the family, which raises consent rates. The bedside nurse supports the family while the referral happens. This item tests taking action.
- B: Waiting for the family to ask breaks the required referral process.
- C: Asking the family is done by a trained requester after the OPO referral.
- D: Removing support too early may rule out donation of some organs.
Question 3 · Hard
At 2200 on a surgical unit, four clients each have a comfort-related concern. Whose concern needs the nurse's attention first?
1. AA client who says he could not sleep at all last night
2. BA client with chronic back pain who asks for a heating pad
3. CA client 1 day after knee surgery who rates pain 8/10 and asks for medicine
4. DA client given IV hydromorphone 30 minutes ago, hard to rouse, RR 8/min
Show answerHide answer
Answer: D · A client given IV hydromorphone 30 minutes ago, hard to rouse, RR 8/min
A client who is difficult to rouse with a respiratory rate of 8 after an IV opioid has opioid-induced sedation and respiratory depression, which can lead to respiratory arrest. The nurse stays, stimulates the client, supports breathing and prepares naloxone. Severe pain, a heating pad and poor sleep are real needs, but they are not immediately life-threatening. This item tests prioritising hypotheses.
- A: Poor sleep matters but is not an immediate safety threat.
- B: A comfort measure for chronic pain can wait.
- C: Severe pain needs prompt treatment but is not life-threatening.
Question 4 · Hard
A client died unexpectedly 6 hours after a fall on the unit. The death has been referred to the medical examiner. How should the nurse prepare the body?
1. ALeave all tubes, lines and dressings in place
2. BRemove all tubes and replace them with dressings
3. CWash the body fully before the family's visit
4. DRemove the IV catheters but leave the urinary catheter
Show answerHide answer
Answer: A · Leave all tubes, lines and dressings in place
When a death is a medical examiner (coroner) case, the body is evidence. All tubes, lines, drains and dressings stay in place exactly as they are, and the nurse follows policy on bagging the client's belongings. Removing devices or washing the body could destroy evidence about the cause of death. The family may still view the body as allowed. This item tests taking action.
- B: Removing tubes alters evidence the examiner needs.
- C: Full washing could remove evidence.
- D: Removing some devices also alters evidence.
Question 5 · Easy
For a client who is alert and able to communicate, the most reliable indicator of the presence and intensity of pain is the:
1. AChange in heart rate and blood pressure
2. BClient's own report of the pain
3. CNurse's observation of facial grimacing
4. DType of surgery the client has had
Show answerHide answer
Answer: B · Client's own report of the pain
Pain is whatever the person experiencing it says it is. Self-report is the gold standard for clients who can communicate, and the nurse accepts it without judging. Vital signs and behaviour vary widely and often return to baseline even when pain continues. This item tests recognising cues.
- A: Vital signs adapt and can be normal despite severe pain.
- C: Behaviour is used when self-report is not possible; it is less reliable.
- D: Pain varies widely between people having the same surgery.
Question 6 · Medium
A client scheduled for elective hip surgery in 3 weeks takes garlic, ginseng and ginkgo supplements daily. What should the nurse tell the client?
1. AContinue them as usual because herbal products are natural
2. BTell the surgeon, who may ask you to stop them about 2 weeks before
3. CStop them on the morning of surgery only
4. DDouble the dose to boost your immune system
Answer and explanation in LearnFree account
Question 7 · Medium
A 76-year-old client says she now wakes several times a night and does not sleep as deeply as she did when she was younger. The nurse explains that a normal sleep change with aging is:
1. AA complete loss of REM sleep after age 70
2. BMore time in deep stage N3 sleep each night
3. CA longer total sleep time with fewer awakenings
4. DLess time in deep stage N3 sleep, with more night waking
Answer and explanation in LearnFree account
Question 8 · Hard
A postoperative client receiving oral oxycodone every 4 hours is frequently drowsy and drifts off to sleep in the middle of conversation, but wakes when spoken to. RR 12/min, SpO2 94% on room air. Pasero Opioid-Induced Sedation Scale (POSS): 3. The next dose is due now. What should the nurse do?
1. AHold the dose and monitor sedation and breathing closely
2. BGive the dose as scheduled and recheck in 4 hours
3. CGive naloxone IV and call the rapid response team
4. DLet the client sleep and turn off the pulse oximeter alarm
Answer and explanation in LearnFree account
Question 9 · Medium
A nurse gives morphine 2 mg IV for postoperative pain rated 7/10. When should the nurse reassess the client's pain and sedation level?
1. AIn 2 hours
2. BIn 60 to 90 minutes
3. CAt the next scheduled vital signs
4. DIn 15 to 30 minutes
Answer and explanation in LearnFree account
Question 10 · Easy
For an adult with advanced dementia who cannot reliably rate pain, the nurse can best assess pain with the:
1. ANumeric rating scale
2. BBraden scale
3. CPAINAD scale
4. DGlasgow Coma Scale
Answer and explanation in LearnFree account
Question 11 · Medium
A client who takes sertraline for depression says she plans to add St. John's wort to help her mood. Which effect is the nurse most concerned about?
1. AHypertensive crisis
2. BSerotonin syndrome
3. CBleeding tendency
4. DSevere hypoglycemia
Answer and explanation in LearnFree account
Question 12 · Medium
A client with chronic low back pain will use a heating pad at home. Which client statement shows a need for further teaching?
1. A"I'll lie on the heating pad so it stays in place."
2. B"I'll use it for about 20 to 30 minutes at a time."
3. C"I'll check my skin for any redness every few minutes."
4. D"I'll put a cloth cover between the pad and my skin."
Answer and explanation in LearnFree account
Question 13 · Medium
A client on long-term warfarin lists the supplements she takes. Which one should the nurse report to the health care provider because it raises the risk of bleeding?
1. AVitamin B12
2. BGinkgo biloba
3. CCalcium carbonate
4. DLactobacillus probiotic
Answer and explanation in LearnFree account
Question 14 · Medium
A 5-year-old child is shown the Wong-Baker FACES scale after a tonsillectomy and points to the face labelled "hurts whole lot." On the 0-10 scale, this face corresponds to a score of:
1. A10
2. B8
3. C4
4. D6
Answer and explanation in LearnFree account
Question 15 · Hard
A client with type 2 diabetes says, "I read that cinnamon lowers blood sugar, so I'm going to stop my metformin and just take cinnamon capsules." Which response by the nurse is best?
1. A"You can stop metformin if you check your blood sugar once a week."
2. B"Cinnamon works just as well as metformin does, so that sounds like a good plan."
3. C"Herbal products are dangerous, so you should never take cinnamon."
4. D"Let's talk about it, and check with your provider before stopping metformin."
Answer and explanation in LearnFree account
Question 16 · Hard
A client with chronic insomnia has received teaching on stimulus control. Which client statement shows the teaching was understood?
1. A"I'll go to bed earlier on the nights after a poor sleep."
2. B"If I'm awake after about 20 minutes, I'll get up and read quietly."
3. C"I'll lie in bed until I fall asleep, however long it takes."
4. D"I'll watch television in bed each night to help my busy mind slow down."
Answer and explanation in LearnFree account
Question 17 · Medium
A client twisted an ankle playing soccer 2 hours ago. The ankle is swollen and painful, with no deformity. Which comfort measure should the nurse recommend first?
1. AA warm, moist pack wrapped around the ankle
2. BA heating pad set on high while sleeping
3. CAn ice pack wrapped in a towel for 15-20 minutes
4. DGentle massage of the swollen ankle
Answer and explanation in LearnFree account
Question 18 · Medium
A family member asks to massage the legs of a client on bed rest who has calf swelling and tenderness and is waiting for a venous Doppler study. The nurse should respond:
1. A"Gentle massage is fine for him as long as it does not hurt him."
2. B"Please don't massage his legs until a clot is ruled out."
3. C"Massage the calves firmly to help the swelling go down."
4. D"Massaging with warm lotion will help to relax the muscles."
Answer and explanation in LearnFree account
Question 19 · Hard
Six months after a kidney transplant, a client on cyclosporine has a trough cyclosporine level below the target range and a serum creatinine that has risen from 1.2 to 1.9 mg/dL. He says he started taking St. John's wort 3 weeks ago for low mood. Which conclusion is most likely?
1. AThe herb has raised his cyclosporine level into a toxic range
2. BThe herb is causing serotonin syndrome affecting the kidneys
3. CThe herb has no effect, so the rise in creatinine is unrelated
4. DThe herb has lowered his cyclosporine level, risking rejection
Answer and explanation in LearnFree account
Question 20 · Hard
A 45-year-old client has had nausea and fatigue for 2 weeks. Her sclerae are yellow, and her ALT is 410 units/L (reference 7-56 units/L). She takes no prescription drugs and drinks no alcohol, but she has used kava extract for anxiety for 3 months. Which nursing action is most appropriate?
1. AReassure her that herbal products like kava do not affect the liver
2. BAdvise her to double the kava dose to ease her anxiety
3. CReport the kava use as a likely cause of liver injury
4. DTell her to switch from kava extract to kava tea
Answer and explanation in LearnFree account
Question 21 · Hard
At handoff, the night nurse says about a client with a fractured femur, "People from his background always exaggerate pain, so I gave him half of the prescribed dose." The client now rates his pain 9/10. What is the oncoming nurse's priority action?
1. AGive half of the prescribed dose, as the night nurse did
2. BDocument the night nurse's comment in the client's chart
3. CAsk his family whether he usually overstates his pain
4. DAssess his pain and treat it as prescribed, based on his own report
Answer and explanation in LearnFree account
Question 22 · Medium
A hospitalized client says he never gets more than an hour of sleep at a time because of night-time care. Which nursing action best promotes his rest?
1. AGive vital signs and medications at separate times through the night
2. BWake him every 2 hours to ask whether he is resting
3. CCluster care to allow periods of at least 90 minutes without waking
4. DKeep the room lights on dimly so staff can check on him
Answer and explanation in LearnFree account
Question 23 · Medium
The nurse teaches a client about a transcutaneous electrical nerve stimulation (TENS) unit for chronic knee pain. Which client statement shows a need for further teaching?
1. A"My pacemaker will not be affected by the TENS unit."
2. B"I will feel a tingling or buzzing sensation when it is on."
3. C"I will not use the unit while I am driving my car to work."
4. D"I will place the electrodes on clean, unbroken skin."
Answer and explanation in LearnFree account
Question 24 · Medium
A client who had abdominal surgery yesterday is talking and laughing with visitors. When asked, the client rates the pain as 8 on a 0-10 scale. What should the nurse do?
1. AWait until the visitors leave and then ask again
2. BTell the client the rating does not match how they appear
3. CAccept the rating and offer the prescribed analgesic
4. DRecord the pain as 3, based on the client's behavior
Answer and explanation in LearnFree account
Question 25 · Easy
The nurse teaches sleep hygiene to a client with insomnia. Which advice is correct?
1. AExercise hard for an hour just before bedtime
2. BDrink a cup of coffee after dinner to relax
3. CGet up at the same time every day, including weekends
4. DTake a long nap in the late afternoon most days
Answer and explanation in LearnFree account

25 more Pain, rest, nonpharmacological and complementary comfort questions

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Pain, rest, nonpharmacological and complementary comfort

A client being admitted tells the nurse, "I'm transgender. My name is Alex and I use he/him pronouns," although the chart shows a different legal name. What should the nurse do?

A 34-year-old client on a ventilator in the ICU has died after a traumatic brain injury. The family is at the bedside. Which action by the nurse is required first under US hospital rules on organ and tissue donation?

At 2200 on a surgical unit, four clients each have a comfort-related concern. Whose concern needs the nurse's attention first?

A client died unexpectedly 6 hours after a fall on the unit. The death has been referred to the medical examiner. How should the nurse prepare the body?

For a client who is alert and able to communicate, the most reliable indicator of the presence and intensity of pain is the:

A client scheduled for elective hip surgery in 3 weeks takes garlic, ginseng and ginkgo supplements daily. What should the nurse tell the client?

A 76-year-old client says she now wakes several times a night and does not sleep as deeply as she did when she was younger. The nurse explains that a normal sleep change with aging is:

A postoperative client receiving oral oxycodone every 4 hours is frequently drowsy and drifts off to sleep in the middle of conversation, but wakes when spoken to. RR 12/min, SpO2 94% on room air. Pasero Opioid-Induced Sedation Scale (POSS): 3. The next dose is due now. What should the nurse do?

A nurse gives morphine 2 mg IV for postoperative pain rated 7/10. When should the nurse reassess the client's pain and sedation level?

For an adult with advanced dementia who cannot reliably rate pain, the nurse can best assess pain with the:

A client who takes sertraline for depression says she plans to add St. John's wort to help her mood. Which effect is the nurse most concerned about?

A client with chronic low back pain will use a heating pad at home. Which client statement shows a need for further teaching?

A client on long-term warfarin lists the supplements she takes. Which one should the nurse report to the health care provider because it raises the risk of bleeding?

A 5-year-old child is shown the Wong-Baker FACES scale after a tonsillectomy and points to the face labelled "hurts whole lot." On the 0-10 scale, this face corresponds to a score of:

A client with type 2 diabetes says, "I read that cinnamon lowers blood sugar, so I'm going to stop my metformin and just take cinnamon capsules." Which response by the nurse is best?

A client with chronic insomnia has received teaching on stimulus control. Which client statement shows the teaching was understood?

A client twisted an ankle playing soccer 2 hours ago. The ankle is swollen and painful, with no deformity. Which comfort measure should the nurse recommend first?

A family member asks to massage the legs of a client on bed rest who has calf swelling and tenderness and is waiting for a venous Doppler study. The nurse should respond:

Six months after a kidney transplant, a client on cyclosporine has a trough cyclosporine level below the target range and a serum creatinine that has risen from 1.2 to 1.9 mg/dL. He says he started taking St. John's wort 3 weeks ago for low mood. Which conclusion is most likely?

A 45-year-old client has had nausea and fatigue for 2 weeks. Her sclerae are yellow, and her ALT is 410 units/L (reference 7-56 units/L). She takes no prescription drugs and drinks no alcohol, but she has used kava extract for anxiety for 3 months. Which nursing action is most appropriate?

At handoff, the night nurse says about a client with a fractured femur, "People from his background always exaggerate pain, so I gave him half of the prescribed dose." The client now rates his pain 9/10. What is the oncoming nurse's priority action?

A hospitalized client says he never gets more than an hour of sleep at a time because of night-time care. Which nursing action best promotes his rest?

The nurse teaches a client about a transcutaneous electrical nerve stimulation (TENS) unit for chronic knee pain. Which client statement shows a need for further teaching?

A client who had abdominal surgery yesterday is talking and laughing with visitors. When asked, the client rates the pain as 8 on a 0-10 scale. What should the nurse do?

The nurse teaches sleep hygiene to a client with insomnia. Which advice is correct?