Free NCLEX-PN Physiological Integrity – Basic Care and Comfort Practice Test – Part 1 (Updated 2026)

1. A client rates their pain as 8 on a scale of 0 to 10. Which action should the practical nurse take FIRST?

2. An older adult client with chronic arthritis pain states, “I don’t want to take pain pills because I’ll become addicted.” What is the BEST response by the practical nurse?

3. A client with postoperative pain is prescribed pain medication every 6 hours as needed. The client has been requesting medication every 4 hours and reporting inadequate relief. What should the practical nurse do?

4. Which pain assessment tool is MOST appropriate for a 4-year-old child who is crying and holding their abdomen?

5. A client with chronic lower back pain reports that heating pads provide better relief than pain medication. The client asks if they can use heat therapy at home. What instruction should the practical nurse provide?

6. A client with dementia is observed grimacing, guarding their right side, and becoming agitated when caregivers attempt to move them. Vital signs are stable. What is the PRIORITY action by the practical nurse?

7. A client from a culture where stoicism is valued reports minimal pain despite having major surgery yesterday. The client states, “Pain is something to endure.” What should the practical nurse consider?

8. A client receiving opioid pain medication has not had a bowel movement in 3 days. The client states they don’t want to take any more medication. What is the BEST action by the practical nurse?

9. Which documentation statement by the practical nurse BEST reflects appropriate pain assessment and intervention?

10. A client with chronic neuropathic pain from diabetes reports burning sensations in their feet. The client asks why regular pain medications don’t seem to help. What explanation should the practical nurse provide?

11. The PN is caring for a client receiving continuous enteral nutrition through a nasogastric (NG) tube. Before administering the scheduled feeding, which action should the PN take FIRST?

12. A 72-year-old client in a long-term care facility has been receiving tube feedings through a PEG tube for 3 weeks. The PN notes that the client’s urine output has decreased from 1,200 mL/day to 600 mL/day over the past 2 days, and the client appears lethargic. Which action should the PN take FIRST?

13. The PN is reviewing the dietary orders for a client with congestive heart failure (CHF). Which diet should the PN expect to be prescribed for this client?

14. The PN is preparing to administer medications through a client’s nasogastric tube. The client is receiving continuous enteral feedings. Which action should the PN take to prevent medication-nutrient interactions?

15. A client receiving total parenteral nutrition (TPN) through a central venous catheter develops a fever of 101.2°F, and the PN notices redness and tenderness at the catheter insertion site. Which action should the PN take FIRST?

16. The PN is calculating the intake for a client receiving enteral nutrition. Over the past 24 hours, the client received 1,500 mL of continuous tube feeding formula, 200 mL of water flushes, and 250 mL of IV fluids. The client’s urine output was 900 mL. What is the client’s total intake for the 24-hour period?

17. A client with chronic kidney disease (CKD) stage 4 is admitted to the skilled nursing facility. The PN reviews the dietary orders and expects which diet to be prescribed?

18. A 68-year-old client receiving intermittent enteral feedings through a PEG tube develops diarrhea after 4 days of feedings. The PN reviews the feeding schedule and notes that the feedings are being administered at room temperature and the rate has been stable. Which additional factor should the PN assess and report to the RN?

19. The PN is caring for a client who is NPO (nothing by mouth) and receiving IV fluids at 100 mL/hour. The PN notes that the client’s mucous membranes are dry, and the client reports feeling thirsty. The client’s daily weight has decreased by 1.5 kg since yesterday. Which finding should the PN report to the RN as MOST concerning?

20. The PN is teaching a client about a newly prescribed low-sodium diet. The client asks which foods should be limited. Which food item should the PN identify as highest in sodium?

21. The nurse is preparing to insert an indwelling urinary catheter for a female patient. Which catheter size is most appropriate for an average adult female?

22. The nurse is caring for a patient with an indwelling urinary catheter. The nurse observes that the drainage bag is lying on the floor beside the bed. Which action should the nurse take?

23. A 72-year-old female patient reports leaking small amounts of urine when she coughs, sneezes, or laughs. The nurse recognizes this as which type of urinary incontinence?

24. The nurse is caring for a 68-year-old male patient with benign prostatic hyperplasia (BPH) who has not voided in 8 hours following surgery. The nurse assesses the abdomen and notes a rounded, firm mass above the symphysis pubis. The patient reports feeling pressure but is unable to void. Which action should the nurse take first?

25. The nurse is teaching a female patient how to perform Kegel exercises. Which instruction is correct?

26. The nurse is collecting a clean-catch midstream urine specimen from a female patient. Which step indicates the patient needs additional teaching?

27. A patient has had an indwelling urinary catheter for 5 days. The nurse notes that the urine has become cloudy and has a strong odor. The patient’s temperature is 100.8°F (38.2°C). Which intervention is most important for the nurse to implement?

28. The nurse is caring for a patient who is recording intake and output. The patient voided 150 mL at 0800, 200 mL at 1200, and 180 mL at 1600. What is the patient’s total urine output for this 8-hour period?

29. The nurse is providing discharge teaching to a 65-year-old patient who experiences urge incontinence. Which statement by the patient indicates a need for additional teaching?

30. The nurse is inserting an indwelling urinary catheter in a male patient. After advancing the catheter 6-7 inches, urine does not appear. What is the most appropriate action?

31. The nurse is assessing a client’s new colostomy stoma. Which finding indicates a healthy stoma?

32. The nurse is teaching a client with a new ileostomy about expected stool characteristics. Which statement by the client indicates correct understanding of the teaching?

33. A client with a colostomy tells the nurse, “My stoma has gotten smaller since I came home from the hospital.” Which response by the nurse is most appropriate?

34. The nurse is caring for a 78-year-old client who has not had a bowel movement in four days. The client’s usual pattern is daily. The client is alert, oriented, and reports mild abdominal discomfort but denies nausea or vomiting. Abdominal assessment reveals hypoactive bowel sounds and a firm, distended abdomen. Which intervention should the nurse implement first?

35. The nurse is preparing to administer a cleansing enema to an adult client. Which action by the nurse demonstrates correct technique?

36. A client returns from surgery with a new sigmoid colostomy. The nurse observes the stoma is dark purple and the client reports severe abdominal pain that is worsening. Vital signs are: BP 102/68 mmHg, HR 112 bpm, RR 22/min, Temp 99.8°F (37.7°C). Which action should the nurse take first?

37. The nurse is teaching a client with chronic constipation about dietary modifications. Which breakfast menu selection indicates the client understands the teaching?

38. A client with an ostomy tells the nurse, “I’m afraid to go out because my pouch leaks at the most inconvenient times.” Which intervention should the nurse implement first?

39. The nurse is caring for a client with acute diarrhea who has had five liquid stools in the past eight hours. Which intervention is most important for the nurse to implement?

40. The nurse is caring for a client who had a colostomy placed in the transverse colon two days ago. The client asks, “When will my stool become formed again?” Which response by the nurse is most accurate?

41. A client has been on bed rest for 5 days. Which complication of immobility should the LPN monitor for MOST closely?

42. An LPN is assessing a client’s sacral area and notes a non-blanchable red area that is intact. How should the LPN document this finding?

43. An LPN is caring for a client with a Braden Scale score of 12. What is the priority nursing intervention?

44. Which type of range of motion (ROM) exercise should the LPN perform for a client who is unable to move their limbs independently?

45. A client who has had a stroke asks the LPN why they need to do range of motion exercises. What is the LPN’s best response?

46. An LPN is positioning a client with difficulty breathing. Which position should the LPN use to MAXIMIZE lung expansion?

47. An LPN is caring for a bedridden client. The client suddenly complains of calf pain, and the LPN notes the calf is warm, red, and swollen. What is the LPN’s priority action?

48. Which exercise should the LPN teach a bedridden client to perform independently to maintain muscle strength?

49. An LPN is assisting a client with ambulation using a walker. What instruction should the LPN give to the client?

50. An LPN is applying antiembolic stockings (TED hose) to a client. Which action by the LPN indicates correct technique?