National Council Licensure Examination for Registered Nurses (NCLEX-RN) Physiological Integrity: Basic Care and Comfort Syllabus

Physiological Integrity: Basic Care and Comfort syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Physiological Integrity: Basic Care and Comfort in National Council Licensure Examination for Registered Nurses (NCLEX-RN), not a summary of it.

1. 1

   Activity, Mobility, and Rest

   4 topics

   • Mobility, immobility, and positioning
     • Complications of immobility and prevention
     • Range of motion and assistive devices
   • Rest and sleep
     • Sleep hygiene and sleep disturbances
   • Assistance with activities of daily living
   • Use of mobility and adaptive equipment
2. 2

   Nutrition and Oral Hydration

   4 topics

   • Nutritional assessment and balanced diet
     • Macronutrients, micronutrients, and food groups
     • Therapeutic and culturally appropriate diets
   • Enteral and parenteral nutrition
     • Tube feeding administration and verification
   • Hydration status and fluid intake
   • Dysphagia and aspiration precautions
3. 3

   Elimination and Comfort Measures

   4 topics

   • Bowel elimination
     • Constipation, diarrhea, and ostomy care
   • Urinary elimination
     • Catheter care and bladder retraining
   • Nonpharmacological comfort interventions
     • Positioning, relaxation, heat, and cold therapy
   • Complementary and alternative therapies

Physiological Integrity: Basic Care and Comfort flashcards for National Council Licensure Examination for Registered Nurses (NCLEX-RN)

18 of 52 cards from the Physiological Integrity: Basic Care and Comfort deck — real questions with worked answers.

1. What are the complications of immobility on the cardiovascular system?

   Orthostatic hypotension, increased cardiac workload, venous stasis leading to thrombus/DVT formation, and dependent edema.

2. What is the recommended frequency for repositioning a bedridden patient to prevent pressure injuries?

   At least every 2 hours; every 1 hour if seated in a chair.

3. Describe the Fowler's position and its primary clinical uses.

   Head of bed elevated 45-60 degrees (semi-Fowler's 30-45, high-Fowler's 60-90). Used to promote lung expansion, ease breathing, and reduce aspiration during/after feeding.

4. What position is used for a patient with hypovolemic shock or to promote venous return?

   Modified Trendelenburg / supine with legs elevated (the legs are raised while the trunk stays flat); classic head-down Trendelenburg is generally avoided.

5. What position is used to administer an enema or for rectal exams?

   Left lateral Sims' position, which follows the natural anatomy of the sigmoid colon and descending colon.

6. What musculoskeletal complications result from prolonged immobility?

   Muscle atrophy and weakness, disuse osteoporosis (bone demineralization), contractures, and foot drop.

7. List the stages of the normal sleep cycle.

   Non-REM stages N1 (light), N2, N3 (deep/slow-wave restorative sleep), followed by REM sleep (dreaming); one full cycle lasts about 90 minutes.

8. During which sleep stage does the body perform most physical restoration and tissue repair?

   N3 (deep/slow-wave sleep), when growth hormone is released and tissue repair occurs.

9. What are key nonpharmacological nursing interventions to promote sleep?

   Maintain consistent sleep schedule, reduce noise/light, limit caffeine and naps, provide comfort and quiet environment, cluster nighttime care to avoid interruptions, and encourage daytime activity.

10. Differentiate insomnia, narcolepsy, and sleep apnea.

    Insomnia = difficulty falling/staying asleep; narcolepsy = sudden uncontrollable daytime sleep attacks; sleep apnea = repeated cessation of breathing during sleep causing fragmented rest.

11. What does the acronym ADL stand for and give examples?

    Activities of Daily Living: bathing, dressing, grooming, toileting, feeding/eating, and transferring/ambulating.

12. What are instrumental activities of daily living (IADLs)?

    More complex self-care tasks needed for independent living: managing finances, medications, cooking, shopping, housekeeping, using transportation, and using the telephone.

13. When assisting a partially dependent patient with dressing, which extremity is dressed first?

    The affected (weak/impaired) extremity is dressed first; when undressing, the unaffected side is removed first ('dress the worst first, undress the best first').

14. How is a cane correctly used and sized for a patient?

    Hold the cane on the strong (unaffected) side; the cane and the weak leg move together. Elbow flexed ~15-30 degrees; cane tip ~6 inches to the side of the foot.

15. Describe correct crutch gait safety and fit.

    Weight is borne on the hands/handgrips, NOT the axillae (to avoid brachial nerve palsy). Crutch pads sit 2-3 fingerwidths below the axilla; elbows flexed ~30 degrees.

16. How should a walker be used to advance safely?

    Patient moves the walker forward a short distance, then steps into it; all four legs should be on the floor before bearing weight. Do not use on stairs.

17. When ascending and descending stairs with a cane or crutches, which leg leads?

    'Up with the good, down with the bad' — the strong/unaffected leg goes up first; the weak/affected leg (with the cane/crutch) goes down first.

18. What anthropometric measurements and labs are used in a nutritional assessment?

    Height, weight, BMI, weight history, mid-arm circumference, and skinfold thickness; labs include serum albumin, prealbumin (transthyretin), transferrin, and total lymphocyte count. Prealbumin best reflects recent status.

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