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Fundamentals of Nursing
NCLEX Practice Questions.
This is the first set of nursing practice questions about the fundamentals of
nursing. Nursing topics in this set include constipation, bowel elimination,
, Question 1
What is the most useful nursing intervention to correct skin dryness?
A. Consult the dietitian about increasing the patient’s fat intake, and take necessary
measures to prevent infection.
B. Ask the physician to refer the patient to a dermatologist, and suggest that the patient wear
home-laundered sleepwear.
C. Encourage the patient to increase his fluid intake, use non-irritating soap when
bathing the patient, and apply lotion to the involved areas.
D. Avoid bathing the patient until the condition is remedied, and notify the physician.
Correct Answer: C. Encourage the patient to increase his fluid intake, use non-
irritating soap when bathing the patient, and apply lotion to the involved areas.
Dry skin will eventually crack, ranking the patient more prone to infection. To prevent
this, the nurse should provide adequate hydration through fluid intake, use non
irritating soaps or no soap when bathing the patient, and lubricate the patient’s skin
with lotion. In most cases, dry skin responds well to lifestyle measures, such as using
moisturizers and avoiding long, hot showers and baths. Moisturizers provide a seal over
the skin to keep water from escaping. Apply moisturizer several times a day and after
bathing.
Creams or gentle skin cleansers and bath or shower gels with added moisturizers.
Choose mild soaps that have added oils and fats. Avoid deodorant and
antibacterial detergents, fragrance, and alcohol.
Option D: Bathing may be limited but need not be avoided entirely. Long
showers or baths and hot water remove oils from the skin. Limit baths or showers
to five to 10 minutes and use warm, not hot, water.
Option B: The attending physician and dietitian may be consulted for treatment,
but home-laundered items usually are not necessary. Natural fibers, such as
cotton and silk, allow the skin to breathe. But wool, although natural, can irritate
even normal skin. Wash clothes with detergents without dyes or perfumes, both
of which can irritate the skin.
Option C: Increasing fat intake is unnecessary. Hot, dry, indoor air can parch
sensitive skin and worsen itching and flaking. A portable home humidifier or one
attached to the furnace adds moisture to the air inside the home. Be sure to keep
the humidifier clean. It’s best to use cleansing
Question 2
, When bathing a patient’s extremities, the nurse should use long, firm strokes from the distal to
the proximal areas. This technique:
A. Provides an opportunity for skin assessment.
B. Avoids undue strain on the nurse.
C. Increases venous blood return.
D. Causes vasoconstriction and increases circulation.
Correct Answer: C. Increases venous blood return.
Washing from distal to proximal areas stimulates venous blood flow, thereby preventing venous
stasis. Good personal hygiene is essential for skin health but it also has an important role in
maintaining self-esteem and quality of life. Supporting patients to maintain personal hygiene is a
fundamental aspect of nursing care.
Option A: The nurse can assess the patient’s condition throughout the bath. Helping
patients to wash and dress is frequently delegated to junior staff, but time spent attending
to a patient’s hygiene needs is a valuable opportunity for nurses to carry out a holistic
assessment (Dougherty and Lister, 2015; Burns and Day, 2012). It also allows time to
address any concerns patients have and provides a valuable opportunity to assess the
condition of their skin.
Option B: The nurse should feel no strain while bathing the patient. Nurses should also
discuss with patients any religious and cultural issues relating to personal care
(Dougherty and Lister, 2015). For example, ideally, Muslim patients should be cared for
by a nurse of the same gender (Rassool, 2015), and Hindus may wish to wash before
prayer (Dougherty and Lister, 2015).
Option D: It improves circulation but does not result in vasoconstriction. Bed bathing is
not as effective as showering or bathing and should only be undertaken when there is no
alternative (Dougherty and Lister, 2015). If a bed bath is required, it is important to offer
patients the opportunity to participate in their own care, which helps to maintain their
independence, self-esteem and dignity.
Question 3
Vivid dreaming occurs in which stage of sleep?
A. Stage I non-REM
B. Rapid eye movement (REM) stage
C. Stage II non-REM
D. Delta stage
Correct Answer: B. Rapid eye movement (REM) stage
, Other characteristics of rapid eye movement (REM) sleep are deep sleep (the patient cannot be
awakened easily), depressed muscle tone, and possibly irregular heart and respiratory rates. This
is the stage associated with dreaming. Interestingly, the EEG is similar to an awake individual,
but the skeletal muscles are atonic and without movement. The exception is the eye and
diaphragmatic breathing muscles, which remain active. The breathing rate is altered though,
being more erratic and irregular. This stage usually starts 90 minutes after falling asleep, and
each of the REM cycles gets longer throughout the night. The first period typically lasts 10
minutes, and the final one can last up to an hour.
Option A: Non-REM sleep is a deep, restful sleep without dreaming. This is the lightest
stage of sleep and starts when more than 50% of the alpha waves are replaced with low-
amplitude mixed-frequency (LAMF) activity. There is muscle tone present in the skeletal
muscle and breathing tends to occur at a regular rate. This stage tends to last 1 to 5
minutes, consisting of around 5% of the total cycle.
Option C: This stage represents deeper sleep the heart rate and body temperature drop. It
is characterized by the presence of sleep spindles, K-complexes, or both. These sleep
spindles will activate the superior temporal gyri, anterior cingulated, insular cortices, and
the thalamus. The K-complexes show a transition into a deeper sleep. Stage 2 sleep lasts
around 25 minutes in the initial cycle and lengthens with each successive cycle,
eventually consisting of about 50% of total sleep.
Option D: Delta stage, or slow-wave sleep, occurs during non-REM Stages III and IV
and is often equated with quiet sleep. This is considered the deepest stage of sleep and is
characterized by a much slower frequency with high amplitude signals known as delta
waves. This stage is the most difficult to awaken from, and for some people, even loud
noises (over 100 decibels) will not awaken them. As people get older, they tend to spend
less time in this slow, delta wave sleep and more time stage N2 sleep. This is the stage
when the body repairs and regrows its tissues, builds bone and muscle, and strengthens
the immune system.
Question 4
The natural sedative in meat and milk products (especially warm milk) that can help induce sleep
is:
A. Flurazepam
B. Temazepam
C. Methotrimeprazine
D. Tryptophan
Correct Answer: D. Tryptophan
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