NCLEX Comfort Care Pro questions
The PrepScore bank has 95 Comfort Care Pro questions, each with a rationale and two tags: the Client Needs category from the test plan and the clinical judgment step it tests. In this topic the items lean on Take action and Recognize cues, which is worth knowing before you practise it. Three worked samples are below, answers behind a reveal.
Practical mastery of basic care: pain non-pharm, sleep hygiene, pressure injury prevention, hydration/nutrition, end-of-life comfort, cultural + family-centered care.
Three worked questions
Q1. An 85-year-old male enrolled in hospice at home with end-stage COPD is in his last 24 hours of life. He develops air hunger with use of accessory muscles, RR 32, anxiety, and gripping the bed rail. SpO2 79% on his comfort-target 2 L NC. Family at bedside asking what to do. Which intervention is the PRIORITY?
- A. Administer low-dose morphine 2.5 mg PO sublingual, position him upright, point a fan toward his face, sit at the bedside, and reassure the family this addresses air hunger
- B. Initiate aggressive IV fluid resuscitation (500 mL bolus normal saline) to support cardiac output and address the perfusion-related dyspnea episode
- C. Perform vigorous oropharyngeal suctioning every 5 minutes to clear secretions before any other comfort-focused intervention is initiated tonight
- D. Encourage deep breathing exercises and instruct him on pursed-lip breathing technique to reduce his respiratory rate over the next 30 minutes
Show answer and rationale
Answer: Administer low-dose morphine 2.5 mg PO sublingual, position him upright, point a fan toward his face, sit at the bedside, and reassure the family this addresses air hunger
Terminal air hunger in hospice is treated with low-dose opioid (only intervention that durably reduces breathlessness sensation), upright position, fan airflow, and presence. IV fluids cause pulmonary edema; suctioning causes distress; deep breathing exercises are inappropriate in the active dying phase.
Q2. A 72-year-old female with metastatic ovarian cancer is being transferred from oncology to hospice care. The hospice nurse is reviewing care principles with the family and the inpatient hospice team. Which actions correctly reflect the principles of hospice care? Select all that apply.
- A. Focus on comfort and quality of life as the primary goal of care
- B. Provide patient- and family-centered care including emotional support
- C. Engage a multidisciplinary team (RN, MD, social worker, chaplain, aides)
- D. Provide bereavement support to the family after the patient's death
- E. Provide symptom management for pain, dyspnea, anxiety, and other distress
- F. Pursue aggressive curative interventions including chemotherapy in hospice care
Show answer and rationale
Answer: Focus on comfort and quality of life as the primary goal of careProvide patient- and family-centered care including emotional supportEngage a multidisciplinary team (RN, MD, social worker, chaplain, aides)Provide bereavement support to the family after the patient's deathProvide symptom management for pain, dyspnea, anxiety, and other distress
Hospice principles: comfort/quality focus, patient + family centered, multidisciplinary team, symptom management, bereavement support. Aggressive curative interventions (chemotherapy, intubation, ICU-level care) are NOT part of hospice — they contradict the comfort focus.
Q3. An 82-year-old female in the inpatient hospice unit with advanced dementia is in the active dying phase. She is non-verbal but observed moaning, grimacing, and restless body movements. She cannot self-report pain. Her current pain regimen is PRN morphine. Which nursing action is the PRIORITY?
- A. Use a validated behavioral pain scale (PAINAD) at rest and with movement, then transition the PRN morphine to scheduled dosing per provider order
- B. Wait until the patient verbalizes pain or specifically requests medication before administering any morphine for symptom relief in this case
- C. Withhold all opioid medication for the rest of her hospice stay to avoid the appearance of hastening her death at the end of life
- D. Offer warm tea or sips of water as the primary comfort measure and reassess pain status in the next 30 minutes of observation
Show answer and rationale
Answer: Use a validated behavioral pain scale (PAINAD) at rest and with movement, then transition the PRN morphine to scheduled dosing per provider order
Non-verbal hospice patients require behavioral pain assessment (PAINAD scored at rest AND with movement) plus scheduled (not PRN) opioid dosing. Waiting for verbalization in dementia guarantees under-treatment; withholding opioids violates hospice goals; warm tea is inadequate comfort.
The rules that decide these questions
From the pack's rule cards — the reasoning shortcuts a wrong answer usually means you were missing.
Elderly insomnia: non-pharm FIRST + address triggers + avoid Beers-list sedatives (diphenhydramine, benzo, zolpidem). Melatonin OK as adjunct.
Every opioid patient gets a bowel regimen ON DAY 1 — stimulant + softener combo. Don't wait for constipation.
PI prevention = Braden-guided bundle: reposition q2h + offload + nutrition + specialty surface + skin moisture control. Stage 1 reversible if pressure removed promptly.
Post-stroke = NPO until dysphagia screened. The 3-oz water bedside test is gatekeeper. Family preference does not override safety screen.
Multimodal pain = scheduled non-opioid (acetaminophen) + non-pharm (ice, position, distraction, relaxation) + opioid only as needed. Reduces sedation/constipation.
HF + dehydration = cautious fluid replacement (250-500 mL boluses, PO first) + close monitoring for overload. Never standard large bolus.
Practise the whole pack, tagged and explained
Every item carries its Client Needs category and clinical judgment step, so a wrong answer names the step that failed.
Frequently asked questions
How many Comfort Care Pro questions does the bank have?
95 multiple-choice items, plus 10 unfolding cases in the Comfort Care Pro pack, each with a rationale.
Are the samples real bank items?
Yes — the three questions above are drawn from the live bank, with their real rationales and tags.
Which clinical judgment steps does this topic train?
Most items in this topic test Take action and Recognize cues, though every step appears.
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