NCLEX Practice Exam for Patient Positioning

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1. Nurse Aaron is inserting a nasogastric tube to a stroke client. He understands that the best position for the insertion is?

1. Low Fowlers.
2. Sims position.
3. Trendelenburg.
4. High Fowlers.

2. Nurse Monica is handling a female client who had undergone a mastectomy. Which is the best position in which she should place the client?

1. Head of bed elevated at least 30° with the affected arm elevated on a pillow.
2. Forward side-lying position.
3. Supine position with the affected arm remain flat.
4. Head of bed elevated at least 30° with the unaffected arm elevated on a pillow.

3. A nurse is caring for a client with severe burns of the face and head. The nurse will place the client in which position?

1. Trendelenburg.
2. Head of bed elevated.
3. Supine position.
4. Prone position.

4. Which of the following does not match with the appropriate position?

1. Vaginal examination: lithotomy position.
2. Thyroidectomy: fowler’s position.
3. Hemorrhoidectomy: lateral position.
4. Hypophysectomy: Prone position.

5. Nurse Ian is handling a client with gastroesophageal reflux disease. Which of the following position will best help the client in this case?

1. Right Lateral Recumbent.
2. Supine position.
3. Reverse Trendelenburg position.
4. Sims position.

6. A client with pleural effusion is scheduled to have a thoracentesis. The nurse on duty will assists the client to which position during the procedure?

1. Lying in bed on the unaffected side with head of bed elevated about 45°.
2. Forward side lying position with head of bed flat.
3. Lying in bed on the affected side with head of bed elevated about 45°.
4. Supine position with both arms extended.

7. Nurse Maria is administering a cleansing enema to a client with severe constipation. She will place the client in which position?

1. Low fowlers position.
2. High fowlers position.
3. Left Sim’s position.
4. Right Sim’s position.

8. What type of client would benefit the most from an elevated head of the bed position?

1. Patient who had a hemorrhoidectomy.
2. Patient who had a laryngectomy.
3. Patient who had a liver biopsy.
4. Patient who had a lumbar puncture.

9. Nurse Justin is taking care a client with deep vein thrombosis. Which position should be provided to the client?

1. Bed rest with the affected extremity remain flat at all times.
2. Bed rest with the unaffected extremity on top of the affected extremity.
3. Bed rest with the affected extremity in a dependent position.
4. Bed rest with the affected extremity elevated.

10. Nurse Sandra had just received a postoperative total hip replacement client from the recovery unit. Which is the best position in which she should place the client?

1. Side-lying with the affected leg externally rotated.
2. Side-lying with the affected leg internally rotated.
3. On the nonoperative side with the legs abducted.
4. On the nonoperative side with the legs adducted.

11. A client has just returned to a nursing unit after a cardiac catheterization performed using the femoral artery. The nurse places the client in which position?

1. Bed rest with head elevation at 30°.
2. Bed rest with head elevation at 45°.
3. Bed rest with head elevation at 60°.
4. Bed rest with head elevation at 90°.

12. A nurse is preparing to care for a client who had undergone an above-knee amputation of the right leg. The nurse plans to allow which position for the client on the first 24 hours?

1. Supine position, with the affected limb flat on the bed.
2. Supine position, with the affected limb supported with pillows.
3. Prone position, with the affected limb on a dependent position.
4. Trendelenburg’s position.

13. A client is to be on a bed rest for 24 hours and the affected extremity is to be kept straight during this time. Which of the following procedure would require a client to do the above?

1. Varicose vein surgery.
2. Myelogram.
3. Abdominal aneurysm resection.
4. Arterial Vascular Grafting.

14. Which is the best position for a client with autonomic dysreflexia?

1. Sim’s Position.
2. Fowler’s Position.
3. Semi-Fowler’s Position.
4. High Fowler’s Position.

15. A nurse is caring for a client who has returned to the recovery unit following a craniotomy. The nurse can safely place the client in which of the position?

1. Trendelenburg position.
2. Fowler’s position with the head leaning on the left side.
3. Semi-fowlers position with the head in a midline position.
4. Supine position with the neck flexed.

Answers and Rationale

1. Answer: D. High Fowlers. The best position during a nasogastric tube insertion is sitting or High fowlers position in order to prevent the risk of aspiration.

2. Answer: A. Head of bed elevated at least 30°. Position a post-mastectomy client with the head of bed elevated at least 30 degrees, with the affected arm elevated on a pillow to promote lymphatic fluid return after the removal of axillary lymph nodes.

3. Answer: B. Head of bed elevated. For clients with burns on the face and head, the best position is to elevate the head of bed to reduce the occurence of facial edema.

4. Answer: D. Hypophysectomy: Prone position. Hypophysectomy is the surgical removal of the hypophysis (pituitary gland). After the surgery, the client head of bed is elevated to prevent increase intracranial pressure.

5. Answer: C. Reverse Trendelenburg position. Reverse Trendelenburg position is advised to a client  to promote gastric emptying and prevent gastroesophageal reflux.

6. Answer: A. Lying in bed on the unaffected side with head of bed elevated about 45°. During thoracentesis, to facilitate removal of pleural fluid from the pleural space, position the client sitting on the edge of the bed, leaning over a bedside table with the feet supported on a stool, or lying in bed on the unaffected side with head of bed elevated about 45°.

7. Answer: C. Left Sim’s position. During a cleansing enema, place the client in the left Sim’s position to allow the solution to flow by gravity in the natural direction of the colon.

8. Answer: B. Patient who had a laryngectomy. Place a post-laryngectomy client with head of bed elevated at 30-45 degrees to maintain a patent airway and reduce edema.

• Option A: Hemorrhoidectomy: Supine position.
• Option C: Liver biopsy: Right side-lying position.
• Option D: Lumbar puncture: Supine position for at least 4 hours.

9. Answer: D. Bed rest with the affected extremity elevated. Bed rest is indicated to prevent emboli while the elevation of the affected leg facilitates blood flow by the force of gravity and reduces pain and edema.

10. Answer: C. On the nonoperative side with the legs abducted. Abduction is maintained when the client is in a supine position or positioned on the non-operative side.

11. Answer: A. Bed rest with head elevation at 30°. During a cardiac catheterization, if the femoral artery was accessed for the procedure, the client is maintained on bed rest for 4 to 6 hours and the affected extremity is maintain straight and the head is elevated of no more than 30°.

12. Answer: B. Supine position, with the affected limb supported with pillows. The amputated limb is usually supported with pillows on the first post-op day to promote venous return and reduces edema.

13. Answer: D. Arterial Vascular Grafting. To promote graft patency after the procedure, bedrest is maintained for the first 24 hours and the affected extremity is kept straight.

14. Answer: D. High Fowler’s Position. Autonomic dysreflexia is a condition in which there is a sudden onset of excessively high blood pressure. If it occurs, immediately place the client in a high fowler’s position to promote adequate ventilation and assist in the prevention of a hypertensive stroke.

15. Answer: C. Semi-fowlers position with the head in a midline position. Post-craniotomy client should be placed in a semi-fowlers position and the head is in a midline position to facilitate venous drainage from the head.