NCLEX-RN · Client-needs page 5 · 3 min read

NCLEX-RN client-needs category for 6 to 12% of items: activities of daily living, mobility and assistive devices, skin integrity, elimination, nutrition and tube feeding, sleep, pain and nonpharmacological comfort. What it covers, how it is tested, a worked example and the usual traps.

What this category covers

Basic Care and Comfort is the hands-on care that keeps a client comfortable and functioning. It makes up 6 to 12% of scored items in the 2026 test plan.

The activity list covers, in short:

• Daily living: assessing and assisting with activities of daily living, dignity and privacy during care, postmortem care.
• Mobility: assistive devices and positioning for physical or sensory impairment, orthopedic devices, range of motion and measures that promote circulation.
• Skin: skin assessment and keeping skin and tissue intact.
• Elimination and intake: bowel and bladder changes, intake and output, irrigations (bladder, ear, eye).
• Nutrition: nutritional status and feeding through tubes.
• Rest and comfort: sleep and rest patterns, pain assessment, nonpharmacological comfort measures, complementary therapies and their benefits and risks.

How it is usually tested

Expect select-all-that-apply items on safe technique (for example with a walker, a cane or a tube feeding), ordered-response items for the steps of a procedure, single-answer items on the best position or the first action, and highlight items on which findings in a skin or nutrition assessment need follow-up.

Worked example (our own)

A client receives a continuous feeding through a nasogastric tube. Which actions lower the client's risk of aspiration? Select all that apply.

1. Keep the head of the bed raised at least 30 degrees during the feeding and for a time afterward.
2. Lay the client flat for bathing while the feeding continues.
3. Check tube placement before giving medications and at the intervals the facility's policy sets.
4. Watch for coughing, breathing difficulty or a change in oxygen saturation.
5. Increase the feeding rate to finish sooner if the client feels full.

Answer: 1, 3 and 4. Keeping the head raised (30 to 45 degrees) uses gravity to keep the formula in the stomach. Placement is confirmed by x-ray when the tube is first inserted, then checked by the external mark and the facility's method before use. Coughing or breathing changes during a feed can mean aspiration, so the feed is stopped and the client assessed. Lying flat with the feed running (2) invites reflux; the feed is paused first. Speeding up the rate (5) when a client already feels full raises the risk of vomiting.

Common pitfalls

• Walking aids the wrong way round. A cane goes on the stronger side and moves with the weaker leg; with a walker, move the walker, then the weaker leg, then the stronger leg.
• Skipping the pain reassessment. Pain is what the client says it is; reassess after every intervention, drug or not.
• Massaging reddened skin. Over a bony prominence it can damage tissue further; relieve pressure and reposition instead.
• Forgetting that complementary therapies interact. Ask about supplements; some, such as St. John's wort, change how prescribed drugs work.
• Dignity as an afterthought. Privacy and dignity are part of the care, including after death.

Category names and percentage ranges: NCSBN, 2026 NCLEX-RN Test Plan (effective April 1, 2026 to March 31, 2029). Portions copyrighted by the National Council of State Boards of Nursing, Inc. All rights reserved. Explanations and examples are our own.