NCLEX Review Guide: Fundamentals - Comfort, Safety & Mobility, Psychosocial Comfort

Pain Assessment & Management

• Pain is the 5th vital sign and should be assessed using standardized scales (0-10 numeric, FACES, FLACC for pediatrics)
• Chronic pain differs from acute pain in duration (>3-6 months) and requires multimodal approach including non-pharmacological interventions
• Never delay pain medication administration - pain relief is a patient right and nursing responsibility

Fall Prevention & Patient Safety

• Falls are the leading cause of injury in healthcare settings, requiring systematic risk assessment using tools like Morse Fall Scale
• High-risk factors include age >65, history of falls, medications (sedatives, diuretics, antihypertensives), and cognitive impairment
• Implement fall precautions immediately for high-risk patients: bed in lowest position, call light within reach, non-slip socks

Safe Patient Transfer Steps

1. Assess patient's ability to assist and weight-bearing status
2. Gather appropriate equipment (gait belt, mechanical lift if needed)
3. Explain procedure and obtain patient cooperation
4. Use proper body mechanics - wide base of support, bend knees
5. Transfer toward patient's stronger side when possible

Therapeutic Communication & Emotional Support

• Therapeutic communication involves active listening, empathy, and non-judgmental responses to promote patient trust and healing
• Avoid communication blocks such as giving advice, false reassurance ("everything will be fine"), or changing the subject
• Reflection and clarification are key techniques to help patients express feelings and concerns effectively

Anxiety & Stress Management

• Anxiety manifests physically (increased HR, BP, diaphoresis) and psychologically (restlessness, difficulty concentrating)
• Severe anxiety can impair learning - provide information in small amounts and repeat as needed
• Implement relaxation techniques: deep breathing, progressive muscle relaxation, guided imagery, and mindfulness