{"id":13246,"date":"2016-12-15T13:10:10","date_gmt":"2016-12-15T18:10:10","guid":{"rendered":"http:\/\/www.kaptest.com\/blog\/prep\/?p=13246"},"modified":"2020-09-11T20:42:29","modified_gmt":"2020-09-11T20:42:29","slug":"nclex-question-strategies-positioning-questions","status":"publish","type":"post","link":"https:\/\/wpapp.kaptest.com\/study\/nclex\/nclex-question-strategies-positioning-questions\/","title":{"rendered":"NCLEX Question Strategies: Positioning Questions"},"content":{"rendered":"<p>Because many illnesses affect body alignment and mobility, you must be able to safely care for these clients in order to be an effective nurse. These topics are also important on the NCLEX- RN\u00ae exam. The successful test taker must correctly answer questions about impaired mobility and positioning.<br \/>\n<i>Immobility <\/i>occurs when a client is unable to move about freely and independently. To answer questions on positioning, you need to know the hazards of immobility, normal anatomy and physiology, and the terminology for positioning.<br \/>\nMany graduate nurses are not comfortable answering these questions because:<\/p>\n<ul>\n<li>They don\u2019t understand the \u201cwhys\u201d of positioning.<\/li>\n<li>They don\u2019t know the terminology.<\/li>\n<li>They have difficulty imagining the various positions.<\/li>\n<\/ul>\n<p>If you have difficulty answering positioning questions, the following strategy will assist you in selecting the correct answer.<br \/>\n<div  class='avia-image-container  av-styling-    avia-builder-el-0  el_before_av_iconlist  avia-builder-el-first  avia-align-center '  itemprop=\"image\" itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/ImageObject\"  ><div class='avia-image-container-inner'><div class='avia-image-overlay-wrap'><img class='wp-image-0 avia-img-lazy-loading-not-0 avia_image' src=\"https:\/\/www.kaptest.com\/blog\/prep\/wp-content\/uploads\/sites\/21\/2016\/12\/Screen-Shot-2016-12-12-at-12.00.18-PM.png\" alt='' title=''   itemprop=\"thumbnailUrl\"  \/><\/div><\/div><\/div><br \/>\n<div  class='avia-icon-list-container   avia-builder-el-1  el_after_av_image  el_before_av_heading '><ul class='avia-icon-list avia-icon-list-left av-iconlist-big avia_animate_when_almost_visible avia-iconlist-animate'>\n<li><div  class='iconlist_icon  avia-font-entypo-fontello'><span class='iconlist-char ' aria-hidden='true' data-av_icon='\ue816' data-av_iconfont='entypo-fontello'><\/span><\/div><article class=\"article-icon-entry \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='iconlist_content_wrap'><header class=\"entry-content-header\"><h4 class='av_iconlist_title iconlist_title   '  itemprop=\"headline\"  >Step 1<\/h4><\/header><div class='iconlist_content  '  itemprop=\"text\"  ><p>Decide if the position for the client is designed to prevent something or promote something.<\/p>\n<\/div><\/div><footer class=\"entry-footer\"><\/footer><\/article><div class='iconlist-timeline'><\/div><\/li>\n<li><div  class='iconlist_icon  avia-font-entypo-fontello'><span class='iconlist-char ' aria-hidden='true' data-av_icon='\ue816' data-av_iconfont='entypo-fontello'><\/span><\/div><article class=\"article-icon-entry \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='iconlist_content_wrap'><header class=\"entry-content-header\"><h4 class='av_iconlist_title iconlist_title   '  itemprop=\"headline\"  >Step 2<\/h4><\/header><div class='iconlist_content  '  itemprop=\"text\"  ><p>Identify what it is you are trying to prevent or promote.<\/p>\n<\/div><\/div><footer class=\"entry-footer\"><\/footer><\/article><div class='iconlist-timeline'><\/div><\/li>\n<li><div  class='iconlist_icon  avia-font-entypo-fontello'><span class='iconlist-char ' aria-hidden='true' data-av_icon='\ue816' data-av_iconfont='entypo-fontello'><\/span><\/div><article class=\"article-icon-entry \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='iconlist_content_wrap'><header class=\"entry-content-header\"><h4 class='av_iconlist_title iconlist_title   '  itemprop=\"headline\"  >Step 3<\/h4><\/header><div class='iconlist_content  '  itemprop=\"text\"  ><p>Think about anatomy, physiology, and pathophysiology (\u201cA&amp;P\u201d).<\/p>\n<\/div><\/div><footer class=\"entry-footer\"><\/footer><\/article><div class='iconlist-timeline'><\/div><\/li>\n<li><div  class='iconlist_icon  avia-font-entypo-fontello'><span class='iconlist-char ' aria-hidden='true' data-av_icon='\ue816' data-av_iconfont='entypo-fontello'><\/span><\/div><article class=\"article-icon-entry \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='iconlist_content_wrap'><header class=\"entry-content-header\"><h4 class='av_iconlist_title iconlist_title   '  itemprop=\"headline\"  >Step 4<\/h4><\/header><div class='iconlist_content  '  itemprop=\"text\"  ><p>Which position best accomplishes what you are trying to prevent or promote?<\/p>\n<\/div><\/div><footer class=\"entry-footer\"><\/footer><\/article><div class='iconlist-timeline'><\/div><\/li>\n<\/ul><\/div><br \/>\nDoes this sound a little confusing? Hang in there. Let\u2019s walk through a question using this\u00a0strategy.<br \/>\n<div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h3    avia-builder-el-2  el_after_av_iconlist  el_before_av_promobox  '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >Practice Question 1<\/h3><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><br \/>\n\t<div   class='av_promobox  avia-button-no   avia-builder-el-3  el_after_av_heading  el_before_av_heading '>\t\t<div class='avia-promocontent'><p>\nImmediately after a percutaneous liver biopsy, the nurse should place the client in which of the following positions?<br \/>\n1. Supine<br \/>\n2. Right side-lying<br \/>\n3. Left side-lying<br \/>\n4. Semi-Fowler\u2019s<\/p>\n<\/div><\/div><br \/>\nBefore you read the answers, let\u2019s go through the four steps outlined above.<br \/>\n<i>Step 1. <\/i>By positioning the client after a liver biopsy, are you trying to prevent something or promote something? Think about what you know about a liver biopsy. You position a client after this procedure to prevent something.<br \/>\n<i>Step 2. <\/i>What are you trying to prevent? The most serious and important complication after a percutaneous liver biopsy is hemorrhage.<br \/>\n<i>Step 3. <\/i>Think about the principles of anatomy, physiology, and pathophysiology. What do you do to prevent hemorrhage? You apply pressure. Where would you apply pressure? On the liver. Where is the liver? On the right side of the abdomen under the ribs.<br \/>\n<i>Step 4. <\/i>How should the client be positioned to prevent hemorrhage from the liver, which is on the right side of the body? Look at your answer choices.<br \/>\n(1) \u00a0Supine. If you lay the client flat on his back, no pressure will be applied to the right side. Eliminate.<br \/>\n(2) \u00a0Right side-lying. If you lay the client in a right side-lying position, will pressure be applied to the right side? Yes. Keep it in for consideration.<br \/>\n(3) \u00a0Left side-lying. No pressure is applied to the right side. Eliminate.<br \/>\n(4) \u00a0Semi-Fowler\u2019s. If you lay the client on his back with head partially elevated, no pressure is applied to the right side. Eliminate.<br \/>\nThe correct answer is (2). Some students select (3) because they don\u2019t know normal anatomy and physiology. Some students select (4) because semi-Fowler\u2019s position is used for a lot of reasons.<br \/>\nLet&#8217;s look at another question.<br \/>\n<div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h3    avia-builder-el-4  el_after_av_promobox  el_before_av_promobox  '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >Practice Question 2<\/h3><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><br \/>\n\t<div   class='av_promobox  avia-button-no   avia-builder-el-5  el_after_av_heading  el_before_av_heading '>\t\t<div class='avia-promocontent'><p>\nAn angiogram is scheduled for a client with decreased circulation in her right leg. After the angiogram, the nurse should place the client in which of the following positions?<br \/>\n1. Semi-Fowler\u2019s with right leg bent at the knee<br \/>\n2. Side-lying with a pillow between the knees<br \/>\n3. Supine with right leg extended<br \/>\n4. High Fowler\u2019s with right leg elevated<\/p>\n<\/div><\/div><br \/>\nLet\u2019s go through the steps.<br \/>\n<i>Step 1. <\/i>By positioning the client after an angiogram, are you trying to prevent something or promote something? You are trying to promote something.<br \/>\n<i>Step 2. <\/i>What are you trying to promote? Adequate circulation of the right leg.<br \/>\n<i>Step 3. <\/i>Thinkabouttheprinciplesofanatomy,physiology, and pathophysiology. What promotes adequate circulation in the right leg? Keeping the leg at or below the level of the heart so blood flow is not constricted.<br \/>\n<i>Step 4. <\/i>How will the client be positioned after an angiography to prevent constriction of vessels and keep the right leg at or below the level of the heart? Look at the answer choices.<br \/>\n(1) \u201cSemi-Fowler\u2019s with the right leg bent at the knee.\u201d The head of the bed is elevated 30\u201345 degrees in this position. The leg is lower than the heart. If the right leg is bent at the knee, this could constrict arterial blood flow. Eliminate.<br \/>\n(2) \u00a0\u201cSide-lying with a pillow between the knees.\u201d Use of a pillow in this position could create pressure points in the right leg. You don\u2019t want the knees bent. Eliminate.<br \/>\n(3) \u00a0\u201cSupine with the right leg extended.\u201d In this position, the leg is at the level of the heart. Circulation will not be constricted because the leg is straight. Keep for consideration.<br \/>\n(4) \u00a0\u201cHigh Fowler\u2019s with her right leg elevated.\u201d The head of the bed is elevated 60\u201390 degrees in this position. Elevating the leg promotes venous return. Eliminate.<br \/>\nThe correct answer is (3). The client is on bed rest for 8\u201312 hours in a supine position after an angiogram.<br \/>\nIf you didn\u2019t know the specific positioning needed after an angiogram, you can apply your knowledge to select the correct answer by just thinking about it.<br \/>\n<div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h3    avia-builder-el-6  el_after_av_promobox  el_before_av_sidebar  '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >Things to Remember<\/h3><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><br \/>\nEven if you didn\u2019t memorize what position to use before, during, and after a procedure, think about the question for a moment. You can figure out what position is needed.<br \/>\nYou cannot figure out the correct position if you do not know what the terms (such as\u00a0supine or Fowler\u2019s) mean.<br \/>\nYou cannot figure out a correct position if you do not know anatomy and physiology. If you\u00a0think the liver is on the left side of the body, you are in trouble!<br \/>\nYou cannot figure out a correct position if you do not know what you are trying to accomplish. If you couldn\u2019t remember that a complication after a liver biopsy is hemorrhage, you\u00a0will simply be taking a random guess at the correct answer.<br \/>\nIf you think in images, you should form a mental image of each position. Picture yourself\u00a0placing the client in each position, and then see if the position makes sense. Let\u2019s try another question using the strategies for positioning.<br \/>\n<div  class='avia-builder-widget-area clearfix  avia-builder-el-7  el_after_av_heading  avia-builder-el-last '><div id=\"text-78\" class=\"widget clearfix widget_text\">\t\t\t<div class=\"textwidget\"><p><span data-sumome-listbuilder-embed-id=\"ed685fed995ca0b14adea942b9321bfdb4da66714744f69d9ba773e8becb00b9\"><\/span><\/p>\n<\/div>\n\t\t<\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Because many illnesses affect body alignment and mobility, you must be able to safely care for these clients in order to be an effective nurse. These topics are also important on the NCLEX- RN\u00ae exam. The successful test taker must correctly answer questions about impaired mobility and positioning. Immobility occurs when a client is unable [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":26937,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[97],"tags":[],"_links":{"self":[{"href":"https:\/\/wpapp.kaptest.com\/study\/wp-json\/wp\/v2\/posts\/13246"}],"collection":[{"href":"https:\/\/wpapp.kaptest.com\/study\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wpapp.kaptest.com\/study\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wpapp.kaptest.com\/study\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/wpapp.kaptest.com\/study\/wp-json\/wp\/v2\/comments?post=13246"}],"version-history":[{"count":2,"href":"https:\/\/wpapp.kaptest.com\/study\/wp-json\/wp\/v2\/posts\/13246\/revisions"}],"predecessor-version":[{"id":36090,"href":"https:\/\/wpapp.kaptest.com\/study\/wp-json\/wp\/v2\/posts\/13246\/revisions\/36090"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/wpapp.kaptest.com\/study\/wp-json\/wp\/v2\/media\/26937"}],"wp:attachment":[{"href":"https:\/\/wpapp.kaptest.com\/study\/wp-json\/wp\/v2\/media?parent=13246"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wpapp.kaptest.com\/study\/wp-json\/wp\/v2\/categories?post=13246"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wpapp.kaptest.com\/study\/wp-json\/wp\/v2\/tags?post=13246"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}