247SimpleTests
NCLEX · Basic Care and Comfort

When positioning a client who had a left-sided stroke resulting in right-sided hemiplegia (weakness/paralysis), which position is contraindicated?

Correct answer

Lying on the affected (right) side without adequate protection — the hemiplegic side has reduced sensation and reduced ability to reposition; lying directly on the affected extremities without padding and correct alignment can cause pressure injuries, joint damage, shoulder subluxation, and skin breakdown

  1. A Semi-Fowler's with right arm supported
  2. B Lying on the affected (right) side without adequate protection — the hemiplegic side has reduced sensation and reduced ability to reposition; lying directly on the affected extremities without padding and correct alignment can cause pressure injuries, joint damage, shoulder subluxation, and skin breakdown
  3. C Supine with foot board
  4. D Supported side-lying on the unaffected (left) side

Why this is the answer

HEMIPLEGIA POSITIONING: The AFFECTED SIDE requires special protection because: reduced or absent sensation (cannot feel pain from poor positioning); reduced motor function (cannot shift weight normally); increased muscle tone in abnormal patterns (spasticity); RISKS OF IMPROPER POSITIONING ON AFFECTED SIDE: SHOULDER SUBLUXATION: Shoulder joint may partially dislocate under the weight of the flaccid arm without support; use arm supports in sitting; CONTRACTURES: Without proper positioning and ranging, affected limbs contract in abnormal positions; PRESSURE INJURIES: Bony prominences on the affected side are at highest risk — use pressure-redistributing surfaces; CORRECT POSITIONING: Affected side up: use pillows to support arm in 90-degree shoulder abduction with elbow extended, wrist neutral; Affected side down (possible if turning): brief; requires full padding of shoulder, arm, knee, ankle; GENERAL PRINCIPLES: Neutral joint alignment; no dependent positioning of affected extremities; regular 2-hour repositioning; passive ROM; splints/positioning devices as ordered.
Source: NCLEX-PN Test Plan: Physiological — Hemiplegia Positioning

Practice more questions

This question is from our NCLEX Practice Tests practice test. Take the full practice test to test your knowledge across all Basic Care and Comfort and other topics.

Take the PN: Physiological Integrity practice test →

New to this exam? Our NCLEX exam guide explains the format, scoring, and how to prepare.

Related questions

Basic Care and Comfort

A nurse is performing range-of-motion (ROM) exercises with a client on bed rest. Which is the CORRECT technique?

 Basic Care and Comfort

A client is at risk for pressure injuries (pressure ulcers) due to prolonged bed rest. What is the PRIMARY nursing intervention?

 Basic Care and Comfort

A client with urinary incontinence requests a urinary catheter for comfort. Which response by the nurse is MOST appropriate?

 Basic Care and Comfort

A nurse is caring for a client with chronic pain. Which non-pharmacological pain management approach is MOST supported by evidence?

State-specific guides

Need information for your state? Our state guides cover local requirements, fees, and what to expect on exam day.

California Texas Florida New York Pennsylvania Illinois Ohio Georgia

Recommended study materials

Study guide

Saunders Comprehensive Review for NCLEX-RN 9th Ed. (Elsevier)

The gold standard for NCLEX-RN prep: 5,200+ practice questions, content review, test-taking strategy.

Check Price → Study guide

NCLEX-PN Prep Plus 2023 (Kaplan)

Targeted NCLEX-PN content review with hundreds of practice questions and video explanations.

Check Price → Study guide

Prioritization, Delegation & Assignment (Elsevier)

The leading resource for NCLEX questions on prioritization, delegation, and management of care.

Check Price →

As an Amazon Associate, CJ Affiliate, and AWIN publisher we earn from qualifying purchases. Links above are affiliate links. Full disclosure →