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Home » My Account » NCLEX-RN Physiological Adaptation Exam

NCLEX-RN Physiological Adaptation Exam

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Question 1 of 20

1. Question

A client with history of primary adrenal insufficiency presents to the emergency department complaining of muscle weakness, dizziness, nausea, and vomiting. The nurse suspects that the client is experiencing Addisonian crisis.

> Which clinical manifestation(s) is strongly supportive of this crisis?

1. Increased irritability and confusion
Correct Incorrect Correct answer

2. Severe headache and facial flushing
Correct Incorrect Correct answer

3. Anxiety and hypertension
Correct Incorrect Correct answer

4. Sudden onset of severe abdominal pain
Correct Incorrect Correct answer

Correct

Incorrect
Question 2 of 20

2. Question

A nurse is caring for a client with cirrhosis. During the morning assessment, the nurse notices that the client has developed asterixis and seems confused. The nurse strongly suspects the onset of hepatic encephalopathy and anticipates an order to change the client’s diet.

> Which dietary modification is necessary in the client with hepatic encephalopathy?

1. Limited fat and carbohydrate intake
Correct Incorrect Correct answer

2. Increased intake of potassium rich foods
Correct Incorrect Correct answer

3. Limited protein intake
Correct Incorrect Correct answer

4. Increased calorie intake with high-protein ketogenic diet
Correct Incorrect Correct answer

Correct

Incorrect
Question 3 of 20

3. Question

A client has just been given news of a cancer diagnosis and is very upset. The nurse is providing emotional support and notes that the client’s respiratory rate is increased at 24 breaths per minute, pulse is 116 beats per minute, blood pressure is 140/96 (increased from baseline), and pupils are dilated.

> Which physiological response is being stimulated?

1. Reflexive response of the vagus nerve
Correct Incorrect Correct answer

2. Activation of the sympathetic nervous system
Correct Incorrect Correct answer

3. Initiation of the somatic nervous system
Correct Incorrect Correct answer

4. Triggering of the parasympathetic nervous system
Correct Incorrect Correct answer

Correct

Incorrect
Question 4 of 20

4. Question

A client newly diagnosed with endometriosis asks the nurse for clarification about the disorder.

> Which statements accurately describe endometriosis? Select all that apply.

1. It involves tissue similar to the uterine lining growing outside the uterus
Correct Incorrect Correct answer

2. It commonly causes painful intercourse
Correct Incorrect Correct answer

3. It results in permanent infertility in all affected clients
Correct Incorrect Correct answer

4. It is associated with painful menstrual periods
Correct Incorrect Correct answer

5. It refers to ovulatory pain occurring mid-cycle
Correct Incorrect Correct answer

Correct / 3 Points

Incorrect / 3 Points
Question 5 of 20

5. Question

The nurse is teaching a client with hypophosphatemia about dietary management.

> Which food item should the client avoid?

1. Baked fish
Correct Incorrect Correct answer

2. Roasted chicken
Correct Incorrect Correct answer

3. Liver
Correct Incorrect Correct answer

4. Cheese
Correct Incorrect Correct answer

Correct

Incorrect
Question 6 of 20

6. Question

A 2-year-old child is brought to the emergency department 6 hours after ingesting an unknown quantity of aspirin. The child is hyperventilating, lethargic, and has a significantly altered mental status.

> Which arterial blood gas result most strongly supports late-stage salicylate toxicity?

1. pH 7.48, PCO₂ 58 mm Hg, HCO₃ 32 mEq/L
Correct Incorrect Correct answer

2. pH 7.52, PCO₂ 25 mm Hg, HCO₃ 20 mEq/L
Correct Incorrect Correct answer

3. pH 7.24, PCO₂ 22 mm Hg, HCO₃ 12 mEq/L
Correct Incorrect Correct answer

4. pH 7.36, PCO₂ 50 mm Hg, HCO₃ 29 mEq/L
Correct Incorrect Correct answer

Correct

Incorrect
Question 7 of 20

7. Question

While assessing a client with acute pancreatitis, the nurse observes bluish discoloration and ecchymosis around the umbilical area.

> How should the nurse document this finding?

1. Brudzinski’s sign
Correct Incorrect Correct answer

2. Grey Turner’s sign
Correct Incorrect Correct answer

3. Cullen’s sign
Correct Incorrect Correct answer

4. Kernig’s sign
Correct Incorrect Correct answer

Correct

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Question 8 of 20

8. Question

The nurse is assessing a client following surgical removal of an adrenal gland.

> Which finding would the nurse monitor for most closely?

1. Manifestations of hypovolemia
Correct Incorrect Correct answer

2. Peripheral fluid retention
Correct Incorrect Correct answer

3. Protrusion of the eyes
Correct Incorrect Correct answer

4. Signs of low serum calcium
Correct Incorrect Correct answer

Correct

Incorrect
Question 9 of 20

9. Question

A client is admitted after sustaining a hip fracture from a fall.

> Which assessment finding would the nurse most likely note in the affected extremity?

1. Shortening with abduction
Correct Incorrect Correct answer

2. Shortening with external rotation
Correct Incorrect Correct answer

3. Abduction with internal rotation
Correct Incorrect Correct answer

4. Shortening with internal rotation
Correct Incorrect Correct answer

Correct

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Question 10 of 20

10. Question

A client receiving peritoneal dialysis asks why glucose is included in the dialysate solution.

> Which explanation should the nurse provide about the purpose of glucose in the solution?

1. It increases osmotic pressure to promote ultrafiltration
Correct Incorrect Correct answer

2. It lowers the client’s risk for developing peritonitis
Correct Incorrect Correct answer

3. It prevents glucose loss from the client’s bloodstream
Correct Incorrect Correct answer

4. It prevents disequilibrium syndrome
Correct Incorrect Correct answer

Correct

Incorrect
Question 11 of 20

11. Question

The nurse is reviewing client assignments on a medical-surgical unit.

> Which clients are most likely to require total parenteral nutrition (TPN)? Select all that apply.

1. A client recovering from an uncomplicated laparoscopic cholecystectomy
Correct Incorrect Correct answer

2. A client with a severe flare of Crohn’s disease
Correct Incorrect Correct answer

3. A client with advanced cancer complicated by sepsis
Correct Incorrect Correct answer

4. A client with persistent chemotherapy-induced vomiting
Correct Incorrect Correct answer

5. A client with extensive full-thickness burns
Correct Incorrect Correct answer

Correct / 4 Points

Incorrect / 4 Points
Question 12 of 20

12. Question

A pregnant client at 28 weeks’ gestation is diagnosed with symphysis pubis dysfunction.

> The nurse explains that increased joint laxity during pregnancy is caused by which hormones? Select all that apply.

1. Cortisol
Correct Incorrect Correct answer

2. Aldosterone
Correct Incorrect Correct answer

3. Relaxin
Correct Incorrect Correct answer

4. Progesterone
Correct Incorrect Correct answer

5. Testosterone
Correct Incorrect Correct answer

Correct / 2 Points

Incorrect / 2 Points
Question 13 of 20

13. Question

A client with a closed head injury is being monitored for secondary brain injury over the next 48 hours.

> Which findings are manifestations of secondary brain injury? Select all that apply.

1. Hypoxia
Correct Incorrect Correct answer

2. Hypotension
Correct Incorrect Correct answer

3. Fever
Correct Incorrect Correct answer

4. Seizures
Correct Incorrect Correct answer

5. Ischemia
Correct Incorrect Correct answer

6. Increased intracranial pressure (ICP)
Correct Incorrect Correct answer

Correct / 3 Points

Incorrect / 3 Points
Question 14 of 20

14. Question

A laboring client with placental separation begins to show signs of abnormal bleeding. Laboratory studies are pending, and the nurse is closely monitoring for a possible coagulopathy.

> Which assessment findings would most strongly support the development of disseminated intravascular coagulation (DIC)? Select all that apply.

1. Blood-tinged urine
Correct Incorrect Correct answer

2. Pinpoint skin hemorrhages
Correct Incorrect Correct answer

3. Firm, tender swelling in one calf
Correct Incorrect Correct answer

4. Prolonged coagulation studies
Correct Incorrect Correct answer

5. Persistent bleeding at venipuncture sites
Correct Incorrect Correct answer

6. Elevated platelet count
Correct Incorrect Correct answer

Correct / 4 Points

Incorrect / 4 Points
Question 15 of 20

15. Question

A client with untreated hyperthyroidism is admitted after developing sudden worsening symptoms following an infection.

> Which findings would alert the nurse to a life-threatening complication? Select all that apply.

1. Persistent nausea or vomiting
Correct Incorrect Correct answer

2. Marked lethargy with cold intolerance
Correct Incorrect Correct answer

3. Slow heart rate
Correct Incorrect Correct answer

4. High fever
Correct Incorrect Correct answer

5. Tremor with severe agitation
Correct Incorrect Correct answer

6. New confusion or delirium
Correct Incorrect Correct answer

Correct / 4 Points

Incorrect / 4 Points
Question 16 of 20

16. Question

A client reports low back pain that radiates down the posterior aspect of one leg and occasionally feels worse after certain daily activities.

> Which factor would the nurse expect to aggravate this type of pain?

1. Gentle heat application
Correct Incorrect Correct answer

2. Bending forward to lift an object
Correct Incorrect Correct answer

3. Resting in a side-lying position
Correct Incorrect Correct answer

4. Taking an NSAID with food
Correct Incorrect Correct answer

Correct

Incorrect
Question 17 of 20

17. Question

A nurse is assessing a client with suspected stimulant toxicity after using amphetamines.

> Which assessment finding would the nurse most expect?

1. Bradypnea
Correct Incorrect Correct answer

2. Hypertension
Correct Incorrect Correct answer

3. Hypothermia
Correct Incorrect Correct answer

4. Bradycardia
Correct Incorrect Correct answer

Correct

Incorrect
Question 18 of 20

18. Question

A client in the first trimester is being followed for iron deficiency anemia and asks how they will know if the condition is improving.

> Which finding suggests the anemia has not yet resolved?

1. Daily fatigue with frequent headaches
Correct Incorrect Correct answer

2. Increased vaginal discharge
Correct Incorrect Correct answer

3. Increased urinary frequency
Correct Incorrect Correct answer

4. Pink oral mucous membranes on exam
Correct Incorrect Correct answer

Correct

Incorrect
Question 19 of 20

19. Question

The emergency department is notified that a client is arriving with severe anaphylaxis and worsening respiratory symptoms. The nurse prepares the room.

> Which intervention should be performed first on arrival?

1. Call a rapid response team
Correct Incorrect Correct answer

2. Start an IV for rapid fluid infusion
Correct Incorrect Correct answer

3. Assess airway patency and breathing status
Correct Incorrect Correct answer

4. Document and monitor the client’s response
Correct Incorrect Correct answer

Correct

Incorrect
Question 20 of 20

20. Question

A child is admitted with persistent vomiting for two days and minimal oral intake.

> Which problem is the child at greatest risk for developing?

1. Diarrhea
Correct Incorrect Correct answer

2. Metabolic alkalosis
Correct Incorrect Correct answer

3. Metabolic acidosis
Correct Incorrect Correct answer

4. Hyperactive bowel sounds
Correct Incorrect Correct answer

Correct

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