Preparing for the NCLEX can feel overwhelming, especially when it comes to mastering Physiological Integrity. This domain tests your ability to provide safe and effective care to promote physical health and wellness.
To help you strengthen this area, here are 15 NCLEX-style physiological questions with rationales—a perfect way to review, test your knowledge, and understand the “why” behind each correct answer.
1. Which assignment should not be performed by a licensed practical nurse (LPN)?
- A. Discontinue a nasogastric tube
- B. Start a blood transfusion
- C. Insert a Foley catheter
- D. Obtain a sputum specimen
✅ Correct Answer: B. Start a blood transfusion
Rationale: Starting blood transfusions requires an RN because it involves initiating therapy that has a high potential for adverse reactions. LPNs may monitor and report, but they cannot initiate.
2. Which finding in a newborn should be reported immediately?
- A. Absent femoral pulses
- B. Acrocyanosis
- C. Harlequin sign
- D. Acyanosis
✅ Correct Answer: A. Absent femoral pulses
Rationale: Absent femoral pulses may indicate congenital heart defects such as coarctation of the aorta and require immediate evaluation.
3. A 71-year-old recovering from a stroke is showing signs of unilateral neglect. Which observation supports this?
- A. Unable to distinguish between two tactile stimuli simultaneously
- B. Unable to carry out cognitive and motor activity at the same time
- C. Shaves only one side of his face
- D. Turns head side to side during vision test
✅ Correct Answer: C. Shaves only one side of his face
Rationale: Unilateral neglect means the client fails to recognize one side of the body, often due to right-sided brain injury. Shaving only one side indicates neglect of the opposite side.
4. A child with an ankle sprain is discharged. Which instruction promotes healing?
- A. Apply cold compress to the affected area
- B. Keep extremity in a dependent position
- C. Apply a hot compress
- D. Restrict activity until swelling resolves
✅ Correct Answer: A. Apply cold compress
Rationale: Cold reduces swelling and inflammation by causing vasoconstriction during the first 24–48 hours post-injury.
5. Which statement from a mother of an eight-month-old infant is most concerning?
“My baby…”
- A. Cries all day at the sitter’s
- B. Is teething and running a fever
- C. Doesn’t pay much attention to loud noises
- D. Throws both arms forward when held
✅ Correct Answer: C. Doesn’t pay much attention to loud noises
Rationale: Lack of response to sound may indicate hearing loss and requires further evaluation.
6. What confirms proper PICC line placement in a 12-year-old after insertion?
- A. Aspirate for blood return
- B. Auscultate for a bruit
- C. Take a chest X-ray
- D. Measure external catheter length
✅ Correct Answer: C. Take a chest X-ray
Rationale: A chest X-ray is the most reliable way to confirm PICC tip placement before use.
7. Important discharge teaching for a child with sickle cell anemia includes:
- A. Increase fluid intake
- B. Increase fat intake
- C. Monitor bowel movements closely
- D. Serve leafy greens daily
✅ Correct Answer: A. Increase fluid intake
Rationale: Adequate hydration prevents sickling by reducing blood viscosity and improving circulation.
8. To assess ear infection symptoms in a 2-year-old, the best question is:
- A. Does your child’s ear hurt?
- B. Does your child have hearing problems?
- C. Does your child tug at either ear?
- D. Does anyone in your family have hearing problems?
✅ Correct Answer: C. Does your child tug at either ear?
Rationale: Toddlers may tug at or rub their ears when experiencing pain or infection, as they cannot always verbalize discomfort.
9. Which order should the nurse question for an infant with AIDS and pneumonia?
- A. Vital signs with rectal temperature every 4 hours
- B. Flush IV saline lock after meds
- C. Check oxygen saturation every shift
- D. Obtain CBC with differential
✅ Correct Answer: A. Vital signs with rectal temperature every 4 hours
Rationale: Rectal temperatures increase risk of mucosal tears and infection—especially dangerous for immunocompromised clients.
10. What is the most important observation that warrants reporting child abuse?
- A. Inconsistency between history and injury
- B. Visible bruises on the child
- C. Caregiver brings child instead of parent
- D. Child cries while being held
✅ Correct Answer: A. Inconsistency between history and injury
Rationale: The key red flag for abuse is when the caregiver’s explanation doesn’t match the injury pattern.
11. Which statement about preterm infants and fluids is incorrect?
- A. Unable to concentrate urine
- B. Large body water content
- C. Requires extra amino acids
- D. Large evaporation of body water
✅ Correct Answer: C. Requires extra essential amino acids
Rationale: Fluid needs are high due to immature kidneys and thin skin—not amino acid requirements.
12. Which immunizations should a 4-month-old receive?
- A. DTaP, IPV, rotavirus, MMR
- B. Hib, rotavirus, DTaP, IPV
- C. DTaP, IPV, Hib, hepatitis B
- D. DTaP, hepatitis B, Hib, varicella
✅ Correct Answer: C. DTaP, IPV, Hib, hepatitis B
Rationale: The standard 4-month vaccines include DTaP, IPV, Hib, and hepatitis B; MMR and varicella are given later at 12–15 months.
13. Best recommendation for a 4-year-old who’s a poor eater:
- A. Allow the child to feed herself
- B. Use fun, colorful dishes
- C. Serve only favorite foods
- D. Let the child eat at a small table alone
✅ Correct Answer: A. Allow the child to feed herself
Rationale: Encouraging independence fosters interest and autonomy in eating, improving intake.
14. Purpose of a peak flow meter for a 13-year-old with asthma:
- A. Detect airway obstruction before symptoms occur
- B. Take deep breaths every 1–2 hours
- C. Adjust oxygen delivery rate
- D. Breathe deeper with inhalers
✅ Correct Answer: A. Detect airway obstruction before symptoms occur
Rationale: Peak flow readings help recognize early airway narrowing, allowing for timely interventions to prevent exacerbations.
15. Minimal apical pulse before giving digoxin to a 5-year-old:
- A. 60
- B. 70
- C. 100
- D. 120
✅ Correct Answer: C. 100
Rationale: For children under 6, hold digoxin if the apical pulse is below 100 beats per minute to prevent bradycardia and toxicity.
Final Thoughts
Practice questions like these not only prepare you for NCLEX test-taking strategies but also strengthen your clinical judgment. Review rationales carefully and reflect on why each answer is correct or incorrect—this is the key to mastering Physiological Integrity.
If you enjoyed these questions, explore our NCLEX Success Mastery Bundle or grab our Med Surgical Nursing Handbook to continue your prep with confidence!
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