Learn Client Needs - Physiological Integrity

The NCLEX-RN exam is organized according to the framework, "Meeting Client Needs." There are four major categories:

• Safe and Effective Care Environment
• Health Promotion and Maintenance
• Psychosocial Integrity
• Physiological Integrity

Learn about Physiological Integrity below.

Physiological Integrity

Subcategories:

• Basic Care and Comfort
• Pharmacological and Parenteral Therapies
• Reduction of Risk Potential
• Physiological Adaptation

Basic Care and Comfort

The concept of basic care and comfort accounts for 6-12 percent of the questions on the NCLEX-RN® Exam. The nursing actions included in this subcategory are:

Assistive devices	Elimination
Mobility	Nonpharmacological comfort interventions
Nutrition and oral hydration	Palliative/comfort care
Personal hygiene	Rest and sleep

Typical Question

The following is an example of a typical basic care and comfort question:

A cast is applied to a 9-month old girl for the treatment of talipes equinovarus. Which of the following instructions is most essential for the nurse to give to the child's mother regarding her care?

1. Offer appropriate toys for her age.
2. Make frequent visits for cast adjustment.
3. Provide an analgesic as needed.
4. Do circulatory checks of the casted extremity.

The correct answer is (4). A possible complication that can occur after cast application is impaired circulation. All of these answer choices might be included in family teaching, but checking the child's circulation is the highest priority.

Pharmacological and Parenteral Therapies

The concept of pharmacological and parenteral therapies accounts for 13-19 percent of the questions on the NCLEX-RN® exam. The nursing actions included in this subcategory are:

Adverse effects	Contraindications
Blood and blood products	Central venous access devices
Chemotherapy	Expected effects
Intravenous therapy	Medication administration
Parenteral fluids	Pharmacological actions
Pharmacological agents	Pharmacological interactions
Pharmacological pain management	Side effects
Total parenteral nutrition

Typical Question

The following is an example of a typical pharmacological and parenteral therapies question:

The home health nurse is going to start an IV with 5% dextrose in water (D5W) for a 76-year old woman. To perform the venipuncture the nurse should start the IV using the:

1. veins of the client's wrist on the nondominant side.
2. veins of the leg so it will not interfere with the client's ability to feed herself.
3. dorsal veins of the client's forearm on the nondominant side.
4. dorsal surface of the client's hand on the nondominant side.

The correct answer is (3). This is the best site for the nurse to use for the IV because of its easy access, availability of elastic veins, and limited use by the client.

Reduction of Risk Potential

The concept of reduction of risk potential accounts for 13-19 percent of the questions on the NCLEX-RN® exam. The nursing actions included in this subcategory are:

Diagnostic tests	Laboratory values
Pathophysiology	Potential for body system alterations
Potential for complications of diagnostic tests, procedures, surgery, and health alterations.	Therapeutic procedures

Typical Question

The following is an example of a typical reduction of risk potential question:

A 7-year old girl with type 1 insulin dependent diabetes mellitus (IDDM) has been home sick for several days and is brought to the emergency department by her parents. If the child is experiencing ketoacidosis, the nurse would expect to see which of the following lab results?

1. Serum glucose 140 mg/dL.
2. Serum creatine 5.2 mg/dL.
3. Blood pH 7.28.
4. Hematocrit 38%.

The correct answer is (3). Normal blood pH is 7.35—7.45. This indicates diabetic ketoacidosis.

Physiological Adaptation

The concept of physiological adaptation accounts for 11-17 percent of the questions on the exam. The nursing actions included in this subcategory are:

Alterations in the body systems	Fluid and electrolyte imbalances
Hemodynamics	Infectious diseases
Medical emergencies	Pathophysiology
Radiation therapy	Respiratory care
Unexpected response to therapies

Typical Question

The following is an example of a typical physiological adaptation question:

The nurse is delivering external cardiac compressions to a 63-year old woman while performing cardiopulmonary resuscitation (CPR). It is most important for the nurse to:

1. maintain a position close to the client's side with the nurse's knees apart.
2. maintain vertical pressure on the client's chest through the heel of the nurse's hand.
3. re-check the nurse's hand position after every 10 chest compressions.
4. check for a return of the client's pulse after every 8 breaths by the nurse.

The correct answer is (2). the nurse's elbows should be locked, arms straight, with shoulders directly over hands. Incorrect pressure or improperly placed hands could cause injury to the client.