NCLEX-PN Physiological Adaptation Practice Test
Changes in condition, fluid and electrolytes, chronic illness and emergencies. Here are 8 NCLEX-PN physiological adaptation questions, each with the answer and the reason.
Updated by the Tigertest team. Based on the NCSBN 2026 NCLEX-PN Test Plan Client Needs categories. Original questions, not affiliated with NCSBN.
- 1.
The PN collects data on a client with untreated hypothyroidism. Which findings should the PN expect?
- A.
Fatigue, weight gain and cold intolerance
- B.
Nervousness, weight loss and heavy sweating
- C.
Bulging eyes, heat intolerance and diarrhea
- D.
Rapid pulse, fine hand tremor and insomnia
Answer: A.Too little thyroid hormone slows the body, so the client is tired, gains weight, feels cold and has dry skin and constipation. The other choices describe the overactive thyroid.
- A.
- 2.
A long-term care resident has had vomiting and diarrhea for 2 days. Which findings suggest to the PN that the resident is dehydrated?
- A.
Bounding pulse and crackles in the lungs
- B.
Dry mouth and dark, scant urine
- C.
Weight gain of 2 kg since yesterday
- D.
Full, bulging neck veins
Answer: B.Fluid loss shows as a dry mouth, concentrated urine, a weak fast pulse, low blood pressure and weight loss. A bounding pulse, crackles, weight gain and full neck veins are signs of too much fluid.
- A.
- 3.
A client's potassium level is 6.4 mEq/L. Which change on the cardiac monitor should the PN expect the RN to be watching for?
- A.
Flattened T waves
- B.
Prominent U waves
- C.
ST segment elevation
- D.
Tall, peaked T waves
Answer: D.High potassium makes the T waves tall and pointed and can widen the QRS and stop the heart. Flat T waves and U waves go with low potassium, and ST elevation points to a heart attack.
- A.
- 4.
A client with diabetes becomes sweaty, shaky and anxious an hour before lunch. Which problem should the PN suspect?
- A.
Hyperglycemia
- B.
Hypoglycemia
- C.
Diabetic ketoacidosis
- D.
Hyperosmolar hyperglycemic state
Answer: B.Sweating, tremor, anxiety and hunger are the adrenergic signs of low blood sugar and come on quickly before a meal. High glucose states develop over hours to days with thirst, frequent urination and dry skin.
- A.
- 5.
A client begins a tonic-clonic seizure in bed. Which action should the PN take?
- A.
Place a padded tongue blade between the teeth to protect the tongue
- B.
Hold the arms and legs still until the movements stop
- C.
Turn the client onto the side and protect the head
- D.
Leave the room to get the RN and the emergency cart
Answer: C.Side-lying lets saliva drain and keeps the airway open, and padding protects the head while the seizure runs its course. Nothing goes in the mouth, limbs are never restrained because that causes injury, and the PN stays with the client and calls for help.
- A.
- 6.
A long-term care resident suddenly has drooping on one side of the face and slurred speech. Which action should the PN take first?
- A.
Give aspirin 325 mg from the stock supply
- B.
Offer a sip of water to test swallowing
- C.
Help the resident walk back to bed
- D.
Note the time and alert the RN immediately
Answer: D.A stroke is treated against the clock, so the time the symptoms were last normal is recorded and the RN activates emergency care at once. Nothing is given by mouth until swallowing is cleared, aspirin is unsafe if the stroke is a bleed, and walking risks a fall.
- A.
- 7.
A client receiving IV fluids develops crackles in both lungs, shortness of breath and a bounding pulse. Which action should the PN take?
- A.
Raise the head of the bed and call the RN
- B.
Increase the IV rate to support the blood pressure
- C.
Lay the client flat to rest
- D.
Encourage the client to drink more fluids
Answer: A.Crackles, dyspnea and a bounding pulse during an infusion mean fluid overload, so the client is sat up to ease breathing and the RN is called to slow the fluid and contact the provider. More fluid or lying flat makes it worse.
- A.
- 8.
The PN collects data on a client with hyperthyroidism. Which findings should the PN expect?
- A.
Weight gain, cold intolerance and a slow pulse
- B.
Weight loss, heat intolerance and a rapid pulse
- C.
Weight gain, heat intolerance and a slow pulse
- D.
Weight loss, cold intolerance and a slow pulse
Answer: B.Excess thyroid hormone speeds up metabolism, so the client loses weight, feels hot, sweats and has a fast pulse. Weight gain, cold intolerance and a slow pulse are the opposite picture of hypothyroidism.
- A.
Drill every physiological adaptation question in the NCLEX-PN Physiological Adaptation drill: questions you miss come back until you have mastered them. Then take a timed practice test with the NCLEX-PN section in it.
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