NCLEX-RN Physiological Adaptation Practice Test
Shock, sepsis, DKA, heart failure, ABGs and emergencies. Here are 5 NCLEX-RN physiological adaptation questions, each with the answer and the reason.
Updated by the Tigertest team. Based on the NCSBN 2026 NCLEX-RN Test Plan Client Needs categories. Original questions, not affiliated with NCSBN.
0900: Monitor shows sinus bradycardia at 38 beats/min. BP 78/44 mm Hg. 0905: Client reports dizziness, skin cool and diaphoretic. Alert and breathing without distress.
1.The nurse reviews telemetry notes. Which medication should the nurse anticipate the HCP will prescribe first?
- A.
Adenosine 6 mg rapid IV push
- B.
Atropine 1 mg IV push
- C.
Amiodarone 150 mg IV
- D.
Metoprolol 5 mg IV
Answer: B.Bradycardia with hypotension, dizziness and diaphoresis is symptomatic, and atropine 1 mg IV is the first-line drug. Adenosine treats stable narrow-complex tachycardia, and metoprolol would slow the heart further.
- A.
- 2.
A client arrives at the emergency department with crushing chest pain. SpO2 is 96% on room air. Which action should the nurse take first?
- A.
Draw a serum troponin
- B.
Obtain a 12-lead ECG
- C.
Apply oxygen at 4 L/min
- D.
Prepare for a chest x-ray
Answer: B.A 12-lead ECG within 10 minutes of arrival identifies ST-elevation MI, which determines urgent reperfusion. Oxygen is not needed with an SpO2 of 96%, and troponin results take longer and do not replace the ECG.
- A.
- 3.
A client has sudden right-sided facial droop and slurred speech. Which information is most important for the nurse to obtain first?
- A.
Time of the last meal
- B.
Time last known well
- C.
Family history of stroke
- D.
Smoking history in pack-years
Answer: B.The time the client was last known to be normal determines eligibility for thrombolytic and clot-retrieval therapy, so it is gathered immediately. Family and smoking history are risk factors that do not change acute treatment.
- A.
- 4.
A client has a chest tube to suction for a pneumothorax. The nurse notes continuous bubbling in the water seal chamber. Which action should the nurse take first?
- A.
Increase suction to -40 cm H2O
- B.
Check tubing connections for leaks
- C.
Strip the tubing toward the drain
- D.
Document it as an expected finding
Answer: B.Continuous bubbling in the water seal chamber signals an air leak, which is most often a loose connection in the system, so the nurse checks from the dressing to the drain. Intermittent bubbling with exhalation or coughing is expected, but continuous bubbling is not.
- A.
0300: High-pressure alarm sounding on the ventilator. Client coughing and restless. Coarse rhonchi over the trachea and both upper lobes. SpO2 91%, down from 96%.
5.The nurse responds to a ventilator alarm. Which action should the nurse take first?
- A.
Check the circuit for disconnection
- B.
Increase the set tidal volume
- C.
Suction the endotracheal tube
- D.
Silence the alarm and recheck
Answer: C.A high-pressure alarm with coughing and coarse rhonchi points to secretions blocking the airway, which suctioning clears. A disconnection causes a low-pressure alarm, and raising the tidal volume would raise airway pressure further.
- A.
Drill every physiological adaptation question in the NCLEX-RN Physiological Adaptation drill: questions you miss come back until you have mastered them. Then take a timed practice test with the NCLEX-RN section in it.
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