NCLEX physiological integrity questions: basic care and risk reduction drills

Physiological Integrity is the biggest Client Needs category on the NCLEX-RN, split into four subcategories. This page covers two: Basic Care and Comfort (6-12%: mobility, skin, nutrition, elimination, comfort) and Reduction of Risk Potential (9-15%: lab values, diagnostic tests, vital sign changes and complications). Pharmacology and Physiological Adaptation have their own pages. The two free drills below are 12 original questions each.

6-12%
Basic Care and Comfort: 9-15%
Reduction of Risk: 18
of our 85 mock questions: 2 × 12
free drill questions

Last checked 13 November 2026 · Ranges from the 2026 NCLEX-RN Test Plan (NCSBN); lab ranges are typical reference ranges

Free drills: 12 original NCLEX-RN-style questions each, at 2 minutes a question, then every rationale shown. No sign-up.

12
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24 min
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Free
every answer explained

By the LifeScore Editorial Team · Updated 13 November 2026 · How we check facts · How this is scored

What is Physiological Integrity on the NCLEX?

The physical care of clients across four subcategories: Basic Care and Comfort, Pharmacological and Parenteral Therapies, Reduction of Risk Potential, and Physiological Adaptation. Together they are the largest share of the exam.

The four Physiological Integrity subcategories and where to practise each
Subcategory	2026 range	Practise on
Basic Care and Comfort	6-12%	This page
Pharmacological and Parenteral Therapies	13-19%	NCLEX pharmacology practice questions
Reduction of Risk Potential	9-15%	This page
Physiological Adaptation	11-17%	NCLEX prioritization questions

Pharmacology has its own page at NCLEX pharmacology practice questions, and Physiological Adaptation, where most emergencies live, at NCLEX prioritization questions.

What does Basic Care and Comfort cover on the NCLEX?

Assistive devices and mobility, positioning, skin and pressure injuries, nutrition and therapeutic diets, enteral feeding, elimination, sleep, hygiene and nonpharmacological comfort.

Rules that decide most Basic Care and Comfort questions
Topic	Rule
Cane	Strong side; move it with the weak leg
Crutches	Weight on the hands; up with the good leg, down with the bad
Walker	Walker first, then the weak leg, then the strong leg
Hip replacement (posterior approach)	No flexion past 90 degrees, no crossing the midline, no internal rotation
Pressure injury stage 1	Intact skin with non-blanchable redness; do not massage it
Tube feeding	Confirm placement; head of bed 30 degrees or higher
Dysphagia	Upright, chin tuck, thickened liquids as ordered, no straws
Enema	Left side-lying (Sims') position

NCLEX-RN-style question 1 · Assistive devices
A client with a weak right leg is going down stairs with crutches. Which instruction is correct?
1. ALead with the left (strong) leg, then the crutches
2. BMove the crutches and the right (weak) leg down first, then the left leg
3. CHop down on the left leg holding both crutches in the right hand
4. DLead with the right leg, then move the crutches last
Show the worked answer
B: Move the crutches and the right (weak) leg down first, then the left leg. "Up with the good, down with the bad": going down, the crutches and the weak leg move first so the strong leg lowers the body.
1. Going down stairs?
2. "Down with the bad": crutches and weak leg first.
3. Then the strong leg follows.
The trap: Using the going-up rule. Up, the strong leg leads; down, the crutches and weak leg lead.
NCLEX-RN-style question 2 · Enteral feeding
A client receiving continuous tube feedings starts coughing and has a sudden drop in SpO2. What should the RN do first?
1. AStop the feeding
2. BFlush the tube with 30 mL of water
3. CCheck the residual volume
4. DLower the head of the bed
Worked answer
A: Stop the feeding. Sudden coughing and desaturation during a feeding suggest aspiration. Stopping the feeding prevents more formula entering the lungs; then suction, assess and notify.
1. What is happening? Likely aspiration.
2. What stops it getting worse? Stop the feeding.
3. Then keep the head raised, suction and notify the provider.
The trap: Flushing or checking residuals. Both put the airway second; anything that adds fluid can make aspiration worse.

Which lab values do I need to know for the NCLEX?

The electrolytes, kidney function, blood counts, glucose, coagulation and arterial blood gases, plus the therapeutic levels of a few drugs. Learn each as a range and what a high or low value makes you do.

High-yield adult lab ranges (typical reference ranges; laboratories vary slightly)
Test	Typical range	Why the NCLEX asks
Potassium	3.5 to 5.0 mEq/L	Below: weakness, flat T waves. Above: peaked T waves, arrhythmia
Sodium	135 to 145 mEq/L	Below 130: confusion and seizure risk
Calcium (total)	About 9.0 to 10.5 mg/dL	Low after thyroid or parathyroid surgery: tingling, Chvostek and Trousseau signs
Magnesium	About 1.3 to 2.1 mEq/L	Loss of reflexes is the first sign of toxicity during magnesium sulfate therapy
Fasting glucose	70 to 99 mg/dL	Under 70 mg/dL: treat hypoglycemia with 15 g of fast carbohydrate
Creatinine	About 0.6 to 1.2 mg/dL	A sudden rise suggests acute kidney injury
BUN	10 to 20 mg/dL	Rises with dehydration, bleeding into the gut and kidney failure
Hemoglobin	About 14 to 18 g/dL (men), 12 to 16 g/dL (women)	A fall with tachycardia and hypotension suggests bleeding
White blood cells	5,000 to 10,000/mm³	ANC under 500/mm³: severe neutropenia, protective precautions
Platelets	150,000 to 400,000/mm³	Under 50,000/mm³: bleeding precautions
INR on warfarin	Usually 2 to 3 (atrial fibrillation, DVT)	High: bleeding risk; vitamin K reverses warfarin
Arterial pH, PaCO2, HCO3	7.35 to 7.45, 35 to 45 mm Hg, 22 to 26 mEq/L	Match the abnormal value to the pH to name the cause
Lithium (maintenance)	About 0.6 to 1.2 mEq/L	Above about 1.5: toxicity; dehydration and low sodium raise levels
Digoxin	About 0.5 to 2.0 ng/mL (0.5 to 0.9 is often the target in heart failure)	Hold for an adult apical pulse under 60; low potassium raises toxicity

For arterial blood gases, use the same three steps every time. Is the pH acidotic (under 7.35) or alkalotic (over 7.45)? Which of PaCO2 or HCO3 moves the same way as the problem (a high PaCO2 is respiratory acidosis, a low HCO3 metabolic acidosis)? Is the other value normal (uncompensated) or moving to correct the pH (compensating)?

NCLEX-RN-style question 1 · Laboratory values
Which laboratory result for a client receiving IV heparin should the RN report right away?
1. APlatelets fell from 250,000 to 95,000/mm³ over 6 days
2. BaPTT within the ordered therapeutic range
3. CHemoglobin 13.8 g/dL
4. DPotassium 4.1 mEq/L
Worked answer
A: Platelets fell from 250,000 to 95,000/mm³ over 6 days. A fall in platelets of more than 50% about 5 to 10 days into heparin suggests heparin-induced thrombocytopenia, which raises the risk of clots. Heparin is stopped and the provider notified.
1. What does heparin cause that labs show? HIT.
2. Platelets from 250,000 to 95,000 is a fall of more than half.
3. Timing (day 6) fits HIT: report it.
The trap: Looking only for the "out of range" number. A therapeutic aPTT is the goal, while the platelet trend is the danger.

Four more drills in each area

The Pass Pack has four 12-question drills each for Basic Care and Comfort and Reduction of Risk Potential, plus two more full mocks.

The NCLEX-RN Pass Pack gives you 3 full mocks on the real clock, 32 drills of 12 questions for the sections that cost you points, and a predictor that turns your mocks into the odds of reaching your target. One payment, no subscription, and your free score stays free.

Prep courses for these tests usually cost $19 to $129. The NCLEX-RN Pass Pack is US$39 (£29), once.

See the NCLEX-RN Pass Pack How our questions are built and checked

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What does the NCLEX ask about diagnostic tests and procedures?

What to do before (consent, NPO, allergies, voiding, metal), how to position the client during, and what complication to watch for after.

Procedures and the nursing care around them
Procedure	Before or during	After: watch for
Cardiac catheterization (femoral)	Allergies to contrast, kidney function, metformin	Bleeding, hematoma, distal pulses; keep the leg straight
Thoracentesis	Sit up, lean over a bedside table	Pneumothorax: sudden dyspnea, falling SpO2
Paracentesis	Empty the bladder	Hypotension from fluid shift
Liver biopsy	Coagulation studies	Bleeding; lie on the right side
Bronchoscopy	NPO	Nothing by mouth until the gag reflex returns
MRI	Pacemaker and metal screening	Claustrophobia; contrast reaction if used
CT with IV contrast	Past contrast reaction, kidney function, metformin	Delayed reaction, kidney injury

NCLEX-RN-style question 1 · Diagnostic tests
A client is going for a CT scan with IV contrast. Which finding should the RN report to the provider before the scan?
1. AThe client had hives after IV contrast dye in the past
2. BThe client is wearing a wedding ring
3. CThe client ate breakfast 8 hours ago
4. DThe client is anxious about the scan
Worked answer
A: The client had hives after IV contrast dye in the past. A previous reaction to iodinated contrast is the strongest risk factor for another one; the provider may premedicate or change the study. A shellfish allergy alone is no longer thought to predict contrast reactions.
1. IV contrast risks: allergic-type reaction and kidney injury.
2. A past contrast reaction is the key history.
3. Report it before the scan.
The trap: Asking only about shellfish. The question that matters is a past reaction to contrast itself, plus kidney function and metformin.

How should I practise these two areas?

With the two free drills above, then a full mock. Basic Care questions are quick wins once the rules are learned; Reduction of Risk questions reward knowing the labs cold.

Make one card per lab and one per procedure, and test yourself until you can say the range and the action without looking. Then take the free NCLEX-RN practice test, where 8 questions are Basic Care and Comfort and 10 are Reduction of Risk Potential, mixed in with everything else. The full plan is in how to pass the NCLEX.

Frequently asked questions

How much of the NCLEX is Physiological Integrity?

Its four subcategories add up to the largest share of the exam. Basic Care and Comfort is 6-12%, Pharmacology 13-19%, Reduction of Risk Potential 9-15% and Physiological Adaptation 11-17%.

Do I need to memorize exact lab ranges?

Know the typical ranges for the high-yield labs and, more important, what a high or low value makes you do. Questions on the real exam usually give a reference range when the exact cut-off matters.

Which side does a client lie on after a liver biopsy?

The right side, which presses the liver against the chest wall at the biopsy site to help prevent bleeding.

Are these real NCLEX questions?

No. They are original NCLEX-RN-style questions written for LifeScore, which is not affiliated with NCSBN.

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