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Physiological Adaptation/Safety-NCLEX-PN

Total questions: 25

Worksheet time: 13mins

Name
Class
Date
1.

An LPN notes a postoperative client has restlessness, heart rate 118/min, urine output 20 mL/hr, and cool skin. Which finding is most concerning?

a)

Heart rate

b)

Urine output

c)

Restlessness

d)

Cool skin

2.

Which findings indicate poor tissue perfusion?

a)

Delayed capillary refill

b)

Bounding pulses

c)

Decreased urine output

d)

Confusion

e)

Warm, flushed skin

3.

Which client is at greatest risk for deep vein thrombosis (DVT)?

a)

Client ambulating twice daily

b)

Client receiving anticoagulants

c)

Client on bedrest after hip surgery

d)

Client with controlled hypertension

4.

Which findings suggest early hypovolemia?

a)

Tachycardia

b)

Hypotension

c)

Restlessness

d)

Increased urine output

e)

Dry mucous membranes

5.

An LPN suspects neurovascular compromise in a client with a cast. Which assessment finding requires immediate RN notification?

a)

Mild swelling

b)

Capillary refill of 2 seconds

c)

Increasing pain unrelieved by medication

d)

Warm toes

6.

Which signs indicate neuromuscular compromise?

a)

Paresthesia

b)

Pallor

c)

Strong distal pulses

d)

Paralysis

e)

Increased appetite

7.

Which finding best differentiates urinary retention from dehydration?

a)

Decreased urine output

b)

Suprapubic distention

c)

Dry mucous membranes

d)

Tachycardia

8.

Which clients are at highest risk for dehydration?

a)

Older adult with decreased thirst sensation

b)

Client taking loop diuretics

c)

Client with high-protein diet

d)

Client with cognitive impairment

e)

Client receiving IV fluids

9.

Which assessment finding best indicates early shock?

a)

Hypotension

b)

Restlessness

c)

Cyanosis

d)

Anuria

10.

Which actions help reduce the risk for pressure injuries?

a)

Reposition every 2 hours

b)

Massage reddened areas

c)

Keep skin clean and dry

d)

Use pressure-reducing surfaces

e)

Limit protein intake

11.

A client with dysphagia begins coughing during meals. What is the priority nursing action?

a)

Offer water

b)

Continue feeding slowly

c)

Stop feeding and notify the RN

d)

Document the finding

12.

Which findings increase aspiration risk?

a)

Decreased level of consciousness

b)

Upright positioning

c)

Wet or gurgly voice

d)

Pocketing food

e)

Alert mental status

13.

Which client is at greatest risk for a healthcare-associated infection (HAI)?

a)

Client ambulating independently

b)

Client with an indwelling Foley catheter

c)

Client receiving oral antibiotics

d)

Client with a healed incision

14.

Which actions help prevent catheter-associated urinary tract infections (CAUTIs)?

a)

Maintain a closed drainage system

b)

Secure catheter to thigh

c)

Keep drainage bag above bladder

d)

Perform routine perineal care

e)

Remove catheter as soon as possible

15.

While collecting a clean-catch urine specimen, which action would contaminate the specimen?

a)

Collecting midstream urine

b)

Touching the inside of the container

c)

Cleansing the perineal area

d)

Refrigerating specimen if delayed

16.

Which clients are at high risk for tissue injury?

a)

Client with incontinence

b)

Client with poor nutritional intake

c)

Client ambulating frequently

d)

Client in traction

e)

Client repositioned regularly

17.

Which finding suggests early DVT rather than expected postoperative discomfort?

a)

Bilateral leg soreness

b)

Localized unilateral calf pain

c)

Incisional tenderness

d)

General muscle stiffness

18.

Which findings indicate circulatory compromise in an extremity?

a)

Pallor

b)

Tingling

c)

Warm skin

d)

Weak pulses

e)

Increasing pain

19.

Which finding best indicates effective perfusion?

a)

Urine output of 10 mL/hr

b)

Delayed capillary refill

c)

Alert mental status

d)

Cool extremities

20.

Which interventions reduce aspiration risk in tube-fed clients?

a)

Elevate head of bed 30–45°

b)

Verify tube placement per policy

c)

Place client flat after feeding

d)

Pause feeding during repositioning

e)

Check residuals per facility policy

21.

A client reports numbness and tingling distal to a cast. What is the best action?

a)

Document and reassess later

b)

Elevate the extremity

c)

Notify the RN immediately

d)

Administer pain medication

22.

Which findings indicate increased fall risk?

a)

Orthostatic hypotension

b)

Opioid use

c)

Clear mental status

d)

Recent surgery

e)

Non-skid footwear

23.

Which client should the LPN see first?

a)

Client requesting pain medication

b)

Client with oxygen saturation of 88%

c)

Client awaiting discharge

d)

Client eating breakfast

24.

Which findings suggest fluid volume deficit?

a)

Dry mucous membranes

b)

Tachycardia

c)

Bounding pulses

d)

Decreased urine output

e)

Weight gain

25.

Which scenario best represents Reduction of Risk Potential?

a)

Monitoring vital signs after surgery

b)

Teaching insulin administration

c)

Repositioning an immobile client

d)

Administering prescribed medication