NCLEX Practice Questions 4: Physiological Integrity Physiological Adaptation

1. A paradoxical effect has occurred when:
A. The wrong antibiotic has been prescribed
B. A medication produces an effect in the patient that is opposite to what is expected
C. The body does not metabolize a medication and liver damage may occur
D. A medication's peaks and troughs are significantly different than those expected

2. A patient with CHF is taking Lasix q day. She begins to complain of pain and cramps in her legs. Her new lab results will probably show:
A. Potassium that is below normal limits
B. Potassium that is above normal limits
C. Sodium that is above normal limits
D. Sodium that is below normal limits

3. The patient is receiving a transfusion of packed red cells. The nurse is watches for the symptoms of a transfusion reaction which can include all of the following except:
A. Fever
B. Back pain
C. Chest pain
D. Euphoria

4. A significant increase in body acid, known as Acidosis, may either be caused by respiratory or metabolic issues. Tests that will determine the type of acidosis include all except:
A. ABG (Arterial Blood Gasses)
B. Urine pH
C. Serum electrolytes
D. CBC with differential

5. Which of the following complications are related to hyperthyroidism?
A. Poor eyesight
B. Brittle bones
C. Nephritis
D. Weight gain

6. On an ECG the P-R interval:
A. Is representative of the time it takes the electrical impulse to get to the ventricle
B. Represents the impulse that begins the atrial contraction
C. Represents the time it takes for the completion of the cardiac cycle
D. Is the duration of the cardiac resting phase

7. A life threatening complication of pancreatitis is:
A. Abdominal pain
B. Nausea and vomiting
C. Abnormal bowel sounds
D. Increased respirations

8. Patients taking cholestyramine to reduce lipids should be made aware that:
A. They may become deficient in Niacin
B. They may become deficient in Folic acid
C. They may need extra B12
D. They may become deficient in vitamins A and D

Answers and Rational
1. Correct answer: B
A paradoxical effect of a medication is the opposite of the expected therapeutic effect. For example, a sleeping pill that keeps the patient restless and awake.
A – A medication error does not constitute a paradoxical effect.
C – Slowed metabolism of a drug is not a paradoxical effect.
D – Peaks and troughs do not indicate a paradoxical effect.

2. Correct answer: A
Lasix, a diuretic often prescribed for CHF patients, causes an increased loss of potassium through the kidneys. Unless the potassium is replaced, severe cramps can result. Lab results would show a decrease in the patient's potassium level.
B – There would be no reason to expect an increase in blood potassium.
C – Diuretics have no significant effect on sodium levels.
D – Lasix has no significant effect on sodium levels.

3. Correct answer: D
Euphoria is not a sign or symptom of a blood transfusion reaction.
A – B – C (Fever, Back pain, and Chest pain) are all common signs of a transfusion reaction.

4. Correct answer: D
A CBC is the exception. It is the least effective test for acidosis.
A – Arterial Blood Gasses are a reliable test to determine the type of acidosis the patient is experiencing.
B – Urine pH will show abnormally acidic if metabolic acidosis is the problem.
C – An electrolyte panel will show bicarbonate levels in the blood. This dictates the pH value of the blood, and can indicate respiratory acidosis.

5. Correct answer: B
Hyperthyroidism causes calcium to be leached out of the bones and teeth into the blood making the bones brittle. This complication can lead to fractures.
A – Hyperthyroidism is not shown to cause poor eyesight.
C – Nephritis is not caused by hyperthyroidism.
D – Hyperthyroidism causes weight loss.

6. Correct answer: A
On an ECG, the P-R interval is representative of the time it takes the electrical impulse to get to the ventricle. This interval goes from the beginning of the P wave through the QRS complex.
B – The atrial contraction begins in the middle of the P wave.
C – The cardiac cycle is represented by a complete P –T complex.
D – The T wave represents the refractory period, or resting phase of the cardiac cycle.

7. Correct answer: D
A critical complication of pancreatitis is respiratory distress, and increased SOB should be reported immediately.
A – Abdominal pain is a normal presenting symptom with Pancreatitis.
B – Nausea and vomiting are normal symptomology for Pancreatitis.
C – Abnormal, or decreased bowel sounds, are a common symptom of Pancreatitis.

8. Correct answer: D
Cholestyramine causes deficiencies in fat-soluble vitamins. They are removed from the blood along with the lipids the medication is meant to reduce.
A – B – and C (Niacin, Folic acid, and B12) are water soluble, and so are not removed from the body by the medication.