KAPLAN PHYSIOLOGICAL INTEGRITY ASSESSMENT QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027..
*Core Domains*
*• Pharmacological Therapies*
*• Reduction of Risk Potential*
*• Physiological Adaptation*
*• Basic Care and Comfort*
*• Parenteral Therapies*
*• Fluid and Electrolyte Management*
*• Medical-Surgical Nursing Interventions*
*Introduction*
*The purpose of this assessment is to evaluate the clinical competence and critical thinking skills of nu
SECTION ONE: QUESTIONS 1–100
A nurse is caring for a client with a potassium level of 3.2 mEq/L. Which clinical manifestation should the nurse anticipate during the
assessment?
A. Hyperactive bowel sounds
B. Muscle twitching
C. Weak, irregular pulse
D. Increased muscle tone
🟢 C. Weak, irregular pulse
🔴 RATIONALE: Hypokalemia causes decreased neuromuscular excitability, which can manifest as muscle weakness, fatigue, and
cardiac dysrhythmias, such as a weak, irregular pulse.
A client is receiving an intravenous infusion of 0.9% Normal Saline at 125 mL/hr. The nurse notes the site is cool to the touch,
edematous, and the infusion has slowed significantly. What is the priority nursing action?
A. Apply a warm compress to the site
B. Discontinue the infusion immediately
C. Slow the infusion rate to 50 mL/hr
,D. Elevate the affected extremity
🟢 B. Discontinue the infusion immediately
🔴 RATIONALE: These findings are indicative of infiltration. The priority action is to stop the infusion to prevent further tissue damage
from the fluid.
A client with chronic obstructive pulmonary disease (COPD) is being evaluated for respiratory status. Which arterial blood gas (ABG)
result would the nurse expect?
A. pH 7.32, PaCO2 50 mmHg, HCO3 26 mEq/L
B. pH 7.48, PaCO2 30 mmHg, HCO3 22 mEq/L
C. pH 7.40, PaCO2 40 mmHg, HCO3 24 mEq/L
D. pH 7.35, PaCO2 45 mmHg, HCO3 28 mEq/L
🟢 A. pH 7.32, PaCO2 50 mmHg, HCO3 26 mEq/L
🔴 RATIONALE: COPD leads to CO2 retention, causing respiratory acidosis, characterized by a low pH and an elevated PaCO2.
When preparing a client for a scheduled magnetic resonance imaging (MRI) scan, which assessment finding is the highest priority for
the nurse to report?
A. The client has a history of claustrophobia
B. The client has a permanent cardiac pacemaker
C. The client reports a mild allergy to iodine
D. The client is currently taking oral contraceptives
🟢 B. The client has a permanent cardiac pacemaker
🔴 RATIONALE: An MRI uses strong magnetic fields that can interfere with the function of electronic medical devices like pacemakers,
posing a severe safety risk.
A client who is postoperative following a total hip arthroplasty should be placed in which position to prevent hip dislocation?
A. Side-lying with the legs adducted
B. Supine with the legs abducted using an abduction pillow
C. High-Fowler's position with the hips flexed at 90 degrees
D. Prone position to relieve pressure on the surgical site
🟢 B. Supine with the legs abducted using an abduction pillow
🔴 RATIONALE: Abduction pillows prevent the hip from adducting past the midline, which is the most common cause of dislocation
after hip surgery.
Which laboratory result is the most critical for the nurse to review before administering heparin therapy?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
, C. International Normalized Ratio (INR)
D. Platelet count
🟢 B. Activated partial thromboplastin time (aPTT)
🔴 RATIONALE: The aPTT is the primary diagnostic test used to monitor the therapeutic efficacy and safety of heparin therapy.
A client is receiving a blood transfusion and begins to experience chills, low back pain, and tachycardia. What is the nurse's first action?
A. Notify the healthcare provider
B. Slow the transfusion rate
C. Stop the transfusion
D. Obtain a blood sample for a repeat cross-match
🟢 C. Stop the transfusion
🔴 RATIONALE: These symptoms indicate an acute hemolytic transfusion reaction. The nurse must stop the infusion immediately to
prevent further reaction and organ failure.
A client with diabetes mellitus is found to be confused, diaphoretic, and tremulous. What is the priority nursing intervention?
A. Administer subcutaneous insulin
B. Check the client’s blood glucose level
C. Provide a high-protein snack
D. Document the neurological status
🟢 B. Check the client’s blood glucose level
🔴 RATIONALE: These symptoms are classic signs of hypoglycemia. A blood glucose reading is necessary to confirm the diagnosis
before treatment is initiated.
A nurse is teaching a client about the use of a metered-dose inhaler (MDI). Which action by the client indicates the need for further
education?
A. Shaking the canister before use
B. Exhaling completely before inhaling the medication
C. Taking a quick, shallow breath during inhalation
D. Waiting one minute between puffs
🟢 C. Taking a quick, shallow breath during inhalation
🔴 RATIONALE: MDI usage requires a slow, deep inhalation to ensure the medication reaches the lower airways. Quick, shallow
breaths are ineffective.
A client is prescribed digoxin 0.25 mg orally daily. Before administering the dose, the nurse assesses an apical pulse of 54 beats per
minute. What is the appropriate nursing action?
A. Administer the dose as prescribed
RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027..
*Core Domains*
*• Pharmacological Therapies*
*• Reduction of Risk Potential*
*• Physiological Adaptation*
*• Basic Care and Comfort*
*• Parenteral Therapies*
*• Fluid and Electrolyte Management*
*• Medical-Surgical Nursing Interventions*
*Introduction*
*The purpose of this assessment is to evaluate the clinical competence and critical thinking skills of nu
SECTION ONE: QUESTIONS 1–100
A nurse is caring for a client with a potassium level of 3.2 mEq/L. Which clinical manifestation should the nurse anticipate during the
assessment?
A. Hyperactive bowel sounds
B. Muscle twitching
C. Weak, irregular pulse
D. Increased muscle tone
🟢 C. Weak, irregular pulse
🔴 RATIONALE: Hypokalemia causes decreased neuromuscular excitability, which can manifest as muscle weakness, fatigue, and
cardiac dysrhythmias, such as a weak, irregular pulse.
A client is receiving an intravenous infusion of 0.9% Normal Saline at 125 mL/hr. The nurse notes the site is cool to the touch,
edematous, and the infusion has slowed significantly. What is the priority nursing action?
A. Apply a warm compress to the site
B. Discontinue the infusion immediately
C. Slow the infusion rate to 50 mL/hr
,D. Elevate the affected extremity
🟢 B. Discontinue the infusion immediately
🔴 RATIONALE: These findings are indicative of infiltration. The priority action is to stop the infusion to prevent further tissue damage
from the fluid.
A client with chronic obstructive pulmonary disease (COPD) is being evaluated for respiratory status. Which arterial blood gas (ABG)
result would the nurse expect?
A. pH 7.32, PaCO2 50 mmHg, HCO3 26 mEq/L
B. pH 7.48, PaCO2 30 mmHg, HCO3 22 mEq/L
C. pH 7.40, PaCO2 40 mmHg, HCO3 24 mEq/L
D. pH 7.35, PaCO2 45 mmHg, HCO3 28 mEq/L
🟢 A. pH 7.32, PaCO2 50 mmHg, HCO3 26 mEq/L
🔴 RATIONALE: COPD leads to CO2 retention, causing respiratory acidosis, characterized by a low pH and an elevated PaCO2.
When preparing a client for a scheduled magnetic resonance imaging (MRI) scan, which assessment finding is the highest priority for
the nurse to report?
A. The client has a history of claustrophobia
B. The client has a permanent cardiac pacemaker
C. The client reports a mild allergy to iodine
D. The client is currently taking oral contraceptives
🟢 B. The client has a permanent cardiac pacemaker
🔴 RATIONALE: An MRI uses strong magnetic fields that can interfere with the function of electronic medical devices like pacemakers,
posing a severe safety risk.
A client who is postoperative following a total hip arthroplasty should be placed in which position to prevent hip dislocation?
A. Side-lying with the legs adducted
B. Supine with the legs abducted using an abduction pillow
C. High-Fowler's position with the hips flexed at 90 degrees
D. Prone position to relieve pressure on the surgical site
🟢 B. Supine with the legs abducted using an abduction pillow
🔴 RATIONALE: Abduction pillows prevent the hip from adducting past the midline, which is the most common cause of dislocation
after hip surgery.
Which laboratory result is the most critical for the nurse to review before administering heparin therapy?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
, C. International Normalized Ratio (INR)
D. Platelet count
🟢 B. Activated partial thromboplastin time (aPTT)
🔴 RATIONALE: The aPTT is the primary diagnostic test used to monitor the therapeutic efficacy and safety of heparin therapy.
A client is receiving a blood transfusion and begins to experience chills, low back pain, and tachycardia. What is the nurse's first action?
A. Notify the healthcare provider
B. Slow the transfusion rate
C. Stop the transfusion
D. Obtain a blood sample for a repeat cross-match
🟢 C. Stop the transfusion
🔴 RATIONALE: These symptoms indicate an acute hemolytic transfusion reaction. The nurse must stop the infusion immediately to
prevent further reaction and organ failure.
A client with diabetes mellitus is found to be confused, diaphoretic, and tremulous. What is the priority nursing intervention?
A. Administer subcutaneous insulin
B. Check the client’s blood glucose level
C. Provide a high-protein snack
D. Document the neurological status
🟢 B. Check the client’s blood glucose level
🔴 RATIONALE: These symptoms are classic signs of hypoglycemia. A blood glucose reading is necessary to confirm the diagnosis
before treatment is initiated.
A nurse is teaching a client about the use of a metered-dose inhaler (MDI). Which action by the client indicates the need for further
education?
A. Shaking the canister before use
B. Exhaling completely before inhaling the medication
C. Taking a quick, shallow breath during inhalation
D. Waiting one minute between puffs
🟢 C. Taking a quick, shallow breath during inhalation
🔴 RATIONALE: MDI usage requires a slow, deep inhalation to ensure the medication reaches the lower airways. Quick, shallow
breaths are ineffective.
A client is prescribed digoxin 0.25 mg orally daily. Before administering the dose, the nurse assesses an apical pulse of 54 beats per
minute. What is the appropriate nursing action?
A. Administer the dose as prescribed
