Physiological Integrity
Safe and Effective Care Environment
Health Promotion & Maintenance
Psychosocial Integrity


[ How The NCLEX Is Scored ]
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Physiological Integrity

The Physiological Integrity category contains the majority of the questions on the exam, about 43-67 percent. This portion of the NCLEX deals with adult medical and surgical care, pediatrics, and gerontology, which is the study of the elderly and the effects of aging. Some of the questions may deal with conditions that nurses treat on a regular basis such as, diabetes, cardiovascular disorders, neurological disorders, renal diseases, and respiratory diseases. In addition, questions on traumatic injuries, immunological disorders, skin disorders and infectious diseases could be asked. There are different topics on the NCLEX pertaining to the pediatric client. These topics may include growth and development, birth abnormalities, child abuse, common infectious diseases of children, and usual childhood traumas such as burn injuries and fractures.

Contents breakdown into four categories:

1). Basic Care and Comfort

providing comfort and assistance in the performance of activities of daily

Assistive Devices
Nutrition and Oral Hydration
Personal Hygiene
Rest and Sleep
Non-Pharmacological Comfort Interventions

2). Pharmacalogical and Parentrial Therapies

providing care related to the administration of medications and parenteral therapies.

Adverse Effects/Contraindications/Side
Expected Actions/Outcomes
Medication Administration
Blood and Blood Products
Parenteral/Intravenous Therapies
Central Venous Access Devices
Pharmacological Pain Management
Dosage Calculation
Total Parenteral Nutrition

3). Reduction of Risk Potential

reducing the likelihood that clients will develop complications or
health problems related to existing conditions, treatments or procedures.

Changes/Abnormalities in Vital Signs
Diagnostic Tests
Potential for Complications from Surgical
Procedures and Health Alterations
Laboratory Values
System Specific Assessments
Potential for Alterations in Body Systems
Therapeutic Procedures
Potential for Complications of Diagnostic

4). Psysiological Adaptation

managing and providing care for clients with acute, chronic or life
threatening physical health conditions.

Alterations in Body Systems
Medical Emergencies
Fluid and Electrolyte Imbalances
Unexpected Response to Therapies
Illness Management

Safe and Effective Care Environment

This category makes up approximately 21-33 percent of the NCLEX questions. Questions in this category cover safety issues in patient care, particularly the administration of medicine to patients, safety measures to prevent further injuries and infections, isolation precautions, safety for pediatric patients, and special safety precautions for patients with psychiatric problems.

This portion of the exam may also include questions pertaining to laboratory tests, test results, and unique nursing procedures that may be associated with test results; ethical and legal nursing problems; nursing management; and issues related to giving patients the best care. NCLEX questions on these topics are randomly spread throughout the exam

This category is broken down into 2 subcategories:

Management of Care

Such contents would include:

Advance Directives
Continuity of Care
Establishing Priorities
Assignment, Delegation and Supervision
Ethical Practice
Case Management
Informed Consent
Client Rights
Information Technology
Collaboration with Interdisciplinary Team
Legal Rights and Responsibilities
Concepts of Management
Performance Improvement (Quality Improvement)
Confidentiality/Information Security

Safety and Infection Control

Such contents would include:

protecting clients and health care personnel from health and environmental hazards.

Accident/Error/Injury Prevention
Emergency Response Plan
Safe Use of Equipment
Security Plan
Ergonomic Principles ( fitting workplace conditions and job demands to the capabilities of the working population )
Standard Precautions/Transmission-
Based Precautions/Surgical Asepsis
Handling Hazardous and Infectious Materials
Home Safety
Reporting of Incident/Event/Irregular
Use of Restraints/Safety Devices

Health Promotion and Maintenance

The Health Promotion and Maintenance category makes up about 12 percent of the NCLEX examination. Questions under this category deal with birth control measures, pregnancy, labor and delivery; care for a newborn infant, growth and development, and diseases that can spread easily like sexually transmitted infections. If a patient is pregnant, it is very important that the nurse be able to act as a teacher or counselor for the patient. This makes it necessary to understand all components of a patient?s pregnancy. Knowledge of a proper diet, development of the fetus, signs and symptoms of pregnancy complications and certain pregnancy related procedures will be helpful for this section of the exam

Such contents would include:

Aging Process
High Risk Behaviors
Ante/Intra/Postpartum and Newborn Care
Lifestyle Choices
Developmental Stages and Transitions
Health Promotion/Disease Prevention
Techniques of Physical Assessment
Health Screening

Psychosocial Integrity

Like the section on Health Promotion and Maintenance, the Psychosocial Integrity category constitutes approximately 12 percent of the NCLEX questions. Questions in this category pertain to patients with psychiatric problems and their unique issues. In addition, this material may cover coping mechanisms for different situations. Other situations covered in this section are about psychosocial problems that fall short of psychiatric illness. Questions could cover information on the following disorders: depression, schizophrenia, organic mental disorders, eating disorders, personality disorders, and anxiety disorders. Also included in this section may be questions about crisis intervention, substance abuse, and therapy through communication.

Such contents would include:

Family Dynamics
Behavioral Interventions
Grief and Loss
Chemical and Other Dependencies/
Substance Use Disorder
Mental Health Concepts
Religious and Spiritual Influences on Health
Coping Mechanisms
Sensory/Perceptual Alterations
Crisis Intervention
Stress Management
Cultural Awareness/Cultural Influences
on Health
Support Systems
Therapeutic Communication
End of Life Care
Therapeutic Environment

You see? This is an aweful lot to take in, understand and process.

Words That Will Help You Choose the Right Answer

Decide What the Question is Dealing With:
  • Which part of the Nursing Process: Assessment; Analysis; Planning; Implementation or Evaluation?
  • Next, Decide the Order of Priority

First you must decide what part of the nursing process the question is connected with:

  • ANALYSIS--is the process of identifying potential and actual health problems. Most identify pertinent assessment information and assimilate it into the nursing diagnosis. Prioritize the needs that have been identified during analysis.
  • Some common words that are associated with ANALYSIS questions:
  • diagnose; contrast; compare; analyze; order; prioritize; define; classify; catagorize; synthesize; sort; arrange;
  • ASSESSMENT--consists of a collection of data. Baseline information for pre and post procedures is included. Also included the recognition of pertinent signs and symptoms of health problems both present and potential. Verification of data and confirmation of findings are also included. Assess a situation before doing an intervention.
  • Some common words that are associated with ASSESSMENT questions:
  • observe; gather; collect; differentiate; assess; recognize; detect; distinguish; identify; display; indicate; describe;
  • PLANNING--Involves formulating goals and outcomes. It also involves various members of the health care team and the patient's family. All outcome criteria must be able to be evaluated with a specific time frame. Be sure to establish priorities and modify according to question.
  • Some common words that are associated with PLANNING questions:
  • rearrange; reconstruct; determine; outcomes; formulate; include; expected; designate; plan; generate; short/long term goal; develop;
  • IMPLEMENTATION--Addresses the actual/direct care of a patient. Direct care entails pre, intra and postoperative management, preforming procedures, treatments, activities of daily living. Also includes the coordination of care and referral on discharge. It involves documentation and therapeutic response to intervention and patient teaching for health promotion and helping the patient maintain proper health.
  • Some common words that are associated with IMPLEMENTATION questions:
  • document; explain; give; inform; administer; implement; encourage; advise; provide; perform;
  • EVALUATION--Determines if the interventions were effective. Were goals met? Was the care delivered properly? Are modification plans needed. Addresses the effectiveness of patient teaching and understands and determines in proper care was offered. Evaluation can involve documentation, reporting issues, evaluates care given and determine the appropriateness of delegating to others. Most significantly, it finds out the response of the patient to care and the extent to which the goals we met.
  • Some common words that are associated with EVALUATION questions:
  • monitor; expand; evaluate; synthesize; determine; consider; question; repeat; outcomes; demonstrate; reestablish;
  • After determining what part of the nursing process the question is concerned with, next focus your attention on determining the category of priority:

    Have a blessed day!~