NCLEX-RN physiological integrity syllabus
Physiological Integrity is the broadest Client Needs category, split across four subcategories whose ranges run from 6 to 12 per cent up to 13 to 19 per cent. Added together at the top of their ranges they are well over half the exam.
Pharmacological and Parenteral Therapies at 13 to 19 per cent is the second largest subcategory on the paper, behind only Management of Care. The NCLEX-RN syllabus hub page covers the other categories.
Pattern
| Element | Detail |
|---|---|
| Format | Computerised adaptive testing |
| Minimum items | 85 |
| Maximum items | 150 |
| Unscored pretest items | 15 on every exam, not identified |
| Maximum time | Five hours, including all breaks |
| Result | Pass or fail. No numerical score is reported |
| Passing standard | 0.00 logits |
| Negative marking | None |
An individual exam may differ from the published distributions by up to three percentage points in each category. The full distribution is below.
| Client Needs category or subcategory | Percentage range |
|---|---|
| Management of Care | 15 to 21% |
| Safety and Infection Prevention and Control | 10 to 16% |
| Health Promotion and Maintenance | 6 to 12% |
| Psychosocial Integrity | 6 to 12% |
| Basic Care and Comfort | 6 to 12% |
| Pharmacological and Parenteral Therapies | 13 to 19% |
| Reduction of Risk Potential | 9 to 15% |
| Physiological Adaptation | 11 to 17% |
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Basic Care and Comfort, 6 to 12 per cent
- Assistive devices
- Elimination
- Mobility and immobility
- Non-pharmacological comfort interventions
- Nutrition and oral hydration
- Personal hygiene
- Rest and sleep
Pharmacological and Parenteral Therapies, 13 to 19 per cent
The second largest subcategory on the exam.
- Adverse effects, contraindications, side effects and interactions
- Blood and blood products
- Central venous access devices
- Dosage calculation
- Expected actions and outcomes
- Medication administration
- Parenteral and intravenous therapies
- Pharmacological pain management
- Total parenteral nutrition
Reduction of Risk Potential, 9 to 15 per cent
- Changes and abnormalities in vital signs
- Diagnostic tests
- Laboratory values
- Potential for alterations in body systems
- Potential for complications of diagnostic tests, treatments and procedures
- Potential for complications from surgical procedures and health alterations
- System specific assessments
- Therapeutic procedures
Physiological Adaptation, 11 to 17 per cent
- Alterations in body systems
- Fluid and electrolyte imbalances
- Haemodynamics
- Illness management
- Medical emergencies
- Pathophysiology
- Unexpected response to therapies
What is not in this category
- No delegation or prioritisation, which sit under Management of Care
- No therapeutic communication, which sits under Psychosocial Integrity
- No developmental milestones or maternity care, which sit under Health Promotion and Maintenance
- No published total for the parent category. NCSBN prints ranges against the four subcategories only
How to spend the time
Start with pharmacology. At 13 to 19 per cent it is the second largest subcategory on the exam, and dosage calculation within it is the one topic where a method practised to automaticity converts directly into marks.
Learn laboratory values as ranges with consequences rather than as numbers. Questions usually give a value and ask what the nurse does next, so the number matters only through what it means.
Keep Reduction of Risk Potential and Physiological Adaptation apart in your head. The first is about what might go wrong and how you would notice. The second is about what has gone wrong and how you respond.
Basic Care and Comfort is the subcategory candidates skip because it feels like foundational material. At 6 to 12 per cent it is the same size as Psychosocial Integrity. Browse the available NCLEX-RN practice papers.
Common mistakes
- Leaving pharmacology late when it is the second largest subcategory on the exam
- Memorising laboratory values without knowing what action each abnormal result calls for
- Confusing Reduction of Risk Potential with Physiological Adaptation
- Skipping Basic Care and Comfort as too foundational to be examined
- Learning drug names without their adverse effects, contraindications and interactions
- Treating dosage calculation as arithmetic to be done under pressure rather than a method to be drilled
The four Physiological Integrity subcategories
| Subcategory | Range | What it asks |
|---|---|---|
| Basic Care and Comfort | 6 to 12% | How do you meet the daily need |
| Pharmacological and Parenteral Therapies | 13 to 19% | What does the medication do and what do you watch for |
| Reduction of Risk Potential | 9 to 15% | What might go wrong and how would you notice |
| Physiological Adaptation | 11 to 17% | What has gone wrong and how do you respond |
Frequently asked questions
How much of the NCLEX-RN is Physiological Integrity?
NCSBN publishes no total for the parent category. Its four subcategories carry 6 to 12, 13 to 19, 9 to 15 and 11 to 17 per cent.
Which is the largest subcategory here?
Pharmacological and Parenteral Therapies at 13 to 19 per cent, which is the second largest subcategory on the whole exam.
Is dosage calculation tested?
Yes, named under Pharmacological and Parenteral Therapies.
Where do laboratory values sit?
Under Reduction of Risk Potential, with diagnostic tests and system specific assessments.
What is the difference between Reduction of Risk Potential and Physiological Adaptation?
The first concerns the potential for complications and how you would detect them. The second concerns managing alterations that have occurred.
Are blood products covered?
Yes, under Pharmacological and Parenteral Therapies, along with central venous access devices and total parenteral nutrition.
Is pathophysiology examined?
Yes, named under Physiological Adaptation.
Is non-pharmacological pain relief included?
Yes, under Basic Care and Comfort as non-pharmacological comfort interventions.
Did any of these percentages change in the current test plan?
No. All four ranges are identical to the previous plan.
Is a calculator available?
Yes. An on-screen calculator is provided.