Title RECALLS 4 - NP4 - SC ✅

RECALLS 4 EXAMINATION NURSING PRACTICE IV CARE OF THE CLIENT WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART B) NOV 2025 Philippine Nurse Licensure Examination Review GENERAL INSTRUCTIONS: 1. This test questionnaire contains 100 test questions 2. Shade only one (1) box for each question on your answer sheets. Two or more boxes shaded will invalid your answer. 3. AVOID ERASURES. 4. Detach one (1) answer sheet from the bottom of your Examinee ID/Answer Sheet Set. 5. Write the subject title “NURSING PRACTICE IV” on the box provided Situation: Karlwin Revillame, a 10-year-old boy, with a known history of severe hemophilia A presents to the emergency department with acute pain and swelling in his right knee. He reports a minor fall earlier that day. 1. What could be the underlying cause of the acute onset of pain and swelling in the right knee? A. Osteoarthritis B. Spontaneous hemarthrosis C. Ligament tear D. Septic arthritis 2. Which of the following is the priority nursing intervention? A. Apply a warm compress to the knee B. Administer factor VIII concentrate C. Perform range-of-motion exercises on the knee D. Prepare the patient for arthroplasty 3. What long-term complication is at risk for if his bleeding episodes are not managed effectively? A. Iron deficiency anemia B. Joint arthropathy C. Thrombocytopenia D. Aplastic anemia 4. The boy's mother asks about the risk of her future children inheriting hemophilia. What is the nurse's best response? A. "Only your sons are at risk of inheriting hemophilia." B. "There is a 50% chance that your daughters will be carriers." C. "Your daughters are at no risk of inheriting hemophilia." D. "Both your sons and daughters are at equal risk." 5. The treatment plan includes prophylactic factor VIII infusions. What is the primary goal of prophylaxis? A. To cure hemophilia B. To reduce the frequency and severity of bleeding episodes C. To increase platelet count D. To improve bone density Management of Patients with Hematologic Neoplasms 6. A 68-year-old male patient presents with fatigue, pallor, and easy bruising. A bone marrow biopsy reveals >20% blast cells. Which of the following is the most likely diagnosis? A. Chronic Lymphocytic Leukemia (CLL) B. Acute Myeloid Leukemia (AML) C. Multiple Myeloma D. Hodgkin's Lymphoma 7. A patient with AML undergoing induction chemotherapy develops a fever and absolute neutrophil count (ANC) of 0. Which intervention is priority? A. Administer granulocyte colony-stimulating factor (G-CSF). B. Begin broad-spectrum antibiotics. C. Monitor for signs of tumor lysis syndrome. D. Increase fluid intake. 8. Which of the following nursing diagnoses is priority for this patient during the induction phase of chemotherapy? A. Risk for infection related to neutropenia B. Imbalanced nutrition: less than body requirements related to anorexia and mucositis C. Activity intolerance related to fatigue and anemia D. Risk for bleeding related to thrombocytopenia 9. A patient with AML is experiencing severe mucositis. Which nursing intervention is most helpful? A. Administer antiemetics. B. Provide frequent mouth care with a soft-bristled toothbrush. C. Encourage increased fluid intake. D. Monitor for signs of infection. 10. Which infection prevention measure should be emphasized during patient and family education? A. Avoid crowds and people with known infections. B. Practice meticulous hand hygiene. C. Report any fever, cough, or diarrhea immediately. D. Avoid raw fruits, vegetables, and undercooked meats. 11. Which condition is suggested by fatigue, bone pain, and an elevated white blood cell count with a high percentage of lymphoblasts in a 4-year-old patient? A. Acute Myeloid Leukemia (AML) B. Chronic Lymphocytic Leukemia (CLL) C. Acute Lymphocytic Leukemia (ALL) D. Hodgkin's Lymphoma 12. A patient with ALL is receiving induction chemotherapy. Which medication is commonly included in the initial treatment regimen? A. Imatinib B. Azacitidine C. Dexamethasone D. Hydroxyurea 13. Which of the following is a common extramedullary site of leukemic cell infiltration in ALL? A. Liver B. Kidneys C. Lungs D. Central Nervous System (CNS) 14. A patient with ALL in remission is undergoing minimal residual disease (MRD) testing. What is the primary purpose of this testing? A. To determine the type of ALL subtype. B. To assess the effectiveness of induction chemotherapy. C. To predict the likelihood of relapse. D. To guide the choice of HSCT. 15. Which of the following treatments is used to improve outcomes in patients with high-risk Acute Lymphocytic Leukemia (ALL)? A. Maintenance chemotherapy only B. Consolidation chemotherapy C. Supportive care alone D. Observation 1 | Page