Title RECALLS 2 - NP4 - SC ✅

RECALLS 2 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 1 – Nurse Alex cares for a terminally ill client with cancer. 1. Nurse Yolan assesses the client for depression. Which of the following is a key indicator for clinical depression? A. Anger due to pain experience B. Feeling of excessive guilt C. Anorexia and weight loss D. Inability to care for one’s physical self 2. The client has difficulty sleeping. Which of the following interventions is LEAST helpful for Nurse Yolan to incorporate in her care plan? A. Instruct the client to drink herbal tea. B. Give warm milk at bedtime C. Perform relaxation routine such as massage, imagery or music D. Instruct the client to drink black tea. 3. The care plan for the client includes family support. Which of the following is MOST appropriate for the family to establish a relationship with the health care team? Nurse Yolan should ___________: A. Give permission to the family to take time to maintain friendship with the health care team. B. Discuss the roles of the family members to the health care team. C. Explain the roles of all members of the interdisciplinary team. D. Provide a brief explanation to the family member about the care being delivered to the client. 4. The client appears to be dehydrated. The family members are discussing whether their loved one should be given intravenous fluid. Which of the following concepts about dehydration in terminally ill clients should guide Nurse Yolan? A. Peripheral edema occurs because of fluid overload. B. Thirst is an indication of dehydration. C. Terminally ill clients are hydrated through oral and intravenous routes. D. All interventions for terminally ill client should be directed towards comfort and reduction of symptoms. 5. The client show signs of imminent death. Nurse Yolan recognizes cardiovascular indicators of imminent death which are the following EXCEPT __________: A. bradycardia B. Irregular heart rate C. tachycardia D. lowered blood pressure Situation 2 – A 65-year old male is admitted for prostate cancer. On assessment, the nurse determines that the patient has experienced incontinence. The nurse knows that incontinence is the first most common symptom of prostate cancer. 6. Based on information gathered, the nurse writes a nursing diagnosis. Which of the following diagnoses is MOST appropriate? A. Deficient knowledge related to self-care and risk prevention. B. Fear secondary to the diagnosis of cancer. C. Risk for urinary infection D. Risk for impaired urinary elimination 7. To help manage incontinence, the nurse instructs the patients to do which of the following: A. Eat foods rich in fiber B. Increase fluid intake. C. Take in medications to manage pain. D. Perform perineal muscle exercises 8. The patient asks for treatment option for his condition. The Nurse explains that treatment options are based on which of the following: A. gender B. ability of the patient to manage physical and emotional implications of incontinence C. Socio-economic status D. grade and stage of the disease 9. The patient asks the nurse what the physician meant about his prostate cancer as Stage C or T3. The nurse explains that the tumor is ______________: A. palpable and has spread to other organs and often to distant sites such as bones and lymph nodes. B. palpable and has spread beyond the prostate but not to other organs. C. confined to the prostate and was not palpable during digital rectal examination. D. confined to the prostate and was not palpable during digital rectal examination. 10. The nurse recalls the staging and classification of prostate cancer. Which of the following statements is TRUE? A. the gleason grading system is usually used for hematological cancers but not prostate cancer. B. the normal prostate specific antigen (PSA) range under 40 years of age is less than 4 to 6 ng/mL. C. at least two separate biopsy specimens are graded based on their differentiation from normal prostate cells. D. A score of D is less invasive than a score of B in the cancer staging system. Situation 3 – You are newly promoted charge nurse of a department in a tertiary hospital. You review management concepts to prepare you for the position. The following questions pertain to management of resources. 11. You are oriented on health care economics. The study of economics focuses on how choices are made to overcome a scarcity of resources. Which of the following statements BEST illustrates health care economics __________: 1. Providing less health care services that is optimal in order to contain costs. 2. Using individuals with less knowledge and skill to perform health care services usually performed by people with advanced knowledge and training. 1 | Page

1. Urinary leakage 2. Delayed bleeding from damage Abscess formation 3. Paralytic 4. ileus Renal failure A. 4 & 5 B. 3 & 4 C. 1 & 2 D. 2 & 3 27. The nurses knows that with renal trauma, further complications may occur such as: . 1. Secondary hemorrhage usually due to infection 2. Renal artery stenosis 3. Renal atrophy 4. Hypotension 5. Hydronephrosis Which are the POSSIBLE complications? A. 2, 3, 4, 5 B. 1, 2, 3, 4, 5 C. 1, 2, 3, 5 D. 1, 3, 4, 5 28. The nurse assesses the patient to determine the extent of injury. Which of the following signs is a CARDINAL sign of renal trauma? A. Shock B. Lumbar pain C. Abdominal pain D. Hematuria 29. The nurse writes a nursing diagnosis for the patient with a stab wound. The MOST appropriate nursing diagnosis is ____________. A. Nutrition imbalance, less than body requirements, related to nausea from renal trauma B. Deficient fluid volume related to blood in the urine C. Acute pain in the abdominal area related to renal trauma D. Acute pain in the lumbar area related to renal trauma 30. The physician prescribes Magnetic Resonance Imaging (MRI) of both kidneys to confirm clinical suspicion and determine the severity of the injury. Which of the following activities is a PRIMARY nursing consideration in preparing the patient for MRI? A. Administer all medications scheduled before the test. B. Report findings of metal screening ; sedate the patient before sending him for MRI. C. Coordinate the MRI with other patient care activities and inform the patient about the test. D. Ensure the patient is on NPO and hold all medications until test is completed. Situation 7- Nurse Ashley is a staff nurse in the oncology unit of a tertiary hospital. She reads literature on antineoplastic medications. 31. Nurse Ashley understands the importance of continuing professional development. Which of the following is the MAIN purpose of continuing professional development? To ____________. A. Update one’s professional knowledge and competence B. Acquire a certificate of attendance to add to one’s curriculum vitae C. Establish networking within the nursing profession D. Fulfill requirements for an advanced degree in nursing 32. Nurse Ashley reads that the drug Cyclophosphamide ( Cytoxan ) is given to patients with breast cancer. Nurse Ashley understand that this drug is ______: A. Cell cycle phase-non-specific B. A hormonal medication C. An antimetabolite D. Cell cycle phase-specific 33. Nurse Ashley reads in the literature that a patient with breast cancer taking Cytoxan should observe the following. Given a case what should nurse Ashley instruct a patient to do? A. Decrease sodium intake while on medication. B. Take the medication with food. C. Increase potassium intake while on medication. D. Increase fluid intake 2000 to 3000 mL daily. 34. Nurse Ashley understands that patients receiving antineoplastic medications should do which of the following? 1. Drinks beverages containing alcohol in moderate amounts. 2. Consult with the physician before receiving immunizations. 3. Be sure to receive flu and pneumonia immunizations. 4. Take aspirin (Acetylsalicylic Acid, ASA) as for headache. A. 2 only B. 3 & 4 C. All of the options D. 1 & 2 35. An incident was described in the literature where a patient developed stomatitis after receiving a course od antineoplastic medications. Which of the following actions would be BEST for a nurse to do? A. Swab the mouth daily with lemon and glycerine. B. Avoid foods and fluids for the next 24 hours. C. Brush the teeth and use waxed dental floss 3x a day. D. Rinse the mouth with diluted baking soda or saline. Situation 8- The head nurse of a trauma unit introduce changes to improve the quality of care of trauma patients. 36. The head nurse presented a set of goals to the staff nurses. Which of the following goals is NOT relevant to improving quality of care? No_______: A. Legal suits. B. Needless deaths. C. Waste of resources. D. Needless pain or suffering. 37. The head nurse reviews reports on nurse staffing. The following findings result to better patient outcomes EXCEPT: A higher _______: A. Nurse to patient ratio shortens lengths of patient stay in the hospital. B. Nurse to patient ratio results to reduced patient mortality. C. Number of nurses, infection rates fall. D. Nurse to patient ratio increases costs. 38. The head nurse determines to reduce medication errors in the trauma unit. She recognizes that medication errors often occur in relation to the following EXCEPT: A. Preparing the wrong concentration and administering the medication via the correct route. B. Failure to question unclear medication errors. C. Lack of knowledge about medication. D. Failure to identify non-therapeutic client responses. 39. The head nurse suggests that to reduce medication errors, several measures will be instituted. Which of the following is MOST appropriate? A. Use point-of-care technology to access drug reference information. B. Use of drug index C. Nurses must help educate patients and their families regarding proper medication administration. D. Patients must become more involved in managing their care. 40. The head nurse is aware that managing and improving quality care in the trauma unit requires which of the following? A. Personalized attention to patient’s needs and their families. B. A blame – free environment. C. All of the choices. D. A clean and orderly trauma unit. Situation 9- Nurse Mirasol is the attending nurse of a 40-year old female admitted in the medical unit with a probable diagnosis of Scleroderma. 41. The patient complains of pain in her fingertips and pallor followed by blanching of the extremities and redness. Nurse Mirasol knows that these symptoms are characteristic of which of the following disorders? A. Swan-neck deformity B. Raynaud’s phenomenon C. Joint swelling and effusion D. Symmetric Polyarthritis 3 | Page