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RECALLS EXAMINATION 8 NURSING PRACTICE V CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART C) NOVEMBER 2024 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 V” on the box provided 1. Which of the following manifestations is a prominent characteristic of borderline personality disorder? A. Suspiciousness B. Reckless disregard for others C. Instability in personal relationships D. Unlawful behavior 2. Which of the following personality disorder is categorized as Cluster B? A. Schizoid Personality Disorder B. Paranoid Personality Disorder C. Narcissistic Personality Disorder D. Avoidant Personality Disorder 3. A patient is taking Parnate, a monoamine oxidase inhibitor (MAOI). Which foods should the nurse teach this patient to avoid? I. Pasta II. Cereals III. Aged cheese IV. Fresh fish V. Wine VI. Ricotta cheese A. I and II B. III and V C. III, V, VI D. II, III, IV 4. The nurse is caring for a client with paranoid personality disorder. Which of the following interventions, if done by nurse, needs further improvement? A. Provide a daily schedule of activities B. Monitoring for agitation C. Providing a safe environment D. Whispering in front of the client 5. Mr. Arlo reports of losing his job, not being able to sleep at night, and feeling upset with his wife. Nurse Christine responds to the client, “You may want to talk about your employment situation in group today.” The Nurse is using which therapeutic communication technique? A. Observations B. Restating C. Exploring D. Focusing 6. Nurse Nicole knows that most crisis situations should resolve in about: A. 1 to 3 weeks B. 4 to 6 weeks C. 4 to 6 months D. 6 to 12 months 7. Bernadette is getting married. As a knowledge nurse, you know that the crisis that she is experiencing can be categorized as: A. Maturational B. Situational C. Adventitious D. None of the above 8. Seraphina, 23 years old was sexually attacked while on her way home from school. She is brought to the hospital by her mother. Rape is an example of which type of crisis: A. Maturational B. Situational C. Adventitious D. None of the above 9. Proxemics is the study of distance zones between people during communication. Which distance zone is used between family and friends who are talking? A. Intimate zone B. Personal zone C. Social zone D. Public zone 10. In order for a therapeutic communication interaction to be comfortable, the nurse and the patient should be ____ apart? A. 0 to 18 inches B. 3 to 6 ft C. 6 to 12 ft D. 12 to 25 ft 11. Nurse Blyke is aware that Ritalin is the drug of choice for a child with ADHD. The intended effect of this drug may be noted by the nurse as: A. Increase attention span B. Reduce hyperactivity C. Reduce impulsivity D. All of the above 12. Client: “I had an accident.” Nurse: “Tell me about your accident.” This is an example of which therapeutic communication technique? A. Making observations B. Offering self C. General lead D. Reflection 13. The nurse is conducting an initial assessment of a client in crisis. When assessing the client’s perception of the precipitating event that led to the crisis, which is the most appropriate question? A. “With whom do you live?” B. “Who is available to help you?” C. “What leads you to seek help now?” D. “What do you usually do to feel better?” 14. The police arrive at the emergency department with a client who has lacerated both wrists. Which is the initial nursing action? A. Administer an antianxiety agent. B. Assess and treat the wound sites C. Secure and record a detailed history. D. Encourage and assist the client to ventilate feelings. 15. The most common defense mechanism used by a paranoid client is: A. Displacement B. Rationalization C. Suppression D. Projection 1 | Page
16. After ECT, the nurse should do this action before giving the client fluids, food or medication: A. Assess the gag reflex B. Assess biceps reflex C. Assess corneal reflex D. Check O2 Sat with a pulse oximeter. 17. A 10-year-old child has arrived in the emergency room. As a newly registered nurse, you know that this child is in what stage of cognitive development? A. Sensorimotor B. Preoperational C. Concrete Operational D. Formal Operational 18. The four levels of anxiety were described by: A. Erik Erikson B. Sigmund Freud C. Hildegard Peplau D. Jean Piaget 19. The personality structures of id, ego, and superego were described by A. Sigmund Freud B. Hildegard Peplau C. Erik Erikson D. Jean Piaget 20. Who described the four stages of cognitive development? A. Sigmund Freud B. Hildegard Peplau C. Erik Erikson D. Jean Piaget Situation: Clients with Bipolar disorder receives a very high nursing attention due to the increasing rate of suicide related to the illness. 21. The nurse is assigned to care for a recently admitted client who has attempted suicide. What should the nurse do? A. Search the client's belongings and room carefully for items that could be used to attempt suicide. B. Express trust that the client won't cause self-harm while in the facility. C. Respect the client's privacy by not searching any belongings D. Remind all staff members to check on the client every 4 hours. 22. In planning activities for the depressed client, especially during the early stages of hospitalization, which of the following plan is best? A. Provide an activity that is quiet and solitary to avoid increased fatigue such as working on a puzzle and reading a book B. Plan nothing until the client gives you a list of things that he wants to do C. Offer the client a menu of daily activities and ask the client to participate in all of them D. Provide a structured daily program of activities and encourage the client to participate 23. The client is taking a Tricyclic anti-depressant, which of the following is an example of TCA? A. Parnate B. Prozac C. Zoloft D. Elavil 24. The nurse is planning activities for a client diagnosed with bipolar disorder with aggressive social behavior. Which activity would be most appropriate for this client? A. Chess B. Writing C. Board games D. Group exercise 25. The physician orders lithium carbonate (Lithonate) for a client who's in the manic phase of bipolar disorder. During lithium therapy, the nurse should watch for which adverse reactions? A. Anxiety, restlessness, and sleep disturbance B. Nausea, diarrhea, and slurred speech C. Constipation, confusion, and ataxia D. Pruritus, hypotonic muscles, and urinary retention Situation: Survey and Statistics are important part of research that is necessary to explain the characteristics of the population. 26. All of the following are measures of Central Tendency, except: A. Mean B. Standard deviation C. Median D. Mode 27. In the value: 87, 85, 88, 92, 90; what is the mean? A. 88.2 B. 88.4 C. 87 D. 90 28. In the value: 80, 80, 80, 82, 82, 90, 90, 100; what is the mode? A. 80 B. 82 C. 90 D. 85.5 29. In the value: 80, 80, 10, 10, 25, 65, 100, 200; what is the median? A. 71.25 B. 22.5 C. 65 and 80 D. 72.5 30. You are interested to study the effects of meditation and relaxation on the pain experienced by cancer patients. What type of variable is pain? A. Dependent B. Independent C. Phenomenology D. Ethnography 31. Blood levels are drawn on the patient who has been taking Lithium for about six months. The present level is 2.1 meq/L. The nurse evaluates this level as: A. Therapeutic B. Mild toxicity C. Moderate toxicity D. Severe toxicity 32. The nursing plan for a patient with bipolar personality disorder should emphasize: A. Offering him finger foods B. Telling him he must sit down and eat C. Serving food like spaghetti D. Serve him foods low in calories but high in protein 33. A 48-year-old female patient is brought to the hospital by her husband because her behavior is blocking her ability to meet her family's needs. She has uncontrollable and constant desire to scrub her hands, the walls, floors and sofa. She keeps repeating," Everything is dirty." This is an example of: A. Compulsion B. Obsession C. Delusion D. Hallucination 34. A client is unwilling to go to church because the ex-spouse goes there and the client feels that the ex-spouse will laugh at the client. Because of this hypersensitivity to a reaction from the spouse, the client remains homebound. The home care nurse develops a plan of care that addresses which personality disorder? A. Avoidant B. Borderline C. Schizotypal D. Obsessive-compulsive 35. When planning the discharge of a client with chronic anxiety, which is the most appropriate maintenance goal? A. Suppressing feelings of anxiety B. Identifying anxiety-producing situations C. Continuing contact with a crisis counselor D. Eliminating all anxiety from daily situations 36. A patient cries and curls in a fetal position refusing to move or talk. This is an example of: A. Regression B. Suppression C. Conversion D. Sublimation 37. An unattractive girl becomes a very good student. This is an example of: 2 | Page
A. Displacement B. Regression C. Compensation D. Projection 38. The patient has a phobia about walking down in dark halls. The nurse recognizes that the defense mechanism usually associated with phobia is: A. Compensation B. Denial C. Conversion D. Displacement 39. A person who cheats on a spouse brings the spouse a bouquet of roses is an example of what defense mechanism? A. Intellectualization B. Compensation C. Undoing D. Identification 40. The client tells the nurse that he can't eat because his food has been poisoned. This statement is an indication of which of the following? A. Delusion of grandiose B. Delusion of persecution C. Delusion of reference D. Delusion of religion 41. The nurse is assessing a client who was admitted 24 hours ago for a fractured humerus. Which findings would alert the nurse to the potential for alcohol withdrawal delirium? A. Hypotension, ataxia, hunger B. Stupor, lethargy, bradycardia C. Hypotension, coarse hand tremors, lethargy D. Hypertension, changes in level of consciousness, hallucinations 42. The spouse of a client admitted to the mental health unit for alcohol withdrawal says to the nurse, “I need to get out of this bad situation.” Which is the most helpful response by the nurse? A. “Why don’t you tell your spouse about this?” B. “What do you find difficult about this situation?” C. “This is not the best time to make that decision.” D. “I agree with you. You should get out of this situation.” 43. Rona has taken amitriptyline HCL (Elavil) for 3 days, but now complains that it “doesn’t help” and refuses to take it. What should the nurse say or do? A. Withhold the drug. B. Switch the medication to a SSRI C. Encourage the client to tell the doctor D. Suggest that it takes a while before seeing the results 44. In preparing a female client for electroconvulsive therapy (ECT), Nurse Rachel knows that succinylcoline (Anectine) will be administered for which therapeutic effect? A. Short-acting anesthesia B. Decreased oral and respiratory secretions C. Skeletal muscle paralysis. D. Analgesia. 45. Nurse Lynnette notices that a female client with obsessive-compulsive disorder washes her hands for long periods each day. How should the nurse respond to this compulsive behavior? A. By designating times during which the client can focus on the behavior. B. By urging the client to reduce the frequency of the behavior as rapidly as possible C. By calling attention to or attempting to prevent the behavior D. By discouraging the client from verbalizing anxieties 46. Nurse Katrina is caring for a client who experiences false sensory perceptions with no basis in reality. These perceptions are known as: A. Delusions B. Hallucinations C. Echolalia D. Neologisms 47. Rudolf is admitted for an overdose of amphetamines. When assessing the client, the nurse should expect to see: A. Tremors and irritability B. Slow pulse C. Hypotension D. Salivation 48. Carlo, a nursing student is anxious about the upcoming board examination but is able to study intently and does not become distracted by a roommate’s talking and loud music. The student’s ability to ignore distractions and to focus on studying demonstrates: A. Mild-level anxiety B. Moderate-level anxiety C. Severe-level anxiety D. Panic-level anxiety 49. Tranylcypromine sulfate (Parnate) is prescribed for a depressed client who has not responded to the tricyclic antidepressants. After teaching the client about the medication, Nurse Marian evaluates that learning has occurred when the client states, “I will avoid: A. Citrus fruit, tuna, and yellow vegetables.” B. Chocolate milk, aged cheese, and yogurt’” C. Green leafy vegetables, chicken, and milk.” D. Whole grains, red meats, and carbonated soda.” 50. Ela with manic episodes is taking lithium. Which electrolyte level should the nurse check before administering this medication? A. Calcium B. Sodium C. Chloride D. Potassium 51. When removing a contaminated gown, the nurse should be careful that the first thing she touches is the: A. Waist tie and neck tie at the back of the gown B. Waist tie in front of the gown C. Cuffs of the gown D. Inside of the gown 52. The physician orders gr 10 of aspirin for a patient. The equivalent dose in milligrams is: A. 0.6 mg B. 10 mg C. 60 mg D. 600 mg 53. A 35-year-old female has intense fear of riding an elevator. She claims “As if I will die inside.” The client is suffering from: A. Agoraphobia B. Monophobia C. Claustrophobia D. Xenophobia 54. John is very hostile toward one of the staff for no apparent reason. He is manifesting: A. Splitting B. Transference C. Countertransference D. Compensation 55. The nurse is assigned to care for four clients. In planning client rounds, which client would the nurse assess first? A. A postoperative client preparing for discharge with a new medication B. A client requiring daily dressing changes of a recent surgical incision C. A client scheduled for a chest x-ray after insertion of a nasogastric tube D. A client with asthma who requested a breathing treatment during the previous shift 56. The nurse manager has implemented a change in the method of the nursing delivery system from functional to team nursing. An assistive personnel (AP) is resistant to the change and is not taking an active part in facilitating the process of change. Which is the best approach in dealing with the AP? A. Ignore the resistance. B. Exert coercion on the AP C. Provide a positive reward system for the AP D. Confront the AP to encourage verbalization of feelings regarding the change. 57. The microwave in the break room has caught on fire. Which type of fire extinguisher will the nurse use for electrical equipment? A. Type A B. Type B C. Type C D. Type D 58. The nurse is giving report to an assistive personnel (AP) who will be caring for a client who has hand restraints (safety 3 | Page
devices) applied. How frequently would the nurse instruct the AP to remove the restraints to allow for muscle activity? A. Every 2 hours B. Every 3 hours C. Every 4 hours D. Every 6 hours 59. All of the following measures are recommended to prevent pressure ulcers except: A. Massaging the reddened are with lotion B. Keeping the client’s skin dry C. Adhering to a schedule for positioning and turning D. Providing meticulous skin care 60. The nurse is preparing to administer exogenous surfactant to a premature infant who has respiratory distress syndrome. The nurse prepares to administer the medication by which route? A. Intradermal B. Intratracheal C. Subcutaneous D. Intramuscular 61. The nurse is caring for a patient who is believed has been abusing opiates. Assessment findings in a client abusing opiates like Morphine Sulfate include: A. Dilated pupils and slurred speech B. Rapid speech and drowsiness C. Dilated pupils and bradypnea D. Constricted pupils and hypotension 62. A patient with schizophreania says “We can, pan, scan, ran, plan.” The nurse identifies this as which speech abnormality? A. Echolalia B. Word salad C. Neologism D. Clang association 63. A patient’s feelings of despair and depression have lifted, and she tells the nurse, “I feel better now.” The nurse understands that this patient is: A. No longer a suicide risk B. Less of a suicide risk than when she was deeply depressed C. More of a suicide risk than when she was deeply depressed D. A suicide risk only in the evening 64. A client with schizophrenia has been started on medication therapy with clozapine. The nurse would assess the results of which laboratory study to monitor for adverse effects from this medication? A. Platelet count B. Creatinine C. Red blood cell count D. White blood cell count 65. A client receiving tricyclic antidepressants arrives at the mental health clinic. Which observation would indicate that the client is following the medication plan correctly? A. Client reports not going to work for the past week. B. Client complains of not being able to “do anything” anymore. C. Client arrives at the clinic neat and appropriate in appearance. D. Client reports sleeping 12 hours per night and 3 to 4 hours during the day. 66. The nurse notes that a client with schizophrenia who is receiving an antipsychotic medication is moving the mouth, protruding the tongue, and grimacing while watching television. The nurse determines that the client is experiencing which medication complication? A. Parkinsonism B. Tardive dyskinesia C. Hypertensive crisis D. Neuroleptic malignant syndrome 67. The client has been subjected to thoracentesis without written consent. What offense are the health care providers for? A. Assault B. Battery C. Manslaughter D. Invasion of privacy 68. The nurse reviews the blood gas results of a client with atelectasis. The nurse analyzes the results and determines that the client is experiencing respiratory acidosis. Which result validates the nurse’s findings? A. pH 7.25, Paco2 50 mm Hg B. pH 7.35, Paco2 40 mm Hg C. pH 7.50, Paco2 52 mm Hg D. pH 7.52, Paco2 28 mm Hg 69. The nurse reviews the arterial blood gas results of a client and notes the following: pH 7.45, Paco2 of 30 mm Hg, and HCO3 of 20 mEq/L (20 mmol/L). The nurse analyzes these results as indicating which condition? A. Metabolic acidosis, compensated B. Respiratory alkalosis, compensated C. Metabolic alkalosis, uncompensated D. Respiratory acidosis, uncompensated 70. Ensuring that there is an informed consent on the part of the patient before a surgery is done, illustrates the bioethical principle of: A. Beneficence B. Autonomy C. Veracity D. Non-maleficence 71. Which sampling method gives equal chance to all units in the population to get picked? A. Random B. Quota C. Snowball D. Convenience 72. Johnson is interested to learn more about transcultural nursing because he is assigned at the family suites where most patients come from different cultures and countries. Which of the following designs is appropriate for this study? A. Grounded theory B. Ethnography C. Case study D. Phenomenology 73. In the statement, “Frequent hand washing of health workers decreases the incidence of nosocomial infections among post-surgery patients”, the dependent variable is A. Incidence of nosocomial infections B. decreases C. frequent hand washing D. post-surgery patients 74. A nurse provides instructions to a malnourished client regarding iron supplementation during pregnancy. Which statement when made by the client would indicate an understanding of the instructions? A. “Iron is best taken on an empty stomach” B. “Iron and Vitamin C should not be taken together as it decreases absorption.” C. “I should take Iron and antacids together” D. “I should report to my HCP if my stool becomes green-black.” 75. A patient is on Coumadin therapy. Which statement made by the client will concern the nurse? A. “I will refrain from taking aspirin for my headache.” B. “I’m glad I’ll be able to eat lettuce, spinach, and other green vegetables.” C. “I will use soft-bristled toothbrush.” D. “I will monitor for signs of bleeding.” 76. Alexa is diagnosed with panic disorder with agoraphobia is talking with the nurse in-charge about the progress made in treatment. Which of the following statements indicates a positive client response? A. “I went to the mall with my friends last Saturday” B. “I drink alcohol with my medications.” C. “Today I decided that I can stop taking my medication” D. “Last night I decided to eat more than a bowl of cereal” 77. Riley, with a panic disorder may obtain secondary gain. Which of the following statement refers to a secondary gain? A. It brings some stability to the family B. It decreases the preoccupation with the physical illness C. It enables the client to avoid some unpleasant activity D. It promotes emotional support or attention for the client 78. Nurse Carlo develops a counter-transference reaction. This is evidenced by: 4 | Page

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