Title RECALLS 3 - NP3 - SC ✅

RECALLS 3 EXAMINATION NURSING PRACTICE III CARE OF THE CLIENT WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART A) 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 III” on the box provided Situation: Ethical and moral issues are becoming a common scenario in practice setting so health care providers have to be equipped with this competency. 1. In the clinical setting, when nurses are confronted with ethicaldilemmas the BEST practical guide she can use of is__. A. PRC oath for professionals B. Code of Ethics C. theological doctrine D. Florence Nightingale oath 2. Mr. RAD is admitted to the hospital complaining of chest pain due to clogged in his coronary arteries. He is diabetic hypertensive and considered by the physician to be a high risk for cardiovascularsurgery. What PRIORITY action should the members of the health team do in this situation? A. Consult the family members and let them give their decision. B. Proceed with the planned surgery, as this will save the patient. C. Consult the Ethics committee on what to do with the patient. D. Discuss with Mr. RAD his health status & let him decide. 3. Mrs. Agnes, 77 y/o is suffering from dementia and demonstrates unruly behavior. When Nurse Gigi describes the patient in her shift report, as "That awful, dirty old woman in Bed 14" is an example of what ethical behavior being employed by the nurse? A. Stigma B. Ageism C. Gender bias D. Depersonalization 4. Mr. Rey, who is on an end-stage of life has an order of "Do Not Resuscitate" and passed away in your shift. He was declared dead by his physician at 8:30 AM. What should be your PRIORITY nursing action in this situation? A. Prepare the death certificate for the physician to sign. B. Allow the family to have private moments with the deceased. C. Request your nurse attendant to call the funeral parlor atonce. D. Clean the body and remove all the IV lines, tubes and other appliances. 5. When a nurse is in full support of patient's care safety and personal rights throughout her hospital stay, she is implementing what ethical principle? A. Responsibility B. Empathy C. Advocacy D. Accountability Situation: A manager of an accounting firm is admitted to the hospital dueto an acute abdominal pain and passing out of bloody stools. After several diagnostic and laboratory examinations the physician ordered him form exploratory laparotomy. You are the nurse on duty that day. 6. While performing your assessment you are guided that the organs found in the epigastrium include which of the following? A. A Portion of duodenum & jejunum, left kidney, appendix & ovary B. Duodenum, pancreas, portion of the liver and pyloric end of the stomach. C. Stomach, spleen, tail of pancreas and adrenal gland. D. Gallbladder, duodenum, gallbladder and portion of the right kidney. 7. When conducting a nursing history on the Health Perception, Health Management pattern of functioning what is the APPROPRIATE question to be asked pre-operatively? A. Do you experience your wounds to heal quickly? B. Do you have shortness of breath when exercising? C. Are you aware of risk factors for your disease? D. Have you experience weight changes in the past? 8. Patient was visited by the anesthesiologist and explained the anesthesiafor his surgery. Which of the following type of anesthesia would youexpect to be ordered? A. Spinal B. Caudal C. Local D. General 9. There are pre-operative medications given to the patient. Which of the following drugs are given in order to decrease intra-operativeanesthetic requirements and pain? A. Celebrex (Celecoxib) B. Ibuprofen (Motrin) C. Acetaminophen (Tylenol) D. Demerol (Meperidine HC1) 10. The goals for patient's safety in the operating room is imperative forall members of the surgical team. Which of the following UniversalSafety Protocol are adopted and validated PRIOR to surgery? I. Patient's identity II. Surgical procedure III. Surgical site IV. Surgical equipment A. II & III B. I & II C. I, II & IV D. I, II & III Situation: Crisostomo a 40 years old employee has been complaining of difficult painful urination for almost a week now. He said he sawsome fresh blood in his urine but was afraid to see a physician, instead, he went to his neighbor who is a herbalist. After a week his condition worsen and his wife brought him to a community clinic. 11. A community clinic does primary care for patients. Most often the one who manages this is which of the following? 1 | Page
A. Physician B. Barangay health worker C. Nurse D. Midwife 12. Upon assessment, the patient was referred immediately to a 25-bed-capacity hospital, which does not have any capacity to do intensive diagnostic examinations. You are a nurse in this hospital, which you know is a LEVEL _________. A. 3 B. 1 C. 4 D. 2 13. In the tertiary hospital where the patient was again referred, he was considered an emergency case. The nurse immediately called for a specialist who is ________. A. Neurologist B. Urologist C. Phlebotomist D. Nephrologist 14. After a thorough assessment by the physician-specialist, an order for an immediate stonogramwas made. The nurse was instructed to call which of the following section of the hospital? A. Operation Room B. Laboratory C. Intervention D. CT scan 15. After the procedure the patient was ordered for Lithotripsy, under spinal anesthesia. The nurse has to call the department of ________. A. Internal medicine B. Anesthesia C. Surgery D. Imagery Situation: An alert 67 year-old woman with diabetes mellitus is discharged from the hospital. A referral is made to a community nursingagency. You are asked to reinforce the teaching program startedin the hospital. The patient is using sulfonylurea compound tolbutamide (Orinase). 16. When the patient turned 69 years old. Orinase was discontinued and NPHinsulin is prescribed for her. After several months, she is determinedto be suffering from the Somogyi effect. Which of the following conditions will most likely result when the patient is receiving too much insulin? A. Developing an elevation of the blood glucose level B. Producing even more insulin C. Becoming resistant to insulin D. Conserving excessive amount of fluid 17. A few days later, the patient comes into the emergency department via ambulance stretcher and reveals a work-up of a blood sugar level at 800mg/dl, ketones are absent in the urine, she is dehydrated, and has an altered mental status. Based on the data, the patient is most likely suffering from what specific medical condition? A. Hyperosmolar nonketotic coma (HNKC) B. Diabetic retinopathy C. Acute renal failure D. Diabetic ketoacidosis (DKA) 18. Upon interview, the patient reported that she often felt nauseated,restless, perspired a lot, felt fatigued, and was often hungry when shewas younger. What do these signs indicate? A. Diabetic nephropathy B. Hyperglycemia C. Hypoglycemia D. Diabetic retinopathy 19. Upon further assessment, you noticed that she had many scratches on her right ankle, a resulting infection and cellulitis. When you ask her about the scratchesthe patient states. "Oh, my cat must have been using my leg as a scratching post again and I did not even feel it”. Which diabetic complications suspect the patient to have? A. Neuropathy B. Macroangiopathy C. Retinopathy D. Ephropathy 20. You should check the patient for suspect disturbed thought processes related to depressed metabolism and altered cardiovascular and respiratory status. What is the rationale for orienting the patient to time, place, date, and events? A. Shows improved cognitive functioning B. Provides reality orientation to patient C. Permits evaluation of the effectiveness of treatment D. Lets the patient identify the time, place, date and eventscorrectly Situation: Nurse Pat is a newly hired Registered Nurse together with 5 licensed graduate nurses coming from different regions. It is their first day of orientation in a big health facility. The continuing nurse educator started the session by projecting the organizational structure of the medical center. 21. Which of the following is the MAJOR PURPOSE of an organizational structure? It is a ______. A. blueprint representing committees for delegation of rolesand functions B. flow chart that shows interaction among members of major and minor groups C. framework of relationship of units, departments and channels of communication D. design that identifies roles, collaboration, interdependence between functions of people 22. Line and staff functions are identified in the presented Organizational Chart. What does line authority mean? A. Staff relationship in the organization is advisory in nature B. Staff mix of personnel reporting to the "Boss". C. Decisions are made from bottom to top in an organization. D. A direct responsibility over a subordinate within anorganization. 23. Which of the following statements is CORRECT of nursing service system in health care? A. Informed leaders are more effective than formal leaders in an organization. B. A shared governance tends to be controlling and with less autonomy. C. Institutional policies are more powerful tool in nursing practice than laws and regulations. D. A situational leadership style provides effective means in achieving patient outcomes. 24. The mode of nursing service delivery system is being revisited in respond to patient's outcome. Which of the following is NOT TRUE of themanager's role in the health care delivery system? A. Provides direct nursing care when needed. B. Manages resource utilization. C. Act as a liaison in litigation cases in court. D. Collaborates with members of the health. 25. Budgeting is an important aspect of financial management. When a unitmanager allocates expenses for unit supplies, stocks and medical-surgical supplies. This is considered _________. A. cash budget B. operational budget C. capital budget D. flexible budget. Situation: Mely, 68 -year-old, was admitted to the hospital because of decreased appetite, easy fatigability, dehydration and weight loss of about 15 lbs for the past weeks. She was examined by the physician and advised to be admitted. You are the nurse assigned to take care of her. 26. The physician ordered to start Ms. Mely on Total Parenteral Nutrition(TPN). What Is your INITIAL step to be undertaken PRIOR to thisintervention? A. Determine if the family can afford the whole treatment. B. Evaluate the tolerance of the patient to glucose. C. Identify allergies of patient to the supplemental nutrition. D. Assess the basic understanding of the patient regarding TPN 27. Choose from the following the primary goals of TPN? I. promote weight gain II. improve nutritional status 2 | Page
III. maintain muscle mass IV. establish nitrogen balance V. enhance healing process A. I, II, & III B. I, II, III, & IV C. I& II D. I, II, III, IV & V 28. When a patient is undergoing TPN, you have to monitor closely for the _______. A. serum creatinine B. potassium level C. serum glucose level D. sodium level 29. While Mrs. Mely is on TPN she suddenly complained of slight chest pain, dyspnea and appears cyanotic. You suspect that she is experiencingwhat possible IMMEDIATE complication? A. Sepsis due to IV line B. Air embolism C. Hyperglycemia D. Allergic reaction to TPN 30. What PRIORITY nursing action should you do with the presentingclinical manifestations of the patient? A. Report to the physician status of the patient at once. B. Take Blood pressure and respiratory rate. C. Stop temporarily the Total Parenteral Nutrition D. Administer Oxygen inhalation. Situation: Ms. Monina is a retired Community Health nurse in barangay SanPablo. Due to her commitment to the nursing profession, she has volunteered in their community to conduct health educationclasses. One Saturday morning, several patients who are hypertensive and with pulmonary health problems attended hersession. 31. Mang Luis, is a newly diagnosed patient with Chronic Obstructive LungDisease (COPD). Which of the following PRIORITY teaching instructionsshould he be given in relation to his condition? A. He should assume supine position when resting. B. Know early signs of respiratory infection. C. He has to be taught how to do Bronchial clapping. D. Family should be advised that patient should sleep in a warmroom. 32. Which of the following health interventions should be included in yourteaching plan for Mang Luis? A. Be on prolonged corticosteroid therapy. B. Lung exercises must be done with longer inhalation than exhalation. C. Reduce risk for infection. D. Have a high flow of oxygen administration. 33. Pulmonary Rehabilitation for COPD has a duration of at least 4 to 12weeks. Which of the following should be avoided while patient is having this program? A. Pursed lip breathing B. Smoking cessation C. Aerobic, upper and lower body conditioning D. Peripheral muscle wasting 34. Weight loss and Malnutrition are commonly observed among patients withCOPD. They should be taught to avoid ________. A. have full stomach even when in dyspneic condition B. keeping body mass between 21-25 kg C. a high caloric and high protein diet D. exercise one hour before and after eating 35. Which of the following energy conserving strategies should NOT be done by COPD patients? A. Exhale when pushing or exerting effort when doing daily activities B. Assume tripod position with elbows supported on the tablewhen shaving or combing C. Inhale when resting, sitting and lying down. D. Stand in front of the mirror while shaving or combing hair Situation: A housewife, appearing jaundice, complaining of abdominal pain,nausea and bloated sensation was rushed to the hospital. Thepatient was examined by the physician and ordered for admissiondue to a suspected stone in the gall bladder. You are the nurseon duty that day. 36. When performing an interview, which is the BEST initial question shouldyou ask when a patient is on pain? A. How often do you feel the pain? B. How would you describe your pain? C. Did you take any drug to relieve the pain? D. When did you first feel the abdominal pain? 37. Which of the following imaging test that uses transducer will be likely be ordered by the physician to detect gallstones? A. Computed Tomography B. Abdominal X-ray C. Abdominal Ultrasound D. Doppler sonography 38. The test revealed presence of gallstones and inflamed gall bladder. Thepatient was advised to undergo open cholecystectomy. This operationcompared to laparoscopic cholecystectomy are _________. I. invasive II. less pain III. longer recovery IV. shorter hospital stay A. I, II, & IV B. I & II C. I, II & III D. I & III 39. After 2 hours post-operatively, the nurse observed reddish drainage from the operative area of the patient. Which of the following nursingactions should you performed FIRST? A. Check if stitches from the operation have come apart. B. Check where is the source of possible bleeding. C. Cover the operative area with sterile gauze bandage. D. Put hand as a pressure on the operative area. 40. After several days in the hospital, the physician ordered for thepatient to be discharged. Which of the following is PRIORITYrestriction that you should emphasize when he goes home? A. Stool softener to induce bowel elimination. B. Driving while using narcotic drug. C. Take shower even if still with surgical drain. D. Lifting of objects not more than 10 lbs. Situation: Sarah, 18 year old, a teller from a bank is admitted to a tertiary hospital due to hypertension and frequent hematoma of the lower extremities every time she bumps herself in the workplace. The physician who examined her gave an impression of Cushingdisease. 41. Which of the following characteristics of Cushing disease is TRUE? I. The disease occurs in women between 20 to 40 year of age. II. The use of corticosteroids for multiple immune conditions is a cause of the disease process. III. Condition is aggravated by excessive production of ACTH. IV. The surgical treatment of choice in Transphenoidalhypophysectomy A. II & III B. I, II, & III C. I, II, III, & IV D. I & II 42. When one has a Cushing disease the focal structure affected is the __________. A. hypothalamus B. pituitary gland C. adrenal gland D. para thyroid gland 43. Which of the following clinical manifestations will NOT be a complaintfrom Sarah's condition? A. Edema of the extremities B. Poor wound healing C. Decrease libido D. Absence of growth in the pubic area 44. The attending physician ordered a Magnetic Resonance Imaging (MRI) topatient Sarah in order to validate the medical impression. This imaging technique is done to detect ________. A. hemorrhagic injury in the brain 3 | Page
B. electrical impulse in the brain C. level of oxygen in the brain D. non-hemorrhagic injury in the brain 45.While patient Sarah is confined in the hospital, the safety measure tobe observed by the nurses is prevention from fall. This is brought about by the patient being prone to fracture as a result of ____. A. aging process B. change in vision C. osteoporosis D. hematologic condition Situation: Mr. Alda, 50 year old company driver is admitted in the Emergency Room (ER) because of pain of the left chest and difficulty of breathing. History revealed that the patient smokes one half to 1 pack of cigarette per day especially when he goes on overtime. Vital signs: BP is 150/90, PR-110/min. RR 38/ beats. Has clammy perspiration and quite restless. The physician ordered chest X-ray and revealed patient has Pneumothorax. You are the nurse in-charge of the patient. 46. As a nurse you are guided that pain is usually described BEST as aphenomenon which is a ______. A. Neurologic activation of norciceptors B. Subjective unpleasant experience C. Adaptive mechanism to a stimulus D. Creation of one's imagination 47. When a patient has a pneumothorax, the nurse's assessment findings will likely reveal_______. I. absent breath sounds on the affected side II. decreased chest expansion unilaterally III. sharp chest pain IV. burning chest pain A. I, II,III B. III &IV C. I, II, IV D. I & II 48. Which of the following statements is NOT true of Pneumothorax? A. Atmospheric air within the pleural space can result to a rise in intra thoracic pressure and reduce vital capacity inthe lungs. B. The loss of positive intra-pleural pressure can producepneumothorax C. The loss of negative intra pleural pressure can result tocollapse of the lungs. D. A spontaneous pneumothorax can occur with the rupture ofpulmonary bleb. 49. The physician inserted a chest tube drainage to Mr. Alda in order tohelp re-expand the lungs. Which of the following should you prepareFIRST as a nurse in case of emergency when the tube is accidentally disconnected? A. sterile clamps. B. Another chest tube. C. Sterile dressing. D. A bottle of sterile water. 50. In order to relieve Mr. Alda of pain, the physician prescribed morphine. So4 2mg/IV PRN for untolerable pain. The overall goal of the Health Care Professional is to provide adequate control so the patient can breathe easily. Which of the following would indicate successful attainment ofthis goal? A. Anxiety level of patient will be reduced. B. Respiratory rate will be decreased to 20 breadths /min. C. Oxygen saturation is at 76% level. D. Pain scale will show 1to 2,in a rating scale of 10(highest, 0-lowest) Situation: Nurse Rachel is assigned in the medical unit of a tertiaryhospital where most of the patients admitted are suffering from Endocrine disorders. She is currently assigned to Patients: Claire, 54 year old, married with hyperthyroidism. Aster, 66 yr. old has an impression of Cushing syndrome while Sonia, 48 year old is suffering from hypothyroidism. 51. While you are doing your physical assessment to patient Aster, she hasbeen exhibiting a UNIQUE clinical manifestation different from patients. Claire and Sonia which is characterized by ________. A. cyanosis, increasing growth of hands and feet B. anemia, weight loss and presence of acne C. moon face purple striae on trunk and buffalo hump D. moon face easy fatigability and peripheral edema. 52. Which one of the following diagnostic tests do you expect NOT to be ordered by Dr. Lim to patient Aster who is suspected to have Cushing Syndrome? A. 24 hour urine cortisol lever B. C reactive Protein level C. ACTH serum concentration D. Computerized tomography of the brain, chest and abdomen 53. Which clinical manifestation should Nurse Rachel watch for patient Claire if she is suffering from hyperthyroidism? A. Cold extremities B. Increased weight C. Decreased bowel movement D. Fine motor tremor 54. Patient Sonia, who has hypothyroidism is given which one of the following drug therapy? A. Propranolol B. Iodine C. Tron pills D. Levothyroxine 55. Which of the following should be AVOIDED by patient Sonia while she isbeing treated for hypothyroidism? A. Use of warm blankets B. Light activities done at home C. Taking foods low in fiber D. Exposure to cold temperature. Situation: Nurse Eileen has just passed the Board Examination for Nurses and set her goals for her Nursing Career for the next 5 years. She is aspiring to become a Diabetes Nurse Educator after completing her2 years as a bedside nurse. 56. Which of the following can Nurse Eileen adopt to visualize her future? A. Flow chart B. Decision tree C. Gantt chart D. Decision grid 57. She started to create her personal and professional portfolioas apreparation for her application to a university medical center in MetroManila. Which of the following is NOT a major purpose of keeping aportfolio? A. Keep on ongoing records of skills development. B. Create a system for documenting accomplishments. C. Set career and educational goals. D. Set system for a possible shift to another job. 58. One area of the professional portfolio is to indicate one's philosophyof life. Which of the following work place values should Nurse Eileenconsider as NOT favorable to be written in her portfolio? A. Customer service based on acceptance, empathy and selflessduty. B. Time and compensation limiting her pursuit of excellence inher job. C. Commitment to continual life long and self-directed learning. D. Challenges which can lead to growth, responsibility andaccountability. 59. In order for Nurse Eileen to be active as a bedside nurse, she has tocomply with the renewal of PRC ID by undertaking continuing professional development (CPD) as mandated by the CPD law. The purposes of which are ________. I. promote and upgrade the practice of the profession II. improve the competence of the professional III. international alignment of competence IV. develop quality assurance for accreditation A. II & III B. I, II, & III C. I, II, III, & IV D. I& II 60. Nurse Eileen is aware that in her personal and professional portfoliohas to include and keep up to date the following EXCEPT _________. A. certificate of CPD attended B. letters of reference 4 | Page