Title RECALLS 7 (NP3) - STUDENT COPY ✅

RECALLS EXAMINATION 7 NURSING PRACTICE III CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART A) 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 III” on the box provided Situation – Nurse Luna is employed in hospital “X” and assigned in the Medical Ward for a year now. The nurse supervisor ordered her to proceed immediately to the Surgical Ward as a reliever to another nurse who went on emergency sick leave. She was not oriented in the Surgical Ward and the unit was very busy. 1. Which of the following is the MOST appropriate action of Nurse Luna A. Request the nurse supervisor to assign a more experienced nurse reliever B. Refuse the order of the nurse supervisor and stay put in the medical ward C. Comply with the order of the nurse supervisor D. Request the nurse supervisor to give her brief orientation before compliance 2. To qualify as an operating room nurse in the Philippines setting, Nurse Luna should possess the minimum requirements of _____________. A. Master’s degree holder with valid and current license B. Worked in the surgical unit for 8 hours C. RN and has worked abroad D. RN with valid and current license and Surgical Ward orientation 3. Nurse Luna is a graduate in the Philippines nursing school. As part her professional and personal development, she should attend which of the following program? EXCEPT___________ A. Programs by the Philippine Nurses Association B. Continuing Professional Development programs by the Professional Regulation Commission C. Symposium and forum offered by the school D. Programs of international nurses associations 4. The PRIORITY objective behind career advancement of Nurse Luna is ____________. A. Increasing revenue of the service providers B. Renew old acquaintances and establish camaraderie C. Increased number of networking activities D. Updating one’s knowledge, skills, conduct and values in professional nursing 5. Nurse Luna has an expired license but promises to renew her license in due time. Which of the following violation can she be charged if she participated in home health care activity? A. Malpractice B. Grave coercion C. Felony D. Negligence Situation– Health Education is an area of nursing practice when the nurse can be creative and independent in the work setting. The following questions apply. 6. A nurse is developing a Teaching plan for Isabel 18 year old with Bronchial Asthma. She has an order for discharge. Which part of the teaching plan should be given PRIORITY? A. Quick relief medicines as ordered B. Avoid contact with fur-bearing pets C. Avoid going to malls D. Wash bed sheets in warm water 7. Mr Gilbert is for postural drainage. The nurse should position the client’s head at ______________. A. No greater than a 25 degree downward angle B. A 30 degree lateral angle for 25 minutes C. 25 degree at lateral angle D. A 30 degree downward angle for 25 minutes 8. Nurse Beth is teaching Michel, an asthmatic, on how to use the Spirometer. She should instruct the client to have the mouthpiece________________. A. Place into the mouth and have regular breathing B. Place into the mouth and have a fast deep breath C. Place into the mouth and inhale slowly D. Place into the mouth and exhale slowly 9. Nurse Beth is teaching a client on how to use metered dose inhaler to prevent asthmatic attack while in the hospital. She should instruct the client to do the following __________________ EXCEPT. A. Keep the head of the bed at 15 degree angle B. Do oral care after use of the inhaler C. Use the inhaler before she take her meals D. Use the inhaler as ordered 10. You are conducting health-teaching sessions to clients with cardiovascular disorders. Client Pedro asks you this question: “Tell me, Nurse, what I should do with my Hypertension?” The best response of a Nurse is____________. A. “comply with your diet, lifestyle and exercise” B. “strictly follow your prescribed daily exercise and smoking cessation” C. “comply with your diet, life style modification and prescribed medicines” D. “include garlic in your meals with regulation of alcohol consumption” Situation - As a staff nurse in a government hospital, you have been exposed to varied cases of clients with endocrine problems. Your nursing responsibility starts from admission to discharge which is a domain of your competencies. 11. Which of the following questions should you ask during an admission interview for a client with a diagnosis of pheochromocytoma? A. Do you always feel like you are suffocating, you want to rest and sleep B. Do you suddenly feel warm and flushed when you get out of bed C. Do you notice an increase in your heart beat? D. Do you have an increase in urination lately? 12. When the sympathetic nervous system is stimulated in the case of pheochromocytoma, you expect which of the following signs? 1. Hypertension 2. Headache 3. Hyperhidrosis 4. Hypermetabolism A. 3 and 4 B. 1 only C. 1, 2, 3, and 4 1 | Page
D. 2 and 3 13. Which of the following drugs can induce hypertensive crisis in Pheochromocytoma? A. Tricyclic antidepressant B. Corticosteroid C. Respiratory stimulant D. Radio iodine therapy 14. In the presence of pheochromocytoma, the diagnostic test which is expected to be elevated is ___________. A. Serum thyroid hormone levels B. Albumin globulin test C. Urine cyclic adenosine mono phosphate D. 24 hours urine collection for vanillylmandelic acid (VMA) 15. Palpation, as a modality for physical examination is AVOIDED when diagnosed with pheochromocytoma because this action_______________. A. Will cause sudden release of norepinephrine and severe hypotension B. Will cause a sudden release of cathecolamines and severe hypertension C. Will displace the location of the tumor D. Will cause sudden release of epinephrine and severe palpitation Situation – Mr. Con is being prepared for a major surgery. Legal preparation for surgery consists of checking all the required forms for the operation. Equally important is to make sure that the patient is physically, psychologically, and emotionally ready for the procedure. 16. Informed consent is a process that gives the patient opportunity involved in his or her care. As patient advocate, the nurse ensures the following three conditions are present to make consent valid, EXCEPT: A. Adequate disclosure of the diagnosis by the physician B. Comprehension of information by the patient before the operation C. Patient voluntarily giving consent D. Forms signed by any close relative or watcher 17. The patient asks you, “What do you think of my surgeon?” You answered “hmmmmm... he is not really the best one and he seems not to care for patient...” As a result, the patient switches to another surgeon. The latter may have grounds to sue you for _____________. A. Slander B. Invasion of privacy C. Malpractice D. Libel 18. One of your patient’s visitors whisper to you, “I hope you will not try to revive my dear friend if her heart stops as she has already suffered a lot.” The correct response is ___________. A. “That decision is up to the physician” B. “We are all trained in cardiopulmonary resuscitation” C. “There is a ‘ Do not resuscitate’ order in her chart” D. “ I understand your concern, but I can’t discuss this matter with you” 19. According to the Joint Commission, the most frequently cited factor in sentinel (unanticipated) events that leads to a patient’s serious physical or psychological injury is ______________________. A. Confusion within the health team B. Miscommunication among health team members C. Incompetence by a team member D. Policy changes are not followed by adequate and consistent staff education Situation – Conducting Research is one of the major roles of the nurses both in hospital and community settings. To be able to develop such competencies, the nurse has to undergo an actual conduct of the research process. 20. Which of the following statements BEST described a researchable problem? A. Responses of parents toward having children with congenital heart diseases. B. The relationship between relaxation technique and relief of pain of post CABG patients in the surgical coronary care unit. C. Incidence of medication errors and reporting practices of Health Care Professional in a teaching hospital D. To what extent do pre-operative teaching affect the length of hospitalization of patients going for surgery 21. Nurse Joan has to undergo literature search for her study. She can avail of this from the following EXCEPT_____________. A. A summary of research articles that are relevant to the study B. A written document published by the investigator herself C. Any retrieval from website that will help her search for the subject on investigation D. A description of the scientific study from an information provided by a faculty member teaching research 22. Weight is taken as a baseline measurement of obese female adolescents as study subjects for a weight reduction program. This is repeated to note any changes. This pre-test is done to___________________. A. Determine whether the instrument is defective B. Assess if research design is appropriate to the problem identified C. Evaluate whether the instrument is defective D. Obtain preliminary data before a treatment is conducted by the researcher 23. A Nurse researcher is using ACCU-CHEK a monitoring kit to test presence of Diabetes Mellitus among her study subject. How do you classify this type of measurement? A. Microbial B. Cytological C. Physiological D. Chemical 24. Nurse Joan, wanted to conduct a study using quasi-experimental design. This design will need a __________. A. Retrospective evaluation B. Field setting for the study C. Comparable group D. Manipulation of the dependent variable Situation – Kian, 16 year old, a foreigner was admitted in the medical ward due to abdominal pain, nausea and vomiting by Nurse Tessie. 25. In initiating care for patient Kian, which of the following would be an APPROPRIATE question to be asked by Nurse Tessie in her assessment? A. Since this is doctor’s order, you have to drink ice water, instead of hot tea. B. Do you have any books I could read about people of your culture? C. Do you need to set aside your cultural practices, and comply with hospital rules and regulations? D. Is there anything I am doing that is not acceptable to your culture? 26. Nurse Tessie respects cultural practices integration in her nursing care plan. Which of the following nursing action is MOST represented of the culturally competent nurse? A. Help patient Kian to learn and understand the language B. Explain and validate health knowledge and beliefs of Patient Kian with that of the hospital C. Help Patient Kian identify ways to relate more to the culture where they now resides D. Ask patient Kian to help Nurse Tessie in knowing more the culture of his origin 27. The family of Patient Kian request utilization of warm compress with banana leaves to Patient Kian. Which of the following is the MOST appropriate response of Nurse Tessie? Alternative therapies_________. A. Cost less than traditional therapies B. Are use when traditional therapies are not effective C. Utilized natural products while traditional therapies do not D. Can be effective as traditional therapies for some conditions 28. Patient Kian’s family requests time for spiritual healing process in the hospital. This is allowed by Nurse Tessie and hospital because it______________________. A. Gives fulfillment and meaning to the patient and 2 | Page
family B. Demonstrate people being responsible for their life patterns C. Is non-denominated community service D. Formalizes a religious dogma 29. Positive Practice Environment (PPE) influences healing process. Which of the following ways can help Nurse Tessie create a healing environment? A. Ensure that relatives and friends visit the patient B. Empower clients to make healthy decisions for themselves C. Place television in each room of the hospital D. Ensure that staff nurses does not experience burnout Situation –Julie, 28 years old, has been diagnosed with Diabetes Mellitus. She was advised by her family physician to be admitted to undergo preservation for insulin therapy. Her blood sugar ranges from 200 to 210 mg/dL. At 6 am, Nurse Cynthia administered her insulin injection. After 2 hours, the patient complained of cold clammy perspiration, chilly sensation and abdominal discomfort. 30. Which of the following PRIORITY nursing actions should the nurse perform? A. Give her biscuit to eat B. Do urine testing for sugar C. Provide her warm blanket D. Take blood pressure and put her on bed rest 31. Patient Julia has been classified to have a type II Diabetes Mellitus. Which of the following is NOT a typical manifestation of individuals with this condition? A. Frequency of urination B. Increased craving for food C. Increased thirst D. Weight loss Situation – Mr Dencio, 58 years old is admitted to the pay ward because of respiratory problem. The nurse initiated oxygen treatment by mask but the client refuses despite the encouragement by the wife. The client is aware of the benefits of the treatment. 32. Which of the following should be given priority? A. Ask the opinion of the wife B. Conduct consensus building C. Let the attending physician decide on the necessity of the treatment D. Respect the decision of the client 33. You are taking care of Mr Dencio who is on the last cycle of radiation therapy for his lung cancer. You should instruct Mr Dencio to A. Brush teeth and gums vigorously after meals B. Wait one hour after treatment before eating C. Use mouthwash containing alcohol every 2 hours D. Avoid drinking hot fluids Situation – Ime is the Nurse on duty in the medical ward and many of her patients are suffering from problems of oxygenation. 34. The following are relevant data to be documented when taking the health history of a client with anemia EXCEPT: A. Alcohol intake B. Fatigue and weakness C. Dietary intake D. Episodes of bleeding 35. A client with congenital heart disease is suffering from thickening of the skin under his fingers due to chronic hemoglobin desaturation. Which of the following specific term should Ime use to accurately describe MOST the client’s condition in the chart? A. Peripheral cyanosis B. Pallor of the finger tips C. Peripheral neuropathy D. Clubbing of the fingers 36. When the Nurse is assessing a client with Congestive Heart failure with pitting edema, the Nurse’s documentation will include which of the following: A. Degree of pitting edema B. Time of indention recovery C. Depth of edema D. All of the options 37. Mr. Gabby is with left sided heart failure. Ime’s documentation of her assessment findings will include the following, EXCEPT______________. A. Dependent edema B. Pulmonary crackles C. Difficulty of breathing D. Cough 38. A client is on a diuretic therapy. Expected entry in patient’s chart should include the following information, EXCEPT: A. Serum electrolytes monitored B. Intake and output recorded C. Lasix administered at 8 o’clock in the evening D. Weight is taken before drug is given Situation 10 – Maya, a 42 year old teacher with cardiac ailment, nervously informs the doctor that her goiter is getting bigger and distracts her while swallowing food. The physician who examined her instructed the nurse to admit Maya and to prepare her for surgery after medical clearance. 39. While interviewing Patient Maya, she claims that she is anxious for the coming surgery. You expect the following signs and symptoms when one is under stress, EXCEPT___________ A. Blood loss and weakness B. Increases respiration rate C. Decreased mobility D. Pain due to tissue damage 40. Based on your knowledge, Patient Maya, who has a history of cardiac illness, should not be given an enema before surgery. Which of the following reasons inhibits the order of enema for Patient Maya? Enema____________ A. Paralyzes the peristalsis movement and increases abdominal pain B. Produces vagal stimulation that is dangerous to cardiac patient C. Causes constipation and fecal impaction after the surgery D. Enema results to increased water absorption in the bowels Situation 11 – Mr. S came to the ER because of sharp troubling pain. After his surgery, he claimed pain is felt even he is asleep. 41. At what stage of pain mechanism do you classify this pain? A. Perception B. Modulation C. Transmission D. Transduction 42. When a client complains of pain less than 6 months, it is called_____________. A. Chronic pain B. Persistent pain C. Acute pain D. Intermittent pain 43. In order for the nurse to recall the location of pain, he has to_______________. A. Asks for onset and duration B. Mark the painful area in a body diagram C. Asks for facial expression D. Asks verbal description using pain intensity scale 44. As example of a drug therapy to relieve moderate pain is_____________. A. Codeine B. Demerol C. Methadone D. Morphine sulphate 45. When a client is on prolonged pain therapy, the nurse should watch for____________. A. Tolerance to drug B. Allergic reaction to drug C. Drug resistance D. Addiction to drug Situation: Donny a 46 year old patient admitted to the coronary care unit (CCU) with an MI and frequent premature ventricular contractions (PVCs) has doctor orders for continuous amiodarone infusion, IV nitroglycerin infusion, and morphine sulfate 2 mg IV every 10 minutes until there is relief of pain. She is taken care by Leona a newly graduate nurse. 3 | Page
46. Because of Donny’s premature ventricular contraction, the nurse should monitor its effects on which of the following parameters? A. Electrolyte levels B. Apical radial heart rate C. Oxygen saturation D. Medications 47. In analyzing a patient’s electrocardiographic (ECG) rhythm strip, Leona uses the knowledge that the time of the conduction of an impulse through the Purkinje fibers is represented by A. PR interval B. QT interval C. QRS complex D. P wave 48. A considerable difference between the apical and radial pulse rate of Donny would indicate A. Stronger left than right ventricular muscles B. Numerous weak ineffectual cardiac contractions C. Thickened myocardium and large heart chambers D. Increased pressure in systemic arteries 49. As Donny is assessed he complains of being nauseated and very weak. The nurse should A. Perform nutritional assessment B. Alert staff for potential help C. Explore and discuss possible effect of stress D. Provide reassurance while focusing on pleasant topics 50. The Physician scheduled for an exercise electrocardiogram (stress test). What information should the nurse include when explaining the value of this test? Exercise stress testing is a: A. definitive method to diagnose the cause of chest pain B. diagnostic modality of minimal value in planning treatment of angina C. noninvasive means of assessing cardiovascular conduction and function D. minimally invasive manner of assessing a body’s reaction to increase in exercise SITUATION: You are a nurse tasked to care for patients with several different conditions. You utilize your knowledge of nursing concepts to help these patients. 51. The patient admitted in the unit with a urinary condition asked you, the nurse, where in the kidney does urine get formed. You answer them correctly by stating that urine is produced in the: A. Glomerulus. B. Proximal convoluted tubule. C. Loop of Henle. D. Nephron. 52. A client was assigned to your unit after their abdominal surgery. You asked the patient during your morning rounds about the passage of flatus. The patient answered, “Yes, flatus has passed earlier this morning”. In anticipation of defecation, which of the following instructions are most important for you, the nurse, to give to this client? A. Please call the nurse if you need to go to the bathroom. B. If you feel the urge to have a bowel movement, please call for assistance before getting up to the toilet. When having a bowel movement, be sure to breathe out to prevent straining. Do not hold your breath. C. To prevent the Valsalva maneuver, contract the stomach muscles while holding your breath and push. This will assist in the passage of the stool and will decrease the amount of time required to have a bowel movement. D. Your bowels will be moving soon. Please report any abdominal pain. 53. You are the nurse on duty in the unit. A client verbalized complaints of a recent constipation. You took the patient’s health history. Which of the following statements by the client suggests the likely cause of their constipation? A. I walk with a group of friends every day at the mall for an hour. B. My spouse died 20 years ago, but my family is very loving and supportive. They live just around the corner and come over a few times a week to visit. C. The fast food place near my home has really good food. I eat there most of the time. D. What is a laxative? 54. You are the nurse on duty in the emergency room. A client came via ambulance with shortness of breath for the past 3 days. After a few hours in the ER, the client is admitted to the intensive care unit with pulmonary edema that requires intubation and ventilation. A Foley catheter was placed in the client and he had a total of 25 mL urine output. The laboratory reveals: blood glucose of 300, blood urea nitrogen of 100, and creatinine of 5.0. The client has a history of CHF, CAD, diabetes, COPD, and asthma. What's the client’s most likely cause of low urine output? A. Acute and chronic renal failure due to diabetes and a decreased blood flow to the kidneys due to heart failure. B. Renal failure due to decreased coronary output secondary to heart failure. C. Decreased blood flow to the kidneys due to congestive heart failure (CHF) secondary to noncompliance with home fluid restriction. D. Severe dehydration. 55. A client came to the hospital complaining of nausea and occasional vomiting. You are the nurse reviewing the client’s medical records when you note that this client has a 4 year history of renal insufficiency. They had been on fluid restriction and renal diet. Their laboratory shows a steady increase in BUN, creatinine, and potassium. The client’s spouse accompanied the client to the appointment. She pulled you aside and stated that his husband has been having episodes of confusion each day. She told you that she is very concerned about her husband and she wants to know if he is having small strokes. Based on the information provided, what is your best response to the spouse’s question? A. Confusion is a common sign of transient ischemic attacks. Thank you for informing me of this. The client will need a CAT scan of the head. B. The client’s kidneys are not working very well. However, confusion is not a common symptom. I will inform the physician of the confusion and have her assess the situation further with the client. C. The elevated potassium is causing the confusion. The client will need some medication to decrease the potassium level. D. The client is experiencing worsening uremic syndrome. This is associated with kidney failure and is a sign that the client’s kidney function is becoming worse. I will notify the physician about the confusion. There are a couple of treatment options to consider. The physician will discuss the treatment options with the client and you. 56. One of the elderly patients assigned to you in the ward has been complaining of increasing trips to the bathroom to urinate. Her estimated coffee intake is 3 cups every day. What is the best explanation you can provide to this patient? A. The increased urine production is most likely due to a urinary tract infection. B. Coffee is causing the increased urination due to your increased fluid intake. This is completely normal and nothing to be concerned about. C. Coffee is causing the increased urination. Coffee contains caffeine that causes diuresis, or increased urine formation. Simply decreasing the number of cups of coffee you drink each day, and limiting the consumption of caffeinated beverages to the morning hours, should help decrease your trips to the bathroom. D. Drinking coffee increases the circulating plasma in the body and this increases the urine formation. Simply decreasing the number of cups of coffee you are drinking should help. 57. You are beginning your shift for the day. You start by assessing a client that has a Foley catheter connected to a collection bag. Which of the following is the best routine catheter care actions to take while caring for this client? A. Encourage increased oral fluid intake and observe for any opacity in the urine suggesting bacterial infection. B. Carefully wash the perineal area with soap and water after each bowel movement. 4 | Page