Title PB1 - NP 4 - STUDENT COPY ✅

1 | Page PRE BOARDS EXAMINATION 1 NURSING PRACTICE IV CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOLOGICAL ALTERATIONS (PART B) 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 I” on the box provide Situation: The following questions about perioperative nursing apply: 1. A 78-year-old blind patient is scheduled for hip surgery. Which of the following constitutes legal validity? A. The spouse’s co-signature B. A notary public seal C. Consent from the patient’s power of attorney D. Consent form signed with an "X" 2. A nurse is preparing a patient for left-sided mastectomy. What action ensures compliance with The Joint Commission's NPSGs? A. Confirm surgical site with the family B. Have the patient verbally state the site C. Ask anesthesia to mark the site D. Mark both breasts with arrows 3. A patient has been NPO for 10 hours pre-op and shows signs of orthostatic hypotension and dry mucosa. What is the best action? A. Notify anesthesia for possible IV fluid administration B. Cancel the surgery C. Encourage oral fluids D. Proceed with surgery as dehydration is expected 4. A patient undergoing experimental surgery has signed a general surgical consent form. What is still required? A. No further documentation is needed B. Verbal agreement with surgeon just before anesthesia C. Consent from a hospital ethics committee D. Special written informed consent for the experimental nature 5. Which of the following actions by a nurse during the pre-op “time-out” violates standard protocol? A. Verifying the correct patient using name and ID band B. Confirming the surgical site marking is visible C. Asking the patient to confirm procedure before sedation D. Delegating time-out initiation to the scrub technician Situation: The nurse is caring for patients with immunologic conditions. The following questions apply: 6. Which of the following hypersensitivity types involves antigen-antibody immune complexes depositing in tissues, leading to complement activation and inflammation? A. Type I B. Type III C. Type IV D. Type V 7. A patient develops hemolytic anemia days after starting a new medication. Which hypersensitivity mechanism best explains this condition? A. T-cell-mediated cytotoxicity B. Autoantibody-mediated destruction of modified self- cells C. Histamine release from mast cells D. Immune complex deposition in renal glomeruli 8. Which of the following best differentiates a Type IV hypersensitivity reaction from the other types? A. It requires prior sensitization and is mediated by IgE B. It causes tissue damage via antibody-mediated complement fixation C. It results in immediate allergic symptoms upon re- exposure D. It is mediated by sensitized T-cells and delayed in onset Situation: The nurse is caring for patients with oncologic conditions. The following questions apply: 9. A patient with small cell lung cancer develops confusion, muscle weakness, and seizures. Labs show Na⁺ = 112 mEq/L. Which intervention is the most appropriate priority? A. Restrict fluid intake and monitor for pulmonary edema B. Administer IV 3% hypertonic saline rapidly C. Administer furosemide IV to promote diuresis D. Encourage oral water intake to promote sodium dilution 10. A nurse prepares to care for a patient with sealed brachytherapy for cervical cancer. Which action is most appropriate to ensure safety? A. Use a lead shield and limit time in the room B. Encourage family to stay and provide emotional support C. Remove all linens and trash at end of shift D. Encourage the patient to ambulate every 2 hours 11. Which finding is most concerning in a patient being treated for tumor lysis syndrome (TLS)? A. Serum uric acid 7.2 mg/dL B. Serum potassium 6.3 mEq/L C. ECG showing peaked T waves and widened QRS D. Patient reports nausea and mild diarrhea 12. A nurse assesses a cancer patient with new-onset spinal cord compression. Which is the best initial nursing action? A. Elevate the head of bed B. Initiate high-dose corticosteroids as prescribed C. Assist patient in walking to preserve mobility D. Apply heat packs to the spine to relieve pain 13. A patient with prostate cancer develops sudden dyspnea, facial swelling, and distended neck veins. Which oncologic emergency is suspected? A. Pulmonary embolism B. Tumor lysis syndrome C. Superior vena cava (SVC) syndrome D. Spinal cord compression 14. A patient with acute leukemia undergoing chemotherapy develops a serum calcium of 11.9 mg/dL, ECG showing shortened QT interval, and generalized weakness. Which is the most likely cause? A. Bone metastasis and increased osteoclastic activity B. Excessive IV calcium supplementation C. Paraneoplastic secretion of calcitonin * NLE * NCLEX * CGFNS * HAAD * PROMETRICS * DHA * MIDWIFERY * LET * RAD TECH * CRIMINOLOGY * DENTISTRY * PHARMACY *