Title RECALLS 9 (NP4) SC ✅

1 | Page RECALLS 9 EXAMINATION NURSING PRACTICE IV CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART B) FEBRUARY 2026 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: Nurse EJ is caring for patients with gastrointestinal disorders who exhibit abdominal pain, altered bowel movements, abdominal distension, and changes in stool and bowel sounds. 1. Nurse EJ is providing home instructions to his patient with gastroesophageal reflux disease (GERD). He will emphasize the following teachings except? A. Keep the head of the bed elevated B. Fluids in between meals C. Drink a cup of green tea before bedtime to warm the stomach D. High fiber diet 2. Nurse EJ is evaluating a patient who reports epigastric pain. Which assessment question would best assist the nurse in identifying whether the pain is associated with a peptic ulcer? A. “Is the pain more severe when you feel the urge to have a bowel movement?” B. “Does physical activity or exercise make the pain worse?” C. “Does eating food relieve your abdominal discomfort?” D. D. “Do nonprescription pain relievers reduce your pain?” 3. While performing your assessment you are guided that the organs found in the epigastrium include which of the following? A. Portion of duodenum and jejunum, left kidney, appendix and 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 4. A patient with ulcerative colitis has an ileostomy. Which statement suggests that the patient requires additional teaching about ileostomy care? A. “I will change my pouch if it begins to leak.” B. “If I notice a red, bumpy, itchy rash, I will contact my healthcare provider.” C. “I will irrigate my ileostomy every morning.” D. “My stoma should appear pink and moist.” 5. Nurse is assessing a patient with gastric ulcer, what assessment findings would support this diagnosis? A. Patient reports a burning sensation moving like a wave B. Patient complains epigastric pain 30-60 minutes after eating C. Presence of blood in the patient’s stool for the past months D. Sharp pain in the upper abdomen after eating a heavy meal 6. A client suspected of having a duodenal ulcer has just undergone an esophagogastroduodenoscopy (EGD). Which aspect of care should the nurse prioritize in the client’s care plan? A. Providing warm gargles to soothe a sore throat B. Evaluating whether the gag reflex has returned C. Checking the client’s temperature D. Monitoring reports of heartburn 7. The nurse is giving discharge teaching to a client who has had a gastrectomy. Which action should the nurse recommend to help prevent dumping syndrome? A. Eat cakes and pastries only if they are homemade B. Consume three large meals a day instead of smaller, more frequent meals C. Decrease the amount of fluids consumed during meals D. Walk around after meals 8. A patient with a hiatal hernia frequently experiences heartburn after eating. Which action should the nurse teach the patient to avoid, as it is not recommended for this condition? A. Lying down after meals B. Taking H2-receptor antagonist medications C. Elevating the head of the bed by 6 inches (15 cm) D. Eating small, frequent, bland meals 9. The nurse is teaching a client strategies for managing irritable bowel syndrome (IBS). Which statement by the client shows that additional teaching is needed? A. “I should eat meals at regular times and chew my food thoroughly” B. “I will take my prescribed medications to help regulate my bowel movements” C. “I should reduce the amount of dietary fiber I eat” D. “I should drink plenty of fluids, at least 8 to 10 cups each day” 10. A patient had a barium enema earlier today. The nurse notes that the patient has not passed stool for 12 hours and reports mild abdominal discomfort. Which nursing action is most appropriate? A. Encourage the patient to increase oral fluids B. Administer a high-fat meal to stimulate bowel movement C. Tell the patient it is normal to have no bowel movement for 24–48 hours D. Immediately notify the physician for possible obstruction Situation: Endocrine conditions arise when the body’s hormone levels are disrupted, leading to alterations in normal physiological processes. Nurses are essential in recognizing early signs, closely monitoring patients, and implementing appropriate care to reduce complications and promote overall well-being. * NLE * NCLEX * CGFNS * HAAD * PROMETRICS * DHA * MIDWIFERY * LET * RAD TECH * CRIMINOLOGY * DENTISTRY * PHARMACY *

3 | Page B. Insulin waning C. Dawn phenomenon D. Sunset phenomenon 29. Nurse Mauie is preparing a patient for paracentesis to remove ascitic fluid. Which position is most appropriate for the patient during the procedure? A. Supine B. Sitting upright on the edge of the bed with feet supported C. Lying prone D. Trendelenburg position 30. Nurse Tala is preparing a patient for a percutaneous liver biopsy. Which is the most appropriate position for the patient during the procedure? A. Supine with right arm behind the head B. Prone with pillow under the abdomen C. Left lateral with knees flexed D. Trendelenburg Situation: A newly registered nurse must be knowledgeable about nursing leadership and management and apply it in the practice. 31. While reviewing Grey’s Medical Center’s guiding documents, Nurse Yang finds the statement: “By December 2027, Grey’s Medical Center aims to reach a 95% patient satisfaction rate in patient-centered care by implementing hourly rounds and bedside shift reports.” This statement most likely represents which of the following? A. Mission B. Vision C. Goal D. Objectives 32. Nurse Manager Tom highlights the need to promote a healthy and positive culture in the nursing unit. Which of the following behaviors would suggest that the team has successfully achieved this goal? A. Exhibiting dominant and confrontational behavior B. Remaining compliant and passive C. Demonstrating proactive and supportive interactions D. Encouraging a highly competitive and perfection- driven mindset 33. Which task is most appropriate to delegate to a nursing assistant (NA)? A. Administering oral medications B. Measuring and recording vital signs C. Teaching a patient how to use an incentive spirometer D. Performing initial patient assessment 34. After delegating tasks, the nurse is accountable for which of the following? A. Only the tasks personally performed B. Ensuring all delegated tasks are completed correctly and patient outcomes are safe C. Only supervising if a complication occurs D. Allowing staff to handle independently 35. During a shift, the nursing manager transitions the unit from individual patient assignments to a team-based care approach. One nursing assistant shows resistance and is reluctant to participate in supporting the new process. Which approach should the nurse manager take to address this behavior? A. Ignore the resistance B. Apply pressure or force compliance C. Offer positive incentives to encourage participation D. Engage the nursing assistant in a discussion to express feelings about the change Situation: A 60-year-old male was brought to the emergency room with complaints of slurred speech and right-sided weakness. 36. Which nursing intervention is priority? A. Contact the speech-language pathologist for an urgent evaluation B. Talk with the patient about the events that triggered the symptoms C. Get ready to give recombinant tissue plasminogen activator (rtPA) D. Arrange an immediate CT scan of the head 37. Nurse Jaja is assessing the patient’s level of consciousness. The nurse notes that the patient opens his eyes when spoken to, is confused when answering questions, and localizes pain when a painful stimulus is applied. What is the patient’s GCS score? A. 10 B. 11 C. 12 D. 13 38. A CT scan confirms an ischemic stroke, and the physician has prescribed tissue plasminogen activator (tPA). What is the most important action the nurse must take before administering tPA? A. Ask the patient about current medications B. Perform a comprehensive health history and physical assessment C. Determine the time the stroke symptoms began D. Check whether the patient has any upcoming surgical procedures 39. A patient is experiencing expressive aphasia following a neurologic injury. Which nursing strategy would be most effective in helping the patient communicate? A. Raising the voice and slowing speech B. Providing a picture or symbol board for the patient to indicate needs C. Giving written instructions for the patient to read D. Communicating using brief, simple sentences 40. A patient has homonymous hemianopia. Which behavior is the nurse most likely to observe during mealtime? A. The patient reports seeing double B. The patient cannot recall the names of foods C. The patient eats only from one side of the plate D. The patient has difficulty swallowing Situation: Nurse Jan is assigned to care for patients with neurologic trauma, peripheral, cranial nerve and spinal cord disorders. The nurse is responsible for monitoring neurologic status, assisting with mobility, preventing complications, providing patient education, and supporting respiratory and autonomic function. 41. An unconscious patient is brought to the emergency department following a motor-vehicle accident. The patient’s cervical spine has been stabilized. What should the nurse do next? A. Carefully remove the patient from the stretcher B. Assess the patient’s pupils for reaction C. Assess the patient’s airway D. Attempt to wake the patient by shaking 42. A patient with a T6 spinal cord injury is at risk for autonomic dysreflexia. Which action should the nurse take first if the patient reports a severe headache and flushed face? A. Administer pain medication B. Check for bladder distention and remove the cause of stimulation C. Apply warm compresses D. Encourage ambulation 43. Nurse Jan is caring for a patient with trigeminal neuralgia. Which instruction is most important for the patient to prevent trigeminal neuralgia attacks? A. Use wet cotton pads when washing face B. Eat food on affected side C. Use hot water when washing face D. Sleep on the affected side 44. A patient has been brought to the emergency department after sustaining a fall at work. What assessment findings supports basilar skull fracture? A. Periorbital edema B. Bruising over mastoid C. Epistaxis D. Unilateral facial numbness 45. Which instruction is most important for the patient with Bell’s Palsy? A. Avoid facial exercises
4 | Page B. Perform gentle facial exercises to maintain muscle tone C. Limit oral intake D. Sleep only on the affected Situation: Nurse Bry is caring for patients with neurologic degenerative disorders. 46. Nurse Bry is admitting a patient suspected of having Parkinson’s disease. Which assessment findings would support this diagnosis? A. Weakness in the upper limbs and drooping of the eyelids (ptosis) B. Crackles in the upper lung fields and distended jugular veins C. Masklike facial expression and shuffling gait D. Exaggerated arm movements and a scanning type of speech 47. A patient with Parkinson’s disease is being discharged with carbidopa/levodopa (Sinemet). Which explanation correctly describes why these two drugs are combined? A. This combination produces fewer side effects than carbidopa alone B. Dopamine D receptors require both drugs to be effective C. Carbidopa makes more levodopa available to the brain D. Carbidopa can cross the blood-brain barrier to treat Parkinson’s disease 48. What is the initial sign of Parkinson’s disease? A. Tremor B. Rigidity C. Akinesia D. Bradykinesia 49. Which nursing strategy is most effective for helping a patient with Parkinson’s disease who experiences freezing of gait and difficulty starting to walk? A. Encourage the patient to stay in place B. Gently pull the patient forward to begin walking C. Advise the patient to use a wheelchair D. Instruct the patient to march in place 50. When is the best time for a patient with Parkinson’s disease to perform their most physically demanding activities in order to reduce the impact of hypokinesia? A. During the peak effect of their medication B. When family members are present C. Early in the morning when energy levels are highest D. Right after a rest period 51. In a patient with myasthenia gravis, which assessment findings with the nurse find? A. Sudden, sharp facial pain B. Progressive muscle weakness that worsens with activity and improves with rest C. Ascending paralysis from feet to hands D. Tremors at rest 52. Nurse Bry is monitoring a patient who was recently diagnosed with myasthenia gravis and has started therapy with pyridostigmine bromide (Mestinon). Which patient outcome would best indicate that the medication is effective? A. Enhanced muscle strength B. Reduced pain levels C. Improved cognitive function D. Better gastrointestinal activity 53. The patient is undergoing diagnostic evaluation for suspected myasthenia gravis using the Tensilon (edrophonium chloride) test. Which finding would support a diagnosis of myasthenia gravis? A. Increased muscle response on electrical stimulation testing B. Noticeable marked improvement in muscle strength C. A reduction in circulating acetylcholine receptor antibodies D. No observable change in the patient’s neuromuscular status 54. The patient has been diagnosed with myasthenia gravis and is prescribed the anticholinesterase medication pyridostigmine (Mestinon). Which nursing action is most appropriate when giving this medication? A. Give the medication about 30 minutes before meals B. Advise the patient to take the drug with a full glass of water C. Teach the patient to remain upright for one hour after taking the medication D. Check the patient’s blood pressure before administering the dose. 55. Which statement by the female client diagnosed with myasthenia gravis indicates the client needs more discharge teaching? A. “This illness will cause my menstrual periods to stop” B. “I should stay away from people who have respiratory infections” C. “I need to avoid hot baths and swimming in cold water” D. “I will make sure to drink at least 2,500 mL of fluids each day” Situation: Nurse Jay is assigned to care for a patient with Alzheimer’s 56. The patient becomes increasingly agitated and confused in the late afternoon. Which nursing intervention is most appropriate? A. Increase environmental stimulation B. Administer sedatives routinely C. Maintain a consistent routine and reduce noise and lighting changes D. Encourage daytime napping for long periods 57. A patient with Alzheimer’s disease is observed pacing and mumbling more during mealtime and shift changes. Which nursing action should be taken first? A. Give an antianxiety medication, such as lorazepam (Ativan), at these times B. Explain the unit schedule and reasons for increased activity to the patient C. Minimize activity throughout the unit D. Relocate the patient to a quieter, less stimulating area during these periods 58. A caregiver of a patient with Alzheimer's disease reports that the patient frequently becomes suddenly angry during meals and cannot be calmed. The nurse advises using distraction techniques. Which example best demonstrates this approach? A. "Let's see what's on television" B. "If you stop yelling, I'll get you dessert" C. "Don't you want to finish your meal?" D. "I don't understand what you are saying." 59. Which communication technique is most effective when caring for a patient with Alzheimer’s disease? A. Ask multiple questions at once B. Use complex explanations C. Speak slowly using short, simple sentences D. Correct the patient each time they are confused 60. A nursing student asks the nurse to explain the difference between dementia and Alzheimer’s disease. Which explanation is most accurate? A. Dementia is a temporary memory loss, while Alzheimer’s disease always resolves spontaneously B. Dementia is a general decline in cognitive function caused by various conditions, whereas Alzheimer’s disease is a progressive, irreversible neurodegenerative disease C. Dementia and Alzheimer’s are exactly the same and interchangeable terms D. Alzheimer’s disease affects only memory, while dementia affects only behavior 61. A patient is unable to recognize ordinary objects, such as brush or mirror. Which would be this symptom of? A. Amnesia B. Apraxia C. Agnosia D. Aphasia