Title RECALLS 12 - NP3 - SC ✅

1 | Page RECALLS 12 EXAMINATION NURSING PRACTICE III CARE OF CLIENTS 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 I” on the box provided Situation: Nurse Joy is caring for multiple clients with renal failure. 1. Nurse Joy is assigned to Mr. Ramon who is a patient who underwent hemodialysis. Before discharge, Nurse Joy discussed care at home with Mr. Ramon and his wife. Which statement by Mr. Ramon’s wife indicates that further teaching is required? A. "I must touch the shunt several times a day to feel for the bruit." B. "I have to take his blood pressure every day in the arm with the fistula." C. "I will remind my husband to be careful not to lie on the arm with the fistula" D. "We should check the fistula every day for signs of redness and swelling” 2. Nurse Joy obtained the laboratory results of all her clients. Which of the following can cause glomerular injury and an increased risk of renal failure for a client? A. Cystitis with urine culture positive for E. coli B. Presence of red blood cell casts in the urine Blood urea nitrogen (BUN) level of 15mg/dL C. Hypotension and increased volume of very dilute urine D. Absence of red blood cells and white blood cells in the urine 3. Nurse Joy is caring for a client diagnosed with acute renal failure. Which of the following would indicate that the client is uremic? A. BUN of 35mg/dl B. Serum calcium of 9.2 mg/dl C. Serum potassium of 2.8 mg/dl D. Urine specific gravity of 1.030 4. Nurse Joy is reviewing the client's morning laboratory results. Which of these results most concern Nurse Joy? A. Serum potassium level of 5.2 mEq/L B. Serum sodium level of 134 mEq/L C. Serum calcium level of 10.6 mg/dL D. Serum magnesium level of 0.5 mEq/L Situation: Peptic ulcer disease (PUD) is a common and often painful condition affecting millions of people worldwide.   5. A client is experiencing peptic ulcer disease caused by Helicobacter pylori. The nurse should plan to administer Clarithromycin (Biaxin) with which of the following oral drugs?  A. Tetracycline (Achromycin) with sodium bicarbonate (baking soda) B. Metronidazole (Flagyl) and aluminum hydroxide (Amphogel) C. Amoxicillin (Amoxil) and Omeprazole (Prilosec) D. Penicillin (Pen-G) and nizatidine (Axid) 6. The nurse is caring for Mrs. Rivera who is admitted due to 6-year history of gastric ulcers. The nurse instructs this client to take which of the following drugs for minor aches and pains? A. Acetaminophen (Tylenol) B. Buffered aspirin C. Plain aspirin D. Ibuprofen (Motrin) 7. Mr. Quezon develops dumping syndrome after a subtotal gastrectomy for cancer of the stomach. When caring for this client, the nurse understands that dumping syndrome refers to: A. Nausea resulting from a full stomach B. Reflux of intestinal contents into the esophagus C. Passage of osmotic fluid into the jejunum D. Build-up of feces and gas within the large intestine 8. A client with gastric tumor is scheduled for a Billroth II procedure. The nurse explains the procedure to the client and tells the client that the: A. Proximal end of the distal stomach is anastomosed to the duodenum. B. Antrum of the stomach is removed with the remaining portion anastomosed to the duodenum. C. Entire stomach is removed and the esophagus is anastomosed to the duodenum. D. Lower portion of the stomach is removed and the remainder is anastomosed to the jejunum. 9. Alvin, a client who has a history of seizure disorder is newly diagnosed with a gastric ulcer, has maintained seizure-free status using phenytoin (Dilantin). The nurse would question a new order for which of the following drugs to treat symptoms caused by the ulcer? A. Famotidine (Pepcid) B. Cimetidine (Tagamet) C. Nizatidine (Axid) D. Ranitidine (Zantac) Situation: Nurse Brian is caring for patients with congestive heart failure in the medical ward of Toprank Hospital and Medical Center.   10. What interventions should Nurse Brian prioritize when managing an exacerbation of left-sided heart failure? Select all that apply: 1.  Metered dose Inhaler of albuterol 2.  High-Fowler's position 3.  Oxygen 4.   IV fluids 5.   Incentive Spirometer 6.  Diuretics A. 2,3,6 B. 1,5,6 * NLE * NCLEX * CGFNS * HAAD * PROMETRICS * DHA * MIDWIFERY * LET * RAD TECH * CRIMINOLOGY * DENTISTRY * PHARMACY *
2 | Page C. 3,4,5 D. 4,5,6 11. A nurse is assessing the client with left-sided heart failure. The client states that he needs to use three pillows under the head and chest at night to be able to breathe comfortably while sleeping. The nurse documents that the client is experiencing: A. Dyspnea on exertion B. Dyspnea at rest C. Orthopnea D. Paroxysmal nocturnal dyspnea 12. Jhana, a client with congestive heart failure, has digoxin (Lanoxin) ordered every day. Prior to giving the medication, the nurse assesses that the digoxin level is 12mg/mL and auscultates a one-minute apical pulse rate of 62. The nurse should: A. Withhold the digoxin B. Withhold the dose and request an order for a potassium level C. Notify the physician D. Give the digoxin as ordered 13. Iyaz, another client hospitalized for heart failure, is receiving digoxin (Lanoxin) IV push. The nurse obtains the following data on the client. Place the data in order from that of highest concern to least concern to the nurse. 1. Potassium (K+-) level is 3.2 mEq/L 2. Apical pulse is 53 beats per minute 3. Client has been taking Furosemide (Lasix) 20mg 4 Client enjoys orange juice with breakfast A. 1,2,3,4 B. 1,3,4,2 C. 2,1,3,4 D. 2,3,4,1 Situation: Nurse Angie is caring for multiple patients assigned in their ward with a diagnosis of Buerger’s disease. 14. Nurse Angie has been assigned to Mr. Reyes; a client diagnosed with Thromboangiitis Obliterans. Which of the following anatomic areas are most often affected by this vascular condition? A. Hands and fingers. B. Lower legs and feet. C. Head and neck. D. Lower back. 15. Mr. Corpuz, a 30-year-old male client, is admitted with Buerger’s disease. Which of the following factors has increased the client's risk for development of Burger's disease? A. History of cigarette smoking. B. Occupational exposure to radiation. C. Age and gender. D. History of hypertension. 16. The primary goal for Mr. Corpuz, the client with Buerger's disease, is to prevent A. Embolus formation. B. Fat embolus formation. C. Thrombus formation. D. Thrombophlebitis. 17. Mr. Corpuz, a client with Buerger's disease, smokes two packs of cigarettes a day. Smoking cessation is critical or the client may lose the affected extremity. When helping a client change behavior it is important to know the client's A. Ability to attend support groups. B. Goals of the treatment. C. Perception of the behavior. D. Motivation 18. Mr. Corpuz’s disease experiences which of the following signs or symptoms? A. A Thickening of the intima and media of the artery. B. Inflammation and fibrosis of arteries, veins, and nerves C. Vasospasm lasting several minutes. D. Pain, pallor, and pulselessness. Situation: According to World Health Organization, Cardiovascular diseases (CVDs) are the leading cause of death globally, taking an estimated 17.9 million lives each year. CVDs are a group of disorders of the heart and blood vessels and include coronary heart disease, cerebrovascular disease, rheumatic heart disease and other conditions. 19. A client with cardiac disease is on a monitor and Nurse Van observes ventricular tachycardia at a rate of 160 beats/mm. The client is awake and coherent, and oxygen is being administered at rate of 6 L/ min via a nasal cannula, what is the first nursing action? A. Immediately defibrillate. B. Administer Lidocaine IV push as ordered. C. Begin cardiopulmonary resuscitation. D. Obtain arterial blood gas values 20. Nurse Van is taking the history from a client with Congestive Heart Failure caused by hypertension. The nurse identifies what data as supportive of the client's medical diagnosis? A. Dyspnea after walking one block. B. Weight loss of 15 pounds over last 3 months. C. Lower extremity edema in the evenings. D. Dizziness and fainting when rising too quickly. 21. Nurse Van is preparing another patient scheduled for CABG. What is the primary pathophysiological reason for performing coronary artery bypass surgery? A. Decrease oxygen overload to the cardiac muscle. B. Increase oxygen supply to the heart muscle C. Reduce plaque build-up in the carotid artery. D. Reduce overall contractility of the heart muscle. 22. Nurse Van is administering nitroglycerin intravenously to relieve chest pain. What is the therapeutic action of this medication? A. Increases diuresis and glomerular filtration, which results in decreased venous return. B. Increases the force of contraction of the myocardium, thereby increasing oxygen delivery. C. Produces an immediate analgesic effect and relieves chest pain. D. Increases the coronary blood supply and decreases the afterload. 23. In discharge planning for the client with Congestive Heart Failure, Nurse Van discusses the importance of adequate rest. What information is most important? A. A warm, quiet room is necessary. B. Bad rest promotes venous return. C. A hospital bed is necessary. D. Adequate rest decreases cardiac workload Situation: Tomorrow, you will be assigned to the Medical Step-down Unit, where you anticipate encountering many patients with acid-base imbalances. To ensure you are well-prepared as a professional nurse, you decide to review relevant information on managing patients with different types of acid-base imbalances. 24. As a nurse you were taught how to evaluate arterial blood gas (ABG) values. Which of the following steps would you do FIRST? A. Evaluate HCO3 B. Evaluate pH C. Determine acid base status D. Evaluate PaCO2 25. Which of the following conditions may cause metabolic acidosis due to a decrease in bicarbonate (HC03) level? 1. Loss of gastric fluids from vomiting or nasogastric suction 2. Loss of body fluids from drains below the umbilicus 3. Gastrointestinal fistulas 4. Aspirin ingestion
3 | Page A. 3 and 4 B. 1 and 2 C. 1 and 4 D. 2 and 3 26. For clients with diabetic ketoacidosis, their body employs several mechanisms to compensate for the acidosis. While caring for these clients, which of the following manifestations should you expect to observe? 1. Nausea and vomiting 2. Oliguria 3. Kussmaul breathing 4. Polyuria A. 1 and 2 B. 3 and 4 C. 1, 3 and 4 D. all of the above 27. Brian, 30 years old, was brought to the Emergency Department (ED) with nausea confusion, dehydration and oliguria. Her mother informs you that Brenda has been depressed after losing her job as a bank executive. An empty bottle of aspirin was found in her bathroom sink. Her laboratory values revealed the if.: pH = 7.35, PaCO2=16 mmHg, PaO2=130 mmHg, and HCO3=15mEq/L. What is the CORRECT acid-base interpretation of her ABG? A. Partially compensated respiratory acidosis B. Uncompensated metabolic acidosis C. Partially compensated metabolic: acidosis D. Compensated metabolic acidosis. Situation: Nurse Benedict is caring for clients in various clinical settings. 28. A patient named Jessie who had a total gastrectomy is given instructions on measure to prevent the developing of dumping syndrome. Which of the following statements, if made by Jessie, would indicate a correct understanding of the instructions? A. "I will have a bedtime snack" B. "I will rest one hour before each meal" C. "I will avoid concentrated sugar" D. "I will include high-carbohydrate foods in my diet.” 29. Which of the following findings, if identified in a patient in the immediate postoperative period following coronary artery bypass grafting (CABG), would indicate the need for immediate follow-up by Nurse Benedict? A. Chest tube drainage of 75 ml/hr B. Urinary output of 100 ml/hr C. Blood pressure of 124/60 mmHg D. Oxygen saturation of 92% 30. Given a patient with venous insufficiency, which of the following nursing interventions would be the most appropriate for their care? A. Elevating the legs B. Increasing the fluid intake C. Limiting the activity level D. Massaging the extremities 31. Which of the following conditions if reported in a patient's history, should Nurse Benedict recognize as a contributing factor to the development of metabolic alkalosis: A. Chronic obstructive pulmonary disease. (COPD) B. Type I Diabetes Mellitus C. Cushing's syndrome D. Reynaud's syndrome 32. Which of the following conditions would Nurse Benedict recognize as contributing factor to the development of respiratory alkalosis? A. Chronic obstructive pulmonary disease (COPD) B. Episodes hyperventilation C. Frequent loose stools D. Hiatal Hernia 33. Which of the following signs and symptoms would Nurse Benedict expect to identify when assessing a patient who has chronic obstructive pulmonary disease (COPD)? A. Increase anterior-posterior chest diameter B. Decreases residual lung volume C. Bronchovesicular breath sounds D. Kussmauls respirations 34. When instructing a patient who rides to restrict potassium intake, which of the following food's would Nurse Benedict identify as being the lowest in potassium? A. Raisins B. Grapes C. Spinach D. Potato 35. A client diagnosed with thrombophlebitis 1 day ago suddenly complains of chest pain and shortness of breath and is visibly anxious. The nurse on duty, Nurse Benedict, immediately assesses the client for other signs and symptoms of: A. Myocardial Infarction B. Pneumonia C. Pulmonary embolism D. Pulmonary edema 36. Mr. Jeffrey will undergo insertion of central venous catheter. The nurse on duty should assist Mr. Jeffrey to assume which of the following positions? A. Supine B. Trendelenburg's C. Reverse Trendelenburg's D. High-Fowlers 37. Nurse Benedict is caring for a client with suspected carbon monoxide poisoning. Of the following interventions that the nurse assists in implementing, which is the highest priority? A. Requesting a building inspection at the site of the incident from the local health department B. Drawing blood for carboxyhemoglobin levels C. Frequently observing the client D. Administering 100% oxygen 38. In peritoneal Dialysis the inflow time to allow 2-3L of dialysate to flow into the peritoneal cavity is: A. 5-10mins B. 10-20mins C. 10-30mins. D. 1 hour 39. The client reports mid-calf pain when walking a block or more, which is alleviated by resting. Nurse Benedict suspects the client may have intermittent claudication. At what percentage of arterial occlusion does intermittent claudication typically occur? A. 20% B. 40% C. 50% D. 100% 40. While the client with hepatitis B is eating, she accidentally dislodges her IV line, resulting in blood on the over-the-bed table. What should Nurse Benedict direct the housekeeper to use for cleaning the table? A. Alcohol B. Acetone C. Ammonia D. Bleach Situation: Nurse Ryan, a competent nurse in medical- surgical ward C, is assigned to care for clients with liver cirrhosis.   41. Nurse Ryan assesses a client with hepatic encephalopathy for asterixis by: A. Asking the client to extend an arm, dorsiflex the wrist and extend the finger. B. Assessing the client for azotemia, oliguria and intractable ascites C. Assessing the client for a musty sweet breath door D. Asking the client to draw a cross and noting any deterioration in the figure construction. 42. Nurse Ryan is assessing an older male client. Which of the following findings would strongly indicate the possibility of cirrhosis?