Title RECALLS 9 (NP4) - STUDENT COPY ✅

RECALLS EXAMINATION 9 NURSING PRACTICE IV CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART B) 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 IV” on the box provided Situation: Anemia is a condition in which the blood lacks adequate healthy red blood cells or hemoglobin, with most common causes being acute blood loss, decreased or faulty red blood cell production, or the destruction of red blood cells. There are several types of anemia, with the main types being anemia related to acute and chronic blood loss, anemia of chronic diseases, anemias caused by nutritional deficiencies, and hereditary anemias (Silvestri L. A., Silvestri A. E. & Silvestri K. M., 2020). 1. Which of the following assessment of a patient who has pernicious anemia would indicate to Nurse Mary that the interventions given has been effective? A. Patient has no dependent edema B. Patient has good appetite C. Patient has slight jaundice D. Patient has no paresthesia 2. Nurse Mary understands that a patient with pernicious anemia will have which laboratory finding? A. Severe pallor B. RBCs 5.0 million C. High Schilling’s Test D. Intrinsic factor: absent 3. Nurse Mary devises a teaching plan for her patient with iron deficiency anemia. Which of the following is the most important teaching for health maintenance? A. Avoid exposure to others with acute infection B. Get 8 hours of sleep at night C. Include animal protein and dark leafy vegetables in patient’s diet D. Take naps during the day 4. A patient was referred to a dietitian for a nutritional counseling for anemia. Which among the following statements indicates a need for further teaching? A. I will take my iron supplements with a multivitamin or fruit juice. B. I will make sure that I’m taking my liquid iron supplement with a straw. C. I can take my iron supplement with a nonfat milk if I want to. D. I will make sure to take my iron supplements in between meals for maximum absorption. 5. Annie, a patient diagnosed with pernicious anemia, asks Bella, a newly Registered Nurse, on why she needs vitamin B12 shots. Nurse Bella is correct if she states that ____? A. There are more vitamins in a vitamin shot than a pill. B. Vitamin B12 cannot be found in foods. C. Your body can no longer absorb Vitamin B12 from foods. D. Vitamin shots work faster. 6. Nurse Bella is caring for a patient with aplastic anemia. For which treatment should Nurse Bella not prepare the patient? A. Therapeutic phlebotomy B. Cyclosporine C. Blood transfusion D. Bone marrow transplant 7. Rain, a patient with aplastic anemia is about to receive a shot of erythropoietin (Epogen). She now asks you, a newly registered nurse, on what this drug is intended to do. Which of the following would you tell patient Rain? A. It will increase your body’s energy as you combat aplastic anemia. B. It will suppress your immune system. C. It will stimulate your bone marrow to produce more of its own red blood cells. D. It increases your immunity against infectious diseases. 8. Abi, a newly registered nurse, instructs the parents of a teenager with sickle cell anemia about the precipitating factors related to sickle cell crisis. Which of the following should they avoid to prevent a sickle cell crisis from happening? A. Strict asepsis B. Fluid resuscitation C. Fluid restriction D. High O2 therapy 9. A patient with sickle cell anemia is admitted to the hospital. For which intervention should the nurse prepare this patient? A. Cyclosporine therapy B. Fluid restriction C. Therapeutic phlebotomy D. Hydroxyurea 10. Nurse Abi is now checking her next patient diagnosed with Polycythemia Vera. Which among the following lab studies should she monitor closely to evaluate the effectiveness of treatment for this patient? A. Blood Urea Nitrogen (BUN) B. Hematocrit C. Serum Creatinine D. Albumin 11. Hannah has been diagnosed with Polycythemia Vera. Which of the following manifestations is expected to be seen in a patient diagnosed with this kind of disease? A. Decreased blood viscosity B. Increased blood flow C. Elevated erythropoietin D. Ruddy appearance 12. Nurse Hans is teaching his patient with Iron Deficiency Anemia about dietary sources of iron. Which of the following food sets should be included in his teaching? A. Milkshake, hotdog sandwich, and frozen yogurt B. Baked chicken, steamed eggplant, and cola C. Eggs, beef and broccoli, and cereals D. Tofu, milk, and sardines 13. Kate, a newly registered nurse, is conducting a dietary assessment on a patient who is on a vegetarian diet. Which among the following vitamins may be lacking in a vegetarian diet? A. Vitamin C B. Vitamin E C. Vitamin B12 D. Vitamin A 1 | Page
14. Nurse Gabby is handling a patient with hemophilia. Among which of the following lab studies will most likely be abnormal in a patient with this kind of disease? A. Hematocrit B. Hemoglobin C. pTT D. Platelet 15. A patient with Thalassemia major is having an iron overload as a result of continuous blood transfusions to sustain life. Which among the following drugs should the nurse anticipate being prescribed? A. Amlodipine B. Deferoxamine C. Metoprolol D. Erythromycin Situation: The digestive system consists of the digestive tract, or gastrointestinal tract, plus specific associated organs. Because the digestive tract is open at the mouth and anus, the inside of the tract is continuous with the outside environment, and food entering the digestive tract may contain not only useful nutrients but also indigestible components such as fiber, or harmful materials such as bacteria. Hence, the GI system is susceptible to many health problems. 16. Nurse Athena is conducting a health teaching session with her patient who is diagnosed with peptic ulcer disease. Which of the following statements should be included in Nurse Athena’s health teaching? Select all that apply. 1. I need to avoid drinking coffee and alcohol. 2. I will take aspirin for my stomach aches instead of other pain relievers. 3. I can drink decaffeinated coffee. 4. I need to have adequate rest and avoid stress. 5. I should chew slow and thoroughly. A. 1, 4, 5 B. 2, 3, 5 C. 1, 3, 5 D. 2, 3 17. Which among the food options should a patient with gastroesophageal reflux disease avoid? A. Chocolate pudding B. Steamed chicken C. Apples D. Whole grain cereals 18. To manage the symptoms of peptic ulcer disease, Nurse Juan should teach his patient to avoid the following dietary management. Select all that apply. 1. Ingest fried and spicy foods. 2. Chewing the food fast. 3. Dividing food into 6 to 10 meals a day. 4. Sucking a peppermint candy after each meal. 5. Eat three big meals that are properly spaced throughout the day. A. 3, 4, 5, 1 B. 5, 2, 1, 3 C. 1, 2, 4, 5 D. 4, 2, 3, 1 19. Nurse Raffy is attending to a patient with peptic ulcer disease who complains of burning pain that occurs approximately 2 to 3 hours after meal and during the night. Based on this complaint, the location of the ulcer is most likely in which of the following areas? A. Jejunum B. Stomach C. Esophagus D. Duodenum 20. Patient Adi is admitted with a diagnosis of gastric ulcer. During the history taking, the nurse would expect the client to report ____? A. Pain common at night B. Epigastric pain relieved by food intake C. Pain relieved by vomiting D. Weight gain 21. Nurse Mika is handling a patient with peptic ulcer. She is teaching the patient about the medication that was prescribed, named Sucralfate. Which statement made by the patient indicates the best understanding of the prescribed medication? A. “My ulcer will heal because Sucralfate kills the bad bacteria in my gut.” B. “I will only take this drug when I have pain from my ulcer.” C. “This drug will coat the ulcer and decrease the acid production in my stomach.” D. “This medication will kill the bacteria and stop the acid production.” 22. Nurse Mika is now handling a patient with a retractable gastric ulcer and just underwent a gastric vagotomy. Which among the following parameters would Nurse Mika expect to increase as a result of the gastric vagotomy? A. Gastric motility B. Gastric pH C. Gastric acidity D. HCl Acid 23. An alcoholic patient with a complaint of abdominal pain came into the emergency room. The physician suspects pancreatitis. What findings below would correlate with pancreatitis? A. Cramping type of pain B. Positive Cullen’s sign C. Rovsing’s sign D. Pain found at McBurney’s point 24. Nurse Louise is caring for a patient with liver cirrhosis. Which of the following findings would not suggest hepatic encephalopathy? A. Presence of asterixis B. Fetor hepaticus C. Constructional apraxia D. Murphy’s sign 25. A 30-year-old patient is admitted with acute pancreatitis. Which lab findings would Nurse Louise expect to be abnormal for this patient? A. Serum amylase and lipase B. BUN C. Creatinine D. Alanine aminotransferase 26. A patient is receiving Pancreatin for chronic pancreatitis. Which among the following observation best indicates effectiveness of the drug? A. Less fatty stools B. Decrease in body weight C. Improved appetite D. Hyperglycemia 27. Nurse Mandy is reviewing the physician’s orders for her patient Candy who is currently admitted due to acute pancreatitis. Which among the following orders would Nurse Mandy question if noted on the Candy’s chart? A. Meperidine for pain PRN B. NPO status C. Atropine Sulfate D. NGT insertion 28. Kia, a newly registered nurse, is doing a health teaching session to the family of her patient with end-stage liver disease. Which of the following food items should be limited in the patient’s diet? Select all that apply. 1. Meats 2. Beans 3. Pastas 4. Milk 5. Baked fish and vegetables 6. Potatoes A. 1, 2, 4 B. 4, 5, 6 C. 3, 5, 6 D. 1, 2, 5 29. Nurse Amanda is caring for a patient with esophageal varices who has a Sengstaken-Blakemore tube inserted. Which of the following items should be readily available at the bedside? A. Large bore needle B. A pair of scissors C. A roll of gauze D. Forceps 30. Patient Aya just underwent a Billroth I procedure. To minimize complications from eating, which actions should the nurse teach Patient Aya? Select all that apply. 1. Lay down after meals for about 20-30 minutes 2. Drink liquids with meals 3. Drink in between meals 2 | Page
4. Eat a low fiber diet 5. Eat a diet high in carbohydrates A. 2, 4, 5 B. 1, 3 C. 5, 4, 1 D. 4, 5 Situation: A good foundation of research designs is crucial in passing the Nursing Licensure Exam. Anna, an aspiring registered nurse, did a review of the following research concepts. 31. Nurse Andrei researched on Tuberculosis. Its transmission, causative factors, treatment, signs and symptoms, as well as medication, and all other in-depth information about Tuberculosis. A design best for this study is: A. Historical B. Survey C. Case study D. Longitudinal 32. Kara has been smoking using an electronic cigarette. You want to determine what will be the effect of e-cigarette smoking to Kara in the next fifteen years. This study is best suited for which research design? A. Historical B. Longitudinal C. Correlational D. Descriptive 33. Jem wants to conduct a study regarding the healthcare delivery system used in World War II. A design best for this study is: A. Historical B. Longitudinal C. Experimental D. Exploratory 34. John is conducting a study on patients with end-stage renal disease who are undergoing hemodialysis. He has decided to focus on the meaning of their experiences in undergoing such treatment procedure. Which of the following types of research design is most appropriate? A. Grounded theory study B. Case study C. Phenomenology D. Ethnography 35. Anna wants to learn more about exploratory design. Which among the following choices is the purpose of this research? A. Test the cause and effect of relationship among the variables B. Predicts the future by studying the present C. Identify the variables in the study D. Study the life experiences of people Situation: Nurse Cali just finished her emergency and disaster nursing training. She is now a part of the emergency team of the hospital she’s working in. 36. Apart from the Glasgow Coma Scale, AVPU is also being used as a quick neurologic assessment. What does A stands for? A. Assessment B. Alert C. Aggressive D. Ability 37. After a scaffolding collapse, series of ambulance delivers 44 critically injured patients to the emergency room. As an effective ER nurse, which among the following types of leadership would be the most effective in this kind of situation? A. Laissez-Faire B. Democratic C. Autocratic D. Bureaucratic Situation: Nurse Lu is currently on duty when a super typhoon struck the city. Ten minutes later, a huge number of patients have started to arrive in the ER. 38. Which among the following patients will be Nurse Lu’s priority? A. A man with a sucking chest wound B. A woman with stable abdominal wounds C. An adolescent with fractures in her upper extremities D. An elderly with an eye injury 39. Nurse Lu will tag patients who suffered maxillofacial wounds without airway compromise on which category? A. Green B. Black C. Red D. Yellow 40. Nurse Lu will tag patients who suffered unstable chest and abdominal wounds on which category? A. Black B. Red C. Green D. Yellow Situation: Nurse Kelly, a newly registered nurse, is assigned to patients with renal disorders and acid-base imbalances. 41. Aluminum Phosphate is used in patients with renal failure to: A. Exchange potassium for sodium B. Reduce serum phosphate levels C. Correct acidosis D. Prevent constipation from sorbitol use 42. A patient is admitted in the hospital due to having a higher than normal potassium level in her bloodstream. Which foods should the Nurse Kelly instruct the client to avoid? A. Whole grains and nuts B. Yogurt and green leafy vegetables C. Orange juice and bananas D. Pork and canned vegetables 43. A female client with chronic renal failure has serum potassium level of 7 mEq/L. Which of the following parameters should Nurse Kelly assess first? A. Blood pressure B. Heart rate C. Respiratory rate D. O2 Sat 44. A male client is admitted for treatment of acute glomerulonephritis. Upon initial assessment, Nurse Kelly detects the classic signs and symptoms of acute glomerulonephritis of sudden onset. Such signs include: (Select all that apply). 1. Oliguria 2. Generalized edema, especially of the face and periorbital area 3. Hypertension 4. Hypotension 5. Polyuria 6. Dark and frothy urine A. 1, 2, 3, 6 B. 4, 5, 1, 2 C. 5, 3, 1, 6 D. 4, 2, 5, 6 45. Nurse Kelly is handling a patient diagnosed with acute kidney injury. Which among the following findings would indicate that the patient is already recovering? Select all that apply. 1. BUN 40 mg/dL 2. GFR 120 ml/min 3. Creatinine 3 mg/dL 4. Potassium 4 mEq/L A. 1, 2 B. 2, 3 C. 4, 1 D. 2, 4 46. Nurse Kelly is taking care of patient diagnosed with acute kidney injury. Which of the following factors would lead to post renal failure? A. Heart failure B. Bladder cancer C. Use of antineoplastics D. Tubular necrosis 47. Nurse Kelly is taking care of a patient diagnosed with acute kidney injury. Which of the following factors would lead to intrarenal failure? A. Heart failure B. Bladder cancer C. Tubular necrosis D. Benign Prostatic Hyperplasia 3 | Page
48. Which among the following abnormal lab values would be improved by dialysis treatment? Select all that apply. 1. Hyperkalemia 2. Hypernatremia 3. Elevated serum creatinine 4. Decreased hemoglobin A. ALL OF THE ABOVE B. 1, 2, 3 C. 1, 3, 4 D. 2, 3, 4 49. Nurse Kelly is taking care of a female patient who has been diagnosed with end stage renal disease. Which among the following assessment findings would Nurse Kelly expect to find in her patient’s records? A. Hemoglobin 14 g/dL B. Potassium 6.8 mEq/L C. BUN 8 mg/dL D. Calcium 11 mg/dL 50. Nurse Kelly is assisting her patient Ram who is scheduled for hemodialysis. Which of the following statements should be included in Nurse Kelly’s health teaching session for Ram? Select all that apply. 1. Monitor for signs of fluid volume deficit after the procedure. 2. Monitor for signs of bleeding after the procedure. 3. Withhold antihypertensive medications and other water soluble medications prior to dialysis. 4. Tell the client that meals are allowed during the procedure. A. 1, 2, 3 B. 3, 2, 4 C. 1, 2, 4 D. ALL OF THE ABOVE 51. Meredith is diagnosed with acute renal failure and is undergoing dialysis for the first time. Nurse Christina monitors her closely for dialysis disequilibrium syndrome. Typically, this syndrome causes the following manifestations except: A. Confusion B. Headache C. Bone pain D. Seizures 52. A patient has an AV fistula in place in his left upper extremity for his hemodialysis treatments. When planning care for this patient, which among the following measures should Nurse Christina not implement? A. Do not use the fistula for venipunctures and intravenous infusions. B. Assess the fistula for the presence of a bruit and thrill every 4 hours. C. Take blood pressures on the left arm only to ensure accuracy. D. Avoid lifting heavy objects with the arm that has an AV fistula. 53. Meredith has been prescribed with polystyrene sulfonate (Kayexalate). Nurse Christina is correct if she states that this drug is used in renal failure to: A. Prevent constipation B. Correct acidosis C. To address hyperphosphatemia D. Exchange potassium for sodium 54. Meredith’s serum potassium continues to rise in acute renal failure. Nurse Christina should anticipate which of the following emergency? A. Hemorrhage B. Pulmonary collapse C. Cardiac arrest D. Pericarditis 55. Calliope’s lab findings revealed that her Calcium level is 6 mg/dL. Which clinical manifestation would Nurse Arizona expect to assess? A. Thirst and confusion B. Muscle twitching and tetany C. Fruity breath D. Muscle weakness and paresthesia 56. Which among the clinical manifestations would lead Nurse Arizona that Calliope is experiencing hyperphosphatemia? A. Muscle pain and acute rhabdomyolysis B. Hot, flushed skin, and hypotension C. Soft tissue calcification and hyperreflexia D. Increased respiratory rate and depth 57. Alex is currently undergoing hemodialysis. He has an AV fistula in place in his right upper extremity. Which of the following findings would suggest that he is experiencing arterial steal syndrome? Select all that apply. 1. Hand swelling 2. Presence of bruit upon auscultation of the fistula 3. Absence of thrill over the fistula 4. Hand numbness 5. Pain and pallor 6. Coldness and weakness A. 4, 5, 6 B. 1, 2, 3 C. 1, 2, 5 D. 1, 4, 5 58. Lexie has urinary calculi that are found to be composed of purine. Nurse Mark teaches her dietary measures to prevent further development of the calculi. Nurse Mark determines that Lexie understands his teaching if she states that it is necessary to avoid which food products? Select all that apply. 1. Shellfish 2. Liver 3. Salmon 4. Spinach 5. Wheat bran 6. Milk Chocolate A. 1, 2, 3 B. 4, 2, 1 C. 4, 5, 6 D. 1, 2, 6 59. Jack just underwent a TURP and continuous bladder irrigation was started. In which of the following situations would Nurse Hailey decrease the flow rate of the irrigation? A. When the drainage is as clear as water B. When the drainage becomes bright red C. When the drainage is continuous but slow D. When there is no drainage of both urine and irrigating solution 60. Nurse Harry is assigned to Kimmy, a patient diagnosed with acute kidney injury. Which of the following interventions should Nurse Harry do? A. Encourage a low protein diet. B. Allow liberal amounts of fluids. C. Allow liberal amounts of potassium. D. Encourage sodium intake. 61. Kimmy was scheduled for hemodialysis. During her hemodialysis session, she suddenly became restless, cyanotic, and complains of chest pain. Which of the following priority intervention should Nurse Harry do? A. Nothing. This is a normal finding during hemodialysis. B. Assess vital signs and document. C. Administer O2 and notify HCP. D. Stop hemodialysis and put on Trendelenburg position turned to the left side. 62. Philip, a patient with chronic renal failure was brought to the emergency room after skipping two dialysis treatments to visit a family member out of town. Which of the following ABG readings would indicate to Nurse Liam that Philip is in a state of metabolic acidosis? A. pH 7.43; PaCO2 36 mmHg; HCO3 26 mEq/L B. pH 7.20; PaCO2 50 mmHg; HCO3 21 mEq/L C. pH 7.33; PaCO2 37 mmHg; HCO3 17 mEq/L D. pH 7.50; PaCO2 20 mmHg; HCO3 26 mEq/L 63. Nurse Rai has been attending to a patient admitted with diarrhea that lasted for 5 days. Which among the following ABG readings would Nurse Rai expect to see in this patient? A. pH 7.34; PaCO2 46 mmHg; HCO3 22 mEq/L B. pH 7.35; PaCO2 35 mmHg; HCO3 26 mEq/L C. pH 7.30; PaCO2 40 mmHg; HCO3 18 mEq/L D. pH 7.50; PaCO2 30 mmHg; HCO3 27 mEq/L 64. Nurse Kara reviews the arterial blood gas results of her patient and notes the following: pH 7.35, PaCO2 30 mmHg, and HCO3 20 mEq/L. Nurse Kara analyzes these results as suggestive of which condition: A. Metabolic acidosis, compensated B. Respiratory acidosis, uncompensated C. Metabolic alkalosis, compensated D. Respiratory acidosis, uncompensated 4 | Page