Title RECALLS 13 - NP4 - SC ✅

RECALLS 13 EXAMINATION NURSING PRACTICE IV CARE OF THE CLIENT WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART B) 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 IV” on the box provided 1-5. Situation. Nurse Kim cares for a 40-year-old male with electrolyte imbalance. On assessment, the nurse observes the client to be confused, restless and lethargic. 1. Nurse Kim carries out the order for the client to have a diagnostic test. Which of the following values indicate hyponatremia? A sodium level _____ A. Below 8.5 to 10.5 mg/dL B. Between 3.5 and 5.5 mEgL C. Above 145 mEg/L D. Below 135 mEg/L 2. Nurse Kim is aware that the MOST common electrolyte abnormality in hospitalized patient is ______ A. Hyperkalemia B. Hyponatremia C. Hypernatremia D. Hypokalemia 3. Nurse Kim writes a nursing diagnosis. Which of the following diagnoses is MOST appropriate for the client? A. Excess Fluid Volume B. Ineffective Breathing Pattern C. Deficient Fluid Volume D. Disturbed Thought Processes 4. The physician prescribes intravenous solutions for the client. Which of the following solutions is appropriate? A. 0.9 % Sodium Chloride B. Dextran 6 % in sterile water C. 0.3 % Sodium Chloride D. Dextrose 5 % in water 5. An appropriate nursing intervention for the client is for Nurse Kim to________ A. Maintain body alignment and assist with movement B. Monitor level of consciousness C. Administer oral hygiene D. Monitor laboratory findings 6-10. Situation. The nurse cares for a group of clients with allergies. 6. The nurse assesses the client who says he is highly allergic to many food items and medications. Which of the following hypersensitivity reactions would be responsible for this type of clinical manifestation? A. Type 4, delayed sensitivity B. Type 1, IgE mediated hypersensitivity C. Type 2, cytotoxic hypersensitivity D. Type 3, immune complex-mediated hypersensitivity 7. The nurse assesses an atopic client who had serious Type 1 hypersensitivity reactions. The nurse is aware that the most severe form of a Type 1 hypersensitivity reaction is which of the following conditions? A. Cell-mediated sensitivity B. Dermatitis C. Anaphylaxis D. Bronchial asthma 8. A client is experiencing anaphylaxis. Which of the following actions by the nurse takes HIGHEST priority? A. Administer epinephrine injection B. Place the client in Trendelenburg position C. Maintain an open airway D. Administer emergency oxygen 9. The nurse develops a care plan for a client with a past history of anaphylaxis. Which drug should the nurse instruct the client to always have it readily available to treat possible allergic reaction? A. Diphenhydramine B. Acetaminophen C. Epinephrine D. Acetyl Salicylic Acid 10. A client with a history of Type 1 hypersensitivity reaction is receiving immunotherapy. The nurse administers the allergen injection and asks the client to wait for how many minutes so that the immediate reactions can be treated? A. 5 – 15 minutes B. 30 – 40 minutes C. 60 minutes D. 15 – 25 minutes 11-15. Situation. Nurse Em cares for a 30 year old male who suffered a spinal cord injury sustained in a sporting accident which resulted in paraplegia. The following questions relate to the care of a client with a paraplegia. 11.The client is fortunate that the level of his injury did not affect his respiratory function. The nurse understands that the cord segments involved in maintaining respiratory function are: A. C1-2 B. C3-4 C. C5 D. C6 12. Nurse Em understands that the LEAST effective method of preventing contractures of the joints of the lower extremities would be to: A. Passively move the extremities through range of motion exercises. B. Provide the client with active exercise instructions. C. Maintain proper alignment in bed. D. Change the client’s position every two hours. 13. Nurse Em plans care for the client which includes turning the client every two hours. This nursing measure is necessary to: A. Improve circulation in the lower extremities. B. Keep the client comfortable. C. Prevent occurrence of pressure sores. D. Prevent flexion contractures in the lower extremities. 14. Nurse Em recognizes that an early major problem of the client with paraplegia is: A. Client education. B. Bladder control. C. Use of mechanical aids for ambulation. 1 | Page
D. Quadriceps setting 15. Nurse Em is aware that a complication the client with paraplegia may experience is formation of urinary calculi. The factor that contributes to this condition is: A. High fluid intake B. Increases loss of calcium for the skeletal system. C. Inadequate kidney functioning. D. Increased calcium intake. 16-20. Situation. A 63-year-old male arrives at the Out-Patient Department complaining of numbness and tingling sensation of the lower extremities and pain in the legs upon exercising. The nurse suspects the client may have Peripheral Arterial Disease (PAD). 16. The nurse asks the client the following questions. Which of the questions would determine the risk factors of PAD? 1. “Do you smoke cigarettes?” 2. “Are you diabetic?” 3. “Are you hypertensive?” 4. “Do you exercise?” 5. “Do you drink alcohol?” A. 2, 3, & 4 B. 1, 2, 3, 4, & 5 C. 1, 4, & 5 D. 1, 2, & 3 17. The client asks the nurse what the doctor meant when he heard him say that the client has intermittent claudication. The nurses’ BEST response is, Intermittent claudication is_______ A. Pain that can occur in the body with exercise B. Pain in the leg when exercising C. Pain in the leg that occurs when at rest D. A tingling feeling of sensation in the hands 18. The nurse writes a nursing diagnosis of Ineffective Tissue Perfusion for the client. Which of the following interventions is MOST appropriate for this nursing diagnosis? A. Keep his legs in dependent position B. Elevate his legs C. Take hot bath D. Limit his daily activities. 19. The nurse writes another nursing diagnosis of Risk for Impaired Skin Integrity related to decreased peripheral circulation. Which of the following interventions is MOST appropriate for the nurse to instruct the client? A. Monitor the extremities for color, motion and sensation, and pulses. B. Maintain an appropriate level of activity to promote circulation. C. Avoid risk factors that may increase problems with Peripheral Arterial Disease. D. Protect the legs from injury because the tissues are fragile. 20. Which of the following outcomes indicate that there is increased arterial blood supply to the extremity of the client with peripheral arterial disease? A. Reduced sensation to touch B. Reduced muscle pain C. Increased rubor D. Decreased hair on the extremity 21-25. Situation. Nurse Rose is a newly registered nurse. She is assigned to the surgical unit of X hospital. She is aware of the legal responsibilities when performing patient care. The following are situations she encountered in the surgical unit with legal significance. 21. A patient is scheduled for abdominal surgery. Which of the following statements is a responsibility of Nurse Rose in obtaining a consent form? 1. Ensure that the consent form has been signed and is attached to the chart of the patient before the operation. 2. Witness the signing of the consent before the operation is performed. 3. Provide a detailed description of the operation before asking the patient to sign the consent form 4. Answer questions that the patient may ask before the patient signs the consent form. A. 3 & 4 B. 1, 2 & 3 C. 1, 2 & 4 D. 1 & 3 22. Which of the following health care professionals is legally responsible for obtaining informed consent for an invasive procedure? The ____ A. Surgeon B. Nurse Supervisor of the unit C. Medical director D. Registered nurse on duty 23. Nurse Rose documents her observation on a patient for abdominal surgery. Which of the following statements is legally appropriate notation? A. “The charge nurse spoke with the patient about the surgery” B. “The surgeon committed an error in the medication dose to be given” C. “Patient says he will sue the surgeon and the hospital if the operation turns out to be a failure.” D. “Patient says he feels sharp and stabbing pain in the abdominal area.” 24. The attending physician writes an order of Do Not Resuscitate (DNR) on a patient who is seriously ill. Which of the following is a responsibility of Nurse Rose? Nurse Rose should ________ 1) Carry out the order in the event the patient experiences sudden need for CPR 2) Determine if there is a living will on the medical record of the patient 3) Consult the policies and procedures of the Institution if she feels such DNR order is contrary to the patient’s or family’s wishes. 4) Refer to the Ethics Committee of the Institution the DNR order to determine appropriateness of the order. A. 2 & 3 B. 1 & 3 C. 3 & 4 D. 1 & 2 25. The physician orders a dose of medication to be given to a patient before undergoing surgery. Nurse Rose is aware that the dose is too high for the patient. She tries to locate the physician to check the order but the physician is not available. Which of the following is the MOST appropriate action Nurse Rose will take to ensure the safety of the patient? A. Notify the nurse supervisor immediately B. Administer half of the dose of the medication ordered. C. Administer the medication as ordered. D. Withhold the medication. 26-30. Situation. The charge nurse in the Emergency Department calls for a crisis meeting to review principles in mass casualty to enhance preparedness and improve emergency quality care. 26. Which of the following statements is NOT TRUE about emergency preparedness? A. Hospitals should have an emergency preparedness plan that is tested through drills or actual participation. B. Generally, hospital employees participate seriously in emergency drills. C. Emergency preparedness training and drills are standard functions of emergency departments of hospitals. D. Drills must involve the participation and collaboration of the community. 27. The charge nurse explains that mass casualty incidents are due to events such as the following EXCEPT: A. Earthquakes B. Severe weather phenomena. C. Lightning strikes. D. Transportation disasters. 28. The charge nurse reiterates the importance of using a disaster triage tag system. Clients that have been “green-tagged” are those ________. A. With injuries of closed fracture, sprains, contusions and abrasions. B. Who are expected to die or are dead already. 2 | Page