Title DIAGNOSTIC EXAMINATION - NP1 - KEY.pdf ✅

REFRESHER PHASE DIAGNOSTIC EXAMINATION NURSING PRACTICE 1 (NP1) NOVEMBER 2024 Philippine Nurse Licensure Examination Review Situation: Verbal communication is extremely important especially when the Nurse is exploring problems and disorders with the clients in any age group. Nurse Dante is assigned to different clients in the ward. 1. A client is hospitalized with a diagnosis of possible Cancer of the pancreas. On admission the client asks the nurse, “Do you think I have anything serious like cancer?” What is the nurse’s best reply? A. “What makes you think you have cancer? B. “I don’t know if you do, but let’s talk about it.” C. “Why don’t you discuss this with your doctor?” D. “Don’t worry, we won’t know until all the test result are back.” 2. Nurse Dante approaches a male client and asks how he is feeling. The client states “I’m feeling a bit nervous today.” Which of the following is the Nurse’s best reply? A. Please explain what you mean by the word nervous B. What is making you feel nervous? C. Would a backrub ease your nervousness? D. You do look like you’re nervous 3. When assessing a client what statement would indicate negative self-talk? A. Everyone has to learn something new sometime B. I am looking forward to making home visits , but I am also nervous C. This is going to be difficult, but I know I can do it D. Who can ever have enough experience to prepare for that job? 4. While receiving a preoperative enema a client starts to cry and says. “I’m sorry you have to do this messy thing me,” what is the best response by the nurse? A. “I don’t mind it.” B. “You seem to be upset.” C. “This is part of my job.” D. “Nurses get used to this.” 5. “But you don’t understand” is a common statement associated with adolescent. The best response by the nurse when communicating with an adolescent is to say: A. “I don’t understand.” B. “I would like to understand, let’s talk.” C. “I don’t understand. I was a teenager once too.” D. “I’m not sure have to I believe it’s you who has to understand.” Situation: One of the important roles of the Nurses is being a Health Educator. Clients would always seek information on Health maintenance to prevent illness. 6. Nurse Diana, daughter of Hippolita and the princess of Themycera, is teaching a client about prescribe restricted diet. What is the Nurse’s best initial comment? A. “You can eat only the on this list.” B. “What types of food do you usually eat?” C. “You need to limit the intake of food on this list.” D. “Do you understand why you have these food restrictions?” 7. Nurse Diana is preparing a nursing care plan to a client with Diabetes Mellitus (D.M.) that includes before discharge to know how to self-administer insulin, adjust the insulin dosage, understand the diet, and test the serum for glucose level. The client progresses well and is discharge 5 days following admission. Legally the: A. Nurse was properly functioning as a health teacher B. Visiting nurse should do health teaching in the client’s home C. Family members also should have been taught to administer the insulin D. Physician was responsible and the nurse should have cleared the care with the physician 8. Which teaching method has been evaluated as most effective in a new diabetic client? A. Utilizing breaks after each unit of the teaching session B. Having the client repeat the steps of insulin administration C. Encouraging the client to ask many questions D. Confirming that the client is able to give his own insulin 9. Which of the following statements by a client would alert the Nurse that further teaching on the idea of a restful sleep is indicated? A. I don’t take naps throughout the day B. I go to bed and get up routinely at the same time each day C. I have a small snack and take a bath before going to bed each day D. I went to bed earlier than usual and I rested and watched television until I fall asleep 10. What can the Nurse do to support the client’s ability to sleep in the hospital setting? A. Assess the client’s towards the end of the shift , closer to the normal awakening time B. Darken the room as much as possible by keeping the lights off C. Limit the noise and distraction on the unit D. Provide a bath or shower before bedtime Situation: Benjie, a charge nurse, is attending to the client with an intravenous fluid. 11. What does Nurse Benjie identify as the most likely cause of the infiltration of a client’s IV? A. Excessive height of the IV solution B. Failure to a adequately secure the catheter C. Lack of asepsis during catheter insertion D. Infusion of chemically irritating medication 12. Another client has an IV infusion. If the IV infusion infiltrates, what should Nurse Benjie do first? A. Elevate the IV site. B. Discontinue the infusion. C. Attempt to flush the tube. D. Apply a warm, moist compress. 13. The Physician orders the application of a warm soak to an IV site that has infiltrated. Nurse Benjie understands that the application of local heat transfer temperature to the body via the principles of: A. Radiation B. Insulation C. Convection D. Conduction 14. A Physician orders 2000 ml of 5% dextrose and 1⁄2 Normal Saline to infuse over 24 hours. The drop factor is 15 drops per ml. Nurse Benjie sets the flow rate at how many drops per minute? A. 15 drops per minute B. 17 drops per minute C. 21 drops per minute D. 28 drops per minute TOP RANK REVIEW ACADEMY, INC. Page 1 | 7

B. Squatting while holding her breath. C. Head elevated, grasping knees, breathing out. D. Lying on side, arms grasped on abdomen. 30. The delivery room nurse based on the standards of nursing practice, episiotomy is usually indicated for which of the following purposes? A. To prevents distention of the bladder. B. To relieve pressure on the fetal head. C. To aid in contraction of the uterus following delivery. D. Done primarily for the physician’s benefit. Situation: It is important for an Obstetric Nurse to perform a comprehensive physical assessment after labor and delivery that could predispose the mothers to potential complications such as hemorrhage. 31. The Nurse in the delivery room is attending to Mrs. Cruz on labor to make sure that maternal injury will be prevented during the postpartum period. Which of the following instruction should the nurse consider to prevent postpartum hemorrhage? A. Massage the fundus regularly B. Postpone breastfeeding of the baby- encourage breastfeeding to stimulate release of oxytocin thereby promoting uterine contraction C. Apply warm compress to her abdomen D. Have bed rest and avoid early ambulation- encourage ambulation 32. When the placenta has been delivered, the first thing the nurse should do in adherence with the standards of nursing practice is to: A. Inspect the placenta for completeness of the cotyledons B. Palpate the uterus to see if it is contracted C. Administer oxytoxic agents as ordered D. Estimate the blood loss to detect any bleeding 33. The delivery room nurse palpates the client’s fundus immediately after delivery of the placenta and assess that it is boggy. The nurse massages the patient’s uterus until it is firm. Considering evidence-based nursing practice, which medication would the nurse anticipate might need to be administered if the uterus becomes boggy again? A. Oxytocin (Pitocin) B. Ibuprofen C. Rho (D) immnune globulin (RhoGAM) D. Magnesium sulfate 34. Mrs. Evita 28 years old gave birth through Cesarian section. The Nurse examines her and identify the presence of lochia serosa and feels the fundus 4 fingerbreadths below the umbilicus. This indicated that the time elapsed is: A. 1 to 3 days postpartum B. 4 to 5 days postpartum C. 6 to 7 days postpartum D. 8 to 9 days postpartum 35. In assessing a new mother’s response to her son’s birth on the first post-partum day, which behavior does the Nurse expect to find present? A. Talkativeness and dependency B. Autonomy and Independence C. Disinterest in her own body function D. Interest in learning to care for the baby Situation: Inday is a 22-year-old G1P0 pregnant client in her 7 th month of pregnancy. She was rushed to the hospital because of persistent uterine contractions. She is currently under the care of Nurse Budoy. 36. Which of the following assessment findings of the nurse would give him a clue that his patient’s preterm labor may still be halted? A. There was no sudden gush of fluid observed. B. The patent is not febrile. C. Fetal heart rate was 175 beats per minute. D. The last internal examination done by the attending obstetrician revealed 4 cm cervical dilation. 37. The attending obstetrician has ordered to start a terbutaline infusion to help stop the preterm labor of the patient. Nurse Budoy should take note not to do ALL of the following measures during the preparation and administration of the infusion EXCEPT: A. Regularly auscultate the lungs of the patient. B. After the infusion has been terminated, check for new orders to switch the patient from intravenous terbutaline to oral terbutaline. C. Monitor for uterine contractions. Should the uterine contractions stop, the infusion should be terminated, as ordered, usually an hour after. D. Mix the drug with a dextrose solution to prevent any unnecessary hypoglycemic episodes. 38. Inday was permitted by her doctor to stay home but advised her to stay on permanent bed rest so as to prevent any recurrence of the preterm labor. Which of the following statements would tell Nurse Budoy that his discharge teachings to help Inday prevent any recurrence of preterm labor was effective? A. “I should only call my doctor if I counted my pulse to be more than 120 beats per minute.” B. “If I feel like uterine contractions are beginning again, I should lie down and elevate my feet.” C. “If I forget a dose of the medication for the contractions, I should take two pills as soon as possible to make up for the lost dose.” D. “If I notice any increase in my frequency of urination, I should lessen my oral fluid intake.” 39. Inday is asking Nurse Budoy how she would perform the Count to 10 Test. The latter should make sure to point out ALL of the following EXCEPT: A. When doing the test, the patient should assume a side-lying position. B. The patient should count the number of fetal movements that will occur in an hour. C. If the time it takes to feel 10 movements is twice what it was the day before, she should immediately call her physician. D. If she was able to count 12 fetal movements in an hour, there is no need to call up her physician. 40. If in case Inday experienced preterm labor again but cannot be medically halted anymore, which of the following information should be provided to her? A. She would only deliver the fetus vaginally considering that it is small enough. B. She should not expect any episiotomies to be performed because the fetus will be able to pass through the vaginal canal easily. C. She may expect analgesic agents such as Meperidine to be given to address the pain she is experiencing. D. The duration of the whole labor will not be significantly different. Situation: Abnormalities that patients experience and which health professionals like nurses watch out for during labor involves complications with the “power” or forces of labor. 41. Nurse Rico is assigned to care for a G1P0 pregnant client. It was endorsed to him that the said patient is currently having hypotonic contractions. Which of the following is TRUE regarding the condition? A. The number of contractions is usually not more than two or three in a 20-minute period. B. The administration of analgesia is not a contributory factor C. Nulliparous patients are mostly at risk to have hypotonic contractions. D. It occurs mostly during the active phase of labor. 42. Which of the following actions should Nurse Rico be keen in doing after the patient in the above case has delivered? A. Monitor the temperature every 15 minutes. B. Palpate the uterus every 15 minutes. C. Provide the patient with oxygen support, as ordered. D. Watch out for any complaints of headache. 43. Nurse Rico has also been assigned to care for another parturient whose labor is being monitored. Which of the following findings would make the nurse suspect the presence of hypertonic contractions? A. The patient’s situation did not improve after the administration of sedatives. B. The patient complains of severe pain during contractions which are relatively mild. TOP RANK REVIEW ACADEMY, INC. Page 3 | 7
C. The patient’s current cervical dilation is estimated to be 6 cm. D. Fetal monitoring reveals no evidences of fetal distress. 44. Which of the following nursing actions should be done if Nurse Rico is assisting in the Laminaria Technique for cervical ripening? A. Establish baseline vital signs and monitor them during and after the procedure. B. Maintain the patient in a side-lying position after the procedure. C. Document the number of dilators and sponges that were used. D. Monitor the fetal heart especially after the procedure has been completed. 45. Which of the following is NOT TRUE regarding the application of prostaglandin gel to facilitate cervical ripening? A. Labor induction with oxytocin may be started after the last prostaglandin dose has been administered. B. Women should stay in bed in a side-lying position after the application of the medication. C. An example of a prostaglandin analog gel is Misoprostol (Cytotec). D. Misoprostol should be used with caution among women who have renal diseases. Situation: The nurse practicing in the field of MCN should be familiar with the professional underpinnings of his/ her practice. 46. What is a legal implication pertinent to maternal and child health? A. Informed consent is rarely needed as children are unable to understand this. B. All adolescents over age 14 are able to sign consent for their own health care. C. Children who feel they have been wronged can sue years into the future. D. Pregnant women are not legally mandated to protect the health of their fetus. 47. A patient asks you whether maternal and child nursing is a profession. What qualifies as an activity of a profession? A. MCN nurses in the community supervise the rural health midwife and the BHWs. B. MCN nurses follow the MCNAP Standards of MCN in their practice. C. MCN nurses enjoy good working conditions in air-conditioned units. D. MCN nurses receive relatively high pay compared with other specialty nurses. 48. Maternal and child nursing is changing because social change affects care. Which of the following is a trend that is occurring because of social change? A. Children are treated in emergent care clinics, so nurses are hardly needed. B. Immunizations are now available for all childhood infectious diseases. C. The use of skilled technology has made nursing care more complex. D. Pregnant women are so healthy today that they rarely need prenatal care. 49. You are working in a maternal unit of a tertiary-level hospital in Manila. The Chief Nurse of the Obstetrics Department is nominated to replace a BON member who served for 1 year. You know that your Chief Nurse will serve for how many years in the Board? A. 1 year B. 2 years C. 3 years D. Past their lawful term until she is replaced 50. In the emergency admitting section of the Obstetrics Department, a G3P2 mother with eclampsia is brought in with active seizures. Which of the following principles is observed when the admitting obstetrician assesses the patient and institutes emergency measures without seeking consent from her? A. Principle of Double Effect B. Benevolent Deception C. Paternalism D. Advocacy Situation: A novice nurse is assigned in the Pediatric Charity Ward as his first job rotation. In his first few weeks, the Charge Nurse assists him closely, and assigns a Senior Nurse as a buddy. 51. The novice nurse observes that a senior nurse avoids any opportunity to do bedside care, and chooses to do all the charting and carrying out of orders. He is more concerned with their delayed salaries, rather than with all the learnings he can get in the area. The novice nurse knows that the senior nurse matches which theory of management? A. Theory X B. Theory Y C. Theory Z D. Theory A 52. Various equipment in the area, such as air-conditioning units, computers, and infusion pumps, are due for maintenance this month. Budget for this will come from: A. Capital Expense Budget B. Operational Budget C. Personnel budget D. Cash budget 53. During another day of duty, two senior nurses are arguing about a patient error. The head nurse calls both parties in her office to immediately end the conflict. The head nurse is using what conflict resolution strategy? A. Smoothing B. Compromise C. Forcing D. Withdrawing 54. The head nurse knows that the practice of instilling normal saline during suctioning of pediatric patients should be avoided, following evidence-based practice guidelines. How will she implement this policy? A. Identify the problems caused by instilling normal saline during suctioning B. Call for a ward meeting to discuss the evidences of this practice C. Attend a pediatric subspecialty conference to get more details about this practice D. Approach each staff nurse one by one to determine their thoughts about normal saline instillation 55. A team from the Nursing Services Division performs an evaluation of nurses’ practice in the pediatric ward. The novice nurses knows that this is also known as: A. Nursing Audit B. Performance Appraisal C. Quality assurance D. Quality improvement Situation: Quality nursing care includes extensive knowledge of the pathophysiological nature of the disease in order to provide superb nursing interventions. Nurse Dianne has been assigned to care for a 7 day old premature newborn who presented with significant respiratory distress after being breastfed. Assessment findings include a poor suck, excessive amount of frothy saliva on his mouth and nose, along with choking and coughing when breastfeeding, circumoral cyanosis, and a small for gestational age weight. Arterial blood gas results showed the ff. values: pH 3.2, pO2 76%, pCO2 50%, HCO3 23, O2 sat 88%. Baby David was immediately intubated and hooked to a mechanical ventilator. 56. Esophageal atresia (EA) / Transesophageal fistula (TEF) are often a component of associated anomalies involving the following organs except: A. Heart B. Trachea C. c. Kidneys D. Lungs 57. When taking the client’s health history, which specific prenatal condition demonstrated by the mother shows the possibility of EA/TEF in the unborn infant: A. Oligohydramnios TOP RANK REVIEW ACADEMY, INC. Page 4 | 7