Title RECALLS 4 (NP5) - STUDENT COPY ✅

2 | Page Prepared by: GARCIA, RHYAN P. ROMAN, HANNAH GISELLA 16. A nurse is assessing a newborn and suspects Trisomy 21 (Down syndrome). Which of the following findings would most likely support this diagnosis? A. Tall stature with long limbs B. Hypertonia and stiff joints C. Upward slanting of the eyes D. Thin, high-arched palate 17. A nurse administers lithium to a client with bipolar disorder. Which electrolyte imbalance increases the risk of lithium toxicity? A. Hyponatremia B. Hypernatremia C. Hypokalemia D. Hypercalcemia 18. A client with Huntington’s disease is prescribed tetrabenazine. Which symptom is the medication intended to manage? A. High blood pressure B. Chorea C. Pyrexia D. Weight gain 19. A client taking phenytoin for seizure control presents with nystagmus and ataxia. What should the nurse suspect? A. Drug toxicity B. Therapeutic effect C. Drug tolerance D. Withdrawal symptoms SITUATION: A doctor suddenly quizzes Nurse Joy during their rounds. The doctor starts enthusiastically asking her about diseases that are commonly not encountered. 20. A nurse is preparing to administer epinephrine to a client in anaphylactic shock. What is the primary action of this medication? A. Vasodilation and decreased heart rate B. Bronchodilation and vasoconstriction C. Increased histamine release D. Suppression of the immune response 21. A client with multiple sclerosis is prescribed interferon beta-1a. Which side effect should the nurse monitor for? A. Flu-like symptoms B. Hypoglycemia C. Bradycardia D. Constipation 22. A client receiving cisplatin chemotherapy reports ringing in the ears. What condition should the nurse suspect? A. Nephrotoxicity B. Ototoxicity C. Cardiotoxicity D. Neurotoxicity 23. A client with Addison’s disease is prescribed hydrocortisone. What is the priority teaching point? A. Take the medication before bedtime B. Double the dose during periods of stress C. Avoid potassium-rich foods D. Discontinue abruptly if feeling better 24. A nurse is caring for a client taking isoniazid for latent tuberculosis. Which supplement should be given to prevent peripheral neuropathy? A. Vitamin B6 B. Vitamin B12 C. Folic acid D. Iron 25. A client with acromegaly is prescribed octreotide. What is the expected outcome of this therapy? A. Increase growth hormone levels B. Decrease growth hormone levels C. Enhance insulin secretion D. Promote linear bone growth 26. A client with Crohn’s disease is prescribed infliximab. What is the most important nursing assessment before administering the medication? A. Blood glucose level B. Signs of infection C. Liver function tests D. Serum calcium levels 27. A nurse is reviewing lab results of a client taking spironolactone. Which finding should be reported to the healthcare provider immediately? A. Sodium 138 mEq/L B. Potassium 5.8 mEq/L C. Chloride 100 mEq/L D. Magnesium 2.0 mg/dL 28. A client with Marfan syndrome is prescribed beta-blockers. What is the therapeutic purpose of this medication? A. Reduce aortic dilation B. Increase heart rate C. Improve muscle strength D. Enhance bone growth 29. A client with rheumatoid arthritis is prescribed methotrexate. Which of the following instructions should the nurse give? A. Increase folic acid intake B. Avoid drinking fluids after taking the medication C. Expect hair growth as a side effect D. Take the medication daily SITUATION: Nurse Minny is handling cases from hematology to endocrinology. As she makes her rounds, she’s being asked by a junior nurse about procedures and advice. 30. A client with cystic fibrosis is prescribed pancrelipase. Which statement by the client indicates correct understanding of the medication? A. “I will take this medication on an empty stomach.” B. “I will take this medication with every meal and snack.” C. “I will take this medication before bedtime.” D. “I will take this medication only when I feel bloated.” 31. A nurse is caring for a client with thalassemia major who requires frequent blood transfusions. Which medication is administered to prevent iron overload? A. Deferoxamine B. Ferrous sulfate C. Cyanocobalamin D. Erythropoietin 32. A client is diagnosed with deep vein thrombosis (DVT). Which finding would the nurse expect? A. Edema and warmth in the affected extremity B. Decreased peripheral pulses C. Pallor and coolness of the affected extremity D. Absence of pain in the affected extremity 33. A client with hypothyroidism is prescribed levothyroxine. Which of the following indicates the medication is effective? A. Weight gain B. Bradycardia C. Improved energy levels D. Cold intolerance 34. A client with hemophilia A is scheduled for surgery. Which medication should the nurse anticipate administering preoperatively? A. Factor VIII concentrate B. Factor IX concentrate C. Vitamin K D. Fresh frozen plasma 35. A client with HIV is prescribed ritonavir. The nurse should monitor for which common side effect? A. Hyperlipidemia B. Hypoglycemia C. Hyponatremia D. Hypotension 36. A client is prescribed carbidopa-levodopa for Parkinson's disease. What is the primary purpose of carbidopa in this combination? A. Increase dopamine breakdown B. Reduce peripheral metabolism of levodopa C. Decrease acetylcholine production D. Enhance dopamine receptor sensitivity 37. A client with gout is prescribed allopurinol. Which of the following is an important teaching point? A. Take the medication during an acute gout attack B. Increase fluid intake to prevent kidney stones

4 | Page Prepared by: GARCIA, RHYAN P. ROMAN, HANNAH GISELLA C. Weight loss D. Increased energy levels 59. A client says, “I feel worthless and like everything is my fault.” Which therapeutic response is most appropriate? A. “You shouldn’t feel that way.” B. “Tell me more about why you feel this way.” C. “You’ve accomplished a lot in your life.” D. “I know how you feel.” 60. A client with a history of alcohol use disorder presents with confusion, ataxia, and nystagmus. Which intervention is a priority? A. Administer thiamine as prescribed B. Place the client on seizure precautions C. Prepare the client for detoxification D. Monitor the client’s vital signs every hour SITUATION: Nurse Nemia and Nurse Caroline are both seasoned psychiatric nurses. They teach their students by giving them plenty of PNLE-styled exams about psychiatric nursing. 61. A nurse is caring for a client with obsessive-compulsive disorder (OCD) who repeatedly washes their hands. What is the most appropriate nursing intervention? A. Restrict the client’s handwashing immediately B. Allow the behavior and do not interfere C. Set limits on the behavior while allowing time for rituals D. Encourage the client to substitute handwashing with another ritual 62. A client experiencing alcohol withdrawal is at risk for which of the following complications? A. Bradycardia B. Hyperglycemia C. Seizures D. Hypothermia 63. A client with borderline personality disorder tells the nurse, “You are the only one who understands me; the other nurses are terrible.” What is the nurse’s best response? A. “I’m glad you trust me more than the others.” B. “I think you should give the other nurses a chance.” C. “Let’s focus on how you’re feeling right now.” D. “The other nurses are trying their best, too.” 64. A client with depression is prescribed sertraline. Which side effect requires immediate attention? A. Dry mouth B. Insomnia C. Increased suicidal thoughts D. Weight gain 65. A client with schizophrenia exhibits a flat affect and minimal speech. The student nurse is correct when he identifies the symptoms are categorized as: A. Positive symptoms B. Negative symptoms C. Cognitive symptoms D. Mood symptoms 66. A client with post-traumatic stress disorder (PTSD) reports nightmares and difficulty sleeping. Which intervention is most appropriate? A. Encourage the client to avoid discussing traumatic events B. Suggest relaxation techniques before bedtime C. Advise the client to increase daytime naps D. Recommend the client watch TV to distract from nightmares 67. A nurse is educating a client on the side effects of haloperidol. Which of the following should be reported immediately? A. Drowsiness B. Muscle stiffness and fever C. Dry mouth D. Blurred vision 68. A nurse is conducting a group therapy session when a client becomes verbally aggressive. What is the nurse’s priority action? A. Confront the client about their behavior B. End the group session immediately C. Set firm boundaries while maintaining a calm demeanor D. Ignore the behavior to avoid escalating the situation 69. A client experiencing a manic episode is pacing around the room and talking rapidly. What is the nurse’s best approach? A. Encourage the client to sit down and discuss their feelings B. Escort the client to a quiet, low-stimulation environment C. Allow the client to continue pacing as long as they are safe D. Provide detailed instructions to help the client focus 70. A client prescribed benzodiazepines for anxiety reports feeling very drowsy. What is the nurse’s priority action? A. Advise the client to stop taking the medication immediately B. Teach the client to avoid activities requiring alertness C. Suggest the client take the medication with energy drinks D. Notify the healthcare provider to discontinue the medication SITUATION: Nurse Edwin is a clinical instructor whose specialty is medical-surgical nursing. However, the staffing shortage in their university requires him to take some of the teaching load in the psychiatric nursing class. He is patiently answering some practice questions to help refresh his knowledge. 71. A nurse applies wrist restraints to a client who is attempting to pull out their IV. Which of the following must be included in the documentation? A. The client’s consent for the restraints B. The specific behaviors leading to the use of restraints C. The client’s history of aggression D. The family’s request for restraints 72. A nurse finds a client with major depressive disorder sitting alone, staring at the floor. Which is the most therapeutic response? A. “You should join the group so you’ll feel better.” B. “Why are you sitting here all alone?” C. “I’ll sit with you for a while.” D. “You seem to be isolating yourself again.” 73. A nurse is reviewing orders for a client with schizophrenia. Which order should the nurse question? A. Haloperidol 5 mg IM for agitation B. Restraints PRN for aggressive behavior C. One-to-one observation for suicidal ideation D. Benzodiazepines as needed for anxiety 74. A client with a generalized anxiety disorder is prescribed buspirone. Which statement indicates the need for further teaching? A. “I can take this medication regularly to help manage my anxiety.” B. “I will avoid drinking alcohol while taking this medication.” C. “I should expect immediate relief after taking this medication.” D. “This medication may take a few weeks to start working.” 75. A nurse is caring for a client in seclusion due to aggressive behavior. Which action is most important? A. Explain to the client that the seclusion is punishment for their actions B. Document the behavior that led to the seclusion and the client’s response C. Keep the client in seclusion until they promise to behave D. Discontinue seclusion only after the healthcare provider evaluates the client 76. A client states, “I feel like everyone is out to get me.” Which term describes this symptom? A. Delusion of grandeur B. Paranoid delusion C. Hallucination D. Flight of ideas 77. A client with bipolar disorder is prescribed valproic acid. Which laboratory value should the nurse monitor? A. Serum sodium B. Platelet count C. Blood glucose D. Serum creatinine