Title RECALLS 2 (NP3) SC ✅

RECALLS EXAMINATION 2 NURSING PRACTICE III CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART A) MAY 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 III” on the box provided Situation – The following situations are related to ethical practices in the workplace. 1. Jillian a registered nurse has signed a contract for two years in a medical center. A recruitment agency has offered her a “fat” salary for foreign employment. If you are in the position of Jillian, what should you do? A. Discuss your plans with your parents B. Accept the recruitment offer and go Absence without official leave. C. Write a letter of resignation to your employer 30 days before leaving. D. Accept the recruiter's offer and give an excuse to the employer on behalf of her “sick” mother. 2. Karylle is a BSN graduate but did not take the National Licensure exams. She is in dire need of money so she applied and was accepted in a health facility. As a nurse she submitted a fake PRC license in order to be given a job. Riza is liable to be charged of ___________. A. False statement B. Misrepresentation C. fraud and deceit D. malpractice 3. Ms. Kendall an R.N was invited as a resource person in a nursing conference. The curriculum vitae she submitted to the PRC Continuing Professional Development Council reflects the word Masters of Arts in Nursing (MAN) after her name. She only completed academic requirements but not her thesis writing. Which of the following did Ms. Paras violate? A. RA 9173 of Nursing Law B. Code of Professional Ethics for Teachers C. Magna Carta for Health Workers D. Code of Ethics for Registered Nurse 4. It is a hospital policy for nurses in a health facility that reporting time is 15 minutes before the official designated time. Nurse Khloe reported 30 minutes late and requested her co-staff to sign in for her. This is an example of __________. A. Dishonesty B. Falsification of document C. Unprofessional conduct D. All of the options 5. What ethical justification is observed when administering Opioids despite the possibility of hastening death. A. Rule of double effect B. Rule of single effect C. Maleficence D. Justice SITUATION: You are a nurse assigned to take care of patients with various liver conditions. You utilize your knowledge and skills on the diseases to effectively plan and manage care for these patients. 6. Patient Bellmere was admitted to the hospital with a diagnosis of nonalcoholic fatty liver disease (NAFLD). You are reviewing her chart for her health history. Which of the following findings is consistent with the NAFLD disease process? A. 70 years old B. Obese C. History of recent antibiotic use D. Living in colder climates 7. Yosaku is a male patient diagnosed with cirrhosis. While caring for Yosaku, you add the nursing diagnosis Disturbed body image related to physical manifestations of the illness when you overheard Yosaku telling his brother: A. “I don’t think I can handle this disease.” B. “I know the doctors say I have liver failure, but I don’t really believe them.” C. “I know I should rest more, but I’m just not that type of person.” D. “I don’t like the fact that I seem to have breasts now.” 8. Patient Johnny was admitted in the ED after complaints of upper right sided abdominal pain. You suspect that the client may have liver cancer when which serum laboratory test result is noted to be elevated? A. Creatinine B. Serum α-fetoprotein (AFP) levels C. Serum phosphorus levels D. CA-125 9. You are caring for patient Carol after her liver biopsy with the assistance of student nurse Apis. You evaluate that Apis understands liver biopsy post procedure care when she does which of the following? A. plans to monitor vital signs every hour. B. promotes ambulation 1 hour after the procedure. C. positions the client on the right side. D. encourages the client to cough and deep breathe immediately following the procedure. 10. Pell is a patient hospitalized for conservative treatment of liver cirrhosis. As part of the collaborative plan of care, you would anticipate which of the following? A. monitoring the client’s blood sugar. B. maintaining NPO (nothing by mouth) status. C. administering antibiotics. D. encouraging frequent ambulation. SITUATION: You are a nurse in the cardiothoracic ward of Hospital Merry. You are assigned to patients with aneurysms. You will utilize your nursing knowledge on aneurysms to care for these patients. 11. You are developing a discharge teaching plan for Morgan, a patient who underwent a repair of abdominal aortic aneurysm a few days ago. You reviewed Morgan’s chart for information about his health history. Key findings you noted in his chart are as follows: 1) Smokes 4 cigars a month. 2) Vital signs: blood pressure, ranges from 150/76 mm Hg to 170/98 mm Hg; heart rate, 90 to 100 beats per minute; respirations, 12–18 per minute; temperature, 99.9° F (37.8° C). 3) +1 bilateral ankle edema. 1 | Page
Based on the data and expected outcomes, which of the following should you emphasize in the teaching plan for Morgan? A. Food intake. B. Fluid volume. C. Skin integrity. D. Tissue perfusion. 12. Helmeppo, a client admitted to the emergency department is complaining of severe abdominal pain. After several tests, a radiograph of his revealed a large abdominal aortic aneurysm. The primary goal for Helmeppo at this time is to: A. Maintain circulation. B. Manage pain. C. Prepare the client for emergency surgery. D. Teach postoperative breathing exercises. 13. Yasopp, a 54 year old client was admitted in the emergency department. On assessment, it was revealed he has severe back pain, Grey Turner’s sign, nausea, BP of 90/40, HR of 128 bpm, and RR of 28 cpm. As Yasopp’s nurse, you should first do which of the following actions: A. Assess the urine output. B. Place a large bore I.V. C. Position onto the left side. D. Insert a nasogastric tube. 14. Arlong, one of the patients assigned to you, complains of sudden, severe pain in his back and chest, accompanied by SOB. He describes the pain sensation as “as if something was tearing inside”. The physician suspects that he is experiencing a dissecting aortic aneurysm. The code cart is brought into Arlong’s room because you know that one of the complications of dissecting aneurysm is: A. Cardiac tamponade. B. Stroke. C. Pulmonary edema. D. Myocardial infarction. 15. Hatchan is to be discharged after his surgery of aortic aneurysm repair with synthetic graft to replace part of his aorta. As part of your discharge teaching, you instruct Hatchan to notify his physician before doing which of the following procedures? A. Blood drawn. B. An I.V. line inserted. C. Major dental work. D. An X-ray examination. Situation – Juliet, a Pediatric Cardiovascular Nurse is assigned to take care of 3 children in her unit. She just admitted a 12- year- old female patient suffering from Rheumatic Fever (RF) 16. When doing an assessment, which ONE of the following conditions is NOT present based on the Jones Criteria? A. Erythema Marginatum B. Subcutaneous nodules C. Chorea D. Bronchopneumonia 17. In Rheumatic fever, the factor contributory to the development of this disease process is brought about by __________. A. Auto-immune reaction to streptococcal infection B. Auto-immune reaction to collagen disease C. Parents had rheumatic heart disease D. Exposure to colds and droplet infection 18. Marimar, 6 years old, is receiving digitals for having Patent Ductus Arteriosus with heart failure with heart failure. Prior to the administration of the medicines, which of the following nursing actions should be done by nurse Rica? A. Take the carotid pulse rate for one full minute. B. Take the heart rate for one full minute C. Take the respiratory rate D. Take the blood pressure 19. While Nurse Juliet was doing her regular rounds, one of the mothers approached her saying that her child who has a Tetralogy of Fallot preferred to squat on bed rather than assuming a supine position. The BEST action of the Nurse is ___________. A. Let the mother continue the position of her child if she feels comfortable with it. B. Divert the child’s attention by letting her join the nurses’ rounds C. Put her in bed and start to administer oxygen inhalation D. Discourage the child and let her lie on bed with 2 pillows instead. 20. Another patient in the Unit is Nikki, 8 years old, waiting to be scheduled for surgery because of a Coarctation of the Aorta. With this disorder, Nikki will manifest which one of the following symptoms? A. Murmur and bruit of the lungs B. Central and peripheral edema C. Hypertension and diminished pulses in the extremities. D. Hepatomegaly and shortness of breath SITUATION: You are a nurse tasked to care for Alvida, a patient with peripheral vascular disease. You use your knowledge on PVD to help care for this patient effectively. 21. You are planning care for patient Alvida with a history of PVD with symptoms of claudication. The focus of your nursing care should be directed in avoiding which of the following scenarios? A. Oxygen demand by the muscle exceeds the supply. B. Oxygen demand and supply of the working muscle are in balance. C. Oxygen supply exceeds the demand of the working muscle. D. Oxygen is absent. 22. You are reviewing the labs of Alvida. You note which of the following common abnormal laboratory results that are associated with the development of peripheral vascular disease (PVD)? A. High serum calcium level. B. High serum lipid levels. C. Low serum potassium level. D. Low serum lipid levels. 23. You are conducting your assessment on Alvida. You are checking her lower extremities expecting to find which of the following clinical manifestations of peripheral vascular disease? A. Hairy legs. B. Mottled skin. C. Pink, cool skin. D. Warm, moist skin. 24. Your patient Alvida with PVD has undergone a right femoral-popliteal bypass graft. You assess her blood pressure noting a decrease from 124/80 to 94/62. Which of the following should you assess in Alvida first? A. IV fluid solution. B. Pedal pulses. C. Nasal cannula flow rate. D. Capillary refill. 25. After further assessment on Alvida who was diagnosed with PVD, you found out that she also has a history of heart failure. You will develop a plan of care for Alvida based on the fact that she may have low tolerance for exercise related to: A. Decreased blood flow. B. Increased blood flow. C. Decreased pain. D. Increased blood viscosity Situation – Mr Rodney, a post- operative, was given Amoxycillin at 12 midnight by the nurse on duty (NOD). The physician asked the patient during his rounds if he has receive the drug, the patient answered “NO”. The physician clarified the claim from the chart and from the chart and from the NOD. 26. When the physician clarifies the process of Drug Administration, this Quality Improvement Process is known as A. System analysis B. Root cause Analysis C. Problem identification D. Pareto Chart 27. Which of the following is the primary reason why the physician wanted to clarify the process? A. Measures the turnaround time of medication B. Better communication with patient and result C. Identify gap in the medication administration 2 | Page
D. Improve care management in drug administration 28. While the medical director is conducting his rounds he observed the presence of scattered supplies and equipment along the corridor as well as 02 tank not properly secured. The Quality Circle (QC) team was informed about this observation. Which of the following is the BEST strategies to be adopted by the team with this concern? A. Adopt the 5 S audit. B. Identify and prioritize the problem C. Select Alternative Solution. D. Enhance Continuous quality improvement. 29. The approach adopted by quality circle team was presented to top management. Which of the following tools is APPROPRIATE to be utilized as a guide for their time management? A. Pre chart B. Radar chart C. Process of flow chart D. Gantt chart 30. In order to determine if the implementation of the activity is successful, the First step to be done by the team is ______________. A. Prioritize the problem B. Coordinate with the different units C. Have a random report to the supervisor D. Develop a monitoring plan SITUATION: You are a nurse knowledgeable about various ethical, legal, and safety issues in nursing as this will guide you in establishing a safe nursing practice. 31. Nojiko is a hospitalized client under your care. She was diagnosed with end stage cancer and has suddenly decided to discontinue her treatment. She requests no more additional treatment like antibiotics, tube feedings, and mechanical ventilation. Acting as Nojiko’s advocate, which of the following actions should you take? A. Respect the client’s wishes and indicate those wishes on the plan of care B. Encourage the client to share the decision with the family and the client’s physician C. Clarify other treatments that the client wishes to withhold D. Wait until additional treatment is required and then decide what to do based on the client’s condition 32. A car-pedestrian accident occurred nearby. The pedestrian client named Mohji was brought to the ER of the hospital you are working on. Mohji is alert and oriented but complains of difficulty breathing. His SpO2 levels vary from 88-90%. O2 was applied at 2L per nasal cannula with no improvement in SpO2. Oxygen per mask is then initiated at 40% with little improvement. After some tests, Mohji’s radiograph films reveal no obvious injuries or fractures. Suddenly, Mohji loses consciousness, has a respiratory arrest, and subsequently dies. During his resuscitation, it is determined that one of the nurses failed to open the valve to the O2 tank and Mohji has not been receiving oxygen. What is the key ethical principle involved in this scenario? A. Nonmaleficence B. Fidelity C. Beneficence D. Justice 33. Van, one of the patients in your unit, has a sudden change in his condition. You called the physician to report this occurrence. He gave orders over the telephone for ABGs to be drawn stat. Which of the following is the most important safety consideration when obtaining the physician’s order over the phone? A. Writing the order down and reading it back to the physician B. Calling the respiratory therapist stat to draw the ABGs C. Giving the order stat to the health unit coordinator to place in the computer D. Writing down the order for ABGs immediately 34. Patient Cabaji is to be admitted to the surgical unit. He has multiple rings, a bracelet, a watch, and PHP 3500 in cash. Which of the following is the safest action for you to take regarding the patient’s valuables? A. Allowing the client to keep the items so they will be safeguarded by the client B. Collecting the items and placing them in the client’s room closet C. Giving the money to the client’s spouse and allowing the client to keep the jewelry D. Collecting the items according to hospital policy for safekeeping 35. You admit patient Kuroobi who is complaining of nausea and vomiting to the emergency department. Kuroobi is alone in the ED without any relatives or guardians. After you complete your assessment on Kuroobi, you prepare to leave the room. Which of the following statements is your safest instruction for Kuroobi? A. “If you need to vomit, here is a basin for you. I don’t want you to get up on your own.” B. “I will be in the room next door. I’ll check back in about 10 minutes.” C. “I will go update the doctor about you. Do you need anything before I go?” D. “Here is the nurse call light. Press this button if you need me.” Situation – Nurse Tin is assigned in the Surgical Ward of a Tertiary Medical Center with several patients who are for diagnostic tests and for surgery. 36. Mr. Anthony, 38 years old, is scheduled for Laparoscopic Cholecystectomy in the morning the next day. He verbalizes to you and says, “Dr. Unido will open me up to remove my gallstones?” which of the following is your BEST response? A. “Let us discuss with the surgeon your operation before you go to the OR.” B. “I know the surgeon will remove your stones with a new technique.” C. “Let me call the OR supervisor to discuss the procedure with you.” D. “I will call the anaesthesiologist to explain more the procedure.” 37. A critical component before Mr. Anthony goes for surgery is the nurse’ preoperative teaching. Which of the following is NOT advisable prior to surgery? A. Teach him deep breathing exercises B. Fast at midnight, but can drink water if he becomes thirsty. C. Instruct him to void before going to the operating room. D. Teach him leg and coughing exercises 38. While giving health instructions to Anthony. He looks very anxious and said to you, “I might not be able to wake from anesthesia after my operation.” Your BEST response is _________. A. “Do not worry, everything will be alright.” B. “Let me tell to your family your fear.” C. “I will not let you go to the OR until I have talked to your surgeon.” D. “Don’t Say that, I will discuss your concerns with your anaesthesiologist.” 39. Mr. Anthony returned back to the ward, after recovering from anaesthesia. He complain of pain over the scapular region. Which of the following nursing actions should you do? A. Apply heating pad over the painful area. B. Turn client from side to side. C. Give demerol as ordered. D. Apply cold pack over the affected area. 40. After 5 days, Mr. Anthony is ready to go home. His discharge instructions include observations of the following complications, EXCEPT: A. Palpitation B. Loss of appetite C. Increased body temperature D. Bleeding SITUATION: You are a nurse providing palliative care to Coby, an elderly with terminal illness. You use your knowledge on terminal illness and palliative care to provide the best care to this patient. 3 | Page
41. Coby approached you and asked about palliative care since he has been hearing it a lot lately after he was diagnosed with his terminal illness. As a knowledgeable nurse, you know which of the following is the best definition of palliative care? A. Care for terminally ill clients. B. Symptom management for a client when a disease no longer responds to cure-focused treatment. C. Aggressive cure-focused disease treatment and management. D. Comfort care. 42. Coby asked you what the goal of palliative care is. You answer him correctly by stating that which of the following are the goals of palliative care? Select all that apply. I. Preventing disease symptoms. II. Relieving disease symptoms. III. Curing a disease. IV. Treating a disease. A. I B. II C. I, II D. III, IV 43. Coby is now under home health with palliative care services. He stated that he has been experiencing nausea. Which of the following actions will most likely promote comfort in this client? A. Educate the patient and family in the use of prescribed antiemetics; providing oral care every 2 to 4 hours; consuming a diet of clear liquids and ice chips; and avoiding liquids such as coffee, milk, and citrus juices. B. Administer additional pain medication. C. Provide education to the patient and family regarding oral care and antiemetic medication. D. Take a detailed medical history to determine the cause of the nausea. 44. The granddaughter of Coby approached you and asked regarding the symptoms their grandfather might experience. You answer her correctly by stating that which of the following are the common symptoms of terminally ill clients? A. Hunger, thirst, fatigue, and diarrhea. B. Dehydration, nausea, effective breathing, and adequate nutrition. C. Discomfort, nausea, ineffective breathing, and fatigue. D. Urinary continence, thirst, dehydration, and diarrhea. 45. Coby is being cared for at home by his family members. You conducted your physical assessment on Coby and based on your findings, you are aware that Coby’s death is imminent. What is your most important role in the care of family at this point in time? A. Providing temporary relief of caregiving duties to allow the family to rest. B. Providing education regarding the symptoms the client will likely experience. C. Coordinating a visiting schedule for the family. D. Communicating news of the client’s impending death to the family while they are together. Situation – Meg is assigned as charge nurse at the Cardiovascular Ward in a Medical Center. There are 20 patients, classified as follows: 2 Total Care (TC), Partial Care (PC) and 9 Ambulatory Care (AC). The ward’s morning duty are 3 staff nurses and 2 nursing attendants (NA). 46. How will your distribute the patients to the 3 Registered Nurses and 2 Nursing Assistants? A. 2 Registered Nurse for Total Care patients, 1 Registered Nurse and 1 Nursing Assistant for Primary Care Patients, 1 Nursing Assistant for Total Care. B. 1 Registered Nurse and 1 Nursing Assistant for Total Care Patients, 1 Registered Nurse and 1 Nursing Assistant for Primary Care Patient, 1 Registered Nurse for Ambulatory Care patients. C. 2 Registered Nurse for Total Care patients, 2 Nursing Assistant for Primary Care Patients, 1 Registered Nurse for Ambulatory Care Patients. D. 1 Registered Nurse for Total Care patients, Registered Nurse and 1 Nursing Assistant for Primary Care patients, 1 Registered Nurse and 1 Nursing Assistant for Ambulatory Care patients 47. In as much as this is a cardio-ward what basic equipment/materials should be available at all times? 1. o2 2. Ambu Bag 3. Suction Apparatus 4. Endotracheal A. 1, 2, 4 B. 1, 2, 3, 4 C. 1, 2, 3 D. 2, 3, 4 48. Which of the following emergency medicines should be available at the emergency cart at the Cardio Ward? 1. Epinephrine 3. Valium 2. Demerol 4. Coumadin A. 1, 3 B. 1, 2 C. 2, 4 D. 3, 4 49. When stocking fluids in the emergency cart. What should Nurse Meg instruct the nurses? 1. Put the recently- delivered at the back of the old stock 2. Put the old stock in front of the newly-delivered ones 3. Check the fluids for sediments and discoloration 4. Keep the fluids inside the cooler A. 1, 2 B. 1, 4 C. 3, 4 D. 2, 3 50. How will Nurse Meg arrange the patients in the ward? Put the ______________. A. Primary Care in between the Ambulatory Care patients. B. Primary Care and Ambulatory Care patients together and Total Care at the corner of the room. C. Total Care patients near the nurses and the Ambulatory farthest D. Ambulatory Care patients near the Total Care ones. SITUATION: You are a nurse providing care for patient Vivi who came to the hospital for assessment. She is suspected to have osteoporosis. You help her by utilizing your knowledge on the topic. 51. You reviewed Vivi’s chart after conducting her physical assessment. You correctly identify that which of the following signs/symptoms indicate that Vivi has already developed osteoporosis? A. The client has lost one (1) inch in height. B. The client has lost 12 pounds in the last year. C. The client’s hands are painful to the touch. D. The client’s serum uric acid level is elevated. 52. After Vivi’s diagnosis of osteoporosis, she asked you why smoking cigarettes causes her bones to become brittle. Your most appropriate response is: A. “Smoking causes nutritional deficiencies, which contribute to osteoporosis.” B. “Tobacco causes an increase in blood supply to the bones, causing osteoporosis.” C. “Smoking low-tar cigarettes will not cause your bones to become brittle.” D. “Nicotine impairs the absorption of calcium, causing decreased bone strength.” 53. When discussing osteoporosis with Vivi, you are aware that which of the following is an example of a secondary nursing intervention? A. Obtain a bone density evaluation test. B. Perform non–weight-bearing exercises regularly. C. Increase the intake of dietary calcium. D. Refer clients to a smoking cessation program. 54. Vivi is prescribed by her physician Calcitonin by nasal spray. Which of the following assessment findings indicate an adverse effect of the medication? A. The client complains of nausea and vomiting. B. The client is drinking two (2) glasses of milk a day. C. The client has a runny nose and nasal itching. D. The client has had numerous episodes of nosebleeds. 4 | Page