Title RECALLS 3 (NP4) - STUDENT COPY ✅

RECALLS EXAMINATION 3 NURSING PRACTICE IV CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART B) 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 IV” on the box provided SITUATION: You are a nurse tasked to care for patients with different pituitary disorders. You are to take care of Karoo and Koza, both diagnosed with SIADH, and Paula, who is diagnosed with diabetes insipidus. You utilize your knowledge on this concept to help care for your patients safely. 1. One of the clients in your unit, Karoo, is diagnosed to have a pituitary tumor. Karoo developed Syndrome of Inappropriate Antidiuretic Hormone (SIADH). Which of the following interventions should you implement as Karoo’s primary nurse? A. Assess for dehydration and monitor blood glucose levels. B. Assess for nausea and vomiting and weigh daily. C. Monitor potassium levels and encourage fluid intake. D. Administer vasopressin IV and conduct a fluid deprivation test. 2. You are reviewing the chart of Karoo who has SIADH. Which of the following clinical manifestations you noted in Karoo’s chart should be reported to his primary care physician? A. Serum sodium of 112 mEq/L and a headache. B. Serum potassium of 5.0 mEq/L and a heightened awareness. C. Serum calcium of 10 mg/dL and tented tissue turgor. D. Serum magnesium of 1.2 mg/dL and large urinary output. 3. Another patient in your unit, Koza, was diagnosed with SIADH secondary to cancer of the lung. He tells you that he wants to discontinue his fluid restriction and that he does not care if he dies. Which of the following actions by the nurse is an example of the ethical principle of autonomy? A. Discuss the information the client told the nurse with the health-care provider and significant other. B. Explain it is possible the client could have a seizure if he drank fluid beyond the restrictions. C. Notify the health-care provider of the client’s wishes and give the client fluids as desired. D. Allow the client an extra drink of water and explain the nurse could get into trouble if the client tells the health-care provider. 4. Paula, another patient assigned to you in the unit, is recently diagnosed with diabetes insipidus. Which of the following interventions should you implement as Paula’s primary nurse? A. Administer sliding-scale insulin as ordered. B. Restrict caffeinated beverages. C. Check urine ketones if blood glucose is >250. D. Assess tissue turgor every four (4) hours 5. Following Paula’s diagnosis of diabetes insipidus, she stayed in the hospital for a few days. She is now about to be discharged and you are conducting your health teaching regarding her condition. Which of the following statements made by Paula warrants further intervention? A. “I will keep a list of my medications in my wallet and wear a Medic Alert bracelet.” B. “I should take my medication in the morning and leave it refrigerated at home.” C. “I should weigh myself every morning and record any weight gain.” D. “If I develop a tightness in my chest, I will call my health-care provider.” SITUATION: You are a nurse caring for patients with inflammatory bowel disease. 6. Pierre is a patient admitted to the hospital with a diagnosis of ulcerative colitis. You are currently reviewing his history and physical assessment chart. Based on Pierre’s diagnosis, which of the following information should you expect to see in Pierre’s medical records? A. Abdominal pain and bloody diarrhea B. Weight gain and elevated blood glucose C. Abdominal distension and hypoactive bowel sounds D. Heartburn and regurgitation 7. Pierre had a recent exacerbation of ulcerative colitis. He is put on mesalamine (Asacol), which is to be administered rectally via an enema. Pierre finds this procedure distasteful and he asks you, “Why can't the medication just be given orally?”. You answer Pierre correctly by saying which of the following? A. “It can be given orally; I’ll contact the doctor and see if the change can be made.” B. “Rectal administration delivers the medication directly to the affected area.” C. “Oral administration will not be as effective for the disease condition.” D. “It can be given orally, I’ll make the change and we’ll tell the doctor in the morning.” 8. You overhear a licensed practical nurse (LPN) talking to one of your patients, Mousse, who is being prepared for a total colectomy with creation of an ileoanal reservoir for her ulcerative colitis. To decrease Mousse’s anxiety, you should intervene to clarify the information given by the LPN when you hear the LPN saying: A. “This surgery will prevent you from developing colon cancer.” B. “After this surgery you will no longer have ulcerative colitis.” C. “When you return from surgery you will not be able to eat solid food for several days.” D. “You will have an ileostomy when you return from this surgery.” 9. Wyper, a 20 year old male client, is admitted to your unit because of the exacerbation of their ulcerative colitis. You go into Wyper’s room to complete an initial assessment, and he yells, “Get outta here! I am tired of you nurses and doctors looking at my body all the time!” Which of the following is your best action? A. Leave the room and ask a male colleague to complete the assessment. B. Verbally acknowledge the client’s frustration and anger. 1 | Page


activity, has a heart rate of 110 bpm, and has generalized edema. Which of the following actions would be most appropriate for this patient? A. Administer high-flow oxygen B. Encourage the client to rest more C. Continue to monitor the client’s heart rhythm D. Compare the client’s admission weight with the client’s current weight 43. You are caring for patient Whitebeard immediately following an insertion of a permanent pacemaker via his right subclavian vein. As a skilled nurse, you know that the action that can best prevent pacemaker lead dislodgement is: A. inspecting the incision site dressing for bleeding and the incision for approximation B. limiting the client’s right arm activity and preventing the client reaching above shoulder level C. assisting the client with getting out of bed and ambulating with a walker D. ordering a stat chest x-ray following return from the implant procedure 44. You are increasing activity for patient Bon with an admitting diagnosis of acute coronary syndrome. Which of the following symptoms experienced by patient Bon best supports the nursing diagnosis of activity intolerance? A. Pulse rate increased by 15 beats per minute during activity B. Blood pressure (BP) 130/86 mm Hg before activity; BP 108/66 mm Hg during activity C. Increased dyspnea and diaphoresis relieved when sitting in a chair D. A mean arterial pressure (MAP) of 80 following activity 45. Cobra is a patient who suffered an inferior septal wall myocardial infarction. Which of the following complications would you suspect in Cobra when you note on your assessment a jugular venous distention and ascites? A. Left-sided heart failure B. Pulmonic valve malfunction C. Right-sided heart failure D. Ruptured septum Situation – A 35-year old female client presents herself in the outpatient Department with complaints of rashes particularly on the face, across the bridge of the nose and on the cheeks. The client is suspected of having systematic lupus erythematous (SLE). She is admitted to the female medical unit. 46. The nurse writes a care plan for the client. The Nurse is aware that this disorder is a/an ________. A. disease caused by over exposure to sunlight B. Local rash that occurs as a result of allergy. C. inflammatory disease of collagen contained in connective tissues. D. disease caused by the continuous release of histamine in the body. 47. The nurse includes in the care plan dietary instructions. Which of the food items should the nurse instruct the client to AVOID? A. steak B. broccoli C. legumes D. fish 48. The nurse is aware that fatigue is experienced by patients with SLE. Which of the following activities should be a component in the care plan for the client to manage fatigue? To ________. 1. sit whenever possible 2. take a hot shower in the morning 3. avoid long periods of rest 4. engage in moderate low impact exercise when not fatigued 5. maintain a balance diet A. 2, 3, 5 B. 1, 2, 3 C. 1, 2, 3, 4, 5 D. 1, 4, 5 49. The physician schedules the client for plasmapheresis. The client asks the nurse what is plasmapheresis. The nurse explains that it is a method that will __________. A. prevent foreign antibodies from damaging various body tissues B. decrease the damage to organs caused by attacking T-lymphocytes C. eliminate eosinophils and basophils from the blood D. remove antibody-antigen complexes from circulation 50. The nurse monitors the client undergoing plasmapheresis. Which of the following reactions should the nurse observe? A. shortness of breath B. numbness and tingling C. transfusion reactions D. high blood pressure Situation – The nurse assists in the care of clients with chronic obstructi pulmonary disease (COPD). 51. The nurse is aware that clients with COPD are at risk for ineffective respirations EXCEPT which of the following _________? A. Clients undergoing thoracic or abdominal surgery B. Clients with rib fractures and kyphosis C. Clients with neuromuscular disorders such as Guillain-Barre’ syndrome D. Clients with fluid volume deficit 52. Nursing interventions for clients with respiratory acidosis include the following EXCEPT to __________. A. monitor arterial blood gases (ABGs), pH, PCO2, and HCO3 B. administer oxygen and medication as ordered C. monitor hourly vital signs and respiratory status D. administer sedation as ordered by the physician to relax the client 53. The nurse understands that excess acid in the body acts as CNS depressant. Clients with acidosis may exhibit which of the following symptoms: 1. reduced level of consciousness 2. confusion 3. lethargy 4. coma A. all of the options B. 1, 3, & 4 C. 1, 2, 3 D. 1 & 3 54. The goal for treatment for respiratory acidosis is to improve ventilation. Which of the following measures is appropriate for clients with COPD experiencing respiratory acidosis? A. Bronchodilators B. Administer medications as ordered C. Ambulation D. Spirometers 55. The nurse understands that respiratory acidosis occurs when __________: A. the body retains too much carbon dioxide B. the client is unable to exhale carbon dioxide C. the client hyperventilates D. there is loss of acid or retention of base in the body Situation – Nurse Mark is assigned in the oncology unit of a tertiary hospital. He is aware of the increase in the number of colorectal cancer patients in his unit. He and a colleague plan to conduct a study of the incidence of colorectal cancer in the Philippines. 56. Nurse Mark formulates a possible title for the study. Which of the following is the MOST appropriate title? A. “Incidence of Colorectal Cancer in the Philippines” B. “Perceptions of the Filipinos on Colorectal Cancer” C. “Colorectal Cancer in the Philippines: It’s Risk Factors and Interventions” D. “A Comparative Study of Gastrointestinal Cancer Cases among Filipinos” 57. What research design is the MOST suitable to gather data for the study? A. Quasi Experimental B. Correlational Study 4 | Page