Title RECALLS 6 (NP4) - STUDENT COPY ✅

RECALLS EXAMINATION 6 NURSING PRACTICE IV CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART B) NOVEMBER 2024 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: Maria has recently graduated from college with a Bachelor of Science in Nursing from a recognized institution. She plans to take the nurse licensure examination so she can practice as a nurse after passing the exam. 1. Which of the following requirements is not needed for Maria to qualify for the said examination? A. A holder of a Bachelor’s Degree in Nursing from a college or university that complies with the standards of nursing education duly recognized by the proper government agency B. Must be of good moral character C. A citizen of the Philippines D. A member of the accredited professional organization 2. To pass the examination, Maria must obtain a general average of ______ with a rating of not below ____ in any subject. A. 75%, 60% B. 70%, 65% C. 75%, 70% D. 70%, 60% 3. If Maria fails one subject but obtains the required general average, what should she do? A. Take the entire examination again B. Take the examination on the subject where she scored below the required passing rate C. Appeal to the board for rechecking of her examination papers D. Enroll in a one-year refresher course 4. Upon passing the licensure examination, what is Maria's priority action? A. Take an oath of profession before the Board of Nursing B. Apply for registration with the Professional Regulation Commission C. Apply for membership to the Philippine Nurses D. Association Prepare credentials for job hunting 5. How often must Maria renew her professional identification card? A. Every five years B. Every three years C. Annually D. Biannually SITUATION: A 67-year-old patient was rushed to the emergency room, presenting with an altered level of consciousness. When the triage nurse asked the daughter about her mother's weight, the daughter's estimate seemed significantly lower than the weight obtained during the physical assessment. Additionally, the daughter reported that her mother had produced little to no urine since the previous day. The medical team quickly recognized the urgency of the situation and began a thorough evaluation to determine the underlying cause and provide immediate care. 6. Based on the patient’s manifestation and history, what could be the underlying condition of the patient? A. DI B. DM C. SIADH D. HYPERTHYROIDSM 7. What disturbance should you be aware of related to this diagnosis? A. Excess water loss B. Dilutional hyponatremia C. Serum sodium level of 148 mg/dL D. Decreased urine osmolality 8. What will be the priority nursing diagnosis for the patient? A. Risk for peripheral neurovascular dysfunction B. Excess fluid volume C. Insufficient fluid volume D. Ineffective airway clearance 9. If that is the priority nursing diagnosis, what could be the ideal nursing intervention now? A. Fluid restriction B. Transfusion of fluids C. Transfusion of fresh frozen plasma (FFP) D. Electrolyte restriction 10. The patient’s plan of care includes assessment of specific gravity every 4 hours. The results of this test will allow you to assess what aspect of the patients health? A. Nutritional status B. Potassium balance C. sodium balance D. Fluid volume status 11. Which of the following medical history if obtained, is strongly related to the patient’s development of the disease? A. Breast carcinoma B. Adrenal carcinoma C. Lung carcinoma D. Liver carcinoma SITUATION: Patrick is a nurse working in a busy dialysis unit, where he provides specialized care for patients undergoing dialysis treatments. 12. Nurse Patrick is on duty in the dialysis unit when a patient receiving hemodialysis suddenly reports shortness of breath and chest pain. The patient exhibits tachycardia, pallor, and anxiety. Recognizing these symptoms, Nurse Patrick suspects an air embolism. What priority nursing actions should he initiate to address the emergency situation? A. Stop dialysis, and turn the client on the right side with head lower than feet. B. Continue dialysis at a slower rate after checking the lines for air. C. Notify the primary health care provider (PHCP) and Rapid Response Team. D. Stop dialysis, and turn the client on the left side with head lower than feet. 13. Prior to initiating hemodialysis to a patient, Patrick must assess the patency of a client’s arm with arteriovenous fistula. The following finding does not indicate patent fistula, except? A. Vibration upon palpating the access site. 1 | Page
B. Presence of a radial pulse in the left wrist. C. Visualization of enlarged blood vessels at the fistula site. D. Capillary refill less than 3 seconds in the nailbeds of the fingers on the left hand. 14. Recognizing that a patient with fistula is at risk for arterial steal syndrome, Patrick always conducts a thorough assessment. He ensures he is vigilant for any indications that require immediate attention. Which of the following manifestations refer to this? A. Warmth, redness, and pain in the left hand B. Ecchymosis and audible bruit over the fistula C. Edema and reddish discoloration of the left arm D. Pallor, coolness, and pain in the left hand 15. Patrick is reviewing another client’s record and notes that the primary health care provider has documented that the client has chronic kidney disease. On review of the laboratory results, the Patrick most likely would expect to note which finding? A. serum CREA: 2.3mg/dL B. hgb level: 21g/dL C. RBC level: 5.3 million/mcL D. Positive WBC in the urine 16. A client with chronic kidney disease returns to the nursing unit following a hemodialysis treatment. On assessment, Patrick notes that the client’s temperature is 38.5° C. Which nursing action is most appropriate? A. Encourage fluid intake. B. Continue to monitor vital signs. C. Notify the primary health care provide. D. Monitor the site of the shunt for bleeding. 17. Patrick is explaining peritoneal dialysis to a client with diabetes mellitus. He highlights that maintaining the prescribed dwell time for the dialysis is crucial to avoid which complication? A. Peritonitis B. Hyperglycemia C. Hyperphosphatemia D. Disequilibrium syndrome 18. Another client newly diagnosed with chronic kidney disease recently has begun hemodialysis. Knowing that the client is at risk for disequilibrium syndrome, Patrick should assess the client during dialysis for which associated manifestations? A. Hypertension, tachycardia, and fever B. Hypotension, bradycardia, and hypothermia C. Restlessness, irritability, and generalized weakness D. Headache, deteriorating level of consciousness, and twitching 19. Patrick is looking after a patient undergoing hemodialysis three times a week who recently had surgery to create an arteriovenous fistula. What should the nurse prioritize when caring for this patient? A. Using a stethoscope for auscultating thrill for the fistula. B. The patient feels best immediately after the dialysis treatment. C. Taking a BP reading on the affected arm can damage the fistula. D. The patient should not feel pain during initiation of dialysis. 20. Patrick needs to educate a 45-year-old man with diabetic nephropathy and end-stage kidney disease (ESKD) who is beginning hemodialysis. What essential information should he provide about the hemodialysis process? A. Hemodialysis is a treatment option that is usually required three times a week. B. Hemodialysis is a program that will require you to commit to daily treatment. C. This will require you to have surgery and a catheter will need to be inserted into your abdomen. D. Hemodialysis is a treatment that is used for a few months until your kidney heals and starts to produce urine again. 21. Patrick has determined that a patient undergoing peritoneal dialysis is at risk for infection. What nursing intervention would most effectively mitigate this risk? A. Maintain aseptic technique when administering dialysate. B. Wash the skin surrounding the catheter site with soap and water prior to each exchange. C. Add antibiotics to the dialysate as ordered. D. Administer prophylactic antibiotics by mouth or IV as ordered. 22. When Patrick notices that the peritoneal fluid is draining slowly and the patient’s abdomen is becoming distended, what should the nurse do next? A. Advance the catheter 2 to 4 cm further into the peritoneal cavity. B. Reposition the patient to facilitate drainage. C. Aspirate from the catheter using a 60-mL syringe. D. Infuse 50 mL of additional dialysate. Situation: You are caring for Antonio, a 65-year-old man who was brought to the hospital after experiencing significant tremors and difficulty with balance. After a thorough assessment and tests, the diagnosis of Parkinson's disease was confirmed. 23.During your health history interview, Antonio reveals that he can no longer perform many activities he once could. What factor should you identify as having the most significant impact on Antonio's life? A. Neurologic deficits B. Loss of independence C. Age-related changes D. Tremors and decreased mobility 24. You are now aiming to determine the current status of his tremors. When would be the best time to conduct this assessment to gather the most accurate information? A. When Antonio is resting B. When Antonio is ambulating C. When Antonio is preparing his or her meal tray to eat D. When Antonio is participating in occupational therapy 25. To provide effective and safe care for Antonio, it is crucial to understand the underlying processes of his condition. Which of the following would you identify as the primary cause? A. Premature degradation of acetylcholine B. Decreased availability of dopamine C. Insufficient synthesis of epinephrine D. Delayed reuptake of serotonin Ans: B 26. Due to the manifestations he display, it is essential to identify appropriate nursing diagnosis to ensure comprehensive care. One significant nursing diagnosis to consider is: A. Acute pain B. Impaired urinary elimination C. Unilateral neglect D. Risk for injury 27. The physician has prescribed both carbidopa and levodopa to Antonio. During a discussion, Antonio expresses curiosity about the need to take these two medications together. What should be your response? A. “To have fewer side effects.” B. “Dopamine requires the presence of both of these medications” C. “Carbidopa makes more levodopa available to the brain” D. “Carbidopa crosses the blood-brain barriers to treat Parkinson’s” 28. Three days after admission, you notice that his temperature has spiked to 39 degrees Celsius. A chest X-ray was ordered by the physician and it reveals lung infiltrates. Which of the following could explain these findings? A. Mask-like facies and shuffling gait. B. Difficulty swallowing and immobility. C. Pill rolling of fingers and flat affect. D. Lack of arm swing and bradykinesia 29. Antonio's condition is advancing quickly, and he has expressed a desire to receive care at home. Which interventions should you prioritize in the care plan? A. Aggressively continuing to fight the disease process B. Moving the patient to a long-term care facility when it becomes necessary C. Including the children in planning their fathers care D. Supporting the patients and family’s values and choices 2 | Page