Title RECALLS 7 - NP5 - SC ✅

RECALLS 7 EXAMINATION NURSING PRACTICE V CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART C) NOVEMBER 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 V” on the box provided Situation: You are responding to neurologic and critical care emergencies, including stroke, airway compromise, cardiac arrest, and post-resuscitation management in the ICU. 1. A patient with suspected stroke suddenly has trouble breathing and low oxygen. What is priority? A. Place patient supine B. Prepare for intubation C. Check blood glucose D. Start IV fluids rapidly 2. Which medication is used in asystole and pulseless electrical activity (PEA) according to ACLS? A. Epinephrine B. Amiodarone C. Adenosine D. Atropine 3. Which assessment finding shows norepinephrine is effective? A. Blood pressure improves to MAP ≥65 mmHg B. Pulse oximetry falls to 85% C. Heart rate decreases to 30 bpm D. Extremities turn pale and cool 4. A patient on mechanical ventilation suddenly has absent breath sounds on one side and hypotension. What should the nurse suspect? A. Atelectasis B. Tension pneumothorax C. Pulmonary edema D. Bronchospasm 5. Which ECG rhythm requires immediate defibrillation? A. Asystole B. Pulseless ventricular tachycardia C. Sinus bradycardia D. First-degree AV block Situation: You are assisting with invasive procedures, managing airway emergencies, and responding to arrhythmias and shock in critical patients. 6. A patient has a sudden drop in blood pressure during central line insertion. What is the first action? A. Apply high-flow oxygen B. Place patient in Trendelenburg and check for air embolism C. Remove the line and apply pressure D. Call respiratory therapy 7. After giving adenosine for supraventricular tachycardia (SVT), what rhythm change is expected initially? A. Immediate return to normal rhythm B. Brief asystole then conversion to sinus rhythm C. Ventricular fibrillation D. Permanent bradycardia 8. A patient with a tracheostomy accidentally removes the tube and is in respiratory distress. What is the first step? A. Call the surgeon B. Use the bag-valve-mask over the stoma or mouth C. Insert a nasogastric tube D. Wait for respiratory therapy 9. Which fluid is used first for hypovolemic shock? A. 0.9% Normal saline B. D5W C. 0.45% Normal saline D. 5% Albumin 10. A patient with cardiac arrest has return of spontaneous circulation (ROSC). Which is the nurse’s priority? A. Discontinue monitoring because the arrest is over B. Maintain oxygenation and check blood pressure C. Give epinephrine again immediately D. Place patient flat and remove IV lines Situation: You are assigned to clients with acute and chronic kidney disease. Your priority is recognizing life-threatening electrolyte imbalances and complications of renal replacement therapies. 11. Which finding is most concerning in a patient with acute kidney injury (AKI)? A. Urine output of 40 mL/hr B. Serum potassium of 6.5 mEq/L C. Mild peripheral edema D. BUN of 30 mg/dL 12. Which diet is appropriate for chronic kidney disease (CKD)? A. High protein, low sodium, high potassium B. Low protein, low sodium, low potassium C. High protein, high sodium, low phosphorus D. No restriction as long as dialysis is done 13. A patient on hemodialysis suddenly complains of dizziness and nausea. What is the nurse’s priority? A. Place patient supine and slow the dialysis rate B. Give antiemetics immediately C. Discontinue dialysis permanently D. Encourage fluids 14. A client misses two hemodialysis sessions and presents with muscle weakness and ECG showing tall peaked T waves. What is expected? A. Hypokalemia B. Hyperkalemia C. Hypercalcemia D. Hypophosphatemia 15. Which is an early sign of peritoneal dialysis infection? A. Cloudy effluent B. Bloody effluent C. Clear, yellow effluent D. Green-tinted effluent Situation: You are monitoring vascular access, managing hemodialysis complications, and reinforcing patient education for home dialysis care. 16. A nurse notes bleeding at the AV fistula site after hemodialysis. What is the priority? 1 | Page
A. Apply gentle pressure B. Call the nephrologist immediately C. Elevate the arm above the heart D. Remove the fistula needle 17. What should the nurse avoid with an AV fistula arm? A. Taking blood pressure B. Placing a tourniquet C. Drawing blood samples D. All of the above 18. Which finding in a dialysis patient suggests disequilibrium syndrome? A. Headache and confusion B. Hypotension and dizziness C. Chest pain and palpitations D. Joint pain and muscle cramps 19. Which fluid is commonly used to prime a dialysis circuit? A. Lactated Ringer’s B. 0.9% Normal saline C. Dextrose 5% in water D. 0.45% Normal saline 20. A patient on peritoneal dialysis reports severe abdominal pain during inflow. What is the best response? A. Increase dialysate flow rate B. Warm the dialysate solution C. Stop dialysis immediately D. Add extra potassium to the solution Situation: You are managing pharmacologic interventions and monitoring lab results to prevent complications of end-stage renal disease (ESRD). 21. Which medication is often given to dialysis patients to prevent anemia? A. Epoetin alfa B. Heparin C. Warfarin D. Iron dextran only 22. A patient with CKD is prescribed calcium acetate. What is its purpose? A. Lower potassium levels B. Increase iron absorption C. Bind phosphorus in the gut D. Raise serum calcium levels 23. What is the priority nursing assessment before starting hemodialysis? A. Serum amylase B. Lung sounds C. Vital signs and weight D. Pain scale 24. A patient with peritoneal dialysis has outflow less than inflow. What is the first nursing action? A. Stop the dialysis B. Turn the patient side to side C. Call the nephrologist D. Add heparin to the solution 25. What is a major complication of hemodialysis needle dislodgment? A. Infection B. Air embolism C. Severe hemorrhage D. Hypokalemia Situation: You are addressing symptoms related to chronic uremia, evaluating hemodynamic changes post-dialysis, and preventing life-threatening complications. 26. A patient on hemodialysis has severe itching (uremic pruritus). Which is the best nursing action? A. Restrict fluids B. Give antihistamines as prescribed C. Apply ice packs D. Encourage high-protein diet 27. Which finding is expected after dialysis? A. Weight gain B. Lowered blood pressure C. Hyperkalemia D. Edema increase 28. A patient on hemodialysis is ordered heparin during treatment. What is its purpose? A. Reduce blood pressure B. Prevent clotting C. Increase potassium removal D. Treat anemia 29. Which is the most serious complication of peritoneal dialysis? A. Hypotension B. Peritonitis C. Nausea D. Constipation 30. A patient undergoing dialysis develops chest pain. What should the nurse do first? A. Stop dialysis and notify the provider B. Increase fluid removal C. Encourage deep breathing D. Give antiemetics You are managing dialysis access and monitoring for vascular and metabolic complications, ensuring patient safety and access function. 31. Which drug is commonly given to control high phosphate in CKD? A. Calcium acetate B. Furosemide C. Epoetin alfa D. Sevelamer 32. Which AV fistula assessment finding should be reported immediately? A. Bruit present B. Thrill present C. Cool pale hand below the fistula D. Slight bruising around site 33. Which dialysis patient is at highest risk for hypotension during treatment? A. One who ate a large meal before dialysis B. One who is slightly hypertensive C. One who had fluid overload corrected slowly D. One who is already volume-depleted 34. Which sign indicates successful AV fistula function? A. No bruit or thrill B. Weak radial pulse C. Palpable thrill and audible bruit D. Edema around the site 35. Which action prevents peritonitis in peritoneal dialysis? A. Use of cold dialysate B. Strict hand hygiene during exchanges C. Increasing dwell time D. Avoiding daily weight checks Situation: You are assigned to monitor fluid balance and electrolyte status in dialysis clients and intervene for post-treatment complications. 36. Which symptom after dialysis indicates hypovolemia? A. Flushed skin and bounding pulse B. Dry mucous membranes and dizziness C. High blood pressure and edema D. Warm, moist skin 37. Which medication should be hold before dialysis? A. Antihypertensives B. Phosphate binders C. Vitamin D supplements D. Erythropoietin 38. Which patient statement about peritoneal dialysis needs teaching? A. “I need to keep my catheter clean and dry.” B. “If the fluid comes out cloudy, I will call the clinic.” C. “I will skip daily weight checks to save time.” D. “I should warm the solution before using it.” 39. Which lab result is expected in end-stage renal disease? A. Metabolic alkalosis B. Low BUN and creatinine C. Hyperkalemia and metabolic acidosis D. Hypophosphatemia 40. Which sign after peritoneal dialysis indicates peritonitis? A. Clear effluent and soft abdomen B. Cloudy effluent and abdominal pain C. Weight gain and hypertension D. Minimal drainage with clear fluid 2 | Page