Title RECALLS 8 - NP4 - SC ✅

RECALLS 8 EXAMINATION NURSING PRACTICE IV CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART B) 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 IV” on the box provided Situation: Renal disease affects millions worldwide and often leads to serious health complications. It commonly results from diabetes, hypertension, infections, or autoimmune disorders. Nurses must understand its causes, recognize early signs, and provide proper care to manage the disease and prevent complications. 1. In caring for patient with renal calculi, which is the priority nursing intervention? A. Record vital sign B. Strain the urine C. Limit fluids D. Administer analgesics as prescribed 2. In a patient with renal failure, the diet should be: A. Low protein, low sodium, high potassium B. Low protein, high potassium C. High carbohydrate, low protein D. Low protein, low sodium, low potassium 3. Which of the following cannot be corrected by dialysis? A. Hypernatremia B. Decreased hemoglobin C. Hyperkalemia D. Elevated Creatinine 4. A patient was admitted to the hospital with a diagnosis of acute glomerulonephritis. History reveals a 5-pound weight gain in one week and peritoneal edema. For the most accurate information on the status of the patient’s edema, nursing intervention should include? A. Measuring the patient’s intake and output B. Obtaining the patient’s daily weight C. Doing a visual inspection on the patient D. Monitoring the patient’s electrolyte values 5. The nurse is caring for a patient suspected of having renal dysfunction. When reviewing laboratory results, the nurse interprets the presence of which substances in the urine as most suggestive of pathology? A. Potassium and sodium B. Bicarbonate and urea C. Glucose and protein D. Creatinine and chloride 6. A patient with acute kidney injury is being assessed to determine where physiologically the cause is. If the cause is found to be prerenal, which condition mostly caused it? A. Glomerulonephritis B. Heart failure C. Ureterolithiasis D. Aminoglycoside toxicity 7. The client receiving dialysis is complaining of being dizzy and light-headed. Which action should the nurse implement first? A. Place the client in the Trendelenburg position. B. Turn off the dialysis machine immediately. C. Bolus the client with 500 mL of normal saline. D. Notify the health-care provider as soon as possible. 8. What is the normal characteristic of peritoneal dialysis effluent? A. Bloody fluid with clots B. Milky and odorless C. Cloudy and pale yellow D. Clear and pale yellow 9. The nurse is caring for a patient receiving hemodialysis three times weekly. The patient has had surgery to form an arteriovenous fistula. What is most important for the nurse to be aware of when providing care for this patient? A. Using a stethoscope for auscultating the fistula is contraindicated B. The patient feels tired immediately after the dialysis treatment C. Taking a BP on the affected arm can damage the fistula D. The patient should not feel pain during initiation of dialysis. 10. A patient was admitted with a diagnosis of post-infectious glomerular disease. The nurse recognizes that this form of kidney disease may have been precipitated by what event? A. Hypersensitivity to immunization B. Menarche C. Sore throat D. Tuberculosis Situation: Endocrine disorders result from hormone imbalances that affect various body functions. Nurses play a key role in early detection, monitoring, and managing these disorders to prevent complications and support patient health. 11. A patient with hyperthyroidism is receiving radioactive iodine therapy. Which of the following should the nurse include in the discharge? A. “You should avoid close contact with pregnant women for a few days.” B. “You may return to work immediately after your treatment.” C. “You should increase your iodine intake in your diet.” D. “You need to take thyroid hormone replacement immediately for life.” 12. The patient underwent total thyroidectomy. You are caring for the patient eight hours postoperative. Which of the following assessment findings indicate that the patient is developing a complication? A. Moderate amount of dry sanguineous drainage on the dressing B. Oral temperature of 99.2°F (37.3°C) C. RR of 23 and apical pulse of 97 D. Patient reports sore throat when speaking 13. The nurse identifies the client problem “risk for imbalanced body temperature” for the client diagnosed with hypothyroidism. Which intervention should be included in the plan of care? A. Discourage the use of an electric blanket. B. Assess the client’s temperature every two hours. C. Keep the room temperature cool. D. Space activities to promote rest. 1 | Page
14. The client is admitted to the intensive care department and diagnosed with myxedema coma. Which assessment data warrant immediate intervention by the nurse? A. Serum blood glucose level of 74 mg/dL. B. Pulse oximeter reading of 90%. C. Telemetry reading showing sinus bradycardia. D. The client is lethargic and sleeps all the time. 15. Propylthiouracil (PTU) is prescribed for a client diagnosed with hyperthyroidism. The client asks the nurse, “Why do I have to take this medication if I am going to get the atomic cocktail? ” The nurse explains that the medication is being prescribed because it decreases the: A. vascularity of the thyroid gland. B. production of thyroid hormones. C. need for thyroid iodine supplements. D. amount of already formed thyroid hormones. 16. A 21-year-old patient with hyperthyroidism complains of her “ugly” appearance and ask, “Will I always look so terrible?” What is the nurse best response? A. Makeup can help your protruding eyes seem less noticeable. B. “Your appearance doesn’t matter. It’s what’s inside that counts.” C. “With treatment, the fluid buildup behind your eyes will decrease.” D. “If you cut back the fluids, the swelling behind your eyes will go down.” 17. The patient with hyperparathyroidism should have extremities handled gently because: A. Decreased calcium bone deposits can lead to pathologic fractures. B. Edema causes stretched tissues to tear easily. C. hypertension can lead to stroke with residual paralysis D. Polyuria leads to dry skin and mucous membranes that can break down 18. Which medication should be available to provide emergency treatment if a client develops tetany after a subtotal thyroidectomy? A. sodium phosphate B. calcium gluconate C. echothiophate iodide D. sodium bicarbonate 19. A client with hyperthyroidism is to take saturated solution of potassium iodide (SSKI). What should the nurse do when administering this drug? A. Pour the solution over ice chips, popsicle, or ice cream. B. Mix the solution with an antacid after the patient’s last meal. C. Dilute the solution with carbonated drink and have the client drink it with a straw. D. Disguise the solution in a pureed fruit or vegetable and let the patient enjoy their meal. 20. A nurse is caring for a patient diagnosed with hypoparathyroidism. Laboratory tests reveal hypocalcemia. Which statement best describes the role of calcitonin in this patient’s condition? A. Calcitonin increases serum calcium levels by stimulating osteoclast activity. B. Calcitonin decreases serum calcium levels by inhibiting bone resorption. C. C. Calcitonin has no effect on calcium regulation in hypoparathyroidism. D. D. Calcitonin increases parathyroid hormone secretion to maintain calcium balance. Situation: A 56-year-old patient has been diagnose to have type 2 Diabetes Mellitus and has been admitted due to headache and blurring of vision. She had been on insulin therapy for almost 10 years now. 21. Which of the following diagnostic test do you expect to be ordered by the diabetologist as an indicator that the patient is compliant to her prescribed diet? A. Oral glucose tolerance test B. Glycosated hemoglobin level C. Fasting blood glucose level D. Finger glucose findings for one day 22. Before supper, an adult client who has type 2 diabetes and requires insulin tells the nurse about having tremors and being weak and anxious. What should the nurse do next? A. Tell the client to lie down for 30 minutes. B. Have the client drink a glass of milk or orange juice. C. Administer IM glucagon D. Administer the next dose of insulin. 23. Which nursing intervention should be done first when managing a pediatric client admitted to the emergency department with severe diabetic ketoacidosis (DKA)? A. Begin an insulin drip to lower the client’s blood glucose level. B. Correct any fluid deficit using an isotonic saline solution. C. Draw a blood glucose level and serum electrolyte panel. D. Secure the client’s airway to ensure adequate ventilation. 24. A client with type 1 diabetes mellitus has diabetic ketoacidosis. Which finding has the greatest effect on fluid loss? A. hypotension B. decreased serum potassium level C. rapid, deep respirations D. warm, dry skin 25. A nurse enters the comfort room and finds a client with Diabetes Mellitus sitting on the floor, appearing confused and disoriented. Which action should the nurse take first? A. Obtain a capillary blood glucose reading B. Administer a prescribed insulin dose C. Administer intramuscular glucagon D. Inform the attending physician immediately 26. The nurse is performing discharge teaching for a client diagnosed with Cushing’s disease. Which statement by the client demonstrates an understanding of the instructions? A. “I will be sure to notify my health-care provider if I start to run a fever.” B. “Before I stop taking the prednisone, I will be taught how to taper it off.” C. “If I get weak and shaky, I need to eat some hard candy or drink some juice.” D. “It is fine if I continue to participate in weekend games of tackle football.” 27. The client diagnosed with Addison’s disease is admitted to the emergency department after a day at the lake. The client is lethargic, forgetful, and weak. Which intervention should the nurse implement? A. Start an IV with an 18-gauge needle and infuse NS rapidly. B. Have the client stay in the waiting room until a bed is available. C. Obtain a permit for the client to receive a blood transfusion. D. Collect urinalysis and blood samples for a CBC and calcium level. 28. The nurse is instructing a college student with Addison’s disease how to adjust the dose of glucocorticoids. The nurse should explain that the patient may need an increased dosage of glucocorticoids in which situation? A. completing course work. B. gaining 4 lb (1.8 kg) C. becoming engaged D. having wisdom teeth extracted 29. Which goal is the priority for a client in addisonian crisis? A. controlling hypertension B. preventing irreversible shock C. preventing infection D. relieving anxiety 30. Which of the following patient statements would indicate that no further teaching is needed for a client newly diagnosed with Addison’s disease who will be taking corticosteroids? A. "I know I need to watch for signs of high blood sugar while I’m on this medication." B. "I will adjust my steroid dose depending on how much I eat or how much exercise I do." C. "If my blood pressure suddenly gets very high, I will notify my health care provider right away." D. "If I’m under a lot of stress, I should lower my corticosteroid dose to avoid side effects." 2 | Page