Title DIAGNOSTIC EXAMINATION - NP1 - STUDENT COPY ✅

REFRESHER PHASE DIAGNOSTIC EXAMINATION NURSING PRACTICE 1 (NP1) NOVEMBER 2025 Philippine Nurse Licensure Examination Review Situation: A novice nurse is assigned in the Pediatric Charity Ward as his first job rotation. In his first few weeks, the Charge Nurse assists him closely, and assigns a Senior Nurse as a buddy. 1. The novice nurse observes that a senior nurse avoids any opportunity to do bedside care, and chooses to do all the charting and carrying out of orders. He is more concerned with their delayed salaries, rather than with all the learnings he can get in the area. The novice nurse knows that the senior nurse matches which theory of management? A. Theory X B. Theory Y C. Theory Z D. Theory A 2. Various equipment in the area, such as air-conditioning units, computers, and infusion pumps, are due for maintenance this month. Budget for this will come from: A. Capital Expense Budget B. Operational Budget C. Personnel budget D. Cash budget 3. During another day of duty, two senior nurses are arguing about a patient error. The head nurse calls both parties in her office to immediately end the conflict. The head nurse is using what conflict resolution strategy? A. Smoothing B. Compromise C. Forcing D. Withdrawing 4. The head nurse knows that the practice of instilling normal saline during suctioning of pediatric patients should be avoided, following evidence-based practice guidelines. How will she implement this policy? A. Identify the problems caused by instilling normal saline during suctioning B. Call for a ward meeting to discuss the evidences of this practice C. Attend a pediatric subspecialty conference to get more details about this practice D. Approach each staff nurse one by one to determine their thoughts about normal saline instillation 5. A team from the Nursing Services Division performs an evaluation of nurses’ practice in the pediatric ward. The novice nurses knows that this is also known as: A. Nursing Audit B. Performance Appraisal C. Quality assurance D. Quality improvement Situation: Quality nursing care includes extensive knowledge of the pathophysiological nature of the disease in order to provide superb nursing interventions. Nurse Dianne has been assigned to care for a 7 day old premature newborn who presented with significant respiratory distress after being breastfed. Assessment findings include a poor suck, excessive amount of frothy saliva on his mouth and nose, along with choking and coughing when breastfeeding, circumoral cyanosis, and a small for gestational age weight. Arterial blood gas results showed the ff. values: pH 3.2, pO2 76%, pCO2 50%, HCO3 23, O2 sat 88%. Baby David was immediately intubated and hooked to a mechanical ventilator. 6. Esophageal atresia (EA) / Transesophageal fistula (TEF) are often a component of associated anomalies involving the following organs except: A. Heart B. Trachea C. Kidneys D. Lungs 7. When taking the client’s health history, which specific prenatal condition demonstrated by the mother shows the possibility of EA/TEF in the unborn infant: A. Oligohydramnios B. Gestational DM C. Polyhydramnios D. PIH 8. Which of the following procedures should Nurse Dianne conduct in the initial nursing physical assessment to help determine the presence of EA/TEF? A. Passage of a small-gauge OG feeding tube B. Suctioning C. Auscultation of bowel sounds D. Abdominal CT Scan 9. Which of the following Nursing Diagnoses should Nurse Dianne prioritize when caring for the client with EA/TEF? A. Imbalanced Nutrition: Less than Body Requirements B. Ineffective Airway Clearance C. Impaired Gas Exchange D. Risk for Aspiration 10. Based on the client’s ABG result, he is experiencing which gas exchange problem? A. Respiratory Acidosis, Uncompensated B. Respiratory Acidosis, Compensated C. Respiratory Alkalosis, Uncompensated D. Respiratory Alkalosis, Compensated 11. Nurse Dianne should be aware that the most desirable position for a newborn who is suspected of having an EA with a TEF is: A. Supine B. High-Fowler’s C. Side-lying D. Semi-Fowler’s 12. Post-surgical repair of the EA/TEF, Nurse Kate understands that oral feedings are begun with A. Breast milk B. Sterile water C. Glucose water D. Ice chips 13. An important intervention to prevent feeding aversion for an infant requiring esophageal replacement and is on NPO for an extended period of time is: A. Parenteral Nutrition B. Early breastfeeding C. Non-nutritive sucking D. IV Therapy 14. Upon discharge, Nurse Kate should educate the parents about a common complication post EA/TEF repair and treatment: A. Atelectasis B. Respiratory Distress C. Trachemoalacia D. GER 15. Discharge education on feeding techniques in an infant with a repaired esophagus include feeding in which of the following positions: A. Semi-upright TOP RANK REVIEW ACADEMY, INC. Page 1 | 7


B. Every 1-3 hours C. Every 4-6 hours D. Every 8-10 hours 45. The client’s prognosis went well and the doctor ordered the patient for possible discharge within 24 hours. As the nurse prepares the client for the removal of a nasogastric tube, she instructs the client to: A. Inhale deeply. B. Exhale slowly. C. Hold in a deep breath. D. Pause between breaths. SITUATION: Ensuring safety before, during and after a respiratory diagnostic procedure is an important responsibility of the nurse. The following questions apply. 46. A client named Daryl is suspected of having a pleural effusion. The nurse assesses him for which typical manifestations of this respiratory problem? A. Dyspnea at rest and moist, productive cough B. Dyspnea on exertion and dry, non-productive cough C. Dyspnea at rest and dry, non-productive cough D. Dyspnea on exertion and moist, productive cough 47. The nurse plans to have which of the following items available for immediate use for Daryl’s untreated condition? A. Intubation tray B. Paracentesis tray C. Thoracentesis tray D. Central venous line insertion tray 48. The nurse recalls the nursing interventions before, during, and after aspiration of fluid in the pleural cavity. She was not able to recollect accurately if she anticipates that the doctor will not insert the trocar: A. Below the seventh rib laterally and above the ninth rib posteriorly B. Below the 2nd intercostal space (ICS) anteriorly and above 4th ICS posteriorly C. Below the seventh rib laterally and below the ninth rib posteriorly D. Above the 2nd intercostal space (ICS) anteriorly and below 4th ICS posteriorly 49. The nurse is assessing Daryl’s respiratory status after thoracentesis. The nurse would become most concerned with which of the following assessment findings? A. Equal bilateral chest expansion B. Respiratory rate of 22 breaths per minute C. Diminished breath sounds on the affected side D. Few scattered wheezes, unchanged from baseline 50. Daryl has become progressively dyspneic and now has been co-diagnosed with left tension pneumothorax. Which of the following observed by the nurse indicates that his pneumothorax is rapidly worsening? A. Tracheal deviation to the left B. Tracheal deviation to the center of carina C. Pain on respiration with flat neck veins D. Tracheal deviation to the right Situation: Verbal communication is extremely important especially when the Nurse is exploring problems and disorders with the clients in any age group. Nurse Dante is assigned to different clients in the ward. 51. A client is hospitalized with a diagnosis of possible Cancer of the pancreas. On admission the client asks the nurse, “Do you think I have anything serious like cancer?” What is the nurse’s best reply? A. “What makes you think you have cancer? B. “I don’t know if you do, but let’s talk about it.” C. “Why don’t you discuss this with your doctor?” D. “Don’t worry, we won’t know until all the test result are back.” 52. Nurse Dante approaches a male client and asks how he is feeling. The client states “I’m feeling a bit nervous today.” Which of the following is the Nurse’s best reply? A. Please explain what you mean by the word nervous B. What is making you feel nervous? C. Would a backrub ease your nervousness? D. You do look like you’re nervous 53. When assessing a client what statement would indicate negative self-talk? A. Everyone has to learn something new sometime B. I am looking forward to making home visits , but I am also nervous C. This is going to be difficult, but I know I can do it D. Who can ever have enough experience to prepare for that job? 54. While receiving a preoperative enema a client starts to cry and says. “I’m sorry you have to do this messy thing me,” what is the best response by the nurse? A. “I don’t mind it.” B. “You seem to be upset.” C. “This is part of my job.” D. “Nurses get used to this.” 55. “But you don’t understand” is a common statement associated with adolescent. The best response by the nurse when communicating with an adolescent is to say: A. “I don’t understand.” B. “I would like to understand, let’s talk.” C. “I don’t understand. I was a teenager once too.” D. “I’m not sure have to I believe it’s you who has to understand.” Situation: One of the important roles of the Nurses is being a Health Educator. Clients would always seek information on Health maintenance to prevent illness. 56. Nurse Diana, daughter of Hippolita and the princess of Themycera, is teaching a client about prescribe restricted diet. What is the Nurse’s best initial comment? A. “You can eat only the on this list.” B. “What types of food do you usually eat?” C. “You need to limit the intake of food on this list.” D. “Do you understand why you have these food restrictions?” 57. Nurse Diana is preparing a nursing care plan to a client with Diabetes Mellitus (D.M.) that includes before discharge to know how to self-administer insulin, adjust the insulin dosage, understand the diet, and test the serum for glucose level. The client progresses well and is discharge 5 days following admission. Legally the: A. Nurse was properly functioning as a health teacher B. Visiting nurse should do health teaching in the client’s home C. Family members also should have been taught to administer the insulin D. Physician was responsible and the nurse should have cleared the care with the physician 58. Which teaching method has been evaluated as most effective in a new diabetic client? A. Utilizing breaks after each unit of the teaching session B. Having the client repeat the steps of insulin administration C. Encouraging the client to ask many questions D. Confirming that the client is able to give his own insulin 59. Which of the following statements by a client would alert the Nurse that further teaching on the idea of a restful sleep is indicated? A. I don’t take naps throughout the day B. I go to bed and get up routinely at the same time each day C. I have a small snack and take a bath before going to bed each day D. I went to bed earlier than usual and I rested and watched television until I fall asleep 60. What can the Nurse do to support the client’s ability to sleep in the hospital setting? A. Assess the client’s towards the end of the shift , closer to the normal awakening time B. Darken the room as much as possible by keeping the lights off C. Limit the noise and distraction on the unit D. Provide a bath or shower before bedtime Situation: Benjie, a charge nurse, is attending to the client with an intravenous fluid. 61. What does Nurse Benjie identify as the most likely cause of the infiltration of a client’s IV? A. Excessive height of the IV solution TOP RANK REVIEW ACADEMY, INC. 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