Title RECALLS 5 - NP4 - SC ✅

1 | Page RECALLS 5 EXAMINATION NURSING PRACTICE IV CARE OF THE CLIENT WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART B) NOV 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 TOPIC: IMMUNOLOGICAL DISORDERS - HIV (AIDS) (MEDSURG)   Situation -  The nursing care of patients with HIV infection is complicated by many emotional, social, and ethical issues. The plan of care that Nurse Bea is preparing for her patients with AIDS is individualized to meet their needs.  1.The client diagnosed with AIDS is complaining of a sore mouth and tongue. When the nurse assesses the buccal mucosa, the nurse notes white, patchy lesions covering the hard and soft palates and the right inner cheek. Which interventions should the nurse implement?  A. Teach the client to brush the teeth and patchy area with a soft-bristle toothbrush. B. Notify the HCP for an order for an antifungal swish- and-swallow medication. C. Have the client gargle with an antiseptic based mouthwash several times a day. D. Determine what types of food the client has been eating for the last 24 hours. 2. Which type of isolation technique is designed to decrease the risk of transmission of recognized and unrecognized sources of infections?  A. Contact Precautions. B. Airborne Precautions C. Droplet Precautions. D. Standard Precautions. 3. The nurse is describing the HIV virus infection to a client who has been told he is HIV positive.Which information regarding the virus is important to teach?  A. The HIV virus is a retrovirus, which means it never dies as long as it has a host to live in. B. The HIV virus can be eradicated from the host body with the correct medical regimen. C. It is difficult for the HIV virus to replicate in humans because it is a monkey virus. D. The HIV virus uses the client’s own red blood cells to reproduce the virus in the body. 4. A nurse is working with a patient who was diagnosed with HIV several months earlier. The nurse should recognize that a patient with HIV is considered to have AIDS at the point when the CD4+ T-lymphocyte cell count drops below what threshold? A. 75 cells/mm3 of blood B. 200 cells/mm3 of blood C. 325 cells/mm3 of blood D. 450 cells/mm3 of blood 5. A patient was tested for HIV using enzyme immunoassay (EIA) and results were positive. The nurse should expect the primary care provider to order what test to confirm the EIA test results?  A. Another EIA test B. RT-PCR C. Western blot test D. CD4/CD8 ratio TOPIC: ONCOLOGY NURSING - BREAST CANCER (MEDSURG)   Situation - You work in an oncology unit and are caring for a 37-year-old woman from Saudi who reported a growing lump on her right breast after it became painful to touch. She is positive for breast cancer and is admitted for unilateral right mastectomy.  6. Which recommendation is the American Cancer Society’s (ACS) guideline for the early detection of breast cancer?  A. Beginning at age 18, have a biannual clinical breast examination by an HCP. B. Beginning at age 30, perform monthly breast self- exams. C. At age 45 through 54, receive a yearly mammogram. D. Beginning at age 50, have a breast sonogram every five (5) years. 7. If the patient and her physician opt for prophylactic treatment, the nurse should prepare the woman for what intervention? A. More aggressive chemotherapy B. Left mastectomy C. Radiation therapy D. Bilateral mastectomy 8. The nurse caring for this patient knows that she is anxious and fearful about the upcoming procedure and the newly diagnosed malignancy. How can the nurse most likely alleviate this patient's fears?  A. Provide written material on the procedure that has been scheduled for the patient. B. Provide the patient with relevant information about expected recovery. C. Give the patient current information on breast cancer survival rates. D. Offer the patient alternative treatment options.  9. The patient just had a mastectomy and axillary node dissection. When providing patient education regarding rehabilitation, what should the nurse recommend?  A. Avoid exercise of the arm for next 2 months. B. Keep cuticles clipped neatly. C. Avoid lifting objects heavier than 10 pounds. D. Use a sling until healing is complete. 10. When planning discharge teaching with a patient who has undergone a total mastectomy with axillary dissection, the nurse knows to instruct the patient that she should report what sign or symptom to the physician immediately? A. Fatigue B. Temperature greater than 37.5 C. Sudden cessation of output from the drainage device D. Gradual decline in output from the drain TOPIC: ONCOLOGY NURSING - CHEMOTHERAPEUTIC DRUGS (MEDSURG) * NLE * NCLEX * CGFNS * HAAD * PROMETRICS * DHA * MIDWIFERY * LET * RAD TECH * CRIMINOLOGY * DENTISTRY * PHARMACY *

3 | Page C. Osmosis D. Ultrafiltration TOPIC: LEADERSHIP AND MANAGEMENT – PRIORITIZATION AND DELEGATION (PALMER) Situation - Ms. Kath is the charge nurse on a 36-bed unit that admits clients with gastrointestinal disorders and gastrointestinal surgery. The unit is staffed with four RNs, and two Nursing Assistants. 26. Ms. Kathy is making assignments. Which client should be assigned to the graduate nurse who has been on the unit for 1 month?  A. The client diagnosed with lower esophageal dysfunction who is complaining of pyrosis. B. The client who had an endoscopy this morning and has absent bowel sounds. C. The client with gastroesophageal reflux disease who has bilateral wheezing. D. The client who is 1 day post-op open cholecystectomy and refuses to breathe. 27. The client is admitted to the medical unit with a diagnosis of acute diverticulitis.Which order should Ms. Kath clarify with the healthcare provider?  A. Insert a nasogastric tube. B. Start IV D5W at 125 mL/hr. C. Schedule the client for a sigmoidoscopy. D. Place the client on bed rest with bathroom privileges 28. Ms. Kathy observes the nursing assistant turning the client who has just had a liver biopsy to the supine position. Which action should Ms. Kath implement first?  A. Tell the UAP to keep the client on bed rest for 2 hours. B. Praise the UAP for placing the client in the supine position. C. Instruct the UAP to place the client on the right side. D. Complete an incident report on the UAP’s behavior 29. One of the primary nurses, Nurse Abby, tells Ms. Kath that she stuck herself in the finger with a “used” needle and cleaned the site with soap and water. Which intervention shouldMs. Kath implement first?  A. Notify the infection control nurse. B. Complete an adverse occurrence report. C. Request post-exposure prophylaxis. D. Check the hepatitis status of the client. 30. Which nursing task is most appropriate for Ms. Kathy to delegate to the Nursing Assistant?  A. Bathe the client with liver failure who has a Sengstaken-Blakemore tube inflated. B. Teach the client with an open cholecystectomy to splint the incision when coughing. C. Assist the client with pruritus to the bathroom for a shower and a.m. care. D. Tell the UAP to assist the nurse performing a paracentesis on the client with liver failure. TOPIC: NURSING ETHICS - BIOETHICAL PRINCIPLES IN NURSING (PALMER)   Situation: Ethical considerations in nursing encompass a broad range of principles and practices that guide nurses in providing compassionate, respectful, and safe patient care. 31. You have just taken a report for your shift and you are doing your initial assessment of your patients. One of your patients asks you if an error has been made in her medication. You know that an incident report was filed yesterday after a nurse inadvertently missed a scheduled dose of the patient's antibiotic. Which of the following principles would apply if you give an accurate response?  A. Veracity B. Confidentiality C. Respect D. Justice 32. A medical nurse has obtained a new patient's health history and completed the admission assessment. The nurse has followed this by documenting the results and creating a care plan for the patient. Which of the following is the most important rationale for documenting the patient's care?  A. It provides continuity of care. B. It creates a teaching log for the family. C. It verifies appropriate staffing levels. D. It keeps the patient fully informed. 33.  The care team has deemed the occasional use of restraints necessary in the care of a patient with Alzheimer's disease. What ethical violation is most often posed when using restraints in a long-term care setting?  A. It limits the patient's personal safety. B. It exacerbates the patient's disease process. C. It threatens the patient's autonomy. D. It is not normally legal. 34. A patient has been diagnosed with small-cell lung cancer. He has met with the oncologist and is now weighing the relative risks and benefits of chemotherapy and radiotherapy as his treatment. This patient is demonstrating which ethical principle in making his decision? A. Beneficence B. Confidentiality C. Autonomy D. Justice 35. The physician has recommended an amniocentesis for an 18-year-old primiparous woman. The patient is 34 weeks gestation and does not want this procedure. The physician is insistent that the patient have the procedure. The physician arranges for the amniocentesis to be performed. The nurse should recognize that the physician is in violation of what ethical principle?  A. Veracity B. Beneficence C. Nonmaleficence D. Autonomy TOPIC: LEADERSHIP AND MANAGEMENT - DELEGATION (PALMER) Situation - Mr. Andrew is the head nurse on the 10-bed Neurological Intensive Care Unit and 20-bed Neurological Step-Down unit. He supervises 15 nurses in the ICU, along with 30 nurses and 15 Nursing Assistants.  36. Elizabeth, who is the day staff nurse, and the nursing assistant are caring for a client with a right-sided cerebrovascular accident (CVA) with hemi-paralysis. Which action by the UAP requires Elizabeth to intervene?  A. The UAP places the call light on the client’s left side. B. The UAP assists the client to eat the breakfast meal. C. The UAP uses the draw sheet to move the client up in bed. D. The UAP places a small pillow under the client’s left shoulder. 37. Klarisse is caring for the following clients on the Neurological Intensive Care unit.Which client should Courtney assess first?  A. The client with a C-6 SCI who is complaining of dyspnea and has crackles in the lungs. B. The client with Guillain-Barré syndrome who is complaining of ascending paralysis. C. The client with traumatic brain injury who has a Glasgow Coma Scale score of 6. D. The client was diagnosed with a cerebrovascular accident (CVA) who has expressive aphasia 38. Mr. Andrew is making shift assignments. Which client should be assigned to the most experienced nurse?  A. The client diagnosed with bacterial meningitis who is experiencing photophobia. B. The client with an L-4 SCI who has spastic muscle spasms of the lower extremities. C. The client diagnosed with Parkinson’s who has a mask-like face and has pill rolling. D. The client has amyotrophic lateral sclerosis (ALS) who is having respiratory distress. 39. Jessie is assigned to care for a client who had a C-6 SCI 2 years ago and is admitted for Stage IV pressure ulcers in the coccyx area. The client is complaining of a severe headache and B/P is 190/110. Which intervention should Jessie implement first?