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

Situation: You are providing end-of-life care in the ICU, focusing on physical changes and emotional support for family members. 41. Which sign indicates circulation is failing in a dying ICU patient? A. Warm pink skin B. Mottled, cool extremities C. Increased urine output D. Bounding peripheral pulses 42. What respiratory pattern often occurs near death? A. Kussmaul respirations B. Cheyne-Stokes respirations C. Eupneic pattern D. Apneustic respirations 43. Which nursing action best supports family presence at the bedside? A. Limit visitation to reduce emotional stress B. Allow family to stay as desired and explain changes they see C. Avoid discussing physical changes to prevent distress D. Ask family to wait outside during care 44. A dying patient has noisy “death rattle” respirations. Which is the priority? A. Suction the patient continuously B. Reposition the patient to a side-lying position C. Restrict all fluids D. Place in Trendelenburg position 45. What is a common psychological sign of approaching death? A. Sudden bursts of energy B. Refusal of food and withdrawal C. Increased talkativeness and socializing D. Insomnia with anxiety Situation: You are supporting family members of dying patients and managing common end-of-life complications like agitation and organ failure. 46. Which statement by the nurse helps support a grieving family? A. “It’s time to stop crying; you need to be strong.” B. “Would you like to hold their hand while I explain the monitors?” C. “Let’s remove all equipment right now so you don’t see them like this.” D. “We will step out and give you no updates until the end.” 47. Which urinary change indicates imminent death? A. Output > 50 mL/hr B. Tea-colored or absent urine output C. Clear and high-volume urine output D. Frequent urination every 30 minutes 48. The nurse notes terminal restlessness in a dying ICU patient. Which is the best intervention? A. Apply soft restraints B. Administer prescribed low-dose morphine or sedative C. Reorient the patient every 15 minutes D. Turn on bright overhead lights 49. What should the nurse say to a family member who asks, “How much longer do they have?” A. “I can’t predict exactly, but I can explain what signs we look for.” B. “That’s private information I can’t share.” C. “Everyone dies eventually; let’s focus on something else.” D. “They will pass exactly at midnight.” 50. A patient’s pulse becomes weak and irregular near death. Which action is most important? A. Begin chest compressions immediately B. Notify family and continue comfort care C. Start IV dopamine infusion D. Prepare for emergent intubation Situation: You are a nurse researcher studying falls in hospitals. One of your proposed studies is titled: “Older adult patients are at higher risk of falls compared to younger adult patients in general medical wards.”The goal is to determine which factor influences fall risk and to guide fall-prevention programs. 51. In this study, what is the independent variable? A. Fall risk B. Patient age group C. Type of hospital ward D. Type of footwear used 52. What is the dependent variable? A. Number of patients admitted B. Fall risk score/incidence C. Hospital staffing pattern D. Medication use 53. What is the population? A. All hospital patients B. Patients in general medical wards C. Healthcare staff D. Nursing students 54. Which research design is most appropriate? A. Randomized controlled trial B. Correlational comparative study C. Case study D. Phenomenological study 55. Which tool is best to measure the dependent variable? A. Morse Fall Scale B. Braden Scale C. Visual analog pain scale D. Apgar score Situation: You want to explore the impact of shift work on nurses. The research title is: “Night-shift nurses report lower sleep quality than day-shift nurses in tertiary hospitals.” 56. What is the independent variable? A. Level of sleep quality B. Nurse shift schedule C. Hospital policies D. Patient acuity level 57. What is the dependent variable? A. Sleep quality score B. Nurse shift rotation schedule C. Type of hospital D. Age of nurse 58. What is the population? A. All nurses in the region B. Nurses in tertiary hospitals C. Only emergency nurses D. Nursing students 59. Which tool measures sleep quality? A. Morse Fall Scale B. PSQI (Pittsburgh Sleep Quality Index) C. Perceived Stress Scale D. Braden Scale 60. Which type of research design is used? A. Experimental with randomization B. Descriptive comparative C. Grounded theory D. Case study Situation: Your research team designs an intervention study titled: “Effect of music therapy on postoperative pain levels among orthopedic patients compared to standard care.” 61. What is the independent variable? A. Type of orthopedic surgery B. Music therapy C. Pain intensity D. Length of hospital stay 62. What is the dependent variable? A. Pain score B. Type of music C. Patient age D. Ward type 63. Which research design best fits this study? A. Randomized controlled trial B. Ethnography C. Phenomenology 3 | Page
D. Case report 64. What is the population? A. All post-op patients B. Orthopedic post-op patients C. Physiotherapy staff D. Nursing students 65. Which instrument measures pain intensity? A. Morse Fall Scale B. Numeric pain rating scale C. Apgar score D. GCS Situation: You are the charge nurse on a medical-surgical unit during a busy shift. Four patients need attention: (1) a patient with COPD reporting shortness of breath, (2) a patient with blood glucose 320 mg/dL waiting for insulin, (3) a post-op cholecystectomy patient with pain score 8/10, and (4) a patient with stage 2 hypertension waiting for medications. 66. Which patient do you see first? A. COPD patient with dyspnea B. Hyperglycemic patient C. Post-op pain patient D. Hypertensive patient 67. Which action for the COPD patient is most urgent? A. Administer pain medication B. Position in high Fowler’s C. Provide orange juice D. Offer emotional support 68. Which task can be delegated to a nursing assistant? A. Blood glucose monitoring B. Adjusting oxygen flow C. Pain assessment D. Teaching breathing techniques 69. Which intervention for the hypertensive patient is correct? A. Encourage fluid restriction immediately B. Administer antihypertensives as ordered C. Place in Trendelenburg position D. Give a high-sodium snack 70. Which documentation is a priority for the post-op patient? A. Surgical site drainage B. Pain score and intervention C. Family’s questions D. Time of last meal Situation: A 65-year-old diabetic patient presents to the ER with foot ulcers, fever 38.5°C, and BP 90/60 mmHg. Blood glucose is 420 mg/dL. The patient is confused and has poor peripheral pulses. 71. What is the first priority? A. Treat the fever B. Start fluid resuscitation C. Administer sliding-scale insulin D. Obtain wound culture 72. What does confusion most likely indicate? A. High anxiety B. Pain C. Hypoperfusion D. Neuropathy 73. Which wound assessment is most important? A. Wound color B. Wound odor C. Wound size D. Surrounding tissue perfusion 74. Which order should the nurse question? A. IV normal saline bolus B. Sliding scale insulin C. High-dose corticosteroids D. Wound culture before antibiotics 75. Which complication is most likely? A. Retinopathy B. Sepsis C. Osteoarthritis D. Cushing’s syndrome Situation: You are assigned to four post-operative patients after abdominal surgeries. One client has an NG tube connected to suction, one has a urinary catheter draining minimal urine, one reports increasing abdominal pain unrelieved by analgesics, and one is requesting discharge teaching about wound care. 76. Which patient should you assess first? A. Patient with unrelieved abdominal pain B. Patient requesting discharge teaching C. Patient with NG tube to suction D. Patient with minimal urine output 77. What does minimal urine output after surgery usually indicate? A. Infection is present B. Patient has renal failure C. Low perfusion or hypovolemia D. Catheter obstruction is expected 78. Which action is safe to delegate to a nursing assistant? A. Assess abdominal distention B. Empty the urinary catheter bag C. Evaluate NG tube placement D. Perform discharge teaching 79. Which teaching point is priority for the client with an NG tube? A. Frequent hand hygiene B. Avoidance of chewing gum C. Need to maintain tube placement and suction D. Taking laxatives to prevent constipation 80. What is the best documentation for the client with pain? A. “Patient seems uncomfortable” B. “Patient complains of pain” C. “Pain score 8/10, analgesic given, reassessment planned in 30 min” D. “Gave morphine” Situation: You are working in the ED with multiple trauma clients after a bus accident: (1) a client with suspected cervical spine injury and shallow respirations, (2) a client with an open femur fracture bleeding heavily, (3) a client with abdominal pain rating 7/10, and (4) a client with minor scalp lacerations. 81. Which client do you assess first? A. Cervical spine injury client B. Femur fracture client C. Abdominal pain client D. Scalp laceration client 82. Which intervention is priority for the femur fracture client? A. Give pain medication B. Apply direct pressure to the wound C. Elevate the head of the bed D. Perform neurological checks 83. Which client is stable and can wait? A. Cervical spine client B. Femur fracture client C. Abdominal pain client D. Scalp laceration client 84. Which team member is best for splint application under supervision? A. Experienced nursing assistant B. Student nurse C. Respiratory therapist D. Charge nurse only 85. What is most important to document for the cervical spine injury client? A. Pain score and medication B. Neuro status and airway management C. Patient’s emotional response D. Time of arrival Situation: On a medical-surgical floor, you have patients with different conditions: (1) pneumonia on IV antibiotics, (2) post-thyroidectomy client reporting hoarseness, (3) diabetic with foot ulcers awaiting dressing change, (4) client with chronic back pain requesting additional opioids. 4 | Page