Title RECALLS 7 - NP4 - SC ✅

RECALLS 7 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: You are caring for clients with thyroid and adrenal disorders. Monitoring for medication complications and hormonal imbalances is critical. 1. A client on propylthiouracil (PTU) reports fever and sore throat. What is the best next action? A. Check TSH level B. Discontinue PTU and get WBC count C. Continue PTU and ice throat D. Teach about agranulocytosis risk 2. A client with Addison’s disease reports nausea, abdominal pain, and profound weakness after missing two doses of hydrocortisone. Which action is priority? A. Provide a high-protein snack B. Obtain serum potassium level C. Prepare to administer IV hydrocortisone D. Monitor intake and output 3. Which teaching point is correct for a client with hyperthyroidism? A. Increase intake of high-iodine foods B. Avoid caffeine and high-stimulant drinks C. Increase caloric intake by 50% D. Restrict fluid intake to 1L/day 4. A client after thyroidectomy reports hoarseness and difficulty speaking. What is the nurse’s best response? A. Reassure the client this is expected and temporary B. Notify the provider immediately of airway obstruction C. Assess for neck swelling and stridor D. Offer lozenges for throat irritation 5. A client with Cushing’s syndrome has a blood glucose of 210 mg/dL and reports muscle weakness. What is the most appropriate nursing action? A. Encourage ambulation and low-protein diet B. Restrict fluid and sodium intake C. Monitor glucose and potassium levels D. Prepare to administer calcium supplements Situation: You are teaching diabetic patients about insulin therapy, glycemic patterns, and self-monitoring of blood glucose. 6. A nurse is teaching a diabetic about the dawn phenomenon. Which statement shows correct understanding? A. “I’ll eat a snack before bed to prevent it.” B. “I’ll measure my blood sugar at 3am.” C. “I’ll increase my insulin in the morning.” D. “I’ll work out before dinner.” 7. Which insulin regimen most closely mimics normal pancreatic function? A. NPH insulin once daily at bedtime B. Short-acting insulin only with meals C. Long-acting insulin once daily with rapid-acting at meals D. Intermediate-acting insulin twice daily only 8. A diabetic client with retinopathy is learning about exercise. Which statement indicates correct understanding? A. “I will avoid heavy weightlifting.” B. “I can exercise vigorously without restriction.” C. “Exercise will reverse my vision loss.” D. “I only need to exercise when my blood sugar is above 250 mg/dL.” 9. A client on an insulin pump has blood glucose of 60 mg/dL and feels shaky. What is the best first action? A. Give 15 g of simple carbohydrate B. Turn off the insulin pump C. Notify the provider immediately D. Administer glucagon IM 10. The nurse is teaching foot care to a client with diabetes. Which statement indicates a need for further teaching? A. “I’ll inspect my feet every day.” B. “I’ll go barefoot at home to strengthen my feet.” C. “I’ll trim toenails straight across.” D. “I’ll wear well-fitting shoes.” Situation: You are caring for patients with acute abdominal emergencies and gastrointestinal disorders. Prompt recognition of complications is essential. 11. Which assessment finding is most concerning in a client with acute pancreatitis? A. Epigastric pain B. Grey-Turner’s sign C. Nausea and vomiting D. Fever 12. Which of the following best indicates resolution of bowel obstruction? A. Distended abdomen B. Absent bowel sounds C. Passage of flatus D. Increased pain 13. A client post-cholecystectomy reports right upper quadrant pain radiating to the shoulder and nausea. What is the nurse’s best initial action? A. Administer ordered opioid analgesic B. Assess for abdominal rigidity and rebound tenderness C. Apply a heating pad to the abdomen D. Encourage deep breathing and coughing 14. A patient with cirrhosis has ascites and dyspnea. Which position best promotes comfort? A. Supine with pillows under the knees B. High Fowler’s with feet dependent C. Prone with head elevated D. Side-lying with knees flexed 15. Which dietary teaching is appropriate for a client with a new ileostomy? A. “Eat high-fiber foods to regulate output.” B. “Limit fluid intake to reduce stool output.” C. “Chew food thoroughly and avoid high-fiber foods initially.” D. “Increase raw fruits and vegetables for bowel health.” 16. A 55-year-old man with a history of alcoholism presents with hematemesis and melena. He is pale, diaphoretic, and 1 | Page