Title RECALLS 9 - NP4 - SC ✅

RECALLS 9 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 patient Igaram, a patient with Addison’s disease. You utilize your knowledge on this concept to help care for the patient. 1. Igaram was just recently diagnosed with Addison’s disease. He still lacks knowledge about his disease so he decided to ask you some questions. Igaram asked you, “How does the disease happen?” You answer him correctly by stating that this disease results from: A. Insufficient secretion of growth hormone (GH). B. Dysfunction of the hypothalamic pituitary. C. Idiopathic atrophy of the adrenal gland. D. Oversecretion of the adrenal medulla. 2. Igaram is admitted to your unit. After your assessment on him, you formulated the nursing diagnosis Deficient fluid volume related to inadequate fluid intake and to fluid loss secondary to inadequate adrenal hormone secretion. As Igaram’s oral intake increases, which of the following fluids would be the most appropriate for him? A. Milk and diet soda. B. Water and eggnog. C. Bouillon and juice. D. Coffee and milkshakes. 3. You are instructing Igaram how to adjust the dose of the glucocorticoids he is taking. As his nurse, you should explain to him that he may need an increased dosage of glucocorticoids in which of the following scenarios? A. Completing the spring semester of school. B. Gaining 4 pounds. C. Becoming engaged. D. Undergoing a root canal. 4. Igaram is diagnosed with Addison’s disease. As a knowledgeable nurse, you know that this condition may lead to Addisonian crisis if not adequately managed. Which of the following manifestations would be expected in Igaram if he develops this condition? A. Fluid retention. B. Pain. C. Peripheral edema. D. Hunger. 5. If Igaram develops Addisonian crisis, which of the following would be your priority as Igaram’s primary nurse? A. Controlling hypertension. B. Preventing irreversible shock. C. Preventing infection. D. Relieving anxiety. SITUATION: You are a nurse tasked to care for patients with different pituitary disorders. You are to take care of Karoo and Koza, both diagnosed with SIADH, and Paula, who is diagnosed with diabetes insipidus. You utilize your knowledge on this concept to help care for your patients safely. 6. One of the clients in your unit, Karoo, is diagnosed to have a pituitary tumor. Karoo developed Syndrome of Inappropriate Antidiuretic Hormone (SIADH). Which of the following interventions should you implement as Karoo’s primary nurse? A. Assess for dehydration and monitor blood glucose levels. B. Assess for nausea and vomiting and weigh daily. C. Monitor potassium levels and encourage fluid intake. D. Administer vasopressin IV and conduct a fluid deprivation test. 7. You are reviewing the chart of Karoo who has SIADH. Which of the following clinical manifestations you noted in Karoo’s chart should be reported to his primary care physician? A. Serum sodium of 112 mEq/L and a headache. B. Serum potassium of 5.0 mEq/L and a heightened awareness. C. Serum calcium of 10 mg/dL and tented tissue turgor. D. Serum magnesium of 1.2 mg/dL and large urinary output. 8. Another patient in your unit, Koza, was diagnosed with SIADH secondary to cancer of the lung. He tells you that he wants to discontinue his fluid restriction and that he does not care if he dies. Which of the following actions by the nurse is an example of the ethical principle of autonomy? A. Discuss the information the client told the nurse with the health-care provider and significant other. B. Explain it is possible the client could have a seizure if he drank fluid beyond the restrictions. C. Notify the health-care provider of the client’s wishes and give the client fluids as desired. D. Allow the client an extra drink of water and explain the nurse could get into trouble if the client tells the health-care provider. 9. Paula, another patient assigned to you in the unit, is recently diagnosed with diabetes insipidus. Which of the following interventions should you implement as Paula’s primary nurse? A. Administer sliding-scale insulin as ordered. B. Restrict caffeinated beverages. C. Check urine ketones if blood glucose is >250. D. Assess tissue turgor every four (4) hours 10. Following Paula’s diagnosis of diabetes insipidus, she stayed in the hospital for a few days. She is now about to be discharged and you are conducting your health teaching regarding her condition. Which of the following statements made by Paula warrants further intervention? A. “I will keep a list of my medications in my wallet and wear a Medic Alert bracelet.” B. “I should take my medication in the morning and leave it refrigerated at home.” C. “I should weigh myself every morning and record any weight gain.” D. “If I develop a tightness in my chest, I will call my health-care provider.” SITUATION: You are a nurse caring for patients with inflammatory bowel disease. 11. Pierre is a patient admitted to the hospital with a diagnosis of ulcerative colitis. You are currently reviewing his history and physical assessment chart. Based on Pierre’s diagnosis, which 1 | Page

26. As an experienced nurse, you know that client incidence of hypermagnesemia is rare in comparison with hypomagnesemia. A student nurse approached you and asked how hypermagnesemia develops. You answer her correctly by saying that hypermagnesemia generally occurs secondary to: A. Cardiac contractility. B. Hypokalemia. C. Liver failure. D. Renal insufficiency. 27. You are assigned to care for Ace, a patient diagnosed to have hypokalemia. As a knowledgeable nurse, you know that the electrolyte that must be corrected in this scenario is: A. Calcium. B. Magnesium. C. Manganese. D. Zinc. 28. You are caring for a group of patients in the ward. While reviewing each of the patient’s charts, you determine which of the following patients is most likely at risk for fluid volume deficit? A. A client with an ileostomy B. A client with heart failure C. A client on long-term corticosteroid therapy D. A client receiving frequent wound irrigations 29. You are refreshing your knowledge on sodium imbalances. As a knowledgeable nurse, you know that which of the following patients in the ward is most likely to develop a sodium level at 130 mEq/L (130 mmol/L)? A. The client who is taking diuretics B. The client with hyperaldosteronism C. The client with Cushing’s syndrome D. The client who is taking corticosteroids 30. You are reviewing one of your patient’s progress notes. You read that the physician has documented “insensible fluid loss of approximately 800mL daily”. As a knowledgeable nurse, you make a notation that insensible fluid loss occurs through which of the following types of excretion? A. Urinary output B. Wound drainage C. Integumentary output D. The gastrointestinal tract SITUATION: You are a nurse assigned to care for and educate patients in the cancer unit of the hospital you are working on. You apply the concepts you’ve learned regarding cancer to ensure a safe nursing practice. 31. You are reviewing your notes on cancer. After much reading, you know that cancer prevalence is defined as? A. The likelihood cancer will occur in a lifetime. B. The number of persons with cancer at a given point in time. C. The number of new cancers in a year. D. All cancer cases more than 5 years old. 32. Gol is your patient diagnosed to have testicular cancer. He expressed his concerns regarding fertility since him and his partner desires to eventually have a family. As Gol’s primary nurse, you discuss the option of sperm banking. You inform Gol and his partner that sperm banking needs to be performed when? A. Before treatment is started. B. Once the client is tolerating the treatment. C. Upon completion of treatment. D. When tumor markers drop to normal levels. 33. You are working with Bellamy, a client with known risks for lung cancer. He asks you why he is scheduled for a computed tomography (CT) scan as part of his initial workup. You answer Bellamy correctly when you respond by saying: A. “CT is far superior to magnetic resonance imaging for evaluating lymph node metastasis.” B. “CT is noninvasive and readily available.” C. “CT is useful for distinguishing small differences in tissue density and detecting nodal involvement.” D. “CT can distinguish malignant adenopathy from nonmalignant adenopathy.” 34. You are caring for Cricket, a patient with pain related to bone cancer. You conducted an assessment on Cricket in relation to this. You know that which of the following is the most important component of a thorough pain assessment specific for patient Cricket? A. Intensity. B. Cause. C. Aggravating factors. D. Location. 35. Noland is a cancer patient you are tasked to care for. He is receiving the medication vincristine (Oncovin). You plan your health teaching for Noland regarding this medication. Which of the following should you include in your instructions to Nolan? A. Use of loperamide (Imodium). B. Fluid restriction. C. Low fiber, bland diet. D. Bowel regimen. 36. Sarquiss is a 57 year old client receiving chemotherapy that has the potential to cause pulmonary toxicity. Which of the following symptoms would you note in Sarquiss that could indicate a toxic response to the chemotherapy? A. Decrease in appetite. B. Drowsiness. C. Spasms of the diaphragm. D. Cough and shortness of breath. 37. Hina is one of the patients you are tasked to care for her in the unit. She is beginning external beam radiation therapy to the right axilla after her lumpectomy for breast cancer. You plan to conduct a health teaching. Which of the following would you include in your education to Hina? A. Use a heating pad under the right arm. B. Immobilize the right arm. C. Place ice on the area after each treatment. D. Apply deodorant only under the left arm. 38. Tony Tony is a patient receiving radiation therapy for lung cancer. He complains that he is having difficulty sleeping. After hearing this statement from your patient, you should: A. Suggest the client stop watching television before bed. B. Assess the client’s usual sleep patterns, amount of sleep, and bedtime rituals. C. Tell the client sleeplessness is expected with radiation therapy. D. Suggest that the client stop drinking coffee until the therapy is completed. 39. You are caring for Nico, a patient with cancer who requires a bolus tube feeding. You prepare to administer the bolus tube feeding and as a skilled nurse, which of the following nursing interventions is most appropriate to decrease the risk of aspiration in this patient? A. Place the client on bed rest with the head of the bed elevated to 60 degrees for 2 hours. B. Place the client on the left side with the head of the bed at 45 degrees for 15 minutes. C. Assist the client out of bed to sit upright in a chair for 1 hour. D. Ask the client to rest in bed with the head of the bed elevated to 30 degrees for 20 minutes. 40. Portgas is a cancer patient receiving chemotherapy. He is experiencing a flare up of pruritus. You are planning to develop a care plan for Portgas. In order to develop the nursing care plan, you should ask him if he has been: A. Wearing clothes made from 100% cotton. B. Sleeping in a cool, humidified room. C. Increasing fluid intake to at least 3,000 mL/ day. D. Taking daily baths with a deodorant soap. SITUATION: You are a nurse caring for patients with cardiac complications. You use your knowledge on cardiovascular concepts to help these patients. 41. You are working on the unit with patient Brogy. At 7:30 AM, you received a verbal order from his primary HCP for a cardiac catheterization to be completed on him by 2:00 PM. Which of the following actions should you initiate first in Brogy? A. Initiate NPO (nothing per mouth) status for the client. B. Teach the client about the procedure. C. Start an intravenous (IV) infusion of 0.9% NaCl. D. Ask the client to sign a consent form. 42. You are working with Dorry, a male patient who experienced a myocardial infarction a few days ago. You noted that patient Dorry seems unusually fatigued. Upon your assessment, you find that patient Dorry is dyspneic with 3 | Page