Tiêu đề RECALLS 2 - NP3 - SC ✅

RECALLS 2 EXAMINATION NURSING PRACTICE III CARE OF THE CLIENT WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART A) 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 III” on the box provided Situation 1 – Mr. GI Joe is 55 year old, married, a car dealer has consulted the ER because of on and fever, indigestion, weight loss, right abdominal pain, body malaise, and itchiness of the skin. Based on the health history the patient has been a chain smoker and drinks alcoholic beverages almost every day especially when he has clients to entertain. His physical examination showed he has suspected liver cirrhosis. He was advised for admission for further work-up and treatment. 1. You are the nurse on duty when Mr. GI Joe was admitted in the pay floor. In your observational data what additional EARLY SIGN of liver cirrhosis do you expect patient to manifest? A. Gonadal atrophy B. Hypotension C. Splenomegaly D. Ankle edema 2. Which of the following statements is TRUE of liver cirrhosis? 1. Nutritional deficiency with decreased protein intake attributes to liver damage. 2. Cirrhosis can happen to people with alcohol intake 3. Women are at greater risk for the development of alcohol-induced liver disease 4. Most patients affected by liver cirrhosis are between 40 to 60 years of age. A. 1, 2, 3, and 4 B. 1 & 2 C. 1, 2 & 3 D. 2 & 3 3. During Mr. GI Joe’s confinement he developed further itchiness of the skin and jaundice. Which of the following nursing actions is NOT recommended as this will induce skin breakdown? A. Add baking soda when bathing the patient. B. Massage the skin with emollients every 2 hours. C. Use of commercial soaps and alcohol-based lotions. D. Rub the itchy skin with knuckles instead of using the nails. 4. At early stage of Mr. GI Joe’s disease process, the physician ordered this SPECIFIC diet for Mr. GI Joe, You emphasized to the dietitian that he should be served foods that is _________. A. High carbohydrate and low sodium B. High calorie and high carbohydrate C. Low protein and high fat D. High protein and high fat 5. Mr. GI Joe started to develop ascites and complained of heaviness of the lower extremities to the physician. An order of Spironolactone (Aldactone) 25 mg. /day. What adverse effect of the drug should you monitor? A. Hyperkalemia B. Palpitation C. Irregular pulse rate D. Hypokalemia Situation 2 – Juliet, a Pediatric Cardiovascular Nurse is assigned to take care of 3 children in her unit. She just admitted a 12- year- old female patient suffering from Rheumatic Fever (RF) 6. When doing an assessment, which ONE of the following conditions is NOT present based on the Jones Criteria? A. Erythema Marginatum B. Subcutaneous nodules C. Chorea D. Bronchopneumonia 7. In Rheumatic fever, the factor contributory to the development of this disease process is brought about by __________. A. Auto-immune reaction to streptococcal infection B. Auto-immune reaction to collagen disease C. Parents had rheumatic heart disease D. Exposure to colds and droplet infection 8. Marimar, 6 years old, is receiving digitals for having Patent Ductus Arteriosus with heart failure with heart failure. Prior to the administration of the medicines, which of the following nursing actions should be done by nurse Rica? A. Take the carotid pulse rate for one full minute. B. Take the heart rate for one full minute C. Take the respiratory rate D. Take the blood pressure 9. While Nurse Juliet was doing her regular rounds, one of the mothers approached her saying that her child who has a Tetralogy of Fallot preferred to squat on bed rather than assuming a supine position. The BEST action of the Nurse is ___________. A. Let the mother continue the position of her child if she feels comfortable with it. B. Divert the child’s attention by letting her join the nurses’ rounds C. Put her on bed and start to administer oxygen inhalation D. Discourage the child and let her lie on bed with 2 pillows instead. 10. Another patient in the Unit is Nikki, 8 years old, waiting to be scheduled for surgery because of a Coarctation of the Aorta. With this disorder, Nikki will manifest which one of the following symptoms? A. Murmur and bruit of the lungs B. Central and peripheral edema C. Hypertension and diminished pulses in the extremities. D. Hepatomegaly and shortness of breath Situation 3 – Mr. Gaudencio Suarez is a surgical nurse in a medical center and he had been practicing for almost five years in this unit. The staffs go on shift rotation. For that shift, he had two patients for operation. One is for Lobectomy and another is for Nephrectomy 11. When is the BEST time for the operative consent is be signed by his patients? A. As soon as the surgical procedure is explained to the patient 1 | Page
B. On admission when the relatives are around C. A day before the surgery D. Before any pre-op medications are administered 12. Which of the following nursing goals are achieved when early ambulation is done by post-surgery patients? 1. Improved circulation 2. Improved respiratory functions 3. Prevent venous stasis 4. Prevent emboli formation A. 3 and 4 B. 1, 2, 3,4 C. 1, 3, 4 D. 1 and 2 13. Which of the following patients is MOST at risk during the induction of anesthesia? A. 6-year-old with history of allergy B. 65 year old diabetic woman C. 35 year old TB case D. 25 year old Polio Case 14. As a circulating nurse, which of the following is your PRIORITY nursing action to promote safety of your patient? A. Prevent peri-operative position injury B. Provide adequate lighting during the procedure C. Optimize surgeon’s access to surgical site D. Maintain surgical aseptic technique during the procedure 15. Being the nurse in the Post-Anesthesia Care Unit, which of the following is your PRIORITY concern after surgery? A. Monitor vital signs B. Observe surgical site for bleeding C. Validate doctor’s orders D. Check level of consciousness 16. There are several factors contributory to the development of these conditions. Which of the following are the PRIORITY causative factors that should be emphasized by Nurse Lydia in her health teaching? A. Cigarette smoking B. Aging process and alcohol intake C. Stress and overacidity D. Sedentary life and obesity 17. Mr. Jesse is admitted due to congestive heart failure. Nurse Brilliantina would expect that if the failure is on the right side of the heart, the patient will manifest which of the following. A. Juguar vein distention B. Crackles on auscultation C. Dry productive cough D. Improved bowel elimination 18. The patient has been receiving, Digoxin 0.25 mg per day to regulate his heart rate. Which of the following outcomes would indicate that his medication is achieving its desired effects? A. Improved appetite B. Increased pedal edema C. Increased urine elimination D. Improved bowel elimination 19. The other patient of Nurse Brilliantina is suffering from Buerger’s disease. He has been complaining of intermittent claudication of the lower extremities which has been giving him so much discomfort. What is the Best nursing action she should perform to address the patient’s complaint? A. Allow the patient to lie flat on bed B. Teach him foot care and leg exercises. C. Place affected extremities in a dependent position D. Apply hot water bag to the affected extremities 20. Which of the following information is NOT True of Buerger’s disease? A. Small and medium arteries and veins are mostly affected. B. Smoking is a major cause of Buerger’s disease. C. Incidence of Buerger’s disease is high in men than women. D. A strong relationship exists between diabetes and Buerger’s disease. Situation 5 – Gloria, 58 years old, beautician has undergone bowel obstruction surgery. During his first day post-op. she vomited clear liquids about three times during your shift. Her vital signs include: temp-37.9 degree C. 138/84 PR-78/min and RR- 26/min. her surgical incision is intact, slight bleeding, swilling and tenderness with slight pain. 21. Which of the following manifestations would indicate the development of wound infection? A. Presence of elevated red blood cells count. B. Profuse and increasing perspiration. C. Increased blood pressure, respiratory rate and pulse rate. D. Increasing pain on the surgical incision. 22. If the wound draining is serosanguineous, it means that the secretion is colored ______. A. Yellow-tinged B. Pinkish-red C. Green-tinged D. Bright-red 23. Later during the day, Gloria became confused, started to pull out her IV fluids as well as her wound dressings. Complained of severe pain over the wound area. The PRIORITY action of the NURSE is to ________. A. Apply sterile dressings over the surgical wound B. Call the surgeon at once for the health status of the patient C. Administer the pain medication at once D. Restrain the hands of the patient 24. The drug of choice of pain relief to patient Gloria considering score of 8 which was assessed by the nurse based on the rating scale of 0-10 (0-lowest, 10 is the highest) is ________. A. Morphines S04 B. Ibuprofen C. Demerol D. Paracetamol 25. When patient is receiving opioid medication, the nurse should observe complications from the side effects by ______. A. Checking for the presence of loose bowel movement B. Observing signs and symptoms of addiction C. Assessing changes of circulatory status D. Assessing wakefulness of the patient at least every 2 hours 26. Situation 6 – Mr Rodney, a post- operative, was given Amoxycillin at 12 midnight by the nurse on duty (NOD). The physician asked the patient during his rounds if he has receive the drug, the patient answered “NO”. The physician clarified the claim from the chart and from the chart and from the NOD. When the physician clarifies the process of Drug Administration, this Quality Improvement Process is known as A. System analysis B. Root cause Analysis C. Problem identification D. Pareto Chart 27. Which of the following is the primary reason why the physician wanted to clarify the process? A. Measures the turnaround time of medication B. Better communication with patient and result C. Identify gap in the medication administration D. Improve care management in drug administration 28. While the medical director is conducting his rounds he observed the presence of scattered supplies and equipment along the corridor as well as 02 tank not properly secured. The Quality Circle (QC) team was informed about this observation. Which of the following is the BEST strategies to be adopted by the team with this concern? A. Adopt the 5 S audit. B. Identify and prioritize the problem C. Select Alternative Solution. D. Enhance Continuous quality improvement. 29. The approach adopted by quality circle team was presented to top management. Which of the following tools is APPROPRIATE to be utilized as a guide for their time management? A. Pre chart B. Radar chart C. Process of flow chart D. Gantt chart 30. In order to determine if the implementation of the activity is successful, the First step to be done by the team is ______________. 2 | Page
A. Prioritize the problem B. Coordinate with the different units C. Have a random report to the supervisor D. Develop a monitoring plan Situation 7 – Nurse Tin is assigned in the Surgical Ward of a Tertiary Medical Center with several patients who are for diagnostic tests and for surgery. 31. Mr. Anthony, 38 years old, is scheduled for Laparoscopic Cholecystectomy in the morning the next day. He verbalizes to you and says, “Dr. Unido will open me up to remove my gallstones?” which of the following is your BEST response? A. “Let us discuss with the surgeon your operation before you go to the OR.” B. “I know the surgeon will remove your stones with a new technique.” C. “Let me call the OR supervisor to discuss the procedure with you.” D. “I will call the anaesthesiologist to explain more the procedure.” 32. A critical component before Mr. Anthony goes for surgery is the nurse’ preoperative teaching. Which of the following is NOT advisable prior to surgery? A. Teach him deep breathing exercises B. Fast at midnight, but can drink water if he becomes thirsty. C. Instruct him to void before going to the operating room. D. Teach him leg and coughing exercises 33. While giving health instructions to Anthony. He looks very anxious and said to you, “I might not be able to wake from anesthesia after my operation.” Your BEST response is _________. A. “Do not worry, everything will be alright.” B. “Let me tell to your family your fear.” C. “I will not let you go to the OR until I have talked to your surgeon.” D. “Don’t Say that, I will discuss your concerns with your anaesthesiologist.” 34. Mr. Anthony returned back to the ward, after recovering from anaesthesia. He complain of pain over the scapular region. Which of the following nursing actions should you do? A. Apply heating pad over the painful area. B. Turn client from side to side. C. Give demerol as ordered. D. Apply cold pack over the affected area. 35. After 5 days, Mr. Anthony is ready to go home. His discharge instructions include observations of the following complications, EXCEPT: A. Palpitation B. Loss of appetite C. Increased body temperature D. Bleeding 36. Situation 8 – Meg is assigned as charge nurse at the Cardiovascular Ward in a Medical Center. There are 20 patients, classified as follows: 2 Total Care (TC), Partial Care (PC) and 9 Ambulatory Care (AC). The ward’s morning duty are 3 staff nurses and 2 nursing attendants (NA). How will your distribute the patients to the 3 Registered Nurses and 2 Nursing Assistants? A. 2 Registered Nurse for Total Care patients, 1 Registered Nurse and 1 Nursing Assistant for Primary Care Patients, 1 Nursing Assistant for Total Care. B. 1 Registered Nurse and 1 Nursing Assistant for Total Care Patients, 1 Registered Nurse and 1 Nursing Assistant for Primary Care Patient, 1 Registered Nurse for Ambulatory Care patients. C. 2 Registered Nurse for Total Care patients, 2 Nursing Assistant for Primary Care Patients, 1 Registered Nurse for Ambulatory Care Patients. D. 1 Registered Nurse for Total Care patients, Registered Nurse and 1 Nursing Assistant for Primary Care patients, 1 Registered Nurse and 1 Nursing Assistant for Ambulatory Care patients 37. In as much as this is a cardio-ward what basic equipment/materials should be available at all times? 1. o2 2. Ambu Bag 3. Suction Apparatus 4. Endotracheal A. 1, 2, 4 B. 1, 2, 3, 4 C. 1, 2, 3 D. 2, 3, 4 38. Which of the following emergency medicines should be available at the emergency cart at the Cardio Ward? 1. Epinephrine 3. Valium 2. Demerol 4. Coumadin A. 1, 3 B. 1, 2 C. 2, 4 D. 3, 4 39. When stocking fluids in the emergency cart. What should Nurse Meg instruct the nurses? 1. Put the recently- delivered at the back of the old stock 2. Put the old stock in front of the newly-delivered ones 3. Check the fluids for sediments and discoloration 4. Keep the fluids inside the cooler A. 1, 2 B. 1, 4 C. 3, 4 D. 2, 3 40. How will Nurse Meg arrange the patients in the ward? Put the ______________. A. Primary Care in between the Ambulatory Care patients. B. Primary Care and Ambulatory Care patients together and Total Care at the corner of the room. C. Total Care patients near the nurses and the Ambulatory farthest D. Ambulatory Care patients near the Total Care ones. Situation 9 – Mr. Nelson, 62 year old, an Executive of a shoe company was brought to the hospital after having vomited bright red blood immediately after supper. He claimed he had drinking session with his former classmates in college. He was already advised by their family physician not to drink alcohol due to a suspected fatty liver. You are the nurse-on-duty when he was admitted. 41. Based on your assessment and history taking for Mr. Nelson which PRIORITY FINDINGS should you document and report to the physician? A. Use of anti-inflammatory drugs. B. Vital signs BP- 140/90, PR- 88/min.PR24/min. C. abdominal pain (3 in a scale of 10) D. Tense, rigid abdomen 42. You have formulated your Nursing Diagnosis for the patient and wrote in the nursing care plan. Which ONE of the following? A. Deficient Fluid Volume R/T vomiting of blood and gastric secretion. B. Non-compliance R/T alcohol and medication intake. C. Fear of death R/T unknown cause of bleeding. D. Risk for Aspiration R/T active bleeding. 43. The physician orders insertion of nasogastric tube with lavage to Mr. Nelson. What kind of solution will you expect to be written in the doctor’s order when a patient will undergo a lavage? A. Normal Saline Solution B. Distilled Water C. Tap warm water D. Dextrose 5% in water 44. When a patient has a gastro-intestinal bleeding and there is a presence of hematemesis, how should you describe this in your documentation? A. Bloody vomitus appearing as fresh, bright red or “Coffee-ground” in appearance. B. Brownish vomitus appearing as “Chocolate” in appearance from a previous Food Intake. C. Black, tarry stools in appearance often foul smelling, from a previous food intake. D. Small amounts of fresh blood observed either through gastric secretions or stools. 45. The following are the practice guidelines in documentation. Which ONE of these is NOT recommended to be written in your charting? A. Had urine output of 600 cc during the whole shift. 3 | Page
B. “Appears to be comfortable with good night rest and sleep” C. Refused to eat her dinner as she feels nauseated at meal time D. Slept from 11 PM to 6 AM after Valium 5mg. was given. Situation 10 – The following situations are related to ethical practices in the workplace. 46. Jillian a registered nurse has signed a contract for two years in a medical center. A recruitment agency has offered her a “fat” salary for foreign employment. If you are in the position of Jillian, what should you do? A. Discuss your plans with your parents B. Accept the recruitment offer and go Absence without official leave. C. Write a letter of resignation to your employer 30 days before leaving. D. Accept recruiter’s offer and give an excuse to employer on behalf her “sick” mother. 47. Karylle is a BSN graduate but did not take the National Licensure exams. She is in dire need of money so she applied and was accepted in a health facility. As a nurse she submitted a fake PRC license in order to be given a job. Riza is liable to be charged of ___________. A. False statement B. Misrepresentation C. fraud and deceit D. malpractice 48. Ms. Kendall an R.N was invited as a resource person in a nursing conference. The curriculum vitae she submitted to the PRC Continuing Professional Development Council reflects the word Masters of Arts in Nursing (MAN) after her name. She only completed academic requirements but not her thesis writing. Which of the following did Ms. Paras violate? A. RA 9173 of Nursing Law B. Code of Professional Ethics for Teachers C. Magna Carta for Health Workers D. Code of Ethics for Registered Nurse 49. It is a hospital policy for nurses in a health facility that reporting time is 15 minutes before the official designated time. Nurse Khloe reported 30 minutes late and requested her co-staff to sign in for her. This is an example of __________. A. Dishonesty B. Falsification of document C. Unprofessional conduct D. All of the options 50. What ethical justification is observed when administering Opioids despite the possibility of hastening death. A. Rule of double effect B. Rule of single effect C. Maleficence D. Justice 51. Which component of chest physiotherapy involves rhythmic clapping with cupped hands on the chest wall over the area being drained? a. Postural drainage b. Percussion c. Nebulization d. Vibration 52. Which among these would indicate that coughing was ineffective? a. Decreased normal breath sounds b. Clearing of adventitious breath sounds c. Sputum expectoration d. Patient’s report of swallowed sputum 53. Postural drainage improves clearance and drainage of secretions by which principle? a. Entropy b. Enthalpy c. Gravity d. Motion 54. A goal for a post-operative patient using an incentive spirometry is: a. Decrease pulmonary ventilation b. Expand collapsed alveoli c. Potentiate effects of general anesthesia d. Thicken respiratory secretions 55. As safety precautions for clients receiving oxygen, which among these should Nurse Tin not do? a. Place a “No Smoking” sign on the client’s door and at the foot or head of the bead. b. Replace woolen blankets with cotton blankets. c. Place and arrange substances like acetone, alcohol, and oils at the bedside. d. Ensure that all electric devices are in good working order. Situation 12 – Mr. Berroya, who has just finished his one (1) year period as a registered nurse in a medical center, is assigned in the medical unit on 3-11 shift. He is having a difficulty interacting with the patient’s family so he consulted his senior Nurse regarding this matter. 56. The BEST approach to be employed by Mr. Berroya upon the advise of his senior nurse is __________. A. send the family members home B. confront with the family regarding their behavior C. ignore family’s behavior D. use active-listening technique 57. The Senior Resident in the medical unit was making his regular rounds with the medical interns and Nurse Berroya was called to receive his orders for Mr. Peeta who has been confined in the unit for almost a week. Nurse Berroya could not understand some of the written order orders of the physician in the chart. Which of the following is the appropriate action of the nurse? A. refer to the nurse supervisor to validate the Physician’s orders. B. approach the physician and clarify his orders C. call his junior resident to rewrite his orders D. complete the orders by rewriting what is in the chart. 58. One of the patients of Mr. Berroya told him that according to his attending physician he would be transferred to the surgical unit because of a suspected stone in the gallbladder causing his on and off pain later in the evening. The wife however, told Mr. Berroya “No, the physician told me, my husband will still be in this unit for 2 more days”. The BEST action of the Nurse should ____________. A. call the physician to clarify management of care for the patient. B. instruct the couple and family members wait for the decision of the health team. C. inform the patient that sometimes the physician need to have more data available. D. inform the couple that the decision of the physician is sometimes not fixed. 59. The members of the health team in the medical unit has been reacting negatively to a patient who has been branded as “Very demanding” He has a diagnosis of Emphysema and had been confined for almost 2 weeks in the ward. Family members come and go to visit him. The best approach of the health team should be _______________. A. request a chaplain to regularly visit the patient. B. hold a team conference on how to approach the issue C. request for a psychological counseling D. talk with the family members and discuss the demanding behavior of the father. 60. Nurse Berroya is taking care of Ms. Gonzaga with a multi-organ disorder. The health care team believes that patient’s survival rate is only 50%. Which of the following nursing actions is MOST APPROPRIATE to be done by Nurse Berroya? A. Avoid discussion of death when family members are present. B. Arrange with the family the available funeral parlors incase of death of the patient. C. Request the husband to prepare a living will. D. Inform the family members that there is a palliative care available. Situation 13 – The coordinator of the In-Service nursing department prepared an enhancement program for a newly board passers on Universal Health Precaution as part of their personal and professional development. 4 | Page