Tiêu đề RECALLS 7 - NP3 - SC ✅

RECALLS 7 EXAMINATION NURSING PRACTICE III CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART A) 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 III” on the box provided Situation - Ethical and moral issues are becoming a common scenario in practice setting so health care providers have to be equipped with this competency. 1. In the clinical setting, when nurses are confronted with ethical dilemmas the BEST practical guide she can use is? A. PRC oath for professionals B. Code of ethics C. Theological Doctrine D. Florence Nightingale Oath 2. Mr. JBM was admitted to the hospital complaining of chest pain due to clogging in his coronary arteries. He is diabetic hypertensive and considered by the physician to be a high risk for cardiovascular surgery. What PRIORITY action should the members of the health team do in this situation? A. Consult the family members and let them give their decision. B. Proceed with the planned surgery, as this will save the patient. C. Consult the ethics committee on what to do with the patient. D. Discuss with Mr. JBM his health status and let him decide. 3. Mrs. Constancia, 77 y/o is suffering from dementia and demonstrates unruly behavior. When Nurse Dan describes the patient in his shift report, as “That awful, dirty old woman in Bed 14.” is an example of what ethical behavior being employed by the nurse? A. Stigma B. Ageism C. Gender Bias D. Depersonalization 4. Mr. Mark, who is on an end-stage of life, has an order of “Do Not Resuscitate” and passes away in your shift. He was declared dead by his physician at 8:30 AM. What should be your PRIORITY nursing action in this situation? A. Prepare the death certificate for the physician to sign. B. Allow the family to have private moments with the deceased. C. Request your nurse attendant to call the funeral parlor at once. D. Clean the body and remove all the IV lines, tubes and other appliances 5. When a nurse is in full support of a patient's care, safety and personal rights throughout her hospital stay, she is implementing what ethical principle? A. Responsibility B. Empathy C. Advocacy D. Accountability Situation: Nurse Janina works in the medical unit of a tertiary hospital, where the majority of patients are diagnosed with endocrine disorders. She is currently caring for the following patients: Juliet, a 54-year-old married woman with hyperthyroidism; Vanessa, 66-year-old with a suspected case of Cushing's syndrome; and Miles, a 48-year-old woman suffering from hypothyroidism. 6. During your physical assessment of patient Vanessa, she displays a UNIQUE clinical manifestation that differs from those of patients Juliet and Miles, characterized by ______ A. cyanosis, increasing growth of hands and feet B. anemia, weight loss and presence of acne C. moon face purple striae on trunk and buffalo hump D. moon face easy fatigability and peripheral edema 7. Which of the following diagnostic tests do you expect the physician NOT to order for patient Vanessa, who is suspected of having Cushing's syndrome? A. 24 hour urine cortisol level B. C reactive Protein level C. ACTH serum concentration D. Computerized tomography of the brain, chest and abdomen 8. Which clinical manifestation should Nurse Janina watch for patient Juliet if she is suffering from hyperthyroidism? A. Cold extremities B. Increased weight C. Decreased bowel movement D. Fine motor tremor 9. Patient Miles, who has hypothyroidism, is prescribed which of the following medications? A. Propranolol B. Iodine C. Iron pills D. Levothyroxine 10. Which of the following should Patient Miles AVOID while undergoing treatment for hypothyroidism? A. Use of warm blankets B. Light activities done at home C. Taking foods low in fiber D. Exposure to cold temperature Situation: A patient who suffered head trauma suddenly experienced an increase in urine output, exceeding 250 mL per hour along with a feeling of intense thirst. 11. The nurse is caring for a patient with DI. Which of the following doctor’s order would the nurse question? A. Weigh the patient daily, using the same type of clothes and same weighing scale at the same time of the day. B. Accurately monitor I&O. C. Restrict fluid intake. D. Make sure to keep the patient hydrated 12. The physician ordered Desmopressin to be given to the patient. What is an important nursing consideration when administering this medication? A. Slowly administer via IV since this is a vesicant. B. Watch out for water intoxication. 1 | Page
C. Watch out for increased urine output. D. Closely monitor the blood pressure for hypotension 13. The nurse asked the student nurse about the clinical manifestations of a patient with diabetes insipidus. The student nurse would be correct if she states the following, except: A. Flat neck veins B. Altered LOC C. Skin tenting D. Crackles on both lungs 14. A fluid deprivation test was ordered by the physician and the patient was deprived of fluid for 10 hours. The patient still excretes large volumes of urine and weight loss. What would warrant the nurse’s attention and prompt for an immediate termination of the test? A. The urine specific gravity gradually increases. B. The urine output decreases. C. The patient’s blood pressure is below the baseline, and continuously decreases. D. 3% of the body weight is lost. 15. DI happens due to a decreased production of ADH. On the other hand, SIADH has an overproduction of ADH leading to hypertension, weight gain, crackles, as well as edema. What nursing interventions are appropriate for a nursing diagnosis of fluid volume excess, except? A. Accurately replace fluid loss. B. Restrict fluid intake. C. Administer furosemide as prescribed. D. Assess lung sounds for crackles. Situation: Evelyn, a retired Barangay Health Worker, came to the OPD for her check-up for her diabetes mellitus. She had been diabetic since she was 37 years old. She has been taking her maintenance medications which she sometimes does not comply with. 16. There are metabolic abnormalities in the development of type 2 Diabetes. Which of the following is NOT included in these abnormalities? A. Inappropriate production of the liver B. Increased ability of the pancreas to produce insulin C. Insulin resistance D. Altered production of hormones by adipose tissues 17. Ms. Evelyn was admitted to the hospital for further check-up. Which of the following diagnostic tests do you expect to be ordered by the diabetologist as an indicator that the patient is compliant to her prescribed diet? A. Oral glucose tolerance test B. Glycosylated hemoglobin level C. Finger glucose findings for one day D. Fasting blood glucose level 18. While Nurse Eric was completing her assessment, she discovered the following findings. Which of the following should she refer immediately to the physician? A. Tingling sensation of the hands and feet B. Changes in the peripheral vision C. Beginning ulceration of the left big toe D. Fruity odor breath 19. Nurse Eric, the nurse in charge of patient Evelyn, informed her physician that her serum glucose level is 38mmol/L and quite unresponsive to verbal questioning. The nurse suspects that she is starting to develop Diabetes Ketoacidosis (DKA). Which of the following manifestations is UNIQUE to this condition? A. Shallow slow respirations B. Increased serum potassium C. Rapid deep respirations D. Decreased serum albumin 20. Nurse Eric’s counseling role includes lifestyle changes as well as pharmacologic regimen. Evelyn’s family were interested to know information regarding insulin. She differentiated an intermediate acting insulin from that of short-acting which is _________. A. Regular onset is 2 hrs. Peak is 3 1⁄2 hr., duration -7 hrs., administered 20-30 min. before meal B. Regular onset is 2-4 hr., peak is 4-12 hr., duration is 8 hr., administered 20-30 min. after meal C. Regular, onset is 1 1⁄2 hr, peak is 3-4 hrs, duration is 6 hrs. administered 20-30 min after meal D. Regular onset is 1⁄2 - 1hr, peak is 2-3 hr., 4-6hr duration administered 20-30 min. before meal Situation: Nurse April is managing patients with cardiac dysrhythmias and conduction problems. 21. Nurse April interprets the rhythm strip of a patient who underwent electrocardiogram. Which of the following waves represent ventricular depolarization? A. P wave B. QRS complex C. T wave D. ST segment 22. Nurse April reads the ECG rhythm of a patient as having torsades de pointes. Which of the following medications must she expect to be ordered immediately? A. Magnesium B. Atropine C. Sodium bicarbonate D. Vasopressin 23. Which of the following ECG rhythms warrant immediate defibrillation? A. Ventricular tachycardia B. Ventricular fibrillation C. Asystole D. Atrial fibrillation Situation: Client suffering from cardiovascular disorders. 24. Which of the following nursing interventions is most appropriate in the care of a patient who has venous insufficiency? A. Elevating the legs B. Increasing the fluid intake C. Limiting the activity level D. Massaging the extremities 25. A client's medical record states a history of intermittent claudication. In collecting data about this symptom, the nurse would ask the client about which symptom? A. Chest pain that is dull and feels like heartburn B. Leg pain that is sharp and occurs with exercise C. Chest pain that is sudden and occurs with exertion D. Leg pain that is achy and gets worse as the day progresses Situation: Nurse Karen is assigned to care of clients with respiratory disorders. 26. The client is scheduled for a bronchoscopy. Which of the following is not necessary to be done by the nurse when preparing the client for the procedure? A. Secure written consent. B. Ask for allergy to seafoods or iodine. C. Maintain NPO for 6 to 8 hours. D. Instruct client to remove dentures or bridges. 27. The nurse is teaching the client how to manage a nosebleed. Which of the following instructions would be appropriate to give to the client? A. "Tilt your head backward' and pinch your nose." B. "Lie down at and place an ice compress over the bridge of your nose." C. "Blow your nose gently with your neck flexed." D. "Sit down, lean forward, and pinch the soft portion of your nose." 28. Which of the following is the primary reason to teach pursed-lip breathing to clients with emphysema? A. To promote oxygen intake. B. To strengthen the diaphragm. C. To strengthen intercostal muscles. D. To promote carbon dioxide elimination. 29. Which of the following diets would be most appropriate for a client with COPD? A. Low fat, low cholesterol diet. B. Bland, soft diet. C. Low sodium diet. D. High calorie, high protein diet. 2 | Page
30. When caring for a client with a chest tube and water-seal drainage system, the nurse should implement which of the following interventions? A. Verify that the air vent on the water-seal drainage system is capped when the suction is off. B. Milk the chest drainage tube at least every four hours if excessive bleeding occurs. C. Ensure that chest tube is clamped when moving the client out of bed. D. Make sure that the drainage apparatus is always below the client's chest level. 31. The nurse reviews the most recent blood gas results of a client diagnosed with asthma. The nurse notes a pH of 7.43, Pco2 of 31 mm Hg, and HCO3 of 21 mEq/L. Based on these results, the nurse determines that which acid-base imbalance is present? A. Compensated metabolic acidosis B. Compensated respiratory alkalosis C. Uncompensated respiratory acidosis D. Uncompensated metabolic alkalosis 32. The nurse is performing a respiratory assessment on a client being treated for an asthma attack. The nurse determines that the client's respiratory status is worsening based upon which finding? A. Loud wheezing B. Wheezing on expiration C. Noticeably diminished breath sounds D. Increased displays of emotional apprehension Situation: Nurse Leah is a compassionate and skilled nurse working in a busy medical ward specializing in gastrointestinal (GI) diseases. Today, she is caring for a 28-year-old patient admitted with severe abdominal pain, chronic diarrhea, and weight loss. After diagnostic tests, the patient is diagnosed with Crohn’s disease. 33. Nurse Leah is assessing a patient with suspected Crohn’s disease. Which finding is most characteristic of Crohn’s disease? A. Continuous inflammation limited to the mucosal layer of the colon. B. Bloody diarrhea with tenesmus. C. Cobblestone appearance of the bowel with skip lesions. D. Pseudopolyps observed during colonoscopy. 34. A patient asks Leah how Crohn’s disease differs from ulcerative colitis. Which response by the nurse is most accurate? A. “Crohn’s disease only affects the colon, while ulcerative colitis affects the entire GI tract.” B. “Crohn’s disease causes continuous inflammation, while ulcerative colitis causes skip lesions.” C. “Crohn’s disease can affect any part of the GI tract, while ulcerative colitis is limited to the colon.” D. “Crohn’s disease is caused by stress, while ulcerative colitis is caused by diet.” 35. Leah is caring for a patient with Crohn’s disease who is refusing to take prescribed oral medications due to severe nausea. The patient states, “I can’t keep anything down, and I don’t want to take those pills.” Despite the patient’s refusal, Leah administers the medication by crushing it and mixing it into the patient’s applesauce without their knowledge. Which legal or ethical principle has Leah most likely violated? A. Negligence B. Malpractice C. Battery D. Breach of confidentiality Situation: Clients suffering from Peptic Ulcer Disease (PUD). 36. Nurse Stephen is assessing a client diagnosed with Peptic Ulcer Disease (PUD). Which physical examination should the nurse implement first? A. Palpate the abdominal area for tenderness B. Auscultate the client's bowel sounds in all four quadrants C. Assess the tender area progressing to nontender D. Percuss the abdominal borders to identify organs 37. Nurse Pamela is assessing a client suspected of having a gastric ulcer. Which of the following assessment findings supports the diagnosis of a gastric ulcer? A. Sharp pain in the upper abdomen after eating a heavy meal B. Complaints of epigastric pain 30 to 60 minutes after ingesting food C. Presence of blood in the client's stool for the past month D. Reports of a burning sensation moving like a wave 38. The nurse is caring for a client who admits to a 15-year history of gastric ulcers. The nurse instructs this client to take which of the following drugs for minor aches and pains? A. Acetaminophen (Tylenol) B. Buffered aspirin C. Plain aspirin D. Ibuprofen (Motrin) 39. One of your patients was diagnosed with PUD, however, she was also found to be pregnant. Which of the following will alarm you if prescribed to the patient? A. Cimetidine B. Misoprostol C. Omeprazole D. None of the above 40. The nurse is caring for a client with a diagnosis of peptic ulcer disease. When monitoring the client for possible gastrointestinal perforation, the nurse identifies the importance of what assessment data? A. Slow, strong pulses B. Increase in bowel sounds C. Positive guaiac stool tests D. Sudden, severe abdominal pain Situation: Incident reports serve as official records of unexpected events. They can be used as legal evidence in case of disputes, complaints, or investigations. 41. The nurse administers digoxin 0.25 mg by mouth rather than the prescribed dose of 0.125 mg to the client. After assessing the client and notifying the primary health care provider (PHCP), which action would the nurse implement first? A. Write an incident report. B. Administer digoxin immune fab. C. Tell the client about the medication error. D. Tell the client about the adverse effects of digoxin. 42. The nurse finds a client lying on the floor. The nurse performs an assessment, assists the client back to bed, and completes an incident report. Which would the nurse document on the incident report? A. The client fell onto the floor. B. The client climbed over the side rails. C. The client was found lying on the floor. D. The nurse was the only responder to the event. 43. After finding a client lying on the floor, the nurse ensures the client's safety, completes an incident report, and notifies the primary health care provider of the incident. Which action would the nurse implement next? A. Staple the incident report in the client's medical record. B. Document the client events and follow-up nursing actions. C. Provide a copy of the incident report to the provider and family. D. Document that a copy of the report was sent to risk management. Situation: Effective teamwork and collaboration in nursing is achieved when individuals work together in harmony, processes and goals are aligned towards achieving safe quality patient care. 44. Which of the following actions is INAPPROPRIATE for a nurse leader to apply in a work Setting? A. Ask staff members for their opinion on the matter. B. Modifies his own behavior favoring the needs of individual staff. C. Gives equal consideration to each staff members. D. Plans and organizes group activities of staff members. 3 | Page
45. A hospital administrator has implemented a change in the method of assigning nurses to client care units. A group of registered nurses is resistant to the change, and the nursing administrator anticipates that the nurses will not facilitate the process of change. Which approach is best for the administrator to take initially in dealing with the resistance? A. Cancel the implementation of the change. B. Implement the change first on a trial basis. C. Delay implementing the change for a few weeks. D. Encourage the nurses to verbalize feelings regarding the change. Situation: Various clients will undergo different post op positioning from various procedures. 46. After Pneumonectomy, a client is positioned: A. Right side lying B. Affected side C. Left side lying D. Unaffected side 47. While after Lobectomy, the client is positioned: A. Right side lying B. Affected side C. Left side lying D. Unaffected side 48. After Liver Biopsy, The client is positioned: A. Right side lying B. Supine C. Left side lying D. Semi Fowlers Situation: A nurse is teaching a group of healthcare workers the proper technique for handwashing in a clinical setting. 49. What is the first step of the handwashing process to ensure proper hygiene and minimize the spread of infections? A. Apply soap to hands B. Wet hands with water C. Scrub the hands for 20 seconds D. Rinse hands with clean water 50. According to WHO guidelines, how long is the recommended duration for the entire procedure of handwashing? A. 20 – 30 secs B. 30 – 60 secs C. 40 – 60 secs D. 15 – 20 secs Situation: You are the ICU nurse handling high-risk cardiovascular patients and post-surgical cases. Prompt recognition of life-threatening signs is critical. 51. A nurse assessing a client who reports persistent lower back pain and a sensation of “beating” in the abdomen. Upon palpation, the nurse notes a pulsating mass in the abdomen. Which of the following is the nurse’s priority action? A. Notify the health care provider B. Apply deep pressure to assess the mass C. Measure abdominal girth D. Reassure the client and continue monitoring 52. A client with left-sided heart failure is admitted with dyspnea and orthopnea. What additional sign is the nurse most likely to find? A. Hepatomegaly B. Crackles in lung bases C. Dependent edema D. Jugular vein distention 53. A patient receiving nitroglycerin IV for chest pain develops a BP of 70/30 mmHg. What is the nurse’s priority action? A. Stop the infusion immediately B. Elevate the foot of the bed C. Notify the provider and reduce the dose D. Administer IV fluids rapidly 54. A client with pericardial effusion suddenly becomes dyspneic and restless. The nurse notes BP 80/50 mmHg, muffled heart sounds, and jugular vein distention. Which nursing action takes priority? A. Elevate the head of the bed to 90 degrees B. Administer high-flow oxygen via non-rebreather mask C. Prepare for emergency pericardiocentesis D. Initiate a rapid IV fluid bolus 55. A client recently discharged after mitral valve replacement returns to the clinic with complaints of fatigue. Which finding is most concerning? A. INR of 2.3 B. Irregular pulse C. Fever and chills D. Mild fatigue Situation: You are preparing patients for discharge and monitoring for high-risk cardiac medication effects. 56. Which client is most at risk for developing digoxin toxicity? A. A client with hyperkalemia B. A client taking a loop diuretic C. A client with low BUN D. A client with a high-potassium diet 57. A client is being discharged after heart surgery. Which statement signals need for further teaching? A. “I will avoid heavy lifting.” B. “I can resume sex when I can climb two flights of stairs.” C. “I’ll take my medications only if I feel chest pain.” D. “I’ll walk daily as tolerated.” 58. A client on IV heparin infusion for atrial fibrillation has an aPTT of 110 seconds. What is the nurse’s best action? A. Stop the infusion B. Slow the infusion and reassess in 2 hours C. Continue as ordered and monitor for bleeding D. Document the result and recheck in the morning 59. Which discharge instruction is most appropriate for a patient with an abdominal aortic aneurysm (AAA) repair? A. “Resume weightlifting in 1 week to regain strength.” B. “Call the provider for back or abdominal pain.” C. “Check blood pressure once a month.” D. “Take your blood pressure only when you feel dizzy.” 60. The nurse is monitoring a client who received IV furosemide. Which finding requires immediate follow-up? A. Serum potassium 2.9 mEq/L B. Mild decrease in BP after ambulation C. Urine output 200 mL after 2 hours D. Complaint of mild muscle cramp Situation: You are the nurse caring for clients with respiratory conditions and trauma. Quick recognition of abnormal signs and proper patient education is key. 61. The nurse is teaching a client with asthma about proper inhaler use. Which statement indicates correct technique? A. “I inhale before pressing the inhaler.” B. “I hold my breath after inhaling the medication.” C. “I exhale immediately after using it.” D. “I don’t need to shake the canister.” 62. The nurse is caring for a client with chest trauma after a road traffic accident. Which finding requires immediate action? A. Paradoxical chest movement B. Chest pain when coughing C. Decreased breath sounds on one side D. Rib tenderness on palpation 63. Which client condition warrants placing them in High Fowler’s position? A. Post-lumbar puncture B. Hypovolemic shock C. Acute respiratory distress D. Severe dizziness 64. A nurse is monitoring a client with asthma. Which finding is most concerning? A. Use of accessory muscles B. Audible wheezing C. Sudden absence of wheezing D. Reports of chest tightness Situation: You are caring for clients with respiratory disorders requiring immediate assessment and intervention. 4 | Page