Tiêu đề DIAGNOSTIC EXAM - NP5 (KEY) ✅

TOP RANK REVIEW ACADEMY, INC. Page 1 | REFRESHER PHASE DIAGNOSTIC EXAMINATION NURSING PRACTICE V FEB 2026 Philippine Nurse Licensure Examination Review Situation 1 - The nurse is often challenged with issues and problems in creating a therapeutic environment for clients. 1. Environment as referred to in milieu therapy refers to: A. Both people and physical environment. B. The buildings and grounds. C. The people who relate with one another. D. The immediate physical surroundings. 2. It is a priority for the nurse to: A. Keep an effective social order. B. Safeguard physical safety and security. C. Keep a restrictive environment. D. Maintain a closed door policy. 3. Hercules constantly manipulates and asks for excuse from not participating in ward activities. A therapeutic approach of the nurse is to: A. Have someone monitor him closely. B. Respond, “Do as you please. Just don’t bother anyone!” C. Respond, “We have agreed on a schedule. I expect you to follow.” D. Ignore the behavior. 4. The nurse is aware that these patients are likely to be exploited in a group setting. These are the patients who are: A. Hostile. B. Sociable. C. Suspicious. D. Withdrawn. 5. A therapeutic community aims to: A. Keep policies and rules to be followed. B. Encourage group problem solving and decision making. C. Have a physical accountability of all patients. D. Encourage patients to police themselves. Situation 2 – Communication is the means for demonstrating compassion and care. It is essential to the nurse-client interaction as it serves as a vehicle in establishing a therapeutic relationship. The following situations require the deliberate planning for effective therapeutic relationship. 6. Zeus is waiting for the result of the magnetic resonance imaging that will describe the extent of the disease in the brain. He says to the nurse, “I think it’s taking a long time to get the results. Something must be wrong.” Which of the following should be the appropriate response of the nurse? A. “Perhaps you would like to talk about it.” B. “Oh, don’t worry, everything’s going to be just fine!” C. “What do you think would be helpful?” D. “Sounds like you are worried about how the procedure turns out.” 7. Artemis, 15 years old, is being treated in the emergency room for treatment of minor injuries from a motor vehicle accident. She is anxious and hysterical. She tells the nurse, “I can’t go home. My father will surely kill me. It’s my fault.” In this situation, the nurse’s appropriate action is to: A. Tell her to calm down and say, “Your mother is coming to take you home.” B. Hold her hands and say, “Slow down. Take a deep breath.” C. “Stop worrying. Your father loves you and understands that it was an accident.” D. Reassure her and say, “It’s not your fault.” 8. Virgil, a young successful businessman, sustained spinal cord injury leaving him paralyzed from the waist down. While the nurse is giving morning care, she notices him to be staring blankly. He states, “I think I am better off dead.” The BEST response of the nurse is: A. “Have you thought about committing suicide?” B. “I don’t think you are serious about these feelings.” C. “When did these feelings start?” D. “There is still hope for you to recover.” 9. Aphrodite, a budding young artist, was confined to the hospital and was diagnosed with multiple sclerosis. The nurse enters the client’s room and found her crying. Which of the following is the MOST appropriate response of the nurse? A. “Do you want me to call your mother?” B. “Tell me what is bothering you?” C. “It’s ok. You will be fine.” D. “Here is a tissue paper. I’ll stay with you for a while.” 10. The nurse is teaching the mother of a 10 month old infant in hip spica. She judges that the mother understands how to feed the infant when she states which of the following? A. “I’ll position my baby flat on bed and will feed her the formula.” B. “I’ll elevate the head of the bed to prevent regurgitation of the milk.” C. “I’ll look for a modified high chair or a special feeding table to use.” D. “I’ll ask somebody to assist me in feeding my baby.” Situation 3 – Galatea, a 27 year old woman, was admitted to an adult inpatient psychiatric unit with symptoms of excessive hand washing and showering. She believed numerous stimuli like door knobs, toilets, and “unclean” individuals were contaminated with chemicals and toxins that could contribute to her development of brain tumor. These resulted in inability to work, crying daily, not eating well and staying in bed a lot. 11. Galatea’s condition indicate a symptomatology of: A. Agoraphobia disorder. B. Personality disorder. C. Obsessive-Compulsive disorder. D. Panic Anxiety disorder. 12. Galatea’s hospitalization lasted for 2 weeks during which she was started on Fluoxetine which is a/an: A. Antidyskinetic. B. Mood stabilizer. C. Neuroleptic. D. Anti-depressant. 13. The nurse interprets Galatea’s hand washing rituals as attempts to reduce her: A. Mania. B. Immobility. C. Isolation. D. Anxiety. 14. The nursing staff in the unit supported interventions for cognitive therapy which include the following EXCEPT: A. Restructuring inaccurate thoughts. B. Refraining from engaging in rituals. C. Recognizing deep seated unconscious conflicts. D. Thought stoppage. 15. Cognitive therapy is a treatment based on principles of: A. Learning theory. B. Phenomenological theory. C. Psychoneuroimmunology. D. Psychodynamic theory. * NLE * NCLEX * HAAD * PROMETRICS * DHA * MIDWIFERY * LET * RAD TECH * CRIMINOLOGY * DENTISTRY * PHARMACY * MED TECH

TOP RANK REVIEW ACADEMY, INC. Page 3 | nurse, “Why are you still here and wait for me to talk? Go and talk to someone else!” What is the most appropriate response of the nurse to the client’s remarks? A. “I am interested in you and I wish to help you.” B. “If that is what you wish, I will come back later when you already feel better.” C. “I am the nurse assigned to you and it is my duty to help you. I hope you’ll let me.” D. “Okay. I will now go.” 29. Annually, there is an estimated of 500,000 cases of suicide attempts among teenagers globally. Upon assessment and interview with the client, Nurse Manzano observed the presence of fresh cuts on both wrists. What is the most appropriate action of the nurse? A. Ignore the observation and continue with the assessment. B. Explore the reason behind having the cuts and document the findings. C. Appropriately document the observation. D. Ask the client to stop hurting himself and never cut his wrists again. 30. During nurses' rounds, Nurse Manzano observed James lying on his bed, facing the wall, rocking himself on fetal position while humming a song. The nurse notes this behavior as: A. Flat affect and apathy B. Severe regression C. A side effect of antidepressant D. Autism Situation: Nurse Gelo is assigned in the Psychiatry unit. In dealing with several clients, therapeutic communication is a vital skill that a nurse should possess. This includes the interpretation of both verbal and nonverbal cues portrayed by the client and using therapeutic communication as a nursing intervention. 31. Jana, one of Nurse Gelo’s clients, reports having thoughts of being followed by several dwarves to get him for his treasures. Given that this shows the client’s disturbed thought process, which is the most appropriate response by the nurse? A. “It seems that these thoughts are frightening you.” B. “You need to calm down, come with me, you better join the group activity now.” C. “I do not see any dwarves in here right now” D. “Are you okay? Tell me more about it.” 32. During a one-on-one session, Clara, a newly admitted person, told Nurse Gelo: “My calling is to eliminate all the provocative sluts in this world. I will be able to protect my husband with that”. Knowing that the unit has several attractive women in it, what should the nurse do initially after he has heard this statement from the patient? A. Organize a group meeting and tell all the female clients to dress simple and less provocatively. B. Ask the other female clients to avoid Clara for their safety. C. Ask Clara to inform the staff if she has negative thoughts and feelings toward other clients in the unit. D. Tell Clara that if she hurts anyone in the group, she will be restrained and kept in a separate room alone. 33. A client is observed to be talking alone, looking frightened, and backing away from the window. He then signaled Nurse Gelo to run away from the window. Which of the following reasons explain why doing as the client requests is contraindicated? A. The action will make the client feel complete control over the nurse. B. This will give the client an idea that the action is a nonverbal agreement to his false ideas. C. The nurse will spoil the client by responding that way to his request. D. The client might think that the nurse is making fun of him. 34. A female client is being admitted to the Psychiatry Emergency Department at 2 o’clock in the morning. During the assessment, the client is very depressed and showed a history of sleeping pills, non accidental overdose, weight loss of 12 pounds in the past two weeks, sleeping 2 hours a night and poor hygiene. She then verbalized, “I will never be good enough for everyone, they are all better off without me.” Which of the following should be the initial reply of the nurse client’s statement? A. “Oh no. I see that you are a very great person and I think everyone loves you!” B. “What makes you think that way?” C. “Are you thinking about hurting yourself?” D. “What do you mean when you say you are not good enough?” 35. An old client who is diagnosed with paranoid schizophrenia is found pacing back and forth in the hall. He then stopped and looked outside the window and returned back to pacing even faster with a worrisome face. What is the most appropriate statement for the nurse to make? A. “I can see that you’ve been pacing and looking afraid. Can you tell me how you feel?” B. “Are you okay? I can tell something is wrong. Tell me something about it.” C. “Please stop pacing back and forth, you might be bothering other clients.” D. “Would you like to join the ball game in the court right now? Looks like you have a lot of energy today.” Situation: In the year 2013, Typhoon Haiyan, one of the strongest typhoons in the Philippine history, hit the country. An approximate of 6,000 casualties was recorded and has caused unimaginable damages never been seen before on almost one-third of the country. 36. In dealing with clients experiencing post-traumatic stress disorder, which of the following approaches is inappropriate? A. Statements of reassurance and simple reorientation to the client to prevent ideas of self-mutilation and suicide B. Establishment of a trusting relationship which conveys a sense of respect and consistent empathic approach to help the client tolerate the pain felt C. Promote the client’s highest level of functioning and maintenance of emotional and psychological dependence D. Acceptance of the client’s reaction to the event and his ongoing distress 37. The following are diagnostic criteria for PTSD. Which one is incorrect? A. Aloof and feeling numb B. Daydreaming and imagery C. Onset 6 months after the traumatic event D. Presence of intrusive reenactment of the events in memories 38. During the rescue of victims in such disastrous events, some clients remain silent and refuse to talk. In this case, it will be non-therapeutic and ineffective if the nurse would: A. Acknowledge that the reaction is normal and they are not to blame as you understand them B. Tell the client that they need to speak up immediately about how they feel so that they can already feel better C. Maintain regular contact with the victims, greet them and offer help once in a while D. Even if they did not talk, tell the victims that you are not angry or upset 39. Red Cross is one of the rescuing organization who responded during the Typhoon Haiyan. After the rescuing process, the organization undergone a formal and routine evaluation of what went well and what should be refined in the future processes in their emergency response. This process provides overall meaning and a degree of closure to the involved parties. This is called the: A. Critical Incidence Stress Debriefing B. Operational debriefing C. Stress debriefing D. Large-scale demobilization and informational briefings
TOP RANK REVIEW ACADEMY, INC. Page 4 | 40. Critical Incident Stress Debriefing (CISD) is a formalized, structured method whereby a group of rescue and response workers reviews the stressful experience of a disaster. It is used to assist first responders such as policemen, firefighters and rescuers and not the victims themselves. It was designed to be delivered in a group format and meant to be incorporated into a larger, multi- component crisis intervention system labeled Critical Incident Stress Management (CISM). The following are components of CISM except: A. Pre-crisis intervention B. disaster or large-scale demobilization and informational briefings (town meetings) C. Crisis Incident Stress Debriefing D. Stress debriefing Situation: As a new nurse in the Psychiatric Unit, Nurse Jane is expected to familiarize herself to different psychiatric drugs as part of functional nursing. This includes their indications, common side effects and nursing interventions. 41. A 65-year old male diagnosed with anxiety disorder is prescribed Lorazepam. With the laboratory findings, it was shown that the client has a 3:1 AST/ALT ratio and granulocyte count of > 2,500. Which of the following actions needs an immediate intervention by the nurse? A. Keeping Flumazenil at the bedside B. Abruptly stopping the anxiolytic C. Going to malls and other crowded places D. Letting the wife drive for the client 42. A 70-year old female client diagnosed with Alzheimer’s disease suffers from sun downing syndrome. Which of the following drugs should does the nurse anticipate to be given in such condition? A. Oxazepam B. Bromocriptine C. Fluoxamine D. Amitryptylline 43. A client with depression being given Luvox (Fluoxamine) has recently suffered from a serotonin crisis and a need to change the current antidepressant was deemed necessary by the attending physician. Which of the following drugs will be anticipated to be given to the client? A. Paxil B. Zoloft C. Elavil D. Marplan 44. Which of the following actions, if done by the nurse, requires immediate correction in administering Chlorpromazine (Thorazine) 300mg QID to a client diagnosed with Schizophrenia? A. Continuous monitoring of complete blood count (CBC) B. Keeping a standing prescription of Cogentin 1mg C. Administering the drug post prandial D. Giving the drug on empty stomach 45. A client with pseudoparkinsonism secondary to the long term use of typical antipsychotics is receiving a dopaminergic drug. Upon assessment, Nurse Jane observed that the client has constant hyperthermia not corrected by antipyretics and increased vital signs. Which of the following actions if done by Nurse Jane should be questioned by the nurse supervisor? A. Providing tepid sponge bath to the client B. Increasing client’s oral fluid intake C. Administration of Dantrolene D. Immersing the client to a cold tub Situation: Parkinson’s disease is a progressive neurologic movement disorder with an unknown etiology. Different studies have shown several causative factors such as genetics, atherosclerosis, excessive free radicals accumulation in the body, viral infections, head trauma, long-term use of antipsychotic medications and some external factors. This disease eventually leads to disability. 46. All but one characterizes Parkinson’s disease as a progressive neurologic disorder. Parkinson’s disease, a progressive neurologic disorder is characterized by: A. Bradykinesia B. Tremors C. None of the above D. Muscle rigidity 47. This known treatment for Parkinson’s disease is an antiviral agent which releases dopamine from the neuronal storage sites. A. Artane B. Symmetrel C. Benadryl D. Sinemet 48. The nurse evaluates the effect of the administered Cogentin 1mg p.o. as effective if she observes which of the following. Which finding suggests its desired side effect? A. Decreased muscle tremors B. Decreased muscle rigidity C. Decreased confusion and anxiety D. Increased endurance and energy 49. The client reports that his resting tremors causes frustration in his activities of daily living. Which of the following advice would the nurse give the client? A. Grasp an object B. Immerse self into a warm tub C. Take diazepam as deemed necessary D. Provide cold compress to the hands 50. A patient with Parkinson’s disease has a nursing diagnosis of Impaired Physical Mobility related to neuromuscular impairment. You observe a nursing assistant performing all of these actions. For which action must you intervene? A. The NA performs the client’s complete bed bath and oral care B. The NA assists the patient in ambulating back and forth the hallway as his daily physical activity C. The NA reminds the patient to avoid looking at his feet when he is walking. D. The NA sets up the patient’s food tray at the bedside and encourages patient to feed himself Situation: Nurse Danj is assigned to the emergency department. Triage and first aid are expected competencies in this area to maximize the utilization of resources. The following questions apply. 51. Nurse Danj is assessing a client who has sustained a cat bite to the hand. The cat’s immunizations are up to date. The date of the client’s last tetanus shot is unknown. Which is the priority nursing diagnosis for the client? A. Risk for infection related to organisms specific to cat bites B. Impaired skin integrity related to puncture wounds C. Ineffective health maintenance related to immunization status D. Risk for impaired physical mobility related to potential tendon damage 52. The following clients come to the ED reporting acute abdominal pain. Prioritize them for care in order of the severity of their conditions. i. 35 year old man reporting severe intermittent cramps with three episodes of watery diarrhea 2 hours after eating ii. 11 year old boy with low grade fever, right lower quadrant tenderness, nausea, and anorexia for the past 2 days iii. 40 year old woman with moderate right upper quadrant pain who has vomited small amounts of yellow bile and whose symptoms have worsened over the past week iv. 65 year old man with pulsating abdominal mass and sudden onset of tearing pain in the abdomen and flank within the past hour v. 23 year old woman reporting dizziness and severe left lower quadrant pain who states she is possibly pregnant vi. 50 year old woman who reports gnawing midepigastric pain that is worse between meals and during the night A. iv,v,iii,ii,i,vi B. iv,v,ii,i,iii,vi