Tiêu đề RECALLS 2 (NP4) SC ✅

RECALLS EXAMINATION 2 NURSING PRACTICE IV CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART B) MAY 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 - A 60 year old male is admitted to the oncology unit. According to the client, he felt a growth during a routine digital prostate examination. He complains of pain on urination and frequent urination. 1. The nurse understands that the function of the prostate gland is primarily to ______; A. Regulate the acidity and alkalinity environment for proper sperm development. B. Produce a secretion that aids the nourishment and passage of sperm. C. Secrete a hormone that stimulates the production and maturation of sperm. D. Store undeveloped sperm before ejaculation. 2. The nurse analyzes the laboratory values and notes that the serum phosphate level is elevated. This finding indicates which of the following: A. It confirms the diagnosis of prostate cancer. B. The progression or regression of prostate cancer. C. The likelihood of metastasis to the bones. D. There are complications associated with cancer. 3. The nurse knows that hormone therapy is the mode of treatment for a client with prostate cancer. The goal of this form of treatment is to ______: A. Limit the amount of circulating androgens. B. Increase prostaglandin level. C. Increase the amount of circulating androgens. D. Increase testosterone level. 4. The nurse writes a nursing diagnosis of Fear and Anxiety secondary to the diagnosis of prostate cancer. Which of the following interventions would be BEST for the nurse? A. Encourage the client to keep his feelings to himself so his family will not be affected. B. Establish a nurse patient therapeutic relationship. C. Advise the client to have a positive outlook relationship. D. Provide spiritual support to the client. Situation – A 65-year old male is admitted for prostate cancer. On assessment, the nurse determines that the patient has experienced incontinence. The nurse knows that incontinence is the first most common symptom of prostate cancer. 5. Based on information gathered, the nurse writes a nursing diagnosis. Which of the following diagnoses is MOST appropriate? A. Deficient knowledge related to self-care and risk prevention. B. Fear secondary to the diagnosis of cancer. C. Risk for urinary infection D. Risk for impaired urinary elimination 6. To help manage incontinence, the nurse instructs the patients to do which of the following: A. Eat foods rich in fiber B. Increase fluid intake. C. Take medications to manage pain. D. Perform perineal muscle exercises 7. The patient asks for treatment option for his condition. The Nurse explains that treatment options are based on which of the following: A. Gender B. ability of the patient to manage physical and emotional implications of incontinence C. Socio-economic status D. grade and stage of the disease 8. The patient asks the nurse what the physician meant about his prostate cancer as Stage C or T3. The nurse explains that the tumor is ______________: A. palpable and has spread to other organs and often to distant sites such as bones and lymph nodes. B. palpable and has spread beyond the prostate but not to other organs. C. confined to the prostate and was not palpable during digital rectal examination. D. confined to the prostate and was not palpable during digital rectal examination. 9. The nurse recalls the staging and classification of prostate cancer. Which of the following statements is TRUE? A. the gleason grading system is usually used for hematological cancers but not prostate cancer. B. The normal prostate specific antigen (PSA) range under 40 years of age is less than 4 to 6 ng/mL. C. at least two separate biopsy specimens are graded based on their differentiation from normal prostate cells. D. A score of D is less invasive than a score of B in the cancer staging system. Situation - A mother with the diagnosis of AIDS states that she has been caring for her baby even though she has not been feeling well. 10. What important information should the nurse determine? A. is she has kissed the baby B. if the baby is breastfeeding C. when the baby last received antibiotics D. how long she has been caring for the baby 11. The nurse is planning to provide discharge teaching to the family of a client with AIDS. Which statement should the nurse include in the teaching plan? A. “Wash the dishes in hot soap as you usually do.” B. “Let the dishes soak in hot water overnight before washing.” C. “You should boil the client’s dishes for 30 minutes after use.” D. “have the client eat from paper plates so they can be discharged.” 12. During an AIDS education class a client states, “Vaseline works great when I use condoms.” Which conclusions about the client’s knowledge of condom use can the nurse draw this statement? A. an understanding of safer sex 1 | Page
B. an ability to assume self-responsibility C. ignorance concerning correct condom use D. ignorance concerning the transmission of HIV 13. The client with AIDS is experiencing nausea and vomiting. The Nurse would make which of the following dietary alterations for this client to enhance nutritional intake? A. Avoid dairy products and red meat B. Plan large nutritious meals C. Add spices to food to enhance flavour D. Serve foods while they are warm 14. The Physician orders a Paracentesis. How should the nurse instruct the client to prepare for the radiograph? A. void before the procedure B. a laxative the evening before the procedure C. nothing by mouth for 8 hours before the procedure D. a low soapsuds enema the morning of the procedure Situation – A 34 year old female client complains of experiencing double vision and frequent headaches. The client claims to be forgetful and has mood swings. A diagnosis of right frontal lobe lesion was made and the client was admitted for craniotomy. 15. The client claims to have a diagnostics work up in the outpatient unit before she was admitted. The admitting nurse prepares the client for which of the procedure that will MOST likely confirm the presence of brain tumor? A. Myelogram B. CT Scan C. Lumbar puncture D. Skull x-ray 16. While the client is being interviewed, she had a seizure. The initial intervention of the nurse must be directed towards: A. Protecting the client B. Controlling the Seizure C. Reducing circulation to the brain D. Restraining the client 17. After surgery, it is important for the nurse to position the head of the client properly to: A. Facilitate venous drainage B. Prevent hemorrhage on the suture line. C. Provide for client comfort D. Maintain patent airway 18. The Nurse is aware that one of the measures listed below is contraindicated in post-operative pulmonary toilet. A. Suctioning B. Deep Breathing C. Turning D. Coughing 19. The surgeon orders glucocorticoid Dexamethasone (Decadron) to be given following craniotomy. The nurse recognizes that this drug: A. Creates a feeling of euphoria, which is beneficial in the early post-operative period. B. Promotes excretion of water which aids in reducing ICP. C. Enhances venous return and thus reduce ICP D. Reduces cerebral edema thus reducing ICP. Situation - Ms. Mika is a director of the critical care unit of hospital x. She utilizes the nursing process to communicate care to the client. 20. She is called to the bedside of a client who is scheduled to have laparoscopic cholecystectomy. The client’s pulse is slightly irregular. Ms. Mika confers with the primary nurse regarding the client’s condition, which step of the nursing process is Ms. Mika applying? A. Implementation B. Evaluation C. Planning D. Assessment 21. Ms. Mika calls for a conference with the staff members who are attending to the client. They decide to obtain a 12-lead ECG for a more definitive picture. They conclude that the client has no serious cardiac or pulmonary problems. Which step of the nursing process is in effect in this situation? A. nursing diagnosis B. assessment C. evaluation D. planning 22. Ms. Mika consults with the attending physician and the anesthesiologist. She advises the primary nurse to proceed with the preparations and to remain alert for any adverse symptoms. Which step of the nursing process is this? A. Assessment B. nursing diagnosis C. planning D. evaluation 23. Ms. Mika confers with the client’s primary nurse the following morning. Together they determine that the client is ready for surgery. This step of the nursing process is: A. evaluation B. Planning C. nursing diagnosis D. assessment 24. Ms. Mika applies the human relations approach in this situation. She is aware that the key to productivity is _________________. A. the degree of independence allowed B. meeting the objectives of the critical care unit C. Firm control of the situation D. the behavior of people under direction Situation – A Nurse in the intensive care unit attends to a 20 – year old female who was involved in a vehicular accident three days prior to admission. The prognosis is very poor. No brain activity was detected after two electro encephalograms (EEGs) were taken. 25. The family decides to wean the patient from the ventilator support. The family talks to the nurse about their decision to get the nurses’ support. Which of the following actions is NOT appropriate? The Nurse ___________. A. Checks the physician’s orders for sedation and analgesia and make sure that the anticipated death is comfortable and dignified. B. Explains to the family what will happen each phase of the weaning and offer support. C. Tells the family that death will occur almost immediately after the patient is removed from the ventilator support. D. Participates in the decision-making process by offering the family information 26. Two hours after the ventilator support was discontinued, the patient dies. The nurse discusses with the family the possibility of donating the deceased person’s organs. The following are guidelines in organ or tissue donation. 1. Religious beliefs in organ donation and transplantation must be respected. 2. Donors must be free of infectious disease and cancer. 3. Consent or written orders by the physician are necessary for referral to an organ procurement organization. 4. The family of the deceased should be offered an opportunity to speak with a knowledge organ procurement coordinator. 5. The person requesting for organ donation does not have to believe in the benefits of organ donation but should support the process with a positive attitude. Which of the guidelines should the nurse observe? A. 1, 2, 3, 4, 5 B. 1, 2, 4 C. 2, 3, 4 D. 1, 3, 5 27. The legal definition of death that facilitate organ donation is the cessation of ________ : A. Function of the entire brain B. Pulse C. Circulatory and respiratory functions D. Respiration 28. The patient is pronounced dead by the physician. Which of the following nursing actions VIOLATES the standards of care for a dead person? A. Removing soiled dressing and tubes. B. Keeping the dead person in a sitting position until the family has arrived and said their goodbyes. 2 | Page
C. Placing identification tags on both the shroud and ankle. D. Preparing to transfer the body to the morgue. 29. The family goes through the stages of grieving. What are the stages in the grieving process? 1. Acceptance 2. Depression 3. Denial 4. Bargaining 5. Anger A. 3, 5, 1, 4, 2 B. 3, 5, 4, 2, 1 C. 1, 5, 3, 4, 2 D. 1, 2, 5, 4, 3 Situation - Nurse Ashley is a staff nurse in the oncology unit of a tertiary hospital. She reads literature on antineoplastic medications. 30. Nurse Ashley understands the importance of continuing professional development. Which of the following is the MAIN purpose of continuing professional development? To ____________. A. Update one’s professional knowledge and competence B. Acquire a certificate of attendance to add to one’s curriculum vitae C. Establish networking within the nursing profession D. Fulfill requirements for an advanced degree in nursing 31. Nurse Ashley reads that the drug Cyclophosphamide ( Cytoxan ) is given to patients with breast cancer. Nurse Ashley understand that this drug is ______: A. Cell cycle phase-non-specific B. A hormonal medication C. An antimetabolite D. Cell cycle phase-specific 32. Nurse Ashley reads in the literature that a patient with breast cancer taking Cytoxan should observe the following. Given a case what should nurse Ashley instruct a patient to do? A. Decrease sodium intake while on medication. B. Take the medication with food. C. Increase potassium intake while on medication. D. Increase fluid intake 2000 to 3000 mL daily. 33. Nurse Ashley understands that patients receiving antineoplastic medications should do which of the following? 1. Drinks beverages containing alcohol in moderate amounts. 2. Consult with the physician before receiving immunizations. 3. Be sure to receive flu and pneumonia immunizations. 4. Take aspirin (Acetylsalicylic Acid, ASA) as for headache. A. 2 only B. 3 & 4 C. All of the options D. 1 & 2 34. An incident was described in the literature where a patient developed stomatitis after receiving a course od antineoplastic medications. Which of the following actions would be BEST for a nurse to do? A. Swab the mouth daily with lemon and glycerine. B. Avoid foods and fluids for the next 24 hours. C. Brush the teeth and use waxed dental floss 3x a day. D. Rinse the mouth with diluted baking soda or saline. Situation - The head nurse of a trauma unit introduce changes to improve the quality of care of trauma patients. 35. The head nurse presented a set of goals to the staff nurses. Which of the following goals is NOT relevant to improving quality of care? No_______: A. Legal suits. B. Needless deaths. C. Waste of resources. D. Needless pain or suffering. 36. The head nurse reviews reports on nurse staffing. The following findings result to better patient outcomes EXCEPT: A higher _______: A. Nurse to patient ratio shortens lengths of patient stay in the hospital. B. Nurse to patient ratio results to reduced patient mortality. C. Number of nurses, infection rates fall. D. Nurse to patient ratio increases costs. 37. The head nurse determines to reduce medication errors in the trauma unit. She recognizes that medication errors often occur in relation to the following EXCEPT: A. Preparing the wrong concentration and administering the medication via the correct route. B. Failure to question unclear medication errors. C. Lack of knowledge about medication. D. Failure to identify non-therapeutic client responses. 38. The head nurse suggests that to reduce medication errors, several measures will be instituted. Which of the following is MOST appropriate? A. Use point-of-care technology to access drug reference information. B. Use of drug index C. Nurses must help educate patients and their families regarding proper medication administration. D. Patients must become more involved in managing their care. 39. The head nurse is aware that managing and improving quality care in the trauma unit requires which of the following? A. Personalized attention to patient’s needs and their families. B. A blame – free environment. C. All of the choices. D. A clean and orderly trauma unit. Situation - Nurse Bessie is a nurse manager of trauma unit. She supervises the staff nurses and regularly holds conferences with them and other unit personnel. In one meeting she reorients the staff nurses on their various functions. She cites clinical situations related to a nurses dependent, interdependent, and collaborative functions. 40. An interdependent function of nurse is when the nurse _______: A. Irrigates a feeding tube that appears obstructed. B. Gives ice chips to a client who has an order of NPO. C. Applies a dry sterile dressing to an abdominal incision. D. Helps a client choose foods rich in protein from an ordered diet. 41. A nurse decides to give a partial bath to a client instead of a complete bath. The nurse is working __________: A. Independently B. Interdependently C. Dependently D. Collaboratively 42. A nurse works with a skin care team. The nurse is functioning _________: A. Dependently B. Interdependently C. Collaboratively D. Independently 43. A nurse initiates a visit from member of the clergy for a terminally ill client. The nurse is functioning ___________: A. Interdependently B. Collegially C. Independently D. Dependently 44. When a nurse uses a straight catheter to obtain a urine specimen for laboratory test, the nurse is functioning ________: A. Dependently B. Interdependently C. Independently D. Collegially Situation - Ms. Hange is the charge nurse of a medical unit. She is responsible for the management and supervision of the unit. 45. Ms. Hange observes that one of the female staff nurses is not performing her duties very well. Which of the following strategies will she implement to assist the staff nurse? A. Discuss with the staff nurse her performance and ways she can improve. 3 | Page
B. Allow the staff nurse to select own assignment. C. Assign the staff nurse several clients with various illnesses. D. Ask the staff nurse to work as an assistant charge nurse. 46. Ms. Hange notes one of the male staff nurse is frequently absent and his absence has adversely affected the quality of care given to the clients unit. Which of the following would be the BEST approach? A. Talk with the staff nurse regarding the concern and remind him of the standards of the agency. B. Write the staff nurse a memorandum regarding his absence. C. Inform the staff nurse that his absence will be a ground for termination. D. Record the absence of the staff nurse in a log book. 47. Ms. Hange assigns a new staff nurse to administer the medications of a client. Which detail of the client’s drug therapy is the staff nurse legally responsible to document? The ________. A. Peak concentration time of the drug. B. Safe ranges of the drug. C. Client’s socio-economic status. D. Client’s reaction to the drug. 48. Ms. Hange decides what is best for a recovering client and acts on the decision without consulting the client. Ms. Hange is applying a moral principle which is ______________. A. Paternalism B. Beneficence C. Fidelity D. Autonomy Situation - Nurse Mirasol is the attending nurse of a 40-year old female admitted in the medical unit with a probable diagnosis of Scleroderma. 49. The patient complains of pain in her fingertips and pallor followed by blanching of the extremities and redness. Nurse Mirasol knows that these symptoms are characteristic of which of the following disorders? A. Swan-neck deformity B. Raynaud’s phenomenon C. Joint swelling and effusion D. Symmetric Polyarthritis 50. Nurse Mirasol assesses the skin of the patient. Which phase of skin changes occur FIRST and are usually painless and symmetrical? A. Indurative B. Primary C. Curative D. Edematous 51. Nurse Mirasol writes a nursing diagnosis for the patient. Which of the following is a PRIORITY nursing diagnosis? A. Social isolation B. Impaired skin integrity C. Disturbed body image D. Low self-esteem 52. Nurse Mirasol assists the patient in coping with the disorder. During the early stages of a chronic disease, patients tend to focus on which of the following behaviors? A. Understanding the disease process B. Impact on lifestyle changes C. Interpretations of symptoms D. Schedule of medications 53. Nurse Mirasol prepares a discharge plan of care for the patient. Which of the following objectives are MOST appropriate? The patient should _______________. 1. Try to prevent breakdown of the skin and ulceration 2. Avoid activities that trigger pain 3. Modify diet to include legumes 4. Avoid exposure to extreme cold temperature A. 1, 2, 3, 4 B. 1, 2, 3 C. 1, 2, 4 D. 2, 3, 4 Situation – A 21 year old male is admitted to the burn unit of x hospital. He sustained burns on the chest, abdomen, right arm and right leg. 54. The nurse assigned to his care anticipates that the client would be particularly susceptible to which of the following fluid and electrolyte imbalances during the emergent phase of burn case. A. Metabolic acidosis B. Hypernatremia C. Hypokalemia D. Metabolic alkalosis 55. The nurse assesses the client for fluid shifting. During the emergent phase of a burn injury, shifts occur due to fluid moving from the_______________. A. Extracellular to intracellular space. B. Intracellular to extracellular space. C. Vascular to interstitial space. D. Interstitial to vascular space 56. The nurse understands that the fluid shift results from an increase in the_____________.: A. Total volume of intravascular plasma B. Total volume of circulating whole blood C. Permeability of capillary walls D. Permeability of the kidney tubules 57. The client receives fluid resuscitation therapy. The nurse adjusts the infusion rate by evaluating the client’s __________: A. Hourly urine output B. Daily body weight C. Hourly urine specific gravity D. Hourly body temperature 58. The client receives total parenteral nutrition (TPN). The nurse understands this therapy will help the client__________. A. Provide adequate nutrition B. Ensure adequate caloric and protein intake C. Correct water and electrolyte imbalances D. Allow the gastrointestinal tract to rest Situation - The nurse cares for a female client who is terminally ill and is experiencing pain. 59. The nurse prepares a care plan for the client. The overall goal for the client is ________. The client will: A. Achieve control of pain and discomfort. B. Receive adequate cerebral oxygenation and perfusion. C. Be free from infection. D. Receive life sustaining food and liquids. 60. The nurse is aware of the document that expresses a client’s wish for life sustaining treatment in the event of terminal illness or permanent unconsciousness. This document is the ______; A. No-code order B. Durable power of attorney C. Living will D. Last will and testament 61. The client nears death and requests that no medication be given that would cause a loss of consciousness, including pain medication. The nurse would promote the best end-of-life care for the client by which of the following? A. Discuss the request of the dying client with family members and respect their wishes. B. Comfort is the highest priority in this situation so give medications as ordered. C. Respect the client’s wishes and withhold pain medications and other medications ordered. D. Be compassionate and give half of dose of the medication ordered. 62. Which of the following statement is TRUE about terminally ill clients? A. Terminally ill clients require minimum physical care. B. Health care personnel do not understand their own feelings about death and dying therefore they avoid caring for terminally clients. C. Terminally ill clients have the right to die with dignity. D. Terminally ill client’s experiences pain most of the time. 63. The dying client wishes to donate her eyes after she dies. Which of the following statements is NOT TRUE about organ donation? A. Any individual, at least 15 years old of age and of a sound mind may donate a part of his body to take the effect after transplantation needed by the recipient. 4 | Page