Tiêu đề RECALLS 10 (NP4) - STUDENT COPY ✅

1 | Page RECALLS EXAMINATION 10 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. The nurse cares for a group of clients with allergies. 1. The nurse assesses the client who says he is highly allergic to many food items and medications. Which of the following hypersensitivity reactions would be responsible for this type of clinical manifestation? A. Type 4, delayed sensitivity B. Type 1, IgE mediated hypersensitivity C. Type 2, cytotoxic hypersensitivity D. Type 3, immune complex-mediated hypersensitivity 2. The nurse assesses an atopic client who had serious Type 1 hypersensitivity reactions. The nurse is aware that the most severe form of a Type 1 hypersensitivity reaction is which of the following conditions? A. Cell-mediated sensitivity B. Dermatitis C. Anaphylaxis D. Bronchial asthma 3. A client is experiencing anaphylaxis. Which of the following actions by the nurse takes HIGHEST priority? A. Administer epinephrine injection B. Place the client in Trendelenburg position C. Maintain an open airway D. Administer emergency oxygen 4. The nurse develops a care plan for a client with a past history of anaphylaxis. Which drug should the nurse instruct the client to always have it readily available to treat possible allergic reaction? A. Diphenhydramine B. Acetaminophen C. Epinephrine D. Acetyl Salicylic Acid 5. A client with a history of Type 1 hypersensitivity reaction is receiving immunotherapy. The nurse administers the allergen injection and asks the client to wait for how many minutes so that the immediate reactions can be treated? A. 5 – 15 minutes B. 30 – 40 minutes C. 60 minutes D. 15 – 25 minutes Situation. Ms. Marites, an oncology nurse assists in the care of a 49 year old female client diagnosed with breast cancer. 6. The client asks Ms. Marites what part of the breast is cancer usually found. Based on her knowledge, the nurse says that most malignant tumors occur in the ____ of her breast. A. Lower, inner quadrant B. Lower, outer quadrant C. Upper, inner quadrant D. Upper, outer quadrant 7. The physician orders a modified radical mastectomy right. The client returns to her room after the surgical procedure. Which of the following positions will the nurse place the right arm of the client? A. Across the client’s chest wall B. In a position that affords the client’s greatest comfort without placing pressure on the incision C. At her side at the same level of her body D. Elevate on pillows with client’s hand higher than her elbow and her elbow higher than her shoulder 8. The client has radiation therapy after a modified radical mastectomy. In caring for the skin at the site of the therapy, the nurse instructs the client to avoid all of the following practices EXCEPT to: A. Wash the area the water B. Apply an ointment to the are C. Use talcum powder on the area D. Expose the area to sunlight 9. The nurse further explains to the client that a normal local tissue response to radiation is: A. Scattered pustule formation B. Atrophy of the skin C. Slouching of two layers of skin. D. Redness of the surface tissue 10. Ms. Marites understands that the risk factors for the development of breast cancer include the following EXCEPT: A. Early onset of menstruation B. Family history of breast cancer C. Breast feeding D. Delayed onset of menopause Situation. Nurse Em cares for a 30 year old male who suffered a spinal cord injury sustained in a sporting accident which resulted in paraplegia. The following questions relate to the care of a client with a paraplegia. 11.The client is fortunate that the level of his injury did not affect his respiratory function. The nurse understands that the cord segments involved in maintaining respiratory function are: A. C1-2 B. C3-4 C. C5 D. C6 12. Nurse Em understands that the LEAST effective method of preventing contractures of the joints of the lower extremities would be to: A. Passively move the extremities through range of motion exercises. B. Provide the client with active exercise instructions. C. Maintain proper alignment in bed. D. Change the client’s position every two hours. * NLE * NCLEX * CGFNS * HAAD * PROMETRICS * DHA * MIDWIFERY * LET * RAD TECH * CRIMINOLOGY * DENTISTRY * PHARMACY *
2 | Page 13. Nurse Em plans care for the client which includes turning the client every two hours. This nursing measure is necessary to: A. Improve circulation in the lower extremities. B. Keep the client comfortable. C. Prevent occurrence of pressure sores. D. Prevent flexion contractures in the lower extremities. 14. Nurse Em recognizes that an early major problem of the client with paraplegia is: A. Client education. B. Bladder control. C. Use of mechanical aids for ambulation. D. Quadriceps setting 15. Nurse Em is aware that a complication the client with paraplegia may experience is formation of urinary calculi. The factor that contributes to this condition is: A. High fluid intake B. Increases loss of calcium for the skeletal system. C. Inadequate kidney functioning. D. Increased calcium intake. Situation. A 63-year-old male arrives at the Out-Patient Department complaining of numbness and tingling sensation of the lower extremities and pain in the legs upon exercising. The nurse suspects the client may have Peripheral Arterial Disease (PAD). 16. The nurse asks the client the following questions. Which of the questions would determine the risk factors of PAD? 1. “Do you smoke cigarettes?” 2. “Are you diabetic?” 3. “Are you hypertensive?” 4. “Do you exercise?” 5. “Do you drink alcohol?” A. 2, 3, & 4 B. 1, 2, 3, 4, & 5 C. 1, 4, & 5 D. 1, 2, & 3 17. The client asks the nurse what the doctor meant when he heard him say that the client has intermittent claudication. The nurses’ BEST response is, Intermittent claudication is_______ A. Pain that can occur in the body with exercise B. Pain in the leg when exercising C. Pain in the leg that occurs when at rest D. A tingling feeling of sensation in the hands 18. The nurse writes a nursing diagnosis of Ineffective Tissue Perfusion for the client. Which of the following interventions is MOST appropriate for this nursing diagnosis? A. Keep his legs in dependent position B. Elevate his legs C. Take hot bath D. Limit his daily activities. 19. The nurse writes another nursing diagnosis of Risk for Impaired Skin Integrity related to decreased peripheral circulation. Which of the following interventions is MOST appropriate for the nurse to instruct the client? A. Monitor the extremities for color, motion and sensation, and pulses. B. Maintain an appropriate level of activity to promote circulation. C. Avoid risk factors that may increase problems with Peripheral Arterial Disease. D. Protect the legs from injury because the tissues are fragile. 20. Which of the following outcomes indicate that there is increased arterial blood supply to the extremity of the client with peripheral arterial disease? A. Reduced sensation to touch B. Reduced muscle pain C. Increased rubor D. Decreased hair on the extremity Situation. The nurse attends a session on alternative and complementary for pain management. Some of the information she acquires are discussed in the following situations. 21. The nurse learned in the session that complementary therapies for pain management ____________: A. Will work only if the patient and the therapist believe it will work. B. Should be prescribed when opioids are no longer effective. C. Have no place in moderate to severe pain management. D. Maybe used at any time as adjunct therapy. 22. Time travel is a _____: A. Form of imagery where the patient visualizes a time when his/her pain is relieved. B. Form of hypnosis that maybe useful in a number of conditions. C. Stress reducer where the client visualizes himself or herself in a quiet environment. D. Form of distraction in which the person places himself in an imaginary environment. 23. Applying pressure to which of the following organs would be considered reflexology that would eliminate specific diseases or conditions. The areas would be the ____: A. Neck and face B. Abdomen and back C. Feet, hands, and ears D. Eyebrows and forehead 24. An agent that is used in aromatherapy to decrease anxiety that often accompanies pain is ____: A. Ginger B. Lemon grass C. Black pepper oil D. Lavender 25. An agent that is used in aromatherapy to decongest and reduce discomfort associated with cold allergies is ______: A. Lemon grass B. Eucalyptus C. Lavender D. Black pepper oil Situation. Nurse Rose is a newly registered nurse. She is assigned to the surgical unit of X hospital. She is aware of the legal responsibilities when performing patient care. The following are situations she encountered in the surgical unit with legal significance. 26. A patient is scheduled for abdominal surgery. Which of the following statements is a responsibility of Nurse Rose in obtaining a consent form? 1. Ensure that the consent form has been signed and is attached to the chart of the patient before the operation. 2. Witness the signing of the consent before the operation is performed. 3. Provide a detailed description of the operation before asking the patient to sign the consent form 4. Answer questions that the patient may ask before the patient signs the consent form. A. 3 & 4 B. 1, 2 & 3 C. 1, 2 & 4 D. 1 & 3 27. Which of the following health care professionals is legally responsible for obtaining informed consent for an invasive procedure? The ____ A. Surgeon B. Nurse Supervisor of the unit C. Medical director D. Registered nurse on duty 28. Nurse Rose documents her observation on a patient for abdominal surgery. Which of the following statements is legally appropriate notation? A. “The charge nurse spoke with the patient about the surgery” B. “The surgeon committed an error in the medication dose to be given” C. “Patient says he will sue the surgeon and the hospital if the operation turns out to be a failure.” D. “Patient says he feels sharp and stabbing pain in the abdominal area.” 29. The attending physician writes an order of Do Not Resuscitate (DNR) on a patient who is seriously ill. Which of the following is a responsibility of Nurse Rose? Nurse Rose should ________ 1)Carry out the order in the event the patient experiences sudden need for CPR