Tiêu đề RECALLS 6 (NP3) - STUDENT COPY ✅

RECALLS EXAMINATION 6 NURSING PRACTICE III CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART A) NOVEMBER 2024 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: You'll be working in the Medical Step-down Unit, where you expect to deal with numerous patients who have acid-base imbalances. To be thoroughly prepared as a professional nurse, you plan to review key information on how to manage various types of acid-base imbalances. 1. As a nurse you were taught how to evaluate arterial blood gas (ABG) values. Which of the following steps would you do FIRST? A. Evaluate HCO3 B. Evaluate pH C. Determine acid base status D. Evaluate PaCO2 2. Which of the following conditions may cause metabolic acidosis due to a decrease in bicarbonate (HC03) level? 1. Loss of gastric fluids from vomiting or nasogastric suction 2. Loss of body fluids from drains below the umbilicus 3. Gastrointestinal fistulas 4. Aspirin ingestion A. 3 and 4 B. 1 and 2 C. 1 and 4 D. 2 and 3 3. Jian, 30 years old, was brought to the Emergency Department (ED) with nausea confusion, dehydration and oliguria. Her mother informs you that Jian has been depressed after losing her job as a bank executive. An empty bottle of aspirin was found in her bathroom sink. Her laboratory values revealed the if.: pH = 7.35, PaCO2=16 mmHg, PaO2=130 mmHg, and HCO3=15mEq/L. What is the CORRECT acid-base interpretation of her ABG? A. Partially compensated respiratory acidosis B. Uncompensated metabolic acidosis C. Partially compensated metabolic: acidosis D. Compensated metabolic acidosis. 4. The nurse reviews the arterial blood gas results of a client and notes the following: pH 7.45, Paco2 of 30 mm Hg, and HCO3 of 20 mEq/L (20 mmol/L). The nurse analyzes these results as indicating which condition? A. Metabolic acidosis, compensated B. Respiratory alkalosis, compensated C. Metabolic alkalosis, uncompensated D. Respiratory acidosis, uncompensated 5. Anne, a client with a 3-day history of nausea and vomiting and suspected gastroenteritis presents to the emergency department. Anne is hypoventilating and has a respiratory rate of 10 breaths per minute. The electrocardiogram (ECG) monitor displays tachycardia, with a heart rate of 120 beats per minute. Arterial blood gases are drawn, and the nurse reviews the results, expecting to note which finding? A. A decreased pH and an increased Paco2 B. An increased pH and a decreased Paco2 C. A decreased pH and a decreased HCO3 D. An increased pH and an increased HCO3 6. Nurse AVA is caring for a client having respiratory distress related to an anxiety attack. Recent arterial blood gas (ABG) values are pH = 7.53, Pao2 =72 mm Hg, Paco2 = 32 mm Hg, and HCO3 = 28 mEq/L (28 mmol/L). Which conclusion about the client would the nurse make? A. The client has acidotic blood. B. The client is probably overreacting. C. The client is fluid volume overloaded. D. The client is probably hyperventilating. Situation: Nurse Ces, an infectious control nurse, is caring for a client with Pulmonary Tuberculosis. 7. Which client has special risk factors that warrant testing for tuberculosis? A. 45-year-old Caucasian man who has been homeless for 2 years B. 15-year-old Caucasian woman with asthma C. 72-year-old woman who is a recent immigrant from Russia D. 50-year-old Iowa farmer 8. Nurse Ces knows that the priority action for a client admitted with a productive cough, weight loss, and a suspected diagnosis of tuberculosis is: A. Instruction on preventing disease transmission B. Planning for frequent rest period C. Recording accurate Intake and output D. Reviewing current dietary patterns 9. Nurse Ces concludes that an intradermal TB test result is positive in any person if the following is present: A. An induration of 15 mm or more B. An induration of 10 cm or more C. An induration of 5-9 mm D. A hivelike vesicle 10. A client with tuberculosis has a prescription for Myambutol (Ethambutol HCI). Nurse Ces should tell the client to notify the doctor immediately if he notices: A. Gastric distress B. Changes in hearing C. Red discoloration of body fluids D. Changes in color vision 11. The Mantoux test is used to determine whether a person has been exposed to tuberculosis. If the test is positive, Nurse Ces will find a: A. Fluid filled vesicle B. Sharply demarcated erythema C. Central area of induration D. Circular blanched area Situation: You are the nurse on duty caring for multiple patients with cardiac conditions. 12. A patient with a history of type 2 diabetes is admitted to the hospital with chest pain and is scheduled for a cardiac catheterization. Which medication should you withheld for 24 hours before the procedure and for 48 hours afterward? A. Glipizide B. Metformin C. Repaglinide D. Regular insulin 1 | Page


following principles should the nurse use to ensure effective delegation? A. Delegate tasks that require the nurse’s unique skills to unlicensed personnel B. Ensure that the delegatee has the necessary competence and training for the task C. Delegate all tasks to ensure that the workload is evenly distributed D. Only delegate tasks that are easy and can be done quickly 48. Nurse Annaliza is dealing with a situation where a nursing assistant is frequently late for their shift. What is the most appropriate action for the nurse manager to take? A. Ignore the lateness if it does not affect patient care B. Discuss the issue with the nursing assistant privately and address the pattern of lateness C. Reprimand the nursing assistant publicly to set an example D. Reassign the nursing assistant to a different shift without discussing the issue 49. Nurse Annaliza is preparing to delegate a complex wound dressing change. Which aspect of delegation is critical for ensuring that the task is performed safely? A. Verifying that the task is within the scope of practice for the delegatee B. Delegating the task without providing instructions C. Only providing verbal instructions without written guidelines D. Assuming that the delegatee knows how to perform the task without supervision 50. A nurse manager in the Philippines needs to prioritize tasks for a busy unit. Which of the following tasks should the nurse manager prioritize? A. Completing paperwork for routine audits B. Addressing a sudden change in a patient's condition C. Organizing a staff social event D. Conducting a review of patient satisfaction surveys SITUATION: Sarah is a 55-year-old woman diagnosed with advanced gastric cancer. Over the past few weeks, she has experienced a significant decrease in appetite, persistent fatigue, dehydration, and weight loss of approximately 15 lbs. Due to her inability to consume food, Sarah has been admitted to the hospital for further evaluation and management. 51. What intervention should you identify as best to meet Sarah’s nutritional needs? A. Administration of parenteral feeds via a peripheral IV B. TPN administered via a peripherally inserted central catheter C. Insertion of an NG tube for administration of feeds D. Maintaining NPO status and IV hydration until treatment completion 52. The method of nutrition administration is being initiated. Based on your nursing expertise, why is it necessary to begin the administration slowly? A. Patients receiving TPN are at risk for hypercalcemia if calories are started too rapidly. B. Malnourished patients receiving parenteral nutrition are at risk for hypophosphatemia if calories are started too aggressively. C. Malnourished patients who receive fluids too rapidly are at risk for hypernatremia. D. Patients receiving TPN need a slow initiation of treatment in order to allow digestive enzymes to accumulate 53. Which of the following nursing assessments most directly addresses a major complication of this kind of nutrition administration? A. Checking the patients capillary blood glucose levels regularly B. Having the patient frequently rate his or her hunger on a 10-point scale C. Measuring the patients heart rhythm at least every 6 hours D. Monitoring the patients level of consciousness each shift 54. In preparing a care plan for Sarah, what nursing diagnosis should the you prioritize? A. Risk for Activity Intolerance B. Risk for Infection C. Risk for Functional Urinary Incontinence D. Risk for Sleep Deprivation 55. Sarah suddenly complained of slight chest pain, dyspnea and appears cyanotic. You suspect that she is experiencing what possible IMMEDIATE complication? A. Sepsis due to IV line B. Air embolism C. Hyperglycemia D. Fluid overload 56. What PRIORITY nursing action should you do with the presenting clinical manifestations of the patient? A. Report to the physician status Sarah at once. B. Take Blood pressure and respiratory rate. C. Stop temporarily the Total Parenteral Nutrition D. Administer Oxygen inhalation. SITUATION: You are a nurse assigned to care for Mr. Thompson, a 72-year-old patient admitted to the medical-surgical ward with a diagnosis of COPD. Mr. Thompson has been experiencing increased shortness of breath, chronic cough, and fatigue, which have significantly impacted his daily activities. 57. As you perform your assessment, you auscultated diminished breath sounds which signify changes in the airway. In this case, what will you expect Mr. Thompson to have? A. Kyphosis and clubbing of the fingers B. Dyspnea and hypoxemia C. Sepsis and pneumothorax D. Bradypnea and pursed lip breathing 58. You are providing palliative care to Mr. Thompson. What is your primary goal of doing this kind of nursing care? A. To improve the patients and family’s quality of life B. To support aggressive and innovative treatments for cure C. To provide physical support for the patient D. To help the patient develop a separate plan with each discipline of the health care team 59. You noticed that Mr. Thompson been receiving high-flow oxygen therapy since the last shift. What symptoms should you anticipate if Mr. Thompson is experiencing oxygen toxicity? A. Bradycardia and frontal headache B. Dyspnea and substernal pain C. Peripheral cyanosis and restlessness D. Hypotension and tachycardia 60. You know that patients like Mr. Thompson requires a reliable and precise oxygen delivery. Which mask will you expect the physician to order? A. Non-rebreather air mask B. Tracheostomy collar C. Venturi mask D. Face tent 61. Mr. Thompson asked what he could have done to minimize the risk of contracting this disease. What would be your best answer? A. The most important risk factor for COPD is exposure to occupational toxins. B. The most important risk factor for COPD is inadequate exercise. C. The most important risk factor for COPD is exposure to dust and pollen. D. The most important risk factor for COPD is cigarette smoking. 62. You must ensure that you give appropriate nursing care to Mr. Thomson because you know that it can lead to which of the following complication? A. Lung cancer B. Cystic fibrosis C. Respiratory failure D. Hemothorax 63. You are developing the teaching portion of your care plan. What would be the most important component for you to emphasize? A. Smoking up to one-half of a pack of cigarettes weekly is allowable. B. Chronic inhalation of indoor toxins can cause lung damage. C. Minor respiratory infections are considered to be self-limited and are not treated. 4 | Page