Tiêu đề RECALLS 2 - NP4 - SC ✅

RECALLS 2 EXAMINATION NURSING PRACTICE IV CARE OF THE CLIENT WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART B) NOV 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 1 – Nurse Alex cares for a terminally ill client with cancer. 1. Nurse Yolan assesses the client for depression. Which of the following is a key indicator for clinical depression? A. Anger due to pain experience B. Feeling of excessive guilt C. Anorexia and weight loss D. Inability to care for one’s physical self 2. The client has difficulty sleeping. Which of the following interventions is LEAST helpful for Nurse Yolan to incorporate in her care plan? A. Instruct the client to drink herbal tea. B. Give warm milk at bedtime C. Perform relaxation routine such as massage, imagery or music D. Instruct the client to drink black tea. 3. The care plan for the client includes family support. Which of the following is MOST appropriate for the family to establish a relationship with the health care team? Nurse Yolan should ___________: A. Give permission to the family to take time to maintain friendship with the health care team. B. Discuss the roles of the family members to the health care team. C. Explain the roles of all members of the interdisciplinary team. D. Provide a brief explanation to the family member about the care being delivered to the client. 4. The client appears to be dehydrated. The family members are discussing whether their loved one should be given intravenous fluid. Which of the following concepts about dehydration in terminally ill clients should guide Nurse Yolan? A. Peripheral edema occurs because of fluid overload. B. Thirst is an indication of dehydration. C. Terminally ill clients are hydrated through oral and intravenous routes. D. All interventions for terminally ill client should be directed towards comfort and reduction of symptoms. 5. The client show signs of imminent death. Nurse Yolan recognizes cardiovascular indicators of imminent death which are the following EXCEPT __________: A. bradycardia B. Irregular heart rate C. tachycardia D. lowered blood pressure Situation 2 – 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. 6. 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 7. 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 in medications to manage pain. D. Perform perineal muscle exercises 8. 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 9. 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. 10. 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 3 – You are newly promoted charge nurse of a department in a tertiary hospital. You review management concepts to prepare you for the position. The following questions pertain to management of resources. 11. You are oriented on health care economics. The study of economics focuses on how choices are made to overcome a scarcity of resources. Which of the following statements BEST illustrates health care economics __________: 1. Providing less health care services that is optimal in order to contain costs. 2. Using individuals with less knowledge and skill to perform health care services usually performed by people with advanced knowledge and training. 1 | Page
3. Taking economic risks as a health care provider. 4. Providing adequate or appropriate care minimize risk of expensive utilization. A. 1 and 2 B. 3 and 4 C. 1 and 4 D. 2 and 3 12. Which of the following statement is TRUE regarding health care economics? A. Contemporary health care is characterized as a business struggling to balance cost and quality. B. Profit in health care is synonymous with billing privileges. C. Health care economics is a new concept in nursing. D. Health care is becoming affordable and clients are demanding quality care. 13. You understand that a key factor that influence client care is the cost involved in the delivery of health services. Which of the following resources is NOT required to support the services delivered by nurses? A. Time B. Client’s environment C. People D. Equipment 14. You are aware that there is a need for you to understand how to manage the cost of client care as it relates to clinical practice. Which of the following are nurses accountable for? A. Decision regarding cost effective practices. B. The Client’s hospital charges C. Distribution and consumption of resources such as time, supplies, drugs, staff and personnel. D. Financial viability of nursing department. 15. While touring the department where you are assigned, you noticed that the supply room is stacked with medical supplies and equipment. Which of the following is the BEST action you will take? A. Create a task force to assess the situation and report the findings. B. Take an inventory of the supplies and equipment. C. Request maintenance to sort out the supplies and check the medical equipment to determine if they are still functional. D. Call for a staff meeting and discuss how best to utilize the available resources. Situation 4 – 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. 16. 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 17. 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 18. 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 19. 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 20. 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 5 – 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 electroencephalograms (EEGs) were taken. 21. 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 22. 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 23. 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 24. 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. C. Placing identification tags on both the shroud and ankle. D. Preparing to transfer the body to the morgue. 25. 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 6- A male teenager was wheeled in the Emergency Department (ED) for injured. 26. The nurse assesses the patient for complications. Which are the MOST COMMON complications? 2 | Page

42. 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 43. 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 44. 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 45. 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 10- 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. 46. 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. 47. 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 48. A nurse works with a skin care team. The nurse is functioning _________: A. Dependently B. Interdependently C. Collaboratively D. Independently 49. 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 50. 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 11- Marie, an oncology nurse assists in the care of patients with cancer. 51. One of her patients is a 50-year old female named Marcela is in the terminal stage of breast cancer. She tells Nurse Marie. “I have given responses of Nurse Marie is MOST therapeutic? A. “You have given up hope?” B. “You should talk to your physician about your fears of dying.” C. “You should talk about dying with your spiritual adviser.” D. “You should not give up hope. There are research studies being done to cure cancer.” 52. Marcela says to Nurse Marie. “ I don’t like to spend my final days on earth in a hospital.” The BEST response of Nurse Marie would be : A. “Can you please tell me more how you are feeling right now?” B. “I know how you feel. It must be hard to know that you are dying.” C. “If I were in your place, I should have refused being admitted to the hospital knowing that I will die soon. D. “What is it that you don’t like being in the hospital?” 53. Marcela tells Nurse Marie that her younger sister was recently diagnosed with cancer. She is concerned because she is aware that breast cancer “ runs in the family” but she could not recall any family member diagnosed with bone or lung cancer. Nurse Marie’s BEST response would be: A. “ I am sorry to hear about your sister. I think you should meet with all of your family members and share with them their increased risk for developing lung and bone cancer.” B. “ Apparently your sister is so unfortunate . it is rare to have three such unrelated cancers at one time.” C. “ I think it is important for you to be tested for lung cancer as soon as possible , because it has hereditary link.” D. “ I am sorry to hear about your sister’s recant diagnosis. Most probably your sister has a breast cancer that has metastasized or spread to the bone and lungs.” 54. Nurse Marie has another patient, Cena who was recently diagnosed with ductal cell carcinoma of the breast. Her oncologist described Cena’s cancer as T2, N1, Mx. Cena asked Nurse Marie to repeat to her what “ all those letters and numbers mean.” Nurse Marie replies that it means the following: A. Two tumours present, one lymph node involved, and many sites of metastasis. B. One large tumour present, nodal involvement in one region, and metastasis was present. C. Two tumours present, one lymph node involved and metastasis was present. D. One tumor present, which is larger than 2.5 centimeters, nodal involvement in one region, and metastasis was unable to be determined. 55. Patient Cena tells Nurse Marie “How did I acquire breast cancer?” Nurse Marie explains that there are risk factors that may have contributed to her condition. Which of the following statements is TRUE concerning the risk factors for breast cancer? A. Hormones are not a risk factor for breast cancer. B. Other types of cancer history have no correlation with breast cancer. C. Ethnicity is a risk factor. D. Environment is not a risk factor for breast cancer. Situation 12 – A 35-year old female client presents herself in the outpatient Department with complaints of rashes particularly on the face, across the bridge of the nose and on the cheeks. The client is suspected of having systematic lupus erythematous (SLE). She is admitted to the female medical unit. 56. The nurse writes a care plan for the client. The Nurse is aware that this disorder is a/an ________. A. disease caused by over exposure to sunlight B. Local rash that occurs as a result of allergy. C. inflammatory disease of collagen contained in connective tissues. D. disease caused by the continuous release of histamine in the body. 4 | Page