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RECALLS 3 EXAMINATION NURSING PRACTICE III CARE OF THE CLIENT WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART A) 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 III” on the box provided Situation: Ethical and moral issues are becoming a common scenario in practice setting so health care providers have to be equipped with this competency. 1. In the clinical setting, when nurses are confronted with ethicaldilemmas the BEST practical guide she can use of is__. A. PRC oath for professionals B. Code of Ethics C. theological doctrine D. Florence Nightingale oath 2. Mr. RAD is admitted to the hospital complaining of chest pain due to clogged in his coronary arteries. He is diabetic hypertensive and considered by the physician to be a high risk for cardiovascularsurgery. What PRIORITY action should the members of the health team do in this situation? A. Consult the family members and let them give their decision. B. Proceed with the planned surgery, as this will save the patient. C. Consult the Ethics committee on what to do with the patient. D. Discuss with Mr. RAD his health status & let him decide. 3. Mrs. Agnes, 77 y/o is suffering from dementia and demonstrates unruly behavior. When Nurse Gigi describes the patient in her shift report, as "That awful, dirty old woman in Bed 14" is an example of what ethical behavior being employed by the nurse? A. Stigma B. Ageism C. Gender bias D. Depersonalization 4. Mr. Rey, who is on an end-stage of life has an order of "Do Not Resuscitate" and passed away in your shift. He was declared dead by his physician at 8:30 AM. What should be your PRIORITY nursing action in this situation? A. Prepare the death certificate for the physician to sign. B. Allow the family to have private moments with the deceased. C. Request your nurse attendant to call the funeral parlor atonce. D. Clean the body and remove all the IV lines, tubes and other appliances. 5. When a nurse is in full support of patient's care safety and personal rights throughout her hospital stay, she is implementing what ethical principle? A. Responsibility B. Empathy C. Advocacy D. Accountability Situation: A manager of an accounting firm is admitted to the hospital dueto an acute abdominal pain and passing out of bloody stools. After several diagnostic and laboratory examinations the physician ordered him form exploratory laparotomy. You are the nurse on duty that day. 6. While performing your assessment you are guided that the organs found in the epigastrium include which of the following? A. A Portion of duodenum & jejunum, left kidney, appendix & ovary B. Duodenum, pancreas, portion of the liver and pyloric end of the stomach. C. Stomach, spleen, tail of pancreas and adrenal gland. D. Gallbladder, duodenum, gallbladder and portion of the right kidney. 7. When conducting a nursing history on the Health Perception, Health Management pattern of functioning what is the APPROPRIATE question to be asked pre-operatively? A. Do you experience your wounds to heal quickly? B. Do you have shortness of breath when exercising? C. Are you aware of risk factors for your disease? D. Have you experience weight changes in the past? 8. Patient was visited by the anesthesiologist and explained the anesthesiafor his surgery. Which of the following type of anesthesia would youexpect to be ordered? A. Spinal B. Caudal C. Local D. General 9. There are pre-operative medications given to the patient. Which of the following drugs are given in order to decrease intra-operativeanesthetic requirements and pain? A. Celebrex (Celecoxib) B. Ibuprofen (Motrin) C. Acetaminophen (Tylenol) D. Demerol (Meperidine HC1) 10. The goals for patient's safety in the operating room is imperative forall members of the surgical team. Which of the following UniversalSafety Protocol are adopted and validated PRIOR to surgery? I. Patient's identity II. Surgical procedure III. Surgical site IV. Surgical equipment A. II & III B. I & II C. I, II & IV D. I, II & III Situation: Crisostomo a 40 years old employee has been complaining of difficult painful urination for almost a week now. He said he sawsome fresh blood in his urine but was afraid to see a physician, instead, he went to his neighbor who is a herbalist. After a week his condition worsen and his wife brought him to a community clinic. 11. A community clinic does primary care for patients. Most often the one who manages this is which of the following? 1 | Page
A. Physician B. Barangay health worker C. Nurse D. Midwife 12. Upon assessment, the patient was referred immediately to a 25-bed-capacity hospital, which does not have any capacity to do intensive diagnostic examinations. You are a nurse in this hospital, which you know is a LEVEL _________. A. 3 B. 1 C. 4 D. 2 13. In the tertiary hospital where the patient was again referred, he was considered an emergency case. The nurse immediately called for a specialist who is ________. A. Neurologist B. Urologist C. Phlebotomist D. Nephrologist 14. After a thorough assessment by the physician-specialist, an order for an immediate stonogramwas made. The nurse was instructed to call which of the following section of the hospital? A. Operation Room B. Laboratory C. Intervention D. CT scan 15. After the procedure the patient was ordered for Lithotripsy, under spinal anesthesia. The nurse has to call the department of ________. A. Internal medicine B. Anesthesia C. Surgery D. Imagery Situation: An alert 67 year-old woman with diabetes mellitus is discharged from the hospital. A referral is made to a community nursingagency. You are asked to reinforce the teaching program startedin the hospital. The patient is using sulfonylurea compound tolbutamide (Orinase). 16. When the patient turned 69 years old. Orinase was discontinued and NPHinsulin is prescribed for her. After several months, she is determinedto be suffering from the Somogyi effect. Which of the following conditions will most likely result when the patient is receiving too much insulin? A. Developing an elevation of the blood glucose level B. Producing even more insulin C. Becoming resistant to insulin D. Conserving excessive amount of fluid 17. A few days later, the patient comes into the emergency department via ambulance stretcher and reveals a work-up of a blood sugar level at 800mg/dl, ketones are absent in the urine, she is dehydrated, and has an altered mental status. Based on the data, the patient is most likely suffering from what specific medical condition? A. Hyperosmolar nonketotic coma (HNKC) B. Diabetic retinopathy C. Acute renal failure D. Diabetic ketoacidosis (DKA) 18. Upon interview, the patient reported that she often felt nauseated,restless, perspired a lot, felt fatigued, and was often hungry when shewas younger. What do these signs indicate? A. Diabetic nephropathy B. Hyperglycemia C. Hypoglycemia D. Diabetic retinopathy 19. Upon further assessment, you noticed that she had many scratches on her right ankle, a resulting infection and cellulitis. When you ask her about the scratchesthe patient states. "Oh, my cat must have been using my leg as a scratching post again and I did not even feel it”. Which diabetic complications suspect the patient to have? A. Neuropathy B. Macroangiopathy C. Retinopathy D. Ephropathy 20. You should check the patient for suspect disturbed thought processes related to depressed metabolism and altered cardiovascular and respiratory status. What is the rationale for orienting the patient to time, place, date, and events? A. Shows improved cognitive functioning B. Provides reality orientation to patient C. Permits evaluation of the effectiveness of treatment D. Lets the patient identify the time, place, date and eventscorrectly Situation: Nurse Pat is a newly hired Registered Nurse together with 5 licensed graduate nurses coming from different regions. It is their first day of orientation in a big health facility. The continuing nurse educator started the session by projecting the organizational structure of the medical center. 21. Which of the following is the MAJOR PURPOSE of an organizational structure? It is a ______. A. blueprint representing committees for delegation of rolesand functions B. flow chart that shows interaction among members of major and minor groups C. framework of relationship of units, departments and channels of communication D. design that identifies roles, collaboration, interdependence between functions of people 22. Line and staff functions are identified in the presented Organizational Chart. What does line authority mean? A. Staff relationship in the organization is advisory in nature B. Staff mix of personnel reporting to the "Boss". C. Decisions are made from bottom to top in an organization. D. A direct responsibility over a subordinate within anorganization. 23. Which of the following statements is CORRECT of nursing service system in health care? A. Informed leaders are more effective than formal leaders in an organization. B. A shared governance tends to be controlling and with less autonomy. C. Institutional policies are more powerful tool in nursing practice than laws and regulations. D. A situational leadership style provides effective means in achieving patient outcomes. 24. The mode of nursing service delivery system is being revisited in respond to patient's outcome. Which of the following is NOT TRUE of themanager's role in the health care delivery system? A. Provides direct nursing care when needed. B. Manages resource utilization. C. Act as a liaison in litigation cases in court. D. Collaborates with members of the health. 25. Budgeting is an important aspect of financial management. When a unitmanager allocates expenses for unit supplies, stocks and medical-surgical supplies. This is considered _________. A. cash budget B. operational budget C. capital budget D. flexible budget. Situation: Mely, 68 -year-old, was admitted to the hospital because of decreased appetite, easy fatigability, dehydration and weight loss of about 15 lbs for the past weeks. She was examined by the physician and advised to be admitted. You are the nurse assigned to take care of her. 26. The physician ordered to start Ms. Mely on Total Parenteral Nutrition(TPN). What Is your INITIAL step to be undertaken PRIOR to thisintervention? A. Determine if the family can afford the whole treatment. B. Evaluate the tolerance of the patient to glucose. C. Identify allergies of patient to the supplemental nutrition. D. Assess the basic understanding of the patient regarding TPN 27. Choose from the following the primary goals of TPN? I. promote weight gain II. improve nutritional status 2 | Page

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