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1 | Page RECALLS 5 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 Hypothyroidism SITUATION: Nurse Lezlie is caring for a client with Hypothyroidism. Using her knowledge, she answered every question that the patient asked.  1. Nurse Lezlie reviewed the signs and symptoms of hypothyroidism. Which of the following is an exception? A. Moist Skin B. Weight gain C. Low energy D. Cold intolerance 2. As a knowledgeable nurse, she knows that she should instruct her patient about the adverse effects of thyroid- replacing hormone. Which of the following should be reported if felt by the patient? A. Tachycardia B. Cold intolerance C. Low energy D. Dry hair 3. Which lab results would confirm the diagnosis? A. High TSH and High FT4 B. Low TSH and High FT4 C. High TSH and Low FT4 D. Low TSH and Normal FT4 4. The nurse provides instructions to a client who is taking levothyroxine. The nurse would tell the client to take the medication in which way? A. With food B. At lunchtime C. On an empty stomach D. At bedtime with a snack 5. Nurse Lezlie assessed that the patient is currently having low RR, low LOC, and low temperature. The following symptoms might indicate which life-threatening condition? A. DKA B. Myxedema Coma C. Thyroid Storm D. Addisonian Crisis Hyperthyroidism SITUATION: Stephen is a nursing student who is currently preparing for the upcoming PNLE. One of his study buddies complained about her constant palpitations and hand tremors despite being calm. Stephen also noticed that his friend's eyes are unusually bigger than before. Stephen recommended that his friend seek consultation. 6. The patient is diagnosed with hyperthyroidism. Before initiating thyroid medications, what laboratory test should be done first? A. CBC B. BUN and Creatinine Clearance C. Urinalysis D. Pregnancy Test 7. This condition is an adverse effect of anti-thyroid medication. It is characterized by vomiting, abdominal pain, metallic or brassy taste in the mouth, rash, and sore gums and salivary glands A. Iodism B. Grave’s Disease C. Hashimoto’s Disease D. Iodization 8. A client has just been admitted to the nursing unit following thyroidectomy. Which assessment is the priority for this client? A. Hoarseness B. Hypocalcemia C. Audible stridor D. Edema at the surgical site 9. A client has been diagnosed with hyperthyroidism. The nurse monitors for which signs and symptoms of this disorder? Select all that apply.                          I.          Irritable                         II.          Pale                        III.          Heat intolerance                       IV.          Tremors                        V.          Bradycardia A. I, II, III B. I, III, IV C. IV, V D. I, III, V 10. A client with hyperthyroidism has been given methimazole. Which nursing considerations are associated with this medication? Select all that apply. 1. Administer methimazole with food. 2. Place the client on a low-calorie, low-protein diet. 3. Assess the client for unexplained bruising or bleeding. 4. Instruct the client to report side and adverse effects such as sore throat, fever, or headaches. 5. Use special radioactive precautions when handling the client’s urine for the first 24 hours following the initial administration. A. 1,2,3 B. 1,3,4 C. 1,4,5 D. 3,4,5 DIABETES   SITUATION: Nurse Rosie is aware that there are 2 types of diabetes. She knows that DM type 1 is autoimmune-related, while DM Type 2 can be traced through lifestyle factors. The following questions relate to diabetes and its complications.  11. A client is brought to the emergency department in an unresponsive state, and a diagnosis of hyperosmolar * NLE * NCLEX * CGFNS * HAAD * PROMETRICS * DHA * MIDWIFERY * LET * RAD TECH * CRIMINOLOGY * DENTISTRY * PHARMACY *


4 | Page C. Res Ipsa Loquitor D. False Imprisonment 48. A patient suffers a burn injury during surgery, and the cause is unclear, but such an injury would not ordinarily occur without negligence. The legal doctrine that might allow the patient to sue without proving specific negligent acts is: A. Respondeat Superior B. Force Majure C. Res Ipsa Loquitor D. False Imprisonment 49. A newly graduated nurse, acting under the direct supervision of a preceptor, makes a medication error that harms a patient. If the patient sues, which legal doctrine would most likely apply? A. Respondeat Superior B. Force Majure C. Res Ipsa Loquitor D. False Imprisonment 50. A nurse stops at the scene of a car accident and provides emergency first aid to an injured person before paramedics arrive. The nurse is protected from liability under which legal doctrine, assuming they acted within their scope of practice and without gross negligence? A. Good Samaritan Law B. Force Majure C. Gawad Parangal Award D. Res Ipsa Loquitor TOPIC: RENAL FABS - ACUTE RENAL FAILURE (MEDSURG)   Situation - Nurse Kaeya is caring for a client diagnosed with Acute Renal Failure (ARF)   51. Which laboratory values are most significant for diagnosing ARF? A. BUN and Creatinine B. WBC and Hemoglobin C. Potassium and sodium D. Bilirubin and ammonia 52. Upon checking the patient's history, the nurse knows that this condition predisposes the client to developing prerenal failure:  A. Diabetes Mellitus B. Hypotension C. Aminoglycosides. D. Benign Prostatic Hypertrophy 53. The client has a serum potassium level of 6.8 mEq/L. Which collaborative treatment should the nurse anticipate for the client?  A. Administer a phosphate binder B. Type and crossmatch for whole blood C. Assess the client for leg cramps D. Prepare the client for dialysis 54. The client is advised to be admitted to the intensive care department and will be placed on a therapeutic diet. Which is most appropriate for the client?  A. A high potassium and low-calcium diet B. A low-fat and low cholesterol diet C. A high-carbohydrate and restricted-protein diet D. A regular with six small feedings a day 55. The client diagnosed with ARF is placed on bedrest. The client asks the nurse, “Why do I have to stay in bed? I don't feel bad.” Which scientific rationale supports the nurse's response?  A. Bedrest helps increase the blood return to the renal circulation. B. Bedrest reduces the metabolic rate during the acute stage. C. Bedrest decreases the workload of the left side of the heart. D. Bedrest aids in reduction of peripheral and sacral edema. TOPIC: HEMATOLOGICAL DISORDERS - HEMOPHILIA A  & IDIOPATHIC THROMBOCYTOPENIC PURPURA (MEDSURG)   Situation - Hematological disorders include a broad range of blood dyscrasias, which may be hereditary or have an unknown etiology; some may be fatal, and some clients may live a normal life.The nurse must know the signs/symptoms of these disorders, what is expected with the disorder, and when immediate intervention is necessary. 56. The unlicensed assistive personnel (UAP) asks Nurse Klee, “How does someone get hemophilia A?” Which statement would be Nurse Klee's best response?  A. It is an inherited X-linked recessive disorder. B. There is a deficiency of the clotting factor VIII. C. The person is born with hemophilia A. D. The mother carries the gene and gives it to the son. 57. Which sign/symptom should Nurse Klee expect to assess in the client diagnosed with hemophilia A?  A. Epistaxis. B. Petechiae. C. Subcutaneous emphysema. D. Intermittent claudication. 58. The client with hemophilia A is experiencing hemarthrosis. Which intervention should the nurse recommend to the client?  A. Alternate aspirin and acetaminophen to help with the pain. B. Apply cold packs for 24 to 48 hours to the affected area. C. Perform active range-of-motion exercise on the extremity. D. Put the affected extremity in the dependent position. 59. Which sign would the nurse expect to assess in the client diagnosed with idiopathic thrombocytopenic purpura (ITP) A. Petechiae on the anterior chest, arms, and neck. B. Capillary refill of less than three (3) seconds. C. An enlarged spleen. D. Pulse oximeter reading of 95%. 60. The next day, Nurse Klee is assigned to Ward C. Which client should Nurse Klee assess first?  A. The client whose partial thromboplastin time (PTT) is 38 seconds. B. The client whose hemoglobin is 14 g/dL and hematocrit is 45%. C. The client whose platelet count is 75,000 per cubic millimeter of blood. D. The client whose red blood cell count is 4.8 × 106/mm3. TOPIC: NEUROLOGICAL DISORDERS - MENINGITIS (MEDSURG)   Situation: Ponpon Alarcon, a 24-year-old male, presents to the emergency department with a 12-hour history of high fever (39.6°C), severe headache, photophobia, nausea, and neck stiffness. His roommate reports that Ponpon became progressively more confused and lethargic and had a seizure before arrival. Appropriate diagnostic procedures will be implemented to rule-out Meningitis.     61. Nurse Athena, who will be the primary nurse of Patient Ponpon, is assessing the client to support his initial diagnosis of meningitis. Which clinical manifestations would support his diagnosis?  A. Positive Babinski’s sign and peripheral paresthesia B. Negative Chvostek’s sign and facial tingling. C. Positive Kernig’s sign and nuchal rigidity. D. Negative Trousseau’s sign and nystagmus 62. The nurse is preparing a client for a lumbar puncture.Which interventions should the nurse not implement?  A. Have the client empty the bladder prior to the procedure B. Place the client in a side-lying position with the back arched. C. Instruct the client to breathe rapidly and deeply during the procedure D. Explain to the client what to expect during the procedure. 63. Which statement best describes the scientific rationale for alternating a nonnarcotic antipyretic and a nonsteroidal anti- inflammatory drug (NSAID) every two (2) hours to patient Ponpon?