Tiêu đề RECALLS 9 - NP4 - SC ✅

RECALLS 9 EXAMINATION NURSING PRACTICE IV CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART B) NOVEMBER 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: You are caring for patient Igaram, a patient with Addison’s disease. You utilize your knowledge on this concept to help care for the patient. 1. Igaram was just recently diagnosed with Addison’s disease. He still lacks knowledge about his disease so he decided to ask you some questions. Igaram asked you, “How does the disease happen?” You answer him correctly by stating that this disease results from: A. Insufficient secretion of growth hormone (GH). B. Dysfunction of the hypothalamic pituitary. C. Idiopathic atrophy of the adrenal gland. D. Oversecretion of the adrenal medulla. 2. Igaram is admitted to your unit. After your assessment on him, you formulated the nursing diagnosis Deficient fluid volume related to inadequate fluid intake and to fluid loss secondary to inadequate adrenal hormone secretion. As Igaram’s oral intake increases, which of the following fluids would be the most appropriate for him? A. Milk and diet soda. B. Water and eggnog. C. Bouillon and juice. D. Coffee and milkshakes. 3. You are instructing Igaram how to adjust the dose of the glucocorticoids he is taking. As his nurse, you should explain to him that he may need an increased dosage of glucocorticoids in which of the following scenarios? A. Completing the spring semester of school. B. Gaining 4 pounds. C. Becoming engaged. D. Undergoing a root canal. 4. Igaram is diagnosed with Addison’s disease. As a knowledgeable nurse, you know that this condition may lead to Addisonian crisis if not adequately managed. Which of the following manifestations would be expected in Igaram if he develops this condition? A. Fluid retention. B. Pain. C. Peripheral edema. D. Hunger. 5. If Igaram develops Addisonian crisis, which of the following would be your priority as Igaram’s primary nurse? A. Controlling hypertension. B. Preventing irreversible shock. C. Preventing infection. D. Relieving anxiety. SITUATION: You are a nurse tasked to care for patients with different pituitary disorders. You are to take care of Karoo and Koza, both diagnosed with SIADH, and Paula, who is diagnosed with diabetes insipidus. You utilize your knowledge on this concept to help care for your patients safely. 6. One of the clients in your unit, Karoo, is diagnosed to have a pituitary tumor. Karoo developed Syndrome of Inappropriate Antidiuretic Hormone (SIADH). Which of the following interventions should you implement as Karoo’s primary nurse? A. Assess for dehydration and monitor blood glucose levels. B. Assess for nausea and vomiting and weigh daily. C. Monitor potassium levels and encourage fluid intake. D. Administer vasopressin IV and conduct a fluid deprivation test. 7. You are reviewing the chart of Karoo who has SIADH. Which of the following clinical manifestations you noted in Karoo’s chart should be reported to his primary care physician? A. Serum sodium of 112 mEq/L and a headache. B. Serum potassium of 5.0 mEq/L and a heightened awareness. C. Serum calcium of 10 mg/dL and tented tissue turgor. D. Serum magnesium of 1.2 mg/dL and large urinary output. 8. Another patient in your unit, Koza, was diagnosed with SIADH secondary to cancer of the lung. He tells you that he wants to discontinue his fluid restriction and that he does not care if he dies. Which of the following actions by the nurse is an example of the ethical principle of autonomy? A. Discuss the information the client told the nurse with the health-care provider and significant other. B. Explain it is possible the client could have a seizure if he drank fluid beyond the restrictions. C. Notify the health-care provider of the client’s wishes and give the client fluids as desired. D. Allow the client an extra drink of water and explain the nurse could get into trouble if the client tells the health-care provider. 9. Paula, another patient assigned to you in the unit, is recently diagnosed with diabetes insipidus. Which of the following interventions should you implement as Paula’s primary nurse? A. Administer sliding-scale insulin as ordered. B. Restrict caffeinated beverages. C. Check urine ketones if blood glucose is >250. D. Assess tissue turgor every four (4) hours 10. Following Paula’s diagnosis of diabetes insipidus, she stayed in the hospital for a few days. She is now about to be discharged and you are conducting your health teaching regarding her condition. Which of the following statements made by Paula warrants further intervention? A. “I will keep a list of my medications in my wallet and wear a Medic Alert bracelet.” B. “I should take my medication in the morning and leave it refrigerated at home.” C. “I should weigh myself every morning and record any weight gain.” D. “If I develop a tightness in my chest, I will call my health-care provider.” SITUATION: You are a nurse caring for patients with inflammatory bowel disease. 11. Pierre is a patient admitted to the hospital with a diagnosis of ulcerative colitis. You are currently reviewing his history and physical assessment chart. Based on Pierre’s diagnosis, which 1 | Page
of the following information should you expect to see in Pierre’s medical records? A. Abdominal pain and bloody diarrhea B. Weight gain and elevated blood glucose C. Abdominal distension and hypoactive bowel sounds D. Heartburn and regurgitation 12. Pierre had a recent exacerbation of ulcerative colitis. He is put on mesalamine (Asacol), which is to be administered rectally via an enema. Pierre finds this procedure distasteful and he asks you, “Why can't the medication just be given orally?”. You answer Pierre correctly by saying which of the following? A. “It can be given orally; I’ll contact the doctor and see if the change can be made.” B. “Rectal administration delivers the medication directly to the affected area.” C. “Oral administration will not be as effective for the disease condition.” D. “It can be given orally, I’ll make the change and we’ll tell the doctor in the morning.” 13. You overhear a licensed practical nurse (LPN) talking to one of your patients, Mousse, who is being prepared for a total colectomy with creation of an ileoanal reservoir for her ulcerative colitis. To decrease Mousse’s anxiety, you should intervene to clarify the information given by the LPN when you hear the LPN saying: A. “This surgery will prevent you from developing colon cancer.” B. “After this surgery you will no longer have ulcerative colitis.” C. “When you return from surgery you will not be able to eat solid food for several days.” D. “You will have an ileostomy when you return from this surgery.” 14. Wyper, a 20 year old male client, is admitted to your unit because of the exacerbation of their ulcerative colitis. You go into Wyper’s room to complete an initial assessment, and he yells, “Get outta here! I am tired of you nurses and doctors looking at my body all the time!” Which of the following is your best action? A. Leave the room and ask a male colleague to complete the assessment. B. Verbally acknowledge the client’s frustration and anger. C. Call the health-care practitioner and ask for a sedative order. D. Tell the client that gathering data about his current condition will promote effective timely treatment of his health concerns. 15. You are caring for Conis, a patient admitted in your unit who is diagnosed with Crohn’s disease. She has undergone a barium enema that demonstrated the presence of strictures in her ileum. Based on this finding, you should monitor the client closely for signs of: A. peritonitis. B. obstruction. C. malabsorption. D. fluid imbalance. SITUATION: You are a new nurse assigned to take care of patients with various eye disorders. You use your knowledge to help these patients with their condition. 16. One of the patients in your unit, Pagaya, is diagnosed with glaucoma. Which of the following symptoms should you expect the client to report during your initial assessment with him? A. Loss of peripheral vision. B. Floating spots in the vision. C. A yellow haze around everything. D. A curtain coming across vision. 17. Pagaya has now been prescribed a miotic cholinergic medication for his glaucoma. Which of the following data indicates that the medication has been effective on Pagaya? A. No redness or irritation of the eyes B. A decrease in intraocular pressure C. The pupil reacts briskly to light D. The client denies any type of floaters 18. You are caring for Gan Fall, a postoperative patient, after his retinal detachment surgery. Gas tamponade was used to flatten the patient’s retina during the procedure. Which of the following interventions should you implement first? A. Teach the signs of increased intraocular pressure. B. Position the client as prescribed by the surgeon. C. Assess the eye for signs/symptoms of complications. D. Explain the importance of follow-up visits. 19. You are caring for Conis, a patient with severe myopia. She is scheduled for a laser assisted in situ keratomileusis (LASIK) surgery. Which of the following instructions should you discuss with Conis prior to her discharge from the surgery? A. Wear bilateral eye patches for three (3) days. B. Wear corrective lenses until the follow-up visit. C. Do not read any material for at least one (1) week. D. Teach the client how to instill corticosteroid ophthalmic drops. 20. Eneru, a 65 year old male client is complaining of blurred vision, but denies having any type of pain. He reports to you, “I feel like I need to clean my glasses all the time”. Which of the following eye disorders should you suspect that Eneru has? A. Corneal dystrophy B. Conjunctivitis C. Diabetic retinopathy D. Cataracts SITUATION: You are a nurse studying the different types of shock and its appropriate nursing interventions. You come across the following patients in your unit. You applied the concepts you’ve learned to your nursing practice. 21. Foxy is a client admitted to the emergency department. Assessment findings include diaphoresis, pale clammy skin, and a blood pressure reading of 90/70. Which of the following interventions should you implement first? A. Start an IV with an 18-gauge catheter. B. Administer dopamine intravenous infusion. C. Obtain arterial blood gases (ABGs). D. Insert an indwelling urinary catheter. 22. Porche is a patient diagnosed with neurogenic shock. As a knowledgeable nurse, you expect to note which of the following signs and symptoms in this client? A. Cool, moist skin. B. Bradycardia. C. Wheezing. D. Decreased bowel sounds 23. One of the patients in your unit, Hamburg, was diagnosed with septicemia. The following are the orders given by Hamburg’s primary physician. Which of these orders will have the highest priority? A. Provide a clear liquid diet. B. Initiate IV antibiotic therapy. C. Obtain a STAT chest x-ray. D. Perform hourly glucometer checks. 24. You wrote the nursing diagnosis of “alteration in comfort related to chills in fever” in one of your patients who has sepsis. Which of the following interventions would you include in this patient’s plan of care? A. Ambulate the client in the hallway every shift. B. Monitor urinalysis, creatinine level, and BUN level. C. Apply sequential compression devices to the lower extremities. D. Administer an antipyretic medication every four (4) hours PRN. 25. A patient named Chiqicheetah presents themselves in the emergency department complaining of abdominal pain, is pale and clammy, and has a pulse of 110 and a blood pressure reading of 92/60. Chiqicheetah has vertebral fractures, and she reported she has been self-medicating with Ibuprofen, a type of nonsteroidal anti-inflammatory drug (NSAID). Which of the following type of shocks should you expect in patient Chiqicheetah? A. Cardiogenic shock. B. Hypovolemic shock. C. Neurogenic shock. D. Septic shock. SITUATION: You are caring for patients in your unit with alterations in their fluid and electrolytes. As a knowledgeable nurse, you apply the concepts of fluid and electrolytes in your nursing practice. 2 | Page