Tiêu đề RECALLS 8 - NP3 - SC ✅

RECALLS 8 EXAMINATION NURSING PRACTICE III CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART A) 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 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 1 | Page
C. Repaglinide D. Regular insulin 13. One of your clients is having a sinus bradycardia, with a heart rate of 45 beats per minute and blood pressure of 82/60 mm Hg, reports dizziness. Which intervention would you anticipate will be prescribed? A. Administer digoxin. B. Defibrillate the client. C. Continue to monitor the client. D. Prepare for transcutaneous pacing. 14. You are watching the cardiac monitor and notices that a client’s rhythm suddenly changes. There are no P waves, the QRS complexes are wide, and the ventricular rate is regular but more than 140 beats per minute. The nurse determines that the client is experiencing which dysrhythmia? A. Sinus tachycardia B. Ventricular Fibrillation C. Ventricular tachycardia D. Premature ventricular contractions 15. You are assisting to defibrillate a client in ventricular fibrillation. Which intervention is your priority after placing the pads on the client’s chest and before discharging the device? A. Ensure that the client has been intubated. B. Set the defibrillator to “synchronize” mode. C. Administer an amiodarone bolus. D. Confirm the cardiac rhythm 16. You noticed that your client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger, and begins coughing frothy, pink-tinged sputum. Which finding would you anticipate when auscultating the client’s breath sounds? A. Stridor B. Crackles C. Scattered rhonchi D. Diminished breath sound 17. You are assessing the neurovascular status of a client who returned to the surgical nursing unit 4 hours ago after undergoing aortoiliac bypass graft. The affected leg is warm, and the nurse notes redness and edema. The pedal pulse is palpable. How would you interpret the client’s neurovascular status? A. The neurovascular status is expected because of increased blood flow through the leg. B. The neurovascular status is moderately impaired, and the surgeon needs to be called. C. The neurovascular status is slightly deteriorating and needs to be monitored for another hour. D. The neurovascular status shows adequate arterial flow, but venous complications are arising. 18. A client has frequent bursts of ventricular tachycardia on the cardiac monitor. Which factor is your highest priority with regard to this dysrhythmia? A. It can develop into ventricular fibrillation at any time. B. It is almost impossible to convert to a normal rhythm. C. It is uncomfortable for the client, giving a sense of impending doom. D. It produces a high cardiac output with cerebral and myocardial ischemia 19. Your client with ventricular fibrillation is about to be defibrillated. Which energy level (in joules, J) would you set on the monophasic defibrillator machine for the first delivery? A. 50 J B. 120 J C. 200 J D. 360 J 20. You are caring for a client who had a resection of an abdominal aortic aneurysm yesterday. The client has an intravenous (IV) infusion at a rate of 150 mL/hr, unchanged for the last 10 hours. The client’s urine output for the last 3 hours has been 90, 50, and 28 mL (28 mL is most recent). The client’s blood urea nitrogen level is 35 mg/dL (12.6 mmol/L), and the serum creatinine level is 1.8 mg/dL (159 mcmol/L), measured this morning. Which nursing action is your priority? A. Check the serum albumin level. B. Check the urine specific gravity. C. Continue to monitor urine output. D. Call the primary health care provider. 21. A client is wearing a continuous cardiac monitor, which begins to sound its alarm. You notice that there are no electrocardiographic complexes on the screen. Which is the priority nursing action? A. Call a code. B. Check the client’s status. C. Call the primary health care provider. D. Document the lack of complexes. 22. You are evaluating a client’s response to cardioversion. Which assessment would be the priority? A. Blood pressure B. Airway patency C. Oxygen flow rate D. Level of consciousness Situation: You are on shift, responsible for managing the care of several patients with various respiratory conditions. 23. A 12-year-old child with asthma is being treated for a severe asthma attack in the emergency room. What symptom should you specifically watch for, as it would signal a worsening of the child's condition? A. Warm, dry skin B. Decreased wheezing C. Pulse rate of 90 beats per minute D. Respirations of 18 breaths per minute 24. An 8-year-old child undergoing home treatment for right lower lobe pneumonia calls the clinic with their parent, who reports that the child is experiencing discomfort on the right side and that ibuprofen is not providing relief. What guidance should you offer to the parent? A. Increase the dose of ibuprofen. B. Increase the frequency of ibuprofen. C. Encourage the child to lie on the left side. D. Encourage the child to lie on the right side. 25. A new parent is worried about sudden infant death syndrome (SIDS) and asks the nurse for guidance on the safest sleep position for their newborn. What position should you recommend for placing the infant? A. Side or prone B. Back or prone C. Stomach with the face turned D. Back rather than on the stomach 26. You are discussing the immunization schedule with the parent of a child with cystic fibrosis. What information should you, as the nurse, provide to the parent regarding the child's vaccinations? A. “The immunization schedule will need to be altered.” B. “The child should not receive any hepatitis vaccines.” C. “The child will receive all of the immunizations except for the polio series.” D. “The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination.” 27. You are an emergency department nurse evaluating a child diagnosed with epiglottitis. What signs should you watch for to determine if the child may be experiencing an airway obstruction? A. The child exhibits nasal flaring and bradycardia. B. The child is leaning forward, with the chin thrust out. C. The child has a low-grade fever and complains of a sore throat. D. The child is leaning backward, supporting self with the hands and arms. 28. A child with croup is being treated with a cool mist vaporizer in their hospital room. The child is visibly distressed, crying persistently, and attempting to leave the area. What should you do to address the child's discomfort and ensure their safety? A. Tell the parent that the child must stay in the tent. B. Place a toy in the tent to make the child feel more comfortable. C. Call the pediatrician and obtain a prescription for a mild sedative. D. Let the parent hold the child and direct the cool mist over the child’s face. 29. You reviews the tuberculin skin test (TST) results for a 3-year-old child and notes an induration area measuring 10 mm. How should you interpret these results? A. Positive B. Negative 2 | Page