Tiêu đề RECALLS 6 (NP5) - STUDENT COPY ✅

RECALLS EXAMINATION 6 NURSING PRACTICE V CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART C) NOVEMBER 2024 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 V” on the box provided SITUATION: Nanay Flor has just been diagnosed with cataract. During her initial visit to the ophthalmology clinic, she reports having blurred vision and difficulty seeing clearly. 1. If you are the nurse caring for Nanay Flor, what would be your priority problem? A. Concern about the loss of eyesight B. Altered vision due to opacity of the ocular lens C. Self-pity due to the debilitating effects of the condition D. Becoming lonely because of decreased community immersion 2. Nanay Flor inquired about what can be done to improve her condition. As a knowledgeable nurse, you understand that the following are ineffective treatment for managing cataracts, except: A. Foods and supplements high in Vitamin A B. Eyeglasses or magnifying lenses C. Corticosteroid eye drops D. Surgical intervention 3. The physician has concluded that Nanay Flor will gain more benefit from surgery to remove her cataract on her right eye. To prepare her for the procedure, you should advise Nanay Flor that after the surgery: A. She should sleep on her left side. B. She should sleep on my right side. C. She should sleep with her head flat. D. She should not wear her glasses at any time. 4. Nanay Flor mentioned before the surgery that she has psoriasis. Although her symptoms are not severe at the moment, she is still taking cyclosporine to manage the condition. Given this, you know that Nanay Flor is at an increased risk for: A. Increased dosage of medications B. Exacerbation of psoriasis C. Infection D. Adrenal storm 5. Two hours after the surgery, Nanay Flor complained of nausea and severe eye pain at the operative site. How should you initially respond? A. Call the surgeon B. Reassure the client that this is normal. C. Turn the client onto her or his operative side. D. Administer the prescribed pain medication and antiemetic. 6. For Nanay Flor's discharge instructions, she should be advised to report immediately if she experiences any of the following symptoms: A. Slight morning discharge from the eye B. Any appearance of redness of the eye C. scratchy feeling in the eye D. A new floater in vision SITUATION: Andres, a 55-year-old patient, has been experiencing recurring episodes of dizziness and sensation of fullness in his ears. These symptoms have progressively worsened over the past few months, affecting his daily activities. After a thorough evaluation, Andres is diagnosed with endolymphatic hydrops. 7. What considerations should the nurse keep in mind when caring for Andres? A. Limit intake of sodium to 4,500 mg per day only. B. Avoid sudden head movements. C. Lie still and watch the television. D. Increase fluid intake to 3000 mL a day. 8. Andres informed the nurse about the foods he ate before his symptoms worsened. Which of the following foods might have contributed to his symptoms? A. Sweet pickles B. Frozen yogurt C. Shellfish D. Red meat 9. The physician informed Andres that his hearing loss is related to damage to cranial nerve VIII. What term describes this condition? A. Otalgia B. Conductive hearing loss C. Sensorineural hearing loss D. Presbycusis 10. Given the symptoms Andres is experiencing, which diagnosis should be of most concern to the nurse? A. risk for falls related to dizziness. B. impaired verbal communication related to tinnitus. C. self-care deficit (bathing and dressing) related to vertigo. D. imbalanced nutrition: less than body requirements related to nausea. 11. Andres has been prescribed meclizine. To assess the effectiveness of the medication, which question is the nurse most likely to ask? A. “Has the medication helped to relieve the pain in the ear canal?” B. “Are you still experiencing the whirling and turning sensations?” C. “Have you been able to hear better since you started the medication?” D. “Are you still having itching and discomfort in the outer ear?” SITUATION: Kathleen, a 30-year-old patient, has recently been diagnosed with open-angle glaucoma. During her consultation, she expresses concern about how her condition will affect her daily life and seeks guidance on managing her glaucoma effectively. 12. Which of the following manifestations is Kathleen most likely to experience? A. Loss of central visual field B. Seeing halos around lights C. Extreme eye aching D. Loss of peripheral vision 13. The physician has prescribed medications for Kathleen. Which of the following medications, if listed on the prescription, would prompt the nurse to ask for clarification? 1 | Page
A. Betaxolol B. Acetazolamide C. Erythromycin D. Atropine sulfate 14. Pilocarpine eye drop is included in Kathleen's prescription. Before administering the medication, she asks about its purpose and expected effects. Which of the following explanations given by the nurse would not require correction? A. “The medication will help dilate the eye to prevent pressure from occurring.” B. “The medication will relax the muscles of the eyes and prevent blurred vision.” C. “The medication causes the pupil to constrict and will lower the pressure in the eye.” D. “The medication will help block the responses that are sent to the muscles in the eye.” 15. After purchasing the medication, the nurse saw Kathleen taking it orally. How should the nurse initially respond? A. Obtain a prescription for tonometry so that her intraocular pressure can be checked. B. Try to determine the frequency and the amount that she has been ingesting. C. Ask her how she decided to take the drops orally instead of instilling them as eyedrops. D. Call the Poison Control Center and be prepared to describe untoward side effects. 16. The nurse then provided Kathleen with health education on proper administration of the eyedrop medication. Which of the following instruction should the nurse say? A. Expose the lower conjunctival sac and holding the medication in the dominant hand, squeeze it. B. Expose the lower conjunctival sac and holding the medication in the non-dominant hand, squeeze it. C. Instruct the client to look down and squeeze the medication. D. Instruct the client to look up, and squeeze the medication from inner canthus to outer canthus of the eye. 17. Kathleen expressed her gratitude, believing that there will come a time when she will no longer need medication and will be fully healed. How should the nurse best respond? A. You have a great attitude. This will likely shorten the amount of time that you need medications. B. Glaucoma usually requires lifelong treatment with medications. C. Most people are treated until their intraocular pressure goes below 50 mm Hg. D. You can likely expect a minimum of 6 months of treatment. SITUATION: Nursing management of patients with hearing and balance disorders. 18. The school nurse is conducting routine health checkups for students in the school clinic. Which findings from the physical assessment would warrant a referral to a healthcare provider? A. Pearly gray or pink tympanic membrane B. Dense whitish ring at the circumference of the tympanum C. Bulging red or blue tympanic membrane D. Cone of light at the innermost part of the tympanum 19. The clinic is busy with several patients undergoing routine follow-ups. The nurse reviews the medication lists of the following patients. Which combination of drugs from the medication lists would be most concerning if a patient reports tinnitus or other hearing problems? A. A 25 year-old patient taking gentamycin and ethacrynic acid B. A 56 year-old man taking furosemide and metoprolol C. A 32 year-old patient taking vancomycin and nitroglycerin patch D. A 40 year-old patient taking aspirin and calcium supplement 20. During the shift, the nurse encounters several patients reporting symptoms related to vertigo. Each patient describes their symptoms in different ways. Which of the following descriptions would be of greatest concern? A. Dizziness with hearing loss B. Episodic vertigo C. Vertigo without hearing loss D. “Merry-go-round”vertigo 21. In the ENT clinic, the nurse is assessing several patients with ear-related issues. Which of the following patients would warrant the most urgent attention? A. Has discomfort of the ear preceded by a viral infection; the tympanic membrane is erythematous B. Has been treated with antibiotics for recurrent acute otitis media four times within the past 6 months C. Reports rapid onset ear pain with pruritus and a sensation of fullness that started after cleaning the ear canal with a finger D. Reports progressive severe otic pain with purulent discharge 22. In the same clinic, a patient taking Meclizine is coming in for a follow-up checkup. What questions should the nurse ask to assess the effectiveness of the medication? A. Has the medication helped to relieve the pain in the ear canal? B. Are you still experiencing the whirling and turning sensations? C. Have you been able to hear better since you started the medication? D. Are you still having itching and discomfort in the outer ear? 23. Pepe had stapedectomy surgery 3 days ago to manage his otosclerosis and is now at his follow-up appointment. Which statement would show that he did not understand the discharge instructions? A. “I re-scheduled my swimming lessons for next month.” B. “I will be needing to book an overseas flight two weeks from now for my business.” C. “I’m so happy I was able to get back to my regular weightlifting class immediately.” D. “I have been coughing a lot with my mouth open.” 24. Before prescribing amoxicillin for a child with acute otitis media, which detail is crucial for the health care provider to know? A. The child has completed a course of amoxicillin for a different condition few months ago. B. The child has a history of both personal and family penicillin allergies C. The child is also experiencing symptoms of allergic rhinitis D. The child is 18 months old, attends daycare, and is exposed to secondhand smoke 25. A 68 year-old patient, Mrs. Rosa is experiencing significant hearing loss. To ensure effective communication, which of the following should a nurse do? A. Sit or stand in front of the Mrs. Rosa when speaking. B. Use exaggerated lip and mouth movements when talking to Mrs. Rosa. C. Stand in front of a light or window when speaking to Mrs. Rosa. D. Say Mrs. Rosa’s name loudly before starting to talk. SITUATION: In psychiatric nursing, understanding legal aspects is crucial for ensuring the safety and rights of patients while providing appropriate care. 26. After being diagnosed with depression, Joy is admitted to treatment on a voluntary basis. While in the hospital, Joy makes several comments about wanting to end it all. Unexpectedly, she decides to leave against medical advice. Which of the following would be the most appropriate action by a nurse? A. Calling security and asking them to detain Joy B. Allowing Joy to leave with community resources for follow-up care C. Contacting the psychiatrist for initiation of commitment proceedings D. Contacting the Joy 's family to request they convince the client to stay 27. Miguel, an 18 year old manic patient is being disruptive and argumentative on the unit. The nurse warns him, "If you keep arguing, you will have to restrained for the rest of the day." The nurse’s approach is: A. inappropriate; room restriction is not treatment in the least restrictive environment. 2 | Page
B. inappropriate; the adolescent should be offered a sedative before room restriction. C. appropriate; room restriction is an effective behavior modification technique. D. appropriate; the adolescent should not have conflicts with others. 28. It has been one year since Kuya Momert was admitted for drug addiction rehabilitation. During the evening shift, the nurse receives a phone call from someone asking about Momert's status. The caller is not on the Momert’s approved contact list. What is the appropriate response by the nurse to this caller? A. “I cannot confirm or deny the existence of any client here.” B. “You will need to be placed on the client's contact list before I can discuss any information with you.” C. “The person you are asking for is not a client here.” D. “Hold 1 minute while I get the client for you.” 29. Student nurse Julliana understands that patient confidentiality can only be breached if: A. An abused woman states, “I have dreams that he is dead.” B. A mother states, “Sometimes I feel like leaving my kids!” C. A paranoid woman states, “I'll get them before they get me.” D. A jealous man states, “I am getting my gun and going to shoot my wife's lover!” 30. Jobert is an extremely paranoid client on the psychiatric unit consistently refuses to take the prescribed medication offered by the nurses. Despite the staff’s efforts to provide reassurance and explain the benefits of the medication, Jobert remains resolute in his refusal. The staff realizes that legally this client can: A. be coerced to accept treatment. B. be committed by her family to receive needed treatment. C. have her family sign permission for treatment. D. continue to refuse treatment. 31. The clinical instructor is educating nursing students about confidentiality before the students begins their clinical duties. The instructor explains that confidentiality can be legally breached if: A. At any time a client is threatening B. If threats are made to an identifiable third party C. Whenever the client starts to become aggressive D. When the client violates the nurse's boundaries 32. Rendon is being brought to Kimpimparah Mental Hospital due to persistent loud and disruptive behavior that has caused significant distress in his village. The family and local authorities believe he needs to be admitted and treated for his behavior. Which criteria for involuntary admission does Rendon meet? A. Dangerous to self. B. Dangerous to others. C. Gravely disabled. D. He does not meet any of the necessary criteria. 33. Joyjoy is being re-admitted to the psychiatric unit following a severe psychotic episode triggered by a recent tragedy. Despite the medical team's efforts to explain the importance of the prescribed medication for her recovery, Joyjoy refuses to take it. Which nursing intervention is most appropriate given Joyjoy's refusal to take her medication? A. Accept Joyjoy's decision B. Obtain a discharge order for Joyjoy's noncompliance C. Insist that Joyjoy is too ill to refuse the medication D. Use restraints to administer the medication IM 34. Nurse Eva is attending an in-service training on proper take-down techniques for aggressive clients before starting her assignment in a mental health facility. Which ethical principle does Eva practices? A. Veracity B. Nonmaleficence C. Justice D. Autonomy 35. It was 5:30 in the morning. The nurses were completing their endorsement and preparing for the upcoming shift. Afterward, they conducted their usual rounds and found one of the depressed patients hanging in her room, pulseless and breathless. What kind of legal action might the patient's family pursue in this case? A. Malpractice B. Breach of duty C. Negligence D. Injury or damage SITUATION: Nurse Bianca is assigned to care for Mikha, a young and ambitious aspiring P-pop idol who was overwhelmed by the pressures of the entertainment industry. Mikha frequently consumes an amount of food much larger than a person would normally eat in a single sitting, often to the point of discomfort. Following these episodes, Mikha purged the food or engages in excessive exercise to compensate. 36. Which of the following disorders might Mikha be suffering from? A. Anorexia nervosa B. Bulimia nervosa C. Pica D. Rumination 37. Nurse Bianca would expect to observe the following to Mikha, except: A. Cold intolerance B. Normal weight for height C. Dental erosion D. Metabolic alkalosis 38. To help Mikha on her path to recovery, Nurse Bianca utilized cognitive and behavioral techniques. Which statement by the nurse would align with this approach? A. “Is there any way you can look at that sandwich as fuel for your body?” B. “You have to eat in moderation for good nutrition.” C. “You seem to have a really hard time controlling your eating patterns.” D. “Is this your way of showing your family that you can make decisions?” 39. After an extended discussion, Nurse Bianca observed certain personality trait in Mikha and concluded that this trait is somewhat typical among clients with eating disorders. Which of the following traits is the most accurate? A. Careless B. Outspoken C. Defiance D. Eager to please 40. Nurse Bianca wanted to explore the reasons behind the development of this trait. Which of the following statements would best help her encourage Mikha to share her feelings? A. Are you sad? B. You look anxious. C. Tell me what you are feeling right now. D. Tell me when you feel bad. 41. Nurse Bianca is teaching Mikha how to use self-monitoring techniques. Which statement from Mikha would suggest that these techniques are working? A. “I am learning to recognize events and emotions that trigger my binges and am working on responses other than binging and purging.” B. “I am beginning to understand how my lack of self-control is hurting me.” C. “I am keeping a record of everything I eat and how I am feeling every day.” D. “I am getting more comfortable confronting people when I have conflict with them.” SITUATION: Therapeutic communication in nursing helps build a trusting relationship between nurses and patients. 42. The nurse noticed a patient sitting quietly near the hospital garden, gazing at the night sky. The nurse sat down beside the patient and tried to start a conversation, but the patient appeared fearful and reluctant to speak. Which of the following techniques would be most effective in encouraging the patient to engage in conversation? A. Broad opening B. Focusing C. Giving information D. Silence 3 | Page