Tiêu đề RECALLS 4 - NP5 - SC ✅

RECALLS 4 EXAMINATION NURSING PRACTICE V CARE OF THE CLIENT WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART C) 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 V” on the box provided Situation: A 28-year-old male client with a history of bipolar disorder and recent suicide attempt is admitted to the psychiatric unit. He is currently exhibiting manic symptoms and is prescribed lithium. 1. Which of the following is the most important nursing intervention when assessing a client taking lithium? A. Monitor for signs of hyperkalemia. B. Assess for gastrointestinal distress. C. Monitor serum lithium levels regularly. D. Observe for extrapyramidal symptoms. 2. The client's lithium level is 1.8 mEq/L. What is the nurse's priority action? A. Administer the next dose of lithium as prescribed. B. Document the finding and continue to monitor the client. C. Notify the physician immediately. D. Encourage increased fluid intake. 3. The signs of lithium toxicity include which? A. Sedation, fever, and restlessness B. Psychomotor agitation, insomnia, and increased thirst C. Elevated WBC count, sweating, and confusion D. Severe vomiting, diarrhea, and weakness 4. Which of the following medications is contraindicated in a client taking an MAOI? A. Lithium B. Sertraline (Zoloft) C. Valproic acid (Depakote) D. Lamotrigine (Lamictal) 5. Which nursing diagnosis is appropriate for this client at this time? A. Risk for injury related to impulsivity B. Ineffective coping related to bipolar disorder C. Disturbed thought processes related to mania D. Imbalanced nutrition: less than body requirements Situation: A nurse is caring for several clients who are exhibiting different coping mechanisms in response to stressful life events. Identify the ego defense mechanism being used in each case. 6. A client who recently lost their job states, "I'm actually better off without that stressful job. I can now focus on my family and hobbies." A. Displacement B. Rationalization C. Projection D. Sublimation 7. A client who experienced a traumatic car accident has no memory of the event. A. Repression B. Dissociation C. Denial D. Regression 8. A client who is angry at their supervisor for a recent reprimand yells at their spouse when they get home. A. Displacement B. Projection C. Reaction Formation D. Compensation 9. A client with a history of substance abuse begins volunteering at a local homeless shelter. A. Undoing B. Sublimation C. Identification D. Compensation 10. A client who has always wanted to be a doctor but failed the medical school entrance exam repeatedly now excels as a medical researcher. A. Reaction Formation B. Compensation C. Intellectualization D. Substitution 11. A client presents with sharpened senses, increased motivation, and reports feeling restless with gastrointestinal "butterflies." They are able to solve problems and learning is effective. A. Panic B. Severe C. Moderate D. Mild 12. A client is unable to complete tasks, solve problems, or learn effectively. They report feeling awe and dread, and have a severe headache. Their behavior is geared toward anxiety relief, but is ineffective. A. Mild B. Moderate C. Severe D. Panic 13. A client's perceptual field is reduced to focus solely on themselves. They cannot process environmental stimuli and exhibit distorted perceptions. They are possibly suicidal and unable to communicate verbally. A. Severe B. Moderate C. Mild D. Panic 14. A client exhibits muscle tension, diaphoresis, and a pounding pulse. They can be redirected from the immediate task, but cannot connect thoughts or events independently. A. Panic B. Severe C. Moderate D. Mild 15. A client reports feeling restless and sleepless. They are irritable and hypersensitive to noise. A. Panic B. Severe C. Moderate D. Mild 1 | Page
Situation: A nurse is conducting therapeutic communication sessions with clients who are experiencing various emotional and mental health challenges. The nurse uses different communication techniques to support effective interaction and understanding. Identify the therapeutic communication technique being used in each situation. 16. A client is hesitant to talk about their feelings, stating only, "I don't know where to begin." The nurse responds, "Is there something you'd like to talk about? What would you like to begin with?" A. Consensual validation B. Encouraging comparison C. Broad openings D. Accepting 17. A client is describing a stressful event, but keeps shifting between different aspects without fully exploring any one point. The nurse says, "Of all the concerns you've mentioned, which is most troublesome?" A. Exploring B. Focusing C. Formulating a plan of action D. Giving information 18. A client expresses anger about a recent situation. The nurse asks, "What could you do to let your anger out harmlessly? Next time this comes up, what might you do to handle it?" A. Exploring B. Focusing C. Formulating a plan of action D. Giving information 19. A client shares a past experience of overcoming a similar challenge. The nurse responds, "Have you had similar experiences? Was it something like...?" A. Accepting B. Encouraging comparison C. Broad openings D. Encouraging expression 20. A client expresses a belief about a situation, and the nurse says, "Tell me whether my understanding of it agrees with yours. Are you using this word to convey that...?" A. Encouraging description of perceptions B. Encouraging expression C. Consensual validation D. Broad openings Situation: A nurse is interacting with several clients exhibiting various emotional states. The nurse needs to identify and avoid using non-therapeutic communication techniques. 21. A client expresses feeling hopeless and says, "I wish I were dead." The nurse responds, "Everybody gets down in the dumps; I've felt that way myself." A. Advising B. Agreeing C. Belittling feelings expressed D. Challenging 22. A client expresses a concern about a medication side effect. The nurse says, "Let's not discuss that." A. Probing B. Making stereotyped comments C. Reassuring D. Rejecting 23. A client says, "I should just quit my job." The nurse says, "I think you should look for a new job instead." A. Advising B. Agreeing C. Belittling feelings expressed D. Challenging 24. A client, experiencing hallucinations, states, "The hospital is trying to poison me." The nurse responds, "But how can you be sure that's true? This hospital has a fine reputation." A. Advising B. Agreeing C. Belittling feelings expressed D. Challenging 25. A client shares a belief that is inconsistent with reality. The nurse asks, "Why do you think that? Why do you feel that way?" A. Rejecting B. Reassuring C. Making stereotyped comments D. Requesting an explanation 26. A client with a history of suicide attempts becomes increasingly agitated and threatens self-harm. The nurse decides to restrain the client without obtaining a physician's order. Which intentional tort has the nurse potentially committed? A. Assault B. Battery C. False imprisonment D. Negligence 27. A client with schizophrenia experiences an acute psychotic episode and becomes verbally abusive towards staff. The nurse responds by threatening to restrain the client. What intentional tort has the nurse potentially committed? A. Battery B. False imprisonment C. Negligence D. Assault 28. A nurse forgets to administer a prescribed medication to a client. The client subsequently experiences a seizure, resulting in a head injury. Which element of negligence is most directly implicated? A. Duty B. Breach of duty C. Injury or damage D. Causation 29. A nurse administers the wrong medication to a client due to a medication error. The client experiences an adverse reaction but recovers fully. Which element of negligence is ABSENT in this scenario? A. Duty B. Breach of duty C. Injury or damage D. Causation 30. A nurse is caring for two clients: one wealthy and one impoverished. The nurse provides the same standard of care to both clients. Which ethical principle is the nurse upholding? A. Autonomy B. Beneficence C. Justice D. Fidelity Situation: A nurse is caring for a client diagnosed with Obsessive-Compulsive Disorder (OCD) who is experiencing significant distress and functional impairment. 31. The client spends hours each day arranging and rearranging items on their bedside table, believing it must be "just so." This behavior is best described as: A. An obsession B. A compulsion C. A delusion D. A hallucination 32. The client reports experiencing persistent, intrusive thoughts of contamination. These thoughts cause significant anxiety and interfere with their ability to eat meals. This behavior is best described as: A. A compulsion B. A delusion C. An obsession D. A hallucination 33. The nurse is implementing exposure and response prevention (ERP) therapy. Which nursing intervention is consistent with this approach? A. Allowing the client extra time to complete their rituals. B. Distracting the client whenever they begin a ritual. C. Gradually reducing the time the client spends performing rituals. D. Immediately stopping the client from performing any ritualistic behavior. 34. The client's family expresses frustration with the client's OCD symptoms and requests advice on how to best support 2 | Page
them. Which of the following is the most helpful suggestion the nurse can offer? A. Ignore the client's rituals to avoid reinforcing the behavior. B. Try to reason with the client to stop performing the rituals. C. Learn about OCD and provide consistent, supportive understanding. D. Punish the client for engaging in ritualistic behaviors. 35. The client is prescribed sertraline (Zoloft) for their OCD. The nurse should educate the client about which potential side effect? A. Increased appetite B. Weight gain C. Sexual dysfunction D. Sedation Situation: A 28-year-old female client, Ms. Santos, is admitted to the psychiatric unit exhibiting symptoms consistent with schizophrenia. She displays disorganized speech, flat affect, and social withdrawal. She has difficulty completing tasks and expresses a lack of motivation. She also reports auditory hallucinations, hearing voices that criticize her. 36. Which of the following is a positive symptom of schizophrenia exhibited by Ms. Santos? A. Apathy B. Avolition C. Auditory Hallucinations D. Flat Affect 37. Ms. Santos's disorganized speech is best described as: A. Circumstantiality B. Associative Looseness C. Perseveration D. Flight of Ideas 38. The nurse observes Ms. Santos exhibiting flat affect. This means: A. Ms. Santos is experiencing intense emotional outbursts. B. Ms. Santos is exhibiting inappropriate emotional responses. C. Ms. Santos shows a restricted range of emotional expression. D. Ms. Santos is actively trying to conceal her emotions. 39. Which nursing intervention is appropriate to address Ms. Santos's avolition? A. Engage her in long, complex tasks to challenge her lack of motivation. B. Provide a structured daily schedule with simple, achievable tasks. C. Allow her to rest as much as she needs to conserve energy. D. Ignore her lack of motivation, as it is a symptom of her illness. 40. Ms. Santos reports hearing voices that criticize her. The nurse's best initial response is: A. "Those voices aren't real; you need to ignore them." B. "Tell me more about the voices you are hearing." C. "Let's focus on more positive things to distract you from the voices." D. "I understand you're hearing voices, but we need to focus on your medication." Situation: A 25-year-old male client, Mr. Dela Cruz, is admitted to the psychiatric unit following a suicide attempt. He is diagnosed with Borderline Personality Disorder (BPD). He exhibits impulsivity, unstable relationships, and intense fear of abandonment. He has a history of self-harm and has difficulty regulating his emotions. 41. Which of the following behaviors is commonly associated with Borderline Personality Disorder? A. Grandiose sense of self-importance B. Persistent suspiciousness and distrust of others C. Unstable interpersonal relationships and impulsivity D. Detachment from social relationships and restricted emotional expression 42. Mr. Dela Cruz expresses intense anger towards the nursing staff after a request is denied. What is the nurse's best initial response? A. Immediately confront Mr. Dela Cruz about his inappropriate behavior. B. Validate his feelings while setting clear limits on his behavior. C. Ignore his outburst to avoid escalating the situation. D. Administer a PRN medication to calm him down without further interaction. 43. Mr. Dela Cruz frequently engages in self-harming behaviors. What is the priority nursing intervention? A. Punish self-harming behaviors to deter future incidents. B. Establish a safety plan with Mr. Dela Cruz to identify coping mechanisms. C. Isolate Mr. Dela Cruz to prevent him from harming himself. D. Constantly monitor Mr. Dela Cruz to prevent any self-harm attempts. 44. Which therapeutic approach is most effective in treating BPD? A. Aversion therapy B. Dialectical Behavior Therapy (DBT) C. Systematic desensitization D. Classical conditioning 45. Mr. Dela Cruz expresses a fear of abandonment. How should the nurse respond? A. Reassure him that he won't be abandoned. B. Acknowledge his fear and explore the origins of this fear. C. Distract him from focusing on his fear. D. Tell him that his fear is irrational. Situation: Ms. Reyes, a 30-year-old female client, is admitted to the psychiatric unit exhibiting symptoms consistent with a personality disorder. She presents with intense fear of abandonment, unstable relationships marked by idealization and devaluation, impulsivity, and self-harming behaviors. She has a history of multiple suicide attempts. 46. Which personality disorder best fits Ms. Reyes' presentation? A. Antisocial Personality Disorder B. Borderline Personality Disorder C. Histrionic Personality Disorder D. Narcissistic Personality Disorder 47. Ms. Reyes tells the nurse, "You're the best nurse ever! You understand me completely." Later that day, she accuses the same nurse of being incompetent and cold. This behavior is an example of: A. Idealization and devaluation B. Splitting C. Projection D. Reaction formation 48. What is the priority nursing intervention for Ms. Reyes' self-harming behaviors? A. Punish self-harming behaviors to deter future incidents. B. Establish a safety plan with Ms. Reyes to identify coping mechanisms. C. Isolate Ms. Reyes to prevent her from harming herself. D. Constantly monitor Ms. Reyes to prevent any self-harm attempts. 49. Which therapeutic approach is most effective in treating Ms. Reyes' BPD? A. Aversion Therapy B. Dialectical Behavior Therapy (DBT) C. Psychodynamic Therapy D. Supportive Therapy 50. When caring for Ms. Reyes during a period of intense emotional distress, which intervention should the nurse prioritize? A. Administer a PRN sedative immediately. B. Encourage her to express her feelings and validate her emotions. 3 | Page