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RECALLS EXAMINATION 9 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: Adam, a 48 yearold bus driver was diagnosed of Cataract formation on both of his eyes. He was told by his physician that visual impairment would likely progress for both his eyes at the same rate, maybe in a matter of years or even months. He was left in the care of his physician and Nurse Trisha. 1. Upon inquiry, Adam’s physician explained that cataract is a condition in which: A. There is an increase in aqueous humor production causing an increase in intraocular pressure B. Retina and choroid would separate causing blockage of the entry of light in the eye. C. Reduction of the amount of light reaching the retina would be caused by opaqueness in the lens of the eyes. D. There is a decrease in the function of the macula resulting to loss of central vision 2. Nurse Trisha is trying to give Adam health teaching regarding the risk factors of Cataract formation. Which of the following is not included? A. Excessive reading and studying B. Diabetes C. Smoking D. Excessive exposure to direct sunlight 3. All of the following procedure may aid in the diagnosis of Cataract Formation EXCEPT? A. Direct ophthalmoscopy B. Perimetry C. Slit-lamp examination D. Gonioscopy 4. Prior the cataract surgery for Adam, Nurse Trisha was ordered by the physician to administer what kind of medication? A. Miotic Agent B. Thiazide Diuretic C. Mydriatic Medication D. Antibiotic 5. Nurse Trisha, a knowledgeable nurse, makes sure to instruct Adam postoperatively to: A. Remain in bed rest B. Perform range of motion exercises C. Avoid action and activities such as coughing or sneezing that may increase IOP D. Position the patient prone Situation: Jasper is the new head nurse of the Medical Surgical Unit in Jose Pedro Medical Center. He is faced with different challenges on the start of his new endeavor. Nurse Jasper noted that there are lots of confusion and chaos that occurs in the unit mainly due to disorganization. 6. Nurse Jasper tries to implement change in order some of the problems he noticed on the early periods of his run as chief nurse. He is met with resistance among his staff, what would he do to overcome this? A. Conduct seminar to re-educate his staff B. Gain early support from staff and slowly introduce the change C. Use authoritarian leadership in implementing the change D. Provide increased benefits and bonuses for the staff to be more receptive. 7. Nurse Jasper deals with lots of people in his unit, what is the most important communication skill he must possess as a nurse manager? A. Assertiveness B. Affirmation C. Questioning D. Listening 8. Nurse Jasper also noticed that there are malfunctions and problems with the mechanical ventilators in the unit. He gave notice to his superiors and allowed him to purchase mechanical ventilators. What type of budget is allotted for this? A. Operational Budget B. Personnel Budget C. Capital Budget D. None of the above 9. One of the staff nurses of Nurse Jasper requested extra budget in anticipation for sudden fluctuations in resources and contingency needs in the area. This type of budget is called? A. Operational Budget B. Personnel Budget C. Cash Budget D. Flexible Budget 10. Which of the following is not included in the Operational Budget of Nurse Jasper? A. Soap for handwashing B. Syringes for medicine administration C. Salary of part time employees D. Emergency Cash 11. Mr. Bean is admitted due to glaucoma. He was conversing with Nurse Joy when he mentions that there are two types of glaucoma. Mr. Bean is well informed if he knows that the main difference with the two types of glaucoma is? A. Drainage angle B. Vision loss C. None of the above D. All of the above 12. Mr. Bean later found out he had Close-Angle Glaucoma. Nurse Joy stressed that the desired effect of therapy for this condition is? A. Resting eye muscles B. Infection control C. Controlling intraocular pressure D. Dilating pupils 13. Which of the following is NOT a symptom of increased IOP? A. Severe eye pain B. Photophobia C. Excessive Lacrimation D. Clouding of the eye 1 | Page
14. Which of the following is the best nursing diagnosis for a patient with Glaucoma? A. Disturbed Sensory Perception B. Activity Intolerance C. Anxiety D. Risk for Fall 15. Which of the following medication may be given to patients with Close Angle Glaucoma? A. Acetazolamide B. Pilocarpine C. Both a and b D. None of the above Situation: Nurse Amanda decides to be part of the research team of the St. John Medical Center. She tried refreshing her concepts and knowledge about nursing research. 16. What are valid reasons to conduct research as a professional nurse? A. Professional advancement B. Improve nursing care C. Increase knowledge on specific conditions and their nursing care D. Financial gains 17. Nurse Amanda is planning to check their instrument’s consistency by its ability to yield the same response upon repeated administration? A. Objectivity B. Validity C. Sensitivity D. Reliability 18. A potential participant of the study decided that he doesn’t want to participate in the study anymore. What should Nurse Amanda do? A. Decline the patient’s wish as they already signed the consent forms B. Threaten the patient with sanctions for backing out C. Respect the rights of the patient D. Ask the patient “What’s the problem?” and explain the research’s purpose again 19. Nurse Amanda tries to formulate a hypothesis for her research. She must know that the following are the parts of a hypothesis except: A. Independent variable B. Dependent variable C. Relationship D. Set 20. What is the purpose of the review of related literature? A. Intelligent guess B. Answer the research question C. Determine statistical treatment of data D. Gathering data that is known and unknown on the topic Situation: Brad, a 39 year old businessman, was rushed to the ER of Doldam Hospital after car accident. He was unconscious upon arrival after sustaining a head injury, few lacerations on his body and a broken leg. 21. Nurse Dani was tasked to assess his motor and sensory function. She should use which technique to test the client’s peripheral response to pain? A. Nailbed pressure B. Striking finger with syringe C. Sternal rub D. Squeezing of sternocleidomastoid muscle 22. Nurse Dani notices an increase in Brad’s intracranial pressure due to his head injury. She would expect which of the following with Brad’s vital signs if ICP keeps on rising? A. Increase in temperature, tachycardia, tachypnea, hypotension B. Increase in temperature, bradycardia, bradypnea, hypertension C. Decrease in temperature, bradycardia, tachypnea, hypotension D. Decrease in temperature, tachycardia, bradypnea, hypertension 23. Brad upon assessment was also found to have a basilar skull fracture. He has clear fluid leaking from the nose. How would Nurse Dani assess for presence of cerebrospinal fluid? A. Clear fluid that has a negative glucose test B. Test positive for glucose and forms concentric rings. C. Has a pH of 7 with clumps D. Has a pH of 6 with blood 24. Nurse Dani knows that the client understands her health teaching regarding preventing the elevation of intracranial pressure if Brad is doing which of the activity? A. Bending over rapidly B. Blowing his nose C. Coughing D. Exhaling during repositioning 25. Which of the following medication can be given to Brad to lower his ICP? A. Mannitol B. Nitroglycerine C. Hydralazine D. Nicardipine Situation: Mrs. Dizon, a clinical instructor in Harvard Muntinlupa University, is discussing neurological disorders with her student nurses. They were all optimistic to learn and some even asks questions during the lecture. 26. During her discussion of spinal cord injury. Mrs. Dizon noted that these patients are prone to having autonomic dysreflexia. According to her, the nurse should include which measures in the plan of care to minimize the risk of the said condition? Select all that apply. A. Avoiding wrinkles on linens that the patient is using B. Avoid unnecessary pressure on the patient’s lower limbs C. Bladder catheterization should only be done once every 12 hours D. Patient must be repositioned and turned at least every 2 hours A. a,b,c B. b,c,d C. a,b,d D. a,c,d 27. Neurological signs of a patient in spinal shock following spinal injury can be detected. Which indicates that spinal shock is present? A. Positive reflexes B. Reflex emptying of the bladder C. Hyperreflexia D. Flaccid paralysis Situation: A family rushed a patient who had a stroke in the hospital. The patient also suffers from homonymous hemianopsia. After a few days of recovery, Nurse Joel prepares the patient and his family for the effects of his stroke. 28. Nurse Joel instructs the family about measures to help the patient overcome his homonymous hemianopsia. Which statement suggest understanding of the family? A. He needs to avoid using sunglasses B. We will place his belongings in his impaired field of vision C. We will approach him in his impaired field of vision D. We will remind him to turn his head to check the lost visual field 29. Nurse Joel asses the patient’s adaptation to changes in functionality after his stroke. Which shows that the client adapted successfully? A. Always lashes out on his family during performance of his task B. Depressed and barely moves C. Experiences difficulty using modified feeding equipment D. Consistently uses adaptive equipment in dressing himself 30. The patient suddenly experiences seizure activity while in bed. Nurse Joel knows that he must not: A. Loosen restrictive clothing B. Restrain the patient’s limbs C. Remove pillows and raise the side rail D. Position the patient to the side Situation: Carlo, a nurse researcher in the Hemodialysis Unit is undertaking a study on the relationship between hemodialysis and hypotension among patients 40 years old or older in selected hemodialysis centers in Central Luzon. 31. The study design to be used by Nurse Carlo is: 2 | Page
A. Experimental B. Non-Experimental C. Phenomenological D. Descriptive Correlational 32. Which of the following describes the study design being used the researchers? A. It proves causation B. There is no researcher intervention C. Effective means of collecting data D. Used to infer causal relationship 33. What is the dependent variable of the study? A. Hemodialysis B. Hypotension C. 40 years old patients D. Central Luzon 34. What is the independent variable of the study? A. Hemodialysis B. Hypotension C. 40 years old patients D. Central Luzon 35. What is not included in the three parts of a True Experimental Research? A. Manipulation B. Randomization C. Survey D. Control Situation: There are many recognized neurological disorders, some relatively common, but many rare. Neurological disabilities include a wide range of disorders. Regardless of the cause, all neurological disabilities result from damage to the nervous system. Depending on where the damage takes place, determines to what extent communication, vision, hearing, movement and cognition are impacted. 36. The doctor wrote in the chart that the client has an ICP of 13 mmHg, Nurse John interprets this reading as: A. Decreased B. Increased C. Normal D. Indefinite\ 37. A client with stroke suffers from hemiplegia on the left arm and left leg. The following are possible nursing interventions, except: A. Maintain intact skin B. Assist patients with ADLs C. Active range of motion exercises D. Turn patient every 2 hours 38. Nurse Marion knows that the major goal in the management of Parkinson’s Disease is: A. Constant medication to cure Parkinson’s B. Weigh gain C. Disease remission D. Symptom management 39. The nurse observes a child starting to have a seizure. Which of the following should not be done to the patient? A. Insert an artificial airway B. Observe and record seizure activity C. Avoid restrains and protect child from injury D. Position the patient on his side 40. After being diagnosed with a seizure disorder, Marco had continuous seizure attacks. This was treated by using medication and has stopped any seizure attacks for several days. Prior to discharge, the nurse would provide health teaching to the patient and his family. Which of the following information should the nurse highlight and give the most importance to? A. Urine would turn reddish from the medication B. The client can’t ever drive any vehicle again C. Patient must adhere to medication regimen religiously to avoid recurrence of seizures D. Seizures attack would stop on their own 41. Which of the following nursing diagnosis would be the highest priority for Marco who is newly diagnosed with seizure disorder? A. Ineffective airway clearance B. Deficient Knowledge C. Impaired Thought Process D. Pain 42. What is use to give a definitive diagnosis of Alzheimer’s disease? A. CT Scan B. MRI C. PET Scan D. None Situation: Ivan and Ivana are expecting their first born. Ivana was diagnosed with Huntington’s disease 3 years prior her being pregnant. 43. Ivana verbalized her concern to her nurse about the chances of their baby having Huntington’s disease. The mode of inheritance of Huntington’s disease will ensure A. Males are affected and females are carriers B. Females are affected and males are carriers C. Both male and females will have equal chances of getting the disease D. None of the above 44. Ivana’s offspring has A. 100 % chance of getting Huntington’s B. 75% chance of getting Huntington’s C. 50% chance of getting Huntington’s D. 25% chance of getting Huntington’s 45. The common symptoms of Huntington’s disease are A. Chorea, decline in intellect, mixed hearing loss B. Tremor, bradykinesia and rigidity C. Emotional disturbance, diplopia and ptosis D. Bizarre behavior, uncontrolled movement, dementia Situation: Nursing practice in the psychiatric unit greatly differ than those on other fields. The nurse and the patient have a unique relationship and care usually is long term. Nurse Joey tackles all these challenges as she prepares for her first duty in the Psychiatric Unit. 46. What is the only tool available for Nurse Joey for therapeutic communication? A. Ballpen B. Academic Excellence C. Self-Awareness D. Intuition 47. Which of the following is not included in the phases of therapeutic relationship? A. Pre-interaction B. Orientation C. Termination D. Extension 48. Nurse Joey must establish a mutual contract with the patient during the orientation phase. She must be knowledgeable of the elements of the contract. Which of the following are elements of a contract? A. Time, duration and venue of sessions B. Prayer for every session C. Termination and criteria for termination D. Nurse and patient responsibilities E. Participants F. Medication Regimen A. A,B,C,F B. A,C,D,E C. B,C,D,F D. A,C,D,F 49. Nurse Joey is in the pre-orientation phase in her care for her first patient. Nurse Joey is aware that her responsibility during this phase is to? A. Read the patient’s chart B. Formulate a nursing diagnosis C. Promote the client’s insight D. Determine the client’s feelings about the end of the relationship 50. Nurse Joey knows that the most important element of the Nurse-Patient Relationship is? A. Openness B. Acceptance C. Honesty D. Humility Situation: Billy, a 45 year old professional basketball player, tore his ACL that caused his early retirement. He was told by their team doctor that he won’t be able to play professionally anymore. After a year, he was diagnosed with major 3 | Page
depression and would constantly experience panic attacks. He was admitted in San Miguel Mental Facility for treatment and care. 51. During one of Billy’s panic attacks he experienced difficulty breathing, chest pains, pallor and palpitations. Which of the following is the priority nursing action? A. Orient patient to time and place B. Encourage patient to verbalize feelings C. Administer anxiolytics I.M. D. Assist with breathing into paper bag 52. Billy is taking parnate, a monoamine oxidase inhibitor (MAOI). Which food should be avoided by Billy? A. Poultry B. Fresh Fish C. Wheat bread D. Preserved fruits 53. Billy tells the nurse “Life aint worth living. This is too much! I can’t stand the pain.” What is the nurse’s best response? A. Do you feel like hurting yourself? B. Rate your pain from 1-10? C. You don’t feel like living? D. Live your life seven days a week 54. Billy’s feelings of depression have lifted, and she tells the nurse, “I feel better now.” The nurse understands that this patient is: A. Already cured of his depression B. No longer a suicide risk C. Less of a suicide risk that when he was depressed D. Higher risk of suicide than when he was depressed 55. The nurse should develop a plan of care for Billy that includes: A. Encourage reading and writing B. Promote exercise or physical activities C. No socialization D. A structured program of activities 56. Billy underwent his first electroconvulsive therapy (ECT) treatment. When assessing Billy after ECT, the nurse can expect: A. Transitory short term memory loss and permanent long term memory loss B. Transitory short term and long-term memory loss and confusion C. Hypertension and Permanent short term memory loss D. Hypomania and Permanent long term memory loss Situation: Joshua, 50 years old, is diagnosed with paranoid schizophrenia. His family sent him to Miami Tondo Mental Hospital as they were hopeless and lack the knowledge to care for him. Joshua is usually reserved and hates being noticed by other patients and nurses. Nurse Derek was assigned to care for him. 57. Joshua has been taking neuroleptics for many years. Assessment reveals unusual movement in his tongue, neck and arms. Which condition would the nurse suspect? A. Acute Dystonia B. Neuroleptic Malignant Syndrome C. Akathisia D. Tardive Dyskinesia 58. Nurse Derek understands that the most important role in caring for a patient with mental health disorder is: A. Offering advice B. Establishing trust and support C. Set limits with the patient D. Keep the patient in their hearts 59. Nurse Derek was called to Joshua’s room as he was experiencing delusions. He was telling Nurse Derek “There is a man with red eyes wearing a black coat waiting to get me.” The patient is getting more anxious the more he focuses on the delusion. Which of the following is the best response of Nurse Joshua? A. “What does he look like?” B. “Do not fear. Nurse Joshua is here.” C. “Why worry? what your seeing is not real.” D. “The subject seems to be troubling you. Let’s walk to the activity room.” 60. During one his rounds, Nurse Derek heard Joshua scream “We can, pan, scan, ran, plan.” Nurse Derek identifies this as which abnormality? A. Clang association B. Neologism C. Echopraxia D. Word Salad 61. 50-year-old Joshua believes that the man with red eyes is coming to take his brain, and his roommate is an FBI agent. Joshua never had a close friend, is estranged with his family and has not been employed in the last 19 years. The nurse recognizes that he failed to achieve which of the following psychosocial tasks? A. Autonomy B. Trust C. Integrity D. Industry 62. During an activity, Joshua turns to the next empty chair and whispers “Now just leave. I told you to stay home. There isn’t enough work here for the both of us.” Which of the following is the nurse best response? A. “When people experience a great deal of stress, they may see or hear things that others don’t. Is that what happened?” B. “I can’t hear you. You should look at me.” C. “Keep quiet.” D. “I know your hearing something. I can hear it too. We must ask him to leave before he disrupts our activity.” Situation: Chito, a known drug user, was admitted to Burnham Mental Hospital. He is dependent on drugs and is usually high on a daily basis. He was also an alcoholic even prior him taking drugs. 63. During assessment, which action should Nurse Katie take to plan appropriate nursing care? A. Ask the patient why is he an addict. B. Ask the patient if he is ashamed of doing drugs. C. Ask the patient about the amount of drug use and its effect. D. Do not ask any questions but stay with the patient to show support. 64. Assessment finding for patients abusing opiates such as morphine includes: A. Rapid speech and agitation B. Relaxed nature and lethargy C. Dilated pupils and slurred speech D. Euphoria and constricted pupils 65. Opiate withdrawal can be life threatening. What can be used to detoxify opiate users? A. Amphetamines B. Aspirin C. Methadone D. Diazepam 66. Which interventions are not appropriate for caring for a patient in alcohol withdrawal? A. Monitor vital signs B. Ensure safe environment C. Orient the patient to reality as needed D. Provide stimulation in the environment 67. One morning, Chito tells Nurse Katie “I don’t want any more treatment. I have to go.” Chito hasn’t been discharged and is scheduled to take an important diagnostic procedure. Nurse Katie enters Chito’s room and saw him getting dressed and begins to walk out of the facility. What should the nurse do? A. Call security to block the exit B. Restrain the patient until doctor arrives C. Call the nursing supervisor D. Lock the patient in his room 68. Chito when asked about alcohol use, would most likely to: A. Accurately describe alcohol intake B. Deny taking any alcohol C. Act like he didn’t hear anything D. Underestimate the amount consumed 69. Which finding would Nurse Katie not expect to assess in Chito if he drinks alcohol while he is taking disulfiram? A. Tachycardia B. Hypervolemia C. Headache D. Blurred vision 70. If Nurse Katie tells Chito “If you refuse to take oral medication, restraints would be applied and I am giving it 4 | Page