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1 | Page RECALLS EXAMINATION 9 NURSING PRACTICE V CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART C) MAY 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 I” on the box provided 1. A high school student in chemistry class is sent to the school nurse after getting a chemical splash in the eyes. Which initial information is the most critical for the nurse to gather? A. Whether the student was wearing protective eyewear B. The name of the chemical involved in the exposure C. What first-aid measures were taken immediately after the incident D. If the student is experiencing any vision problems 2. The school nurse is preparing to rinse the affected eye to minimize irritation and damage. Which of the following is the most suitable solution to use in this situation? A. Tap water B. Sodium bicarbonate solution C. Normal saline D. Magnesium sulfate solution 3. When performing eye irrigation, which technique ensures the safest and most effective flow of the solution? A. Directing it straight onto the cornea B. Aiming it away from the inner corner of the eye C. Instilling it into the anterior chamber D. Guiding it toward the tear duct 4. A client has a foreign object embedded in the eye. What is the nurse’s immediate action before referring the client for emergency care? A. Attempt to remove the object with forceps B. Encourage the client to blink repeatedly C. Apply antibiotic ointment to the affected eye D. Cover both eyes with a loose protective patch 5. Before the physician assesses the client, the nurse performs a visual acuity test using a Snellen chart. How should the nurse describe the procedure to the client? A. "You will read text that is about the size of regular newsprint." B. "You will read a series of letters from a distance of 20 feet (6 meters)." C. "You will identify an image from a color-patterned chart." D. "You will look at a screen and indicate when you see an object appear." 6. A retinoscopic exam has been ordered to determine the client’s refractive error. Before performing the examination, which type of eye medication should the nurse administer to dilate the pupil and temporarily paralyze the ciliary muscle? A. Pilocarpine (Pilocar) B. Dipivefrin (Propine) C. Gentamicin (Genoptic) D. Cyclopentolate solution (Cyclogyl) 7. A client arrives at the eye clinic and informs the nurse that prescription glasses have been recommended to correct their nearsightedness. Which term should the nurse use in the documentation for nearsightedness? A. Presbyopia B. Amblyopia C. Hyperopia D. Myopia 8. The nurse observes a nursing assistant assisting a visually impaired client with ambulation. Which instruction would best ensure the client’s safety and comfort? A. Allow the client to hold onto your arm while walking. B. Hold onto the client’s arm while guiding them. C. Position the client slightly ahead and to your side. D. Encourage the client to walk independently beside you. 9. Which approach would best support a visually impaired client’s independence while eating? A. Describe the food placement using a clock-face reference. B. Arrange for a volunteer to feed the client to avoid the need for assistance. C. Provide meals in drinkable form to eliminate the need for utensils. D. Request the dietary staff to serve meals using disposable plates and cups. 10. A nurse is reviewing the medical history of an elderly client diagnosed with bilateral cataracts. Which symptom is most directly associated with cataract development? A. Gradual decline in vision B. Sensation of pressure inside the eye C. Eye pain or discomfort D. Sudden flashes of light 11. During an eye examination, which finding would most strongly indicate the presence of cataracts? A. Broken blood vessels in the eye B. An abnormally shaped iris C. A cloudy or white area behind the pupil D. A painless lesion on the cornea 12. A client diagnosed with cataracts asks the nurse when surgery should be considered. Which response by the client indicates the best understanding of when cataract surgery is necessary? A. "I should have surgery when my vision loss significantly affects my daily activities." B. "I’ll need surgery once I can no longer manage the eye pain with drops." C. "Surgery is needed when I start feeling self-conscious about how my eyes look." D. "I should wait until my cataracts are as dense as possible before having surgery." 13. A client is scheduled for cataract surgery on the right eye. Preoperative instructions include facial cleansing, discontinuation of anticoagulants, and frequent administration of dilating drops before surgery. Which preoperative assessment is the highest priority for the nurse? A. Checking for any facial skin abnormalities * NLE * NCLEX * CGFNS * HAAD * PROMETRICS * DHA * MIDWIFERY * LET * RAD TECH * CRIMINOLOGY * DENTISTRY * PHARMACY *
2 | Page B. Confirming the last time the client took an anticoagulant C. Assessing the right eye for any discharge D. Observing the left eye for signs of strain 14. An hour before cataract surgery, the nurse administers prescribed eye drops. Where should the nurse instill the medication? A. Directly onto the cornea B. In the inner corner of the eye C. Near the outer edge of the eye D. Into the lower conjunctival sac 15. A nurse is caring for an older client diagnosed with chronic open-angle glaucoma. Which symptom is the client most likely to report? A. Persistent itching and burning in the eyes B. Headaches when reading C. Seeing halos around lights D. Gradual loss of peripheral vision 16. When assessing a client’s eye after surgery, which postoperative finding is most expected? A. The pupil appears cloudy and gray. B. The pupil remains a fixed size and shape. C. The iris has completely lost its color. D. A portion of the iris appears black. 17. A client with macular degeneration describes their vision changes to the nurse. Which type of visual impairment is the client most likely to report? A. Clear vision of objects that are close B. Clear vision of distant objects C. Retained peripheral vision D. Distorted or missing central vision 18. Which tool is most appropriate for the nurse to use when assessing a client’s hearing ability? A. Otoscope B. Tuning fork C. Reflex hammer D. Stethoscope 19. When administering ear drops to an adult, what technique should the nurse use to straighten the ear canal? A. Pull the ear upward and backward. B. Pull the ear downward and forward. C. Pull the ear upward and forward. D. Pull the ear downward and backward. 20. After administering ear medication, which instruction is most appropriate for the nurse to give the client? A. Keep your head tilted for at least 5 minutes. B. Insert a cotton ball tightly into the ear. C. Avoid blowing your nose for at least an hour. D. Wipe away any excess medication. 21. The parents of a 3-year-old child with a suspected ear infection ask the nurse why their 18-year-old rarely experiences ear infections. Which response shows that the parents understand why infections travel more easily to the middle ear in young children? A. A child's eustachian tube is shorter and more horizontal. B. A child's eustachian tube is longer and straight. C. A child's eustachian tube is shorter and more curved. D. A child's eustachian tube is longer and more angled. 22. When preparing a client for a myringotomy, which statement best explains the reason for the procedure? A. It helps prevent permanent hearing impairment. B. It creates an opening for fluid drainage. C. It allows for direct medication administration. D. It preserves normal middle ear function. 23. While reviewing a client’s health history, which finding would the nurse expect in a person with otosclerosis? A. Hearing loss that began in childhood. B. Frequent respiratory infections with high fevers. C. History of tonsil and adenoid removal. D. A family history of the condition. 24. Which statement by the nurse best explains the mechanism of conductive hearing loss? A. Sound waves are unable to reach the inner ear. B. The inner ear structures are not functioning properly. C. The eighth cranial nerve has sustained irreversible damage. D. The ear fails to convert sound waves into electrical signals. 25. A client scheduled for a stapedectomy expresses fear about potential surgical complications. Which response by the nurse is most appropriate? A. "Your surgeon is highly skilled and experienced." B. "Can you tell me more about what concerns you?" C. "Don't worry, complications are very rare." D. "Let's try to focus on a positive outcome." 26. Following a stapedectomy, which method is most effective for evaluating the client’s facial nerve function? A. Ask the client to recognize familiar scents. B. Ask the client to smile or lift their eyebrows. C. Ask the client to extend their tongue outward. D. Ask the client to read a printed passage. 27. What is the best position for a client during the first 24 hours after a stapedectomy? A. Lying flat with the head slightly elevated and turned toward the unaffected ear. B. Sitting upright with the head straight and knees slightly bent. C. Lying on their back with the head of the bed elevated, resting on the back of the head. D. Lying face down with the head turned toward the operated ear. 28. Which symptom is most commonly reported by clients with Ménière’s disease? A. A burning sensation. B. A feeling of pressure. C. Severe dizziness or spinning sensation. D. Persistent ear pain. 29. A client diagnosed with Ménière’s disease appears anxious when nursing staff enter the room. The nurse suspects the client fears that care activities may worsen symptoms. Which nursing intervention is most appropriate? A. Allow the client to help determine how care is provided. B. Suspend nursing care interventions for the time being. C. Limit care to only essential tasks like eating and toileting. D. Perform all nursing tasks as quickly as possible. 30. What is the most accurate statement regarding the cause of Ménière's disease? A. It results from an electrolyte imbalance. B. It is caused by an excess of fluid. C. It stems from a vitamin deficiency. D. It is caused by an anatomical defect. 31. Which nursing action is most helpful in preventing nausea and vomiting in a client with Ménière's disease? A. Increase the client’s intake of oral fluids. B. Frequently change the client’s position. C. Keep the room lights dim. D. Avoid jarring the bed. 32. Which dietary restriction should the nurse emphasize to the client with Ménière’s disease upon discharge? A. Fats B. Sodium C. Potassium D. Cholesterol 33. Which statement by the client indicates that further education about Ménière’s disease is needed? A. "I will feel well between attacks." B. "Attacks may last from minutes to days." C. "My hearing will gradually improve." D. "Ménière’s disease is incurable." 34. What is the best nursing action to control a client’s nosebleed? A. Have the client lie down slowly and swallow frequently. B. Have the client lie down and breathe through the mouth. C. Have the client lean forward and apply direct pressure to the nose. D. Have the client lean forward and clench the teeth. 35. How can the nurse best alleviate a client’s fear and anxiety after witnessing blood from a nosebleed?

4 | Page What is the most beneficial nursing intervention? A. Suggest scheduling a physical exam for the spouse. B. Encourage the spouse to take breaks from caregiving. C. Remind the spouse of designated visiting hours. D. Reassure the spouse that staff are providing good care. 55. A client’s daughter expresses sadness, saying, "I don’t think my mom recognizes me anymore." Which nursing response is most therapeutic? A. “This is just part of the disease progression.” B. “It sounds like you’re feeling very upset about this.” C. “Don’t worry, she’s receiving excellent care.” D. “Some days are better than others.” 56. An older adult with Alzheimer’s disease appears confused about how to use a fork during mealtime. Which nursing action would best help the client maintain independence in self-care? A. Request a physician’s order for a liquid diet. B. Seat the client in a way that allows them to observe others eating. C. Serve the client first to provide additional time for eating. D. Place the client in a private area to minimize embarrassment. 57. A client’s daughter wants to take her mother, who has Alzheimer’s disease, home for the day. What is the most critical nursing assessment before the visit? A. The caregiver’s awareness of the client’s symptoms. B. The caregiver’s knowledge of the time the client should return. C. The caregiver’s understanding of medication administration. D. The caregiver’s ability to assist with hygiene needs. 58. A nurse is educating a family about the recovery process for a client struggling with alcoholism. Which action is considered the first step toward recovery? A. Acknowledging the inability to control drinking. B. Developing a strong support system. C. Strengthening religious or spiritual beliefs. D. Enrolling in an inpatient rehabilitation program. 59. During a routine clinic visit, a nurse suspects a 20-year-old client may be experiencing domestic abuse. Which action is most appropriate to assess the situation? A. Ask the client directly if they are being abused. B. Schedule a follow-up appointment to gather more information. C. Examine any young children for signs of abuse. D. Speak with family members or neighbors to gather more details. 60. A nurse is working with a client who remains in a physically abusive relationship. Which belief is most common among individuals who stay in such situations? A. The abuse is not serious or life-threatening. B. Family members will provide protection if needed. C. They can prevent the abuse by behaving a certain way. D. They have the freedom to leave at any time. 61. A rape survivor arrives at the emergency department visibly distressed. Which nursing action is most effective in reducing the client’s anxiety? A. Determine the client’s last menstrual period. B. Collect forensic evidence for legal proceedings. C. Assess the client’s physical injuries. D. Stay with the client to provide continuous support. 62. A rape survivor has arrived at the emergency department seeking care. Which nursing intervention is the highest priority at this time? A. Recording details of the assault for documentation. B. Minimizing the number of interactions with unfamiliar staff. C. Offering sedative medication to help calm the client. D. Providing hygiene supplies, including a gown and washcloth. 63. The nurse in the emergency department explains each procedure before performing it on a rape victim. What is the primary reason for this approach? A. It helps the victim regain a sense of control. B. It helps alleviate the victim’s anxiety. C. It aligns with hospital policies for trauma care. D. It ensures the victim is fully educated about their care. 64. A nurse is advising a client with bulimia on strategies to manage their condition. Which recommendation is most effective in helping control the disorder? A. Limit access to the restroom immediately after eating. B. Keep a list of all food options available in the cafeteria. C. Avoid dining at fast food restaurants. D. Track daily calorie intake. 65. A client with bulimia has been taking an antidepressant for several weeks. Which outcome would indicate the most significant therapeutic improvement? A. The client reports a decrease in depressive symptoms. B. The client is consuming a more balanced diet. C. The client engages in fewer binge-eating episodes. D. The client experiences a reduction in suicidal thoughts. 66. During a support group for eating disorders, a client with bulimia tells another, “You’re pathetic if you think you have a weight problem.” What is the most appropriate nursing intervention? A. Confront the client about their inappropriate remark. B. Comfort the client who was insulted. C. Encourage group members to address the situation. D. Respond with a similar remark to the client who made the comment. 67. A client experiencing chest pain is diagnosed with panic disorder. What is the most likely cause of this symptom? A. An unknown medical condition B. Symptoms that are being exaggerated C. A way to gain attention from others D. An overwhelming sense of fear 68. A nurse is educating a group of nursing students about Freud’s psychosexual stages. One student asks, "At what stage does a child develop unconscious desires toward the opposite- sex parent, leading to possible gender identity struggles?" Which response by the nurse is correct? A. Oral B. Latent C. Genital D. Phallic 69. A nurse is supporting a client during a panic attack. Which message is most crucial to communicate? A. "You are safe." B. "I believe you." C. "I trust you." D. "You are accepted." 70. A client begins to cry and states, "Nurse, I feel like I’m going to die." Which response is most therapeutic? A. "Try not to cry—it won’t change anything right now." B. "You wouldn’t want the doctor to see you like this." C. "Everyone feels scared in situations like this." D. "I will stay with you until you feel better." 71. A client with panic disorder is prescribed alprazolam (Xanax). Which instruction is most important for the nurse to provide? A. "Avoid drinking alcohol while taking this medication." B. "You can safely take this medication long-term without dependence." C. "This drug may cause difficulty sleeping in some people." D. "Regular blood tests will be required while using this medication." 72. A client is experiencing increasingly frequent panic attacks.