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RECALLS EXAMINATION 5 NURSING PRACTICE III CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART A) 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 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 C. Repaglinide D. Regular insulin 1 | Page


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