Tiêu đề RECALLS 6 - NP3 - SC ✅

RECALLS 6 EXAMINATION NURSING PRACTICE III CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART A) NOVEMBER 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 III” on the box provided Situation: Nurse Greg is working on a busy surgical floor. He is responsible for caring for patients pre- and post-operatively, maintaining sterile technique, and ensuring early detection of complications such as infections, pressure ulcers, or thromboembolism. 1. Greg notices that a patient scheduled for surgery has a temperature of 102°F (38.9°C) but appears otherwise stable. What is Greg’s first action? A. Notify the surgeon B. Notify the charge nurse C. Validate the temperature reading D. Document the temperature in the chart 2. While performing a sterile dressing change, which action by Greg would break sterile technique? A. Opening the first flap of a sterile package away from himself B. Keeping his hands above his waist C. Turning his back to the sterile field D. Adding sterile items by dropping them onto the field 3. Greg is transferring a post-stroke patient with right-sided weakness from the bed to a wheelchair. Which positioning is best? A. Place the wheelchair parallel and close to the bed B. Position the wheelchair on the patient’s weaker side C. Keep the wheelchair one foot away from the bed D. Lock the bed but not the wheelchair 4. A patient recently transferred to Greg’s unit is unable to ambulate. Which factor places this patient at greatest risk for pressure ulcer development? A. Limited mobility and need for assistance to move from bed to chair B. Eating only half of most meals C. Mild apathy but oriented to time and place D. Good skin turgor and normal capillary refill 5. Greg is opening a sterile package from central supply. Which direction should the first flap be opened? A. Toward himself B. Away from himself C. To the left or right D. It does not matter Situation: Nurse Darryl is caring for patients with cardiovascular conditions in a telemetry unit. He must recognize early warning signs of complications, manage medications, and provide accurate patient education before discharge. 6. A patient with a recent myocardial infarction is admitted with chest pain and diaphoresis. What is Darryl’s first action? A. Order an ECG B. Administer prescribed morphine sulfate C. Start an IV line D. Measure vital signs 7. A patient is discharged after a myocardial infarction and asks why metoprolol (Lopressor) was prescribed. What is Darryl’s best explanation? A. “It increases your heart rate so the heart pumps more effectively.” B. “It dilates your coronary arteries to improve blood flow.” C. “It makes your heart contract stronger to increase blood supply.” D. “It slows your heart rate and decreases the workload so your heart can heal.” 8. A heart failure patient is prescribed digoxin and furosemide. Which meal would Darryl recommend? A. Grilled chicken, baked potato, and cantaloupe B. Eggs and ham C. Grilled cheese sandwich and French fries D. Pepperoni pizza 9. A patient is taught how to take sublingual nitroglycerin for angina. Which statement shows correct understanding? A. “I can swallow the tablet if it burns my tongue.” B. “I will take one tablet every 5 minutes up to 3 doses if chest pain continues.” C. “I will store the tablets in the refrigerator for freshness.” D. “I can take as many tablets as needed until pain is gone.” 10. A patient with heart failure is being discharged. Which teaching by Darryl is most important? A. “You should weigh yourself daily at the same time.” B. “Avoid eating any foods that contain sodium.” C. “You can skip diuretics on days you feel well.” D. “Check your blood pressure only if you feel dizzy.” Situation: Nurse Fiona is caring for patients on a respiratory care unit. She is responsible for managing clients with chronic respiratory conditions, maintaining oxygen therapy safety, and recognizing early complications of airway problems or infections. 11. Fiona is caring for a client with a new tracheostomy tube. After cleaning the reusable inner cannula, what should she do before reinsertion? A. Dry it thoroughly with sterile gauze B. Suction the client’s airway C. Tap the cannula gently against a sterile surface D. Rinse it with sterile saline 12. Fiona is preparing to initiate continuous IV therapy. What is the most important step before venipuncture? A. Apply a tourniquet below the selected vein B. Inspect the IV solution for particles or contamination C. Place a cool compress over the vein D. Secure the client’s arm with a splint 13. A patient on the unit with tuberculosis needs a chest X-ray. Which action by Fiona is most appropriate when preparing for transport? A. Notify radiology so personnel can wear masks 1 | Page
B. Apply a mask to the client C. Gown and mask the client D. Use a full isolation transport team 14. During assessment, Fiona notes a pulsating mass in a client’s periumbilical area. Which action is most appropriate? A. Palpate the mass for size and tenderness B. Auscultate the mass for a bruit C. Measure its length with a tape measure D. Percuss the abdomen 15. A post-operative client suddenly becomes profoundly short of breath and gray in color. Which earlier assessment finding would have been the first sign of deterioration? A. Temperature 100.4°F (38°C) B. Respiratory rate of 26/min C. Heart rate of 110 bpm D. Blood pressure of 120/70 mmHg Situation: Nurse Lara is assigned to the gastrointestinal surgical ward. She is caring for patients undergoing diagnostic procedures and recovering from abdominal surgeries. Her responsibilities include providing pre- and post-operative teaching, preventing complications, and ensuring patients follow dietary modifications. 16. Lara is preparing a patient for a barium swallow and gastroduodenoscopy. Which instruction should she give? A. “You’ll need to eat a low-residue diet the day before and be NPO for 6–12 hours before the test.” B. “You’ll be NPO for 24 hours after the test to ensure you can tolerate food.” C. “You’ll have a nasogastric tube for 24 hours after the test for drainage.” D. “You’ll be placed under general anesthesia and recover in the OR.” Answer: A Ratio: Patients are placed on a low-residue diet the night before and NPO 6–12 hours before procedures like barium swallow and gastroduodenoscopy. (Source: Smeltzer & Bare, Medical-Surgical Nursing (10th ed.), p. 108) 17. A client recovering from gastrectomy asks Lara how to prevent dumping syndrome. Which advice is most appropriate? A. “You should eat 5–6 small meals a day indefinitely.” B. “Limit fluids during meals and for 1 hour afterward.” C. “Increase your carbohydrate and salt intake.” D. “Increase activity for 1 hour after meals to help digestion.” Answer: B Ratio: Limiting fluids during and after meals reduces rapid gastric emptying, which triggers dumping syndrome. (Source: Smeltzer & Bare, Medical-Surgical Nursing (10th ed.), p. 112) 18. In the recovery room, a patient who underwent gastric resection complains of nausea. What is Lara’s priority action? A. Check the patency of the nasogastric tube B. Administer an antiemetic as ordered C. Place the patient in semi-Fowler’s position D. Provide a narcotic analgesic for pain Answer: A Ratio: Nausea after gastric surgery can indicate NG tube obstruction, which must be corrected before giving medications. (Source: Smeltzer & Bare, Medical-Surgical Nursing (10th ed.), p. 112) 19. Which diagnostic test confirms pyloric stenosis? A. Flat plate of the abdomen B. Colonoscopy C. Electrolyte levels D. Upper GI series Answer: D Ratio: An upper GI series will reveal delayed gastric emptying and a narrowed pyloric channel. (Source: Smeltzer & Bare, Medical-Surgical Nursing (10th ed.), p. 109) 20. A client with a duodenal ulcer is admitted. Which symptom does Lara expect to find? A. Recent weight loss B. Worsening indigestion after meals C. Awakening at night with epigastric pain D. Frequent episodes of vomiting Situation: Nurse Ramon is caring for patients with renal and urologic conditions. His role includes monitoring fluid balance, preventing complications of altered renal function, and teaching clients about dietary and medication adherence. 21. A client with altered renal function is being managed at home. Which assessment provides the most accurate indicator of fluid balance? A. Measuring intake and output B. Assessing mucous membrane moisture C. Checking skin turgor D. Monitoring daily weight 22. A client with chronic kidney disease is prescribed a low-sodium diet. Which food selection shows the client understands the instructions? A. Canned vegetable soup B. Fresh apple slices C. Processed cheese D. Pickled cucumbers 23. Ramon is caring for a client with a new arteriovenous (AV) fistula for hemodialysis. Which nursing action is appropriate? A. Draw blood samples from the fistula arm B. Apply a blood pressure cuff to the fistula arm C. Assess for a bruit and thrill over the fistula daily D. Use the arm for routine IV infusions 24. A patient with renal calculi is encouraged to increase fluid intake. What is the goal of this intervention? A. Dilute urine and reduce stone formation B. Flush out electrolytes C. Decrease protein metabolism D. Promote blood pressure control 25. A client with end-stage renal disease reports itchy, dry skin. Which nursing measure is most appropriate? A. Restrict fluids further B. Bathe the client twice daily using hot water C. Apply emollient lotion after bathing D. Avoid all forms of soap Situation: Nurse Andrea is assigned to the endocrine unit where she cares for patients with hormonal disorders. She provides pre-operative and post-operative teaching, monitors for complications, and offers lifestyle counseling for patients with chronic endocrine conditions. 26. Andrea is caring for a client diagnosed with hypopituitarism. Which assessment finding should she expect? A. Increased blood pressure B. Truncal obesity C. Increased cardiac output D. Hyperactivity and increased energy levels 27. A client recovering from a hypophysectomy reports clear nasal drainage. What is Andrea’s initial action? A. Notify the surgeon immediately B. Encourage the client to blow their nose C. Test the drainage for glucose D. Place the client in Trendelenburg position 28. After a hypophysectomy, Andrea teaches the client to monitor for which possible complication? A. Cushing’s disease B. Grave’s disease C. Diabetes mellitus D. Hypopituitarism 29. A client with diabetes insipidus is prescribed vasopressin (Pitressin). What is the purpose of this medication? A. Stimulate pancreatic insulin production B. Slow glucose absorption in the intestines C. Increase reabsorption of water in the renal tubules D. Increase blood pressure 2 | Page