Tiêu đề PRE-INTENSIVE - NP3 - SC ✅

PRE-INTENSIVE EXAMINATION NURSING PRACTICE III CARE OF THE CLIENT WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS (PART A) 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 III” on the box provided Situation: Nurse Jade is in charge of a client who was admitted for management of acute episodes of cholecystitis. 1. Nurse Jade did her admission assessment. She understands that the pain is characterized as: A. Tenderness that is generalized in the upper epigastric area B. Tenderness and rigidity at the left epigastric area radiating to the back C. Tenderness and rigidity of the upper right abdomen radiating to the midsternal area D. Pain of the left upper quadrant radiating to the left shoulder 2. To confirm the diagnosis of cholecystitis, the attending physician ordered the procedure that can detect gallstones as small as 1 to 2 cm and inflammation. Nurse Jade would prepare the client for which specific diagnostic procedure? A. cholangiography B. gall bladder series C. oral cholecystogram D. ultrasonography 3. The diagnosis was confirmed as cholecystitis with gallstones. The doctor prepared the client for the removal of his gallbladder. The client asks the nurse: “How will this procedure affect my digestion?” The nurse’s most correct response would be: A. “Your body system will adjust in due time.” B. “The removal of the gallbladder usually interferes with digestion but can be remedied by dietary modifications.” C. “The removal of the gallbladder would significantly interfere only with the digestion of fatty food.” D. “The removal of gallbladder does not usually interfere with digestion.” 4. While reviewing the laboratory findings of the client, Nurse Jade found out that which findings are elevated? 1. white blood cell count 2. total serum bilirubin 3. alkaline phosphate 4. red blood cell count 5. cholesterol 6. serum amylase A. 3,5,6 B. 1,2,6 C. 1,2,3 D. 2,3,4 5. A T-tube was inserted and the doctor ordered: “Monitor the amount, color, consistency and odor of drainage.” Which of the following procedures can the nurse perform without the doctor’s order? A. clamping B. emptying C. aspirating D. irrigating Situation: Alfonsus sought hospital confinement for pleuritic pain, fever, and cough. The attending physician had a chest x-ray taken STAT. Result revealed presence of lung infiltrates. The client was assigned to Kianne the staff nurse. 6. When Kikay performed chest auscultation, she observed short discreet bubbling sounds over the lower region of the right lung. Which of the following abnormal findings will Kikay consider? A. Friction rub B. Murmur C. Wheezes D. Crackles 7. Kikay put her priority nursing diagnosis as “Ineffective airway clearance related to increased secretions and ineffective coughing.” Which nursing intervention would be considered to facilitate coughing with the LEAST discomfort? A. Splinting chest wall with pillow when coughing B. Putting the client in semi-Fowler’s position all the time C. Taking cough med q4 hours round the clock D. Utilizing the purse-lip technique of breathing 8. The physician prescribes oral penicillin 500 mg every six hours for seven days. On the fifth day, before Kikay administers the first dose for the day, she computed for the total amount in the milligrams of the oral penicillin that has been received by the client. Which of the following is the correct amount? A. 2,500 mg B. 15,000 mg C. 10,000 mg D. 8,000 mg 9. Standard precaution dictates that the nurse observes which of the following when caring for a client with streptococcal pneumonia? A. Use of face mask B. Use of sterile gloves C. Observe two-feet distance when giving care D. Use clean gloves 10. Sputum cultures are to be obtained to establish the client’s specific antibiotic treatment. Kikay would BEST collect the specimen: A. Early in the morning B. Early morning after an antiseptic gargle C. After brushing the client’s teeth D. Anytime of the day after a warm salt solution gargle Situation: Different communicable diseases spike up in today’s trends. It is important for the nurse to understand the background of different emerging diseases, its presentation, diagnosis and interventions associated to the diseases. The following questions apply to emerging communicable diseases. 11. Ebola virus was discovered in 1978 in Congo and re-appeared last 2014 in Guinea with case fatality rate of 50%. It has several different causative agents and is transmitted through direct or indirect contact to affected primates such as 1 | Page
bats. It is also commonly known as the hemorrhagic fever. Given its signs and symptoms of myalgia, high fever, malaise, internal bleeding and shock, the nurse should anticipate all of the following management except: A. Intensive fluid replacement B. Contact tracing C. Isolation D. Close-door home care 12. Zika virus is another emerging disease which was discovered in Uganda in 1947. It is known to be transmitted through mosquito bites specifically of Aedesaegypti and albopictus. Aside from a known complication of microcephaly to infants born to a mother who had a history of Zika virus, which complication is known to develop among adults who have had a history of the disease? A. Guillain-Barre Syndrome B. Alzheimer’s disease C. Degenerative spondylosis D. Hunter’s syndrome 13. In caring for a client with AIDS and is currently on HAART therapy, which of the following statements indicates a need for further teaching regarding the management of the disease? A. “I should take my HAART medications with meals” B. “I should regularly check my liver function.” C. “I should immediately consult my physician if I experience abdominal pain which radiates to the back” D. “I could go swimming in a public resort with my family and friends” 14. Nurse Pau is teaching a group of student nurses about Dengue. Which of the following statements if said by the student indicates correct understanding of the topic being discussed? A. “The confirmatory test for Dengue virus is the complete blood count test” B. “20 or more petechial spots inside a 2.5 cm2 box may indicate presence of bleeding according to the principle of the Rumpel lead test” C. “The drug of choice for the client’s fever is acetylsalicylic acid” D. “There is a need to restrict the client’s fluid during Grade III Dengue Fever” 15. SARS and MERS-COV almost have the same presenting signs and symptoms. Although they both have the same causative agent which beta-coronavirus, MERS-COV has a higher case fatality rate of 30% compared to the 10% CFR of SARS. The difference between the statistics of the two diseases can be attributed to: A. The extent of respiratory complications in MERS-COV B. The presence of renal involvement in MERS-COV C. The easier diagnosis of SARS D. The self-limiting nature of SARS Situation: Verbal communication is extremely important especially when the Nurse is exploring problems and disorders with the clients in any age group. Nurse Dante is assigned to different clients in the ward. 16. A client is hospitalized with a diagnosis of possible Cancer of the pancreas. On admission the client asks the nurse, “Do you think I have anything serious like cancer?”What is the nurse’s best reply? A. “What makes you think you have cancer? B. “I don’t know if you do, but let’s talk about it.” C. “Why don’t you discuss this with your doctor?” D. “Don’t worry, we won’t know until all the test result are back.” 17. Nurse Dante approaches a male client and asks how he is feeling. The client states “I’m feeling a bit nervous today.” Which of the following is the Nurse’s best reply? 1. Please explain what you mean by the word nervous 2. What is making you feel nervous? 3. Would a backrub ease your nervousness? 4. You do look like you’re nervous 18. When assessing a client what statement would indicate negative self-talk? A. Everyone has to learn something new sometime B. I am looking forward to making home visits , but I am also nervous C. This is going to be difficult, but I know I can do it D. Who can ever have enough experience to prepare for that job? 19. While receiving a preoperative enema a client starts to cry and says. “I’m sorry you have to do this messy thing me,” what is the best response by the nurse? A. “I don’t mind it.” B. “You seem to be upset.” C. “This is part of my job.” D. “Nurses get used to this.” 20. “But you don’t understand” is a common statement associated with adolescent. The best response by the nurse when communicating with an adolescent is to say: A. “I don’t understand.” B. “I would like to understand, let’s talk.” C. “I don’t understand. I was a teenager once too.” D. “I’m not sure have to I believe it’s you who has to understand.” Situation: Knowledge of the physiologic and pathologic changes in pregnant women is necessary in order to determine which situations require management and possible referral. 21. Nurse Dianne is observing a client in the labor room. Which of the following changes in the cardiovascular system shows a pathologic response? A. Increase in total cardiac volume by 40-50%. B. Anasarca C. Varicosities of the lower extremities D. Heart is elevated slightly upward and to the left. 22. The gastrointestinal system is also one of the systems most affected by the pregnancy. Which of the following is true? A. Nausea and vomiting as a result of the secretion of the HCG, subsiding by the 6 th month. B. Poor appetite caused by increased gastric motility. C. Flatulence and heartburn due to decreased gastrointestinal motility and slowed emptying of the stomach caused by a decrease in progesterone production. D. Ptyalism as a result of increasing levels of estrogen. 23. Changes in the endocrine system also occur during the pregnancy process. Which of the following are true A. BMR Increases B. Metabolic function Increases C. Anterior lobe of the pituitary gland reduces D. Thyroid gland enlarges slightly E. Thyroid activity decreases F. Parathyroid gland increases G. Aldosterone levels gradually decrease H. Body weight increases I. Water retention decreases A. H, F, D, C, I B. I, F, B, G, C C. B, A, E, H, F D. A, B, D, F, H 24. After the 8-hour shift, Nurse Dianne is asked to go on duty on another 8 hours.She is performing an assessment of a primigravid mother who is being evaluated in a clinic during her second trimester. Which of the following indicates an abnormal finding? A. Quickening B. Braxton Hicks Contractions C. FHR of 180 beats per minute D. Consistent increase in fundal height 25. She explains some of the purposes of the placenta to a client during a prenatal visit. The nurse determines that the client understands some of these purposes when the client states that the placenta: A. Cushions and protects the baby. B. Maintains the temperature of the baby. C. Is the way the baby gets food and oxygen. D. Prevents all antibodies and viruses from passing to the baby. 26. The patient’s ABG result reveals presence of respiratory acidosis. Which among these values would you expect to see? A. pH 7.35, CO2 39 mmHg, HCO3 24 mEq/L B. pH 7.47, CO2 30 mmHg, HCO3 22 mEq/L C. pH 7.32, CO2 49 mmHg, HCO3 29 mEq/L D. pH 7.31, CO2 31 mmHg, HCO3 20 mEq/L 27.During the initial stages of cardiogenic shock, respiratory 2 | Page