RECALLS EXAMINATION 14
NURSING PRACTICE I
COMMUNITY HEALTH NURSING
NOV 2023 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
Situation: Ice, a community health nurse, is newly assigned
as the clinic manager at Brgy. Cagdara-O Health Station
(BHS). He is to provide nursing care to the members of the
community and to train the barangay health workers in the
provision of health services. The Municipal Health Officer
(MHO) supervises his activities in the barangay.
1. A mother with her child comes in to the clinic. She
complains that her child, baby SC, an 18- month old male, is
coughing with no secretions for about two days. She tells the
nurse that “My child is coughing. This is going on for two
days. Can I ask for Cotrimoxazole?” The nurse’s best response
for this situation is:
a. “This is not permissible because I am not a doctor. I
advise that you go to the Rural Health Unit for the
medicine. They have a doctor there.”
b. “Please wait, mother. There might be a problem that
can be solved by IMCI.”
c. “Okay, mother. There is medicine here that you
need.”
d. “Mother, I need to check him first. There might be a
more appropriate treatment for baby.”
2. After assessing the child, as per the Integrated
Management for Childhood Illnesses (IMCI) in 2014, the child
only has coughs and colds. The nurse determines that the
child should be given a safe remedy. With the nurse’s
knowledge on herbal medicine, which plant decoction should
he give to the child?
a. Oregano leaves
b. Five-leaved Chaste tree leaves
c. Ginger
d. Young leaves of the Mango tree
3. After two days, the mother returns with the child
experiencing asthma. Upon assessment per IMCI, the nurse
needs to nebulize the child with inhaled albuterol. The BHS
does not have any stock right now, but there is a botika ng
barangay a few meters away that is selling albuterol nebules.
What is an appropriate response of the nurse?
a. “Mother, here is a prescription for medicine. Please
go to the botika ng barangay right now. They are
selling albuterol there. Afterwards, please go back
here so that I could administer the drug to the baby.
You can leave the baby here.”
b. “Mother, this is the prescription for the medicine and
the nebulizer. Please go to the pharmacy to buy the
nebule. Afterwards, please nebulize the baby.”
c. “Mother, here is a prescription for medicine. Please
go with the baby to the pharmacy right now. They
are selling albuterol there. Afterwards, please go
back here so that I could administer the drug to the
baby.”
d. “Mother, let’s just cry because your baby might die.”
4. Ice wants to know the predominating health problems in
the community. As part of data collection, he performs
interviews with random members of the community. During
one of his interviews, a man named Argie said that “Come
and eat with us first in our babang luksa” before we answer
your question.” What is an appropriate response of the nurse?
a. “I’ll go and eat with you for a bit, but we’ll have to
talk about it over the food.”
b. “I have to refuse. I’m not allowed.”
c. “I’ll just stay with you.”
d. “I have to refuse. If you force me, I will tell on the
barangay captain.”
5. Wednesdays, as declared by the Philippine Department of
Health, is the vaccination day for children. Ice encounters
baby GB, a 9- month old female. The anti-measles vaccine is
prepared, with you knowing that it should be administered
through:
a. Intramuscular route; lower inner quadrant of the
gluteal area
b. Intramuscular route; middle third of the vastus
lateralis
c. Subcutaneous route; 90° angle
d. Subcutaneous route; 45° angle
Situation: Ice decides to go back to the hospital setting.
You, a new registered nurse and a top notcher in last board
exams, gets accepted as the community health nurse with the
position of a Public Health Nurse II (PHN II). You will provide
nursing care to all the members of the community, regardless
of the age and the place of conduct.
6. You make it to a point that the BHS is cleaned every day
because you know that this assists clients to a better state of
health. This notion is in accordance with the theory of nursing
proposed by:
a. M. Leininger
b. D. Orem
c. F. Nightingale
d. C. Roy
7. The previous nurse wanted to know the predominating
health problems in the community. However, this was not
finished during his years of service. You, as the new nurse, is
responsible for the continuation of the process. Upon checking
the records, you noticed that the persons infected with the
human immunodeficiency virus (HIV) have exponentially
increased during the previous months. As a health care
professional, you need to protect yourself from being infected
with the virus. To avoid being infected, you know that the
precautions that you need to do when you handle a client with
HIV is:
a. Universal Precautions
b. Blood Precautions
c. Airborne Precautions
d. Contact Precautions
8. For you to conclude that there really is an increase in the
cases of people living with HIV (PLHIV), you must know the
______ of PLHIV in Brgy. Cagdara-O.
A. Incidence rate New cases
B. Prevalence rate
C. Morbidity Rate
D. Gender
1 | Page

9. You finished your community diagnosis and planning of
programs targeted at reducing the rate of increase in HIV
cases. During the implementation, you admitted to yourself
that, while you are well-versed with the artificial methods in
family planning, you are not entirely familiar with the natural
methods. You wanted to cooperate with an organization that
is well known for promoting natural family planning and has
collaborated with the Department of Health (DOH) for the
advocacy. You would call a representative from:
a. Victory Church
b. Catholic Bishops Conference of the Philippines
c. Couples for Christ
d. United Methodist Church
10. During your screening, a mother with a 4- month old child
admits that she is positive for HIV. The records she showed
you confirms that she indeed has contracted the disease. The
mother asks, “Nurse, I read that HIV can be transmitted
through breastfeeding. However, my mother said that it’s just
okay to continue it, despite my status. Which one is really the
truth?” What is the appropriate response of the nurse?
a. “Ma’am, that is correct. You can pass HIV through
breast milk because it was proven to contain HIV. In
this case, you can use bottle feeding for your child as
stated by your doctor.”
b. “Ma’am, you should go with breast milk. The chances
are low for breast milk to transmit HIV. The benefits
of breast feeding outweigh the risks.”
c. “Ma’am, just give him rice water. I became smart
because of that. Just boil it enough to be sterilized.”
d. “Ma’am, you should ask your doctor about that.”
Situation: A woman goes into the BHS to ask for a check-up.
She complains occasional syncope, pallor, and vaginal
bleeding, with blood saturating a napkin pad every hour. The
client has just undergone hysterectomy. You, a topnotch
nurse, is considering heavy bleeding secondary to surgical
complications. You filled up a referral form and calmed the
client until the rural health unit’s ambulance came to take her
into the hospital. The day has passed, and the client’s
husband returned the referral form, blaming the nurse for the
loss of his wife. He sued you for negligence.
11. The court issues an order to summon the MHO and bring
all relevant and tangible documents for use in the hearing.
What order is this?
a. Subpoena ad testificandum
b. Subpoena duces tecum
c. Subpoena opera omnia
d. Subpoena bravus exvius
12. Upon investigation, the court found no charting of the
incident. Because there was no proof of your interventions,
you were found guilty of the charges. In addition, the court
charged the MHO because he was the one supervising you.
This liability imposed upon to the MHO is termed as:
a. Assumption of risk
b. Res ipsa loquitur
c. Mea maxima culpa
d. Respondeat superior
13. Accurate documentation is the hallmark of nursing
accountability, as dictated by the PRC BON Resolution No. 220,
s. 2004. This is also known as:
a. Affirmation of the Board of Nursing as the
Regulatory Arm of the Professional Regulations
Commission for the Profession of Nursing
b. Code of Ethics for Nurses
c. Implementing Rules and Regulations of the
Philippine Nursing Act of 2002
d. Implementing Rules and Regulations of the
Comprehensive Nursing Law
14. The nurse, while claiming to have done everything in his
scope to help the client, admitted that he indeed was not able
to chart the incident because he forgot about it. This ethical
principle exerted by the nurse is called:
a. Veracity
b. Non-maleficence
c. Beneficence
d. Respect for Autonomy
15. The law governing your practice of the profession as nurse
is called:
a. RA 9731
b. RA 9713
c. RA 9173
d. RA 9371
Situation: Four months after the incident, the family forgives
you and the court lifts your suspension. You decide to apply in
a non governmental organization (NGO) as a community
health nurse.
16. The Projects Director for Public Health of that NGO
becomes your interviewer. She asks you about the concept of
primary health care. You, the most stellar nurse in your batch
during your board exams, answers this question with:
a. “To strengthen the health care system by increasing
opportunities and supporting conditions wherein
people will manage their own health care”
b. “Health for all Filipinos, and health in the hands of
the people by the year 2020”
c. “To partner with and empower the people towards
self-reliance in health care”
d. “Guarantee equitable, sustainable, quality health for
all Filipinos”
17. You have been assigned as a clinic manager to the
“Post-Haiyan Community-Based Communicable Disease
Prevention Program” of the said NGO. Upon your arrival in
Guiuan, Eastern Samar, a child was immediately brought to
your post. He was bitten by a dog. Using your knowledge on
rabies, you treat the child based on this sequence for the
prevention of rabies:
I. Wash with soap and water for 15 minutes
II. Vaccinate with ERIg or HRIg
III. Apply either 70% ethanol, tincture, or aqueous
solution of iodine
IV. Observe the dog for 10- 14 days
V. Lie down.
VI. Try not to cry.
VII. Cry a lot.
a. I, VII, V, II
b. IV, V, VI, III
c. III, II, VI, I
d. I, III, II, IV
18. The next morning, a three-month pregnant mother comes
into the clinic. She verbalized, “My boyfriend said that you
have a vaccine here for pregnant mothers. What is that
vaccine?” This vaccine is:
a. Measles, Mumps, Rubella (MMR) vaccine
b. Tetanus Toxoid (TT)
c. Anti-Measles Vaccine (AMV)
d. Pentavalent Vaccine (PentaHib)
19. The mother shows her vaccination record. It was indicated
she was first vaccinated for TT on June 12, 2018. If today’s
date is July 16, 2018, the next dose should have been given
on:
a. July 2, 2018
b. December 12, 2018
c. June 12, 2019
d. Today
20. If the pregnant mother’s vaccination record shows that
she was given 3 DPT doses during childhood, when will be the
next dose?
a. July 2, 2018
b. December 12, 2018
c. June 12, 2018
d. Today
Situation: After spending 5 years in the program, you
decided that you want to be a maternal and child nurse (MCN)
in Eurasia Vienna Regional Medical Center (EVRMC). As an
MCN, you are tasked to take care of pregnant mothers and
their newborns.
21. During your break on your first day, you decided to go to
the staff room. You found out that your head nurse was
injecting an unknown liquid in his arm. Your priority nursing
action is:
a. Stop the head nurse from injecting that liquid.
b. Report the incident to your charge nurse
c. Report the incident to the nurse supervisor
d. Ask the police to kill the head nurse because he is an
“adik” and deserves to die, as dictated by a certain
high-ranking politician
2 | Page
22. After responding to that event, you admitted a laboring
37-week pregnant mother who was pregnant 4 times prior,
with 3 babies reaching childhood. All prior pregnancies
reached term, but 1 child died 30 minutes after birth. There
were no preterm deliveries. What is the mother’s obstetric
score?
a. G 4 T 4 P 0 A 0 L 4 M 0
b. G 5 T 5 P 0 A 0 L 5 M 0
c. G 4 T 3 P 0 A 0 L 3 M 0
d. G 5 T 4 P 0 A 0 L 4 M 0
23. You now have a total of 8 single-gestation pregnant
mothers under your care. How many are your clients?
a. 8
b. 16
c. 9
d. 18
24. Your current hospital is a facility that provides all basic
emergency maternal and neonatal care, with the addition of
blood transfusions and caesarian deliveries to mothers. With
your experience in the community, you know that this is the
highest level in the four-tier service delivery model. Recalling,
what is the first level in this delivery model used in the
Philippines?
a. Comprehensive Emergency Obstetric and Newborn
Care (CEmONC)
b. Basic Emergency Obstetric and Newborn Care
(BEmONC)
c. Basic Essential Obstetric and Newborn Care (BEONC)
d. Community-based Teams (CBTs)
25. In a CEmONC facility, which of the following is NOT a part
of the team?
a. Midwife
b. Nurse
c. Surgeon
d. None of the Above
Situation: While you are a stellar MCN and CHN, your friend
Dindin is an excellent pediatric nurse. She is assigned in the
pediatric surgical ward.
26. Dindin is caring for 2-year-old child named CP. CP is
diagnosed with Pyloric Stenosis. The child comes back from
the Post-Anesthesia Care Unit (PACU). Knowing the surgical
procedure needed to correct the problem, Dindin is expecting
that the child is status post- ?
a. Fredet-Ramstedt Procedure
b. Swenson Pullthrough
c. Exploratory Laparotomy, Total Abdominal
Hysterectomy and Bilateral Salpingo oopherectomy
(EL-TAHBSO)
d. Lobotomy
27. The resident physician orders for CP’s urine output to be
monitored hourly. If CP weighs 12 kg, her regular hourly
output should be approximately:
a. 6 cc
b. 12 cc
c. 24 cc
d. 36 cc
28. During the first hour of the client after the surgery,
Dindin notices that the child is having slow respirations of
about 18 cycles/minute (CPM). Dindin’s priority nursing
action is to:
a. Monitor the client and document findings.
b. Provide oxygen of about 2 liters/minute (LPM) via
face mask
c. Refer to physician
d. Start Cardio-Pulmonary Resuscitation (CPR)
29. CP has an abdominal wound that has never been
cleaned after the surgery. The surgical consultant orders
that the surgical wound be cleaned every 8 hours by the
nurse on duty. Dindin’s first nursing action is to:
a. Use povidone-iodine to clean the wound
b. Wash hands with soap and water
c. Ask the resident physician to clean the wound
d. Clarify the order with the consultant
30. CP’s father asks if the baby’s thumb-sucking is normal.
She explains to the father that the child is in the “oral
phase”, according to a psychoanalyst named Freud. Dindin
displays her knowledge on the psychosexual stages if she
states that: (SELECT ALL THAT APPLY by encircling all
possible letters of the correct answers)
a. An infant sucks for nourishment & pleasure
b. An infant does not find pleasure in sucking but does find
enjoyment from the perception of nourishment from the
thumb
c. An infant may have more pleasure in breastfeeding than in
bottle feeding because it expends more energy
d. An infant does not find pleasure on a pacifier
e. An infant explores the world through her mouth
f. An infant begins to explore the genital area to learn sexual
identity
a. A,C,E
b. B,C,F
c. A,B,E
d. D,E,D
Situation: The nursing staff of the pediatric neurology ward
is having a mid-year staff outing. Dindin was asked to relieve
in the area.
31. Dindin is preparing a 4 year-old intersex client for
craniotomy. Which nursing action is appropriate for
preoperative teaching based on Erikson’s developmental
stages?
a. Allowing the child to make a project related to the
surgery
b. Having the child put a surgical mask on a doll
c. Asking the child how he feels about surgery
d. Allowing the child to listen to music without further
instructions
32. Dindin prepares the child’s medications. The mother says,
“My baby is afraid of strangers and afraid of separating from
me. My mother in-law is upset and thinks I am causing it.”
Which response by the nurse is most appropriate?
a. “Give your baby to strangers while you are present,
so he gets used to strangers.”
b. “Your mother-in-law is correct; you need to include
her more in your baby’s needs.”
c. “Separation anxiety is an important component of a
parent-child attachment.”
d. “Just let your baby cry for a while; your baby will get
used to being separated from you.”
33. A 15 year-old transwoman client previously diagnosed
with a pituitary adenoma is about to be discharged. The
parents were taking care of the child’s hospital clearance
when Dindin approached the adolescent. She told the nurse
that, “I have something to say to you, but I beg you, do not
tell anyone about this.” Dindin’s most appropriate action would
be to:
a. Promise the client that the information will not be
told to anyone.
b. Tell the client that the information will be confidential
unless it is life threatening or harmful.
c. Tell the client that only the physician will be told;
otherwise the information will remain confidential.
d. Ask the client to tell a social worker who then can
follow through with the information if it is
concerning.
34. Dindin is assessing an infant for attachment behavior.
Which observations are important in assessing this
relationship? (SELECT ALL THAT APPLY by encircling all
possible letters of the correct answers)
a. The kind of body contact between the parent and infant
b. If the parent is holding and cuddling the infant
c. The kind of comfort techniques being used by the parent
d. The comfort level of the parent while interacting with the
baby
e. Whether the infant is crying
a. A,B,D,C
b. B,A,D,C
c. A,B,C,D
d. D,B,C,A
35. A nursing care plan is being made by Dindin for a child
who is s/p removal of brain tumor. The child is confused,
disoriented, and restless. Which nursing diagnosis should
receive the highest priority?
a. Altered Sensory Perception r/t neurological surgery
b. Self-Care Deficit r/t confusion and disorientation
c. Impaired Verbal Communication r/t confusion
3 | Page
 d. Risk for injury s/t disorientation and restlessness
Situation: A strong earthquake has recently hit the Province
of Morgana. EVRMC was asked by the Local Government Unit
of Morgana and the DOH to send health care providers. You,
Dindin, and two other colleagues named Vina, and Jousch
were deployed. You were to provide primary health care as
supervised by the Municipal Health Officer.
36. Dindin was assigned to provide reproductive health (RH)
services to the Manunubang. She helped a mother to deliver
the newborn. She was about to pull the placenta. The cord
was lengthening and there was a sudden gush of blood. She
is now only waiting for the uterus to become firm and
globular. This sign that Dindin is waiting for is called:
a. Cullen’s Sign
b. Culkin’s Sign
c. Chadwick’s Sign
d. Candor’s Sign
37. A nursing supervisor from a known OB-Gyne hospital in
Manila told Dindin that what she did is termed as the
expectant management of the third stage of labor. However,
as per new evidence, the Philippines is moving towards the
active management of the third stage of labor (AMTSL). The
components of AMTSL includes the following EXCEPT:
a. Giving a uterotonic drug to contract the uterus
(oxytocin)
b. Controlled Cord Traction
c. Delayed Cord Clamping
d. None of the Above
38. Vina and Jousch were assigned to provide primary health
care to adult clients. Jousch claimed that she was told by the
MHO that she is given permission to diagnose and prescribe
medicines to adult clients by virtue of an interim primary
health care guideline for first level health workers. Jousch was
referring to:
a. International Guidelines on Medical Diagnoses for
Nurses
b. Nurse’s Primer for Advanced Primary Health Care
c. Integrated Management of Adult and Adolescent
Illnesses (IMAI)
d. Emergency Medical Training Guidelines for Allied
Health Professions
39. After the incident, Vina decided to go out with the
emergency response team and looked for people needing
help. She saw a man standing near a house. Because Vina is
knowledgeable about Psychological First Aid (PFA), she
approached him and introduced herself. The man told her “I’m
Tarib Yorimit. I’m scared! I was about to come home from the
farm when it started shaking! I don’t understand what is
happening!” Vina’s best response for Tarib is:
a. “You should have run away from your house. It could
be dangerous.”
b. “Yes, a 4.5 magnitude earthquake with the epicenter
at Fata, Morgana and a hypocenter at about 79 miles
deep into the earth’s crust happened.”
c. “Everything will be okay. You will have a new house.
The government will surely give you a job with a
salary of 10,000 pesos per month for a decent living.
You just have to work hard and not be lazy.”
d. “Yes, it was an earthquake and I can imagine it was
terrible for you. It’s not safe in this area for now, and
you might get hurt.”
40. Francois, an emergency room nurse, is assigned as a
triage nurse in the emergency center of the hospital. She
receives four admissions. Prioritize the order in which
Francois will assess the clients.
I. A 40 year-old client who is diaphoretic and is feeling
chest pressure
II. An 18 year-old client who thinks he might have a
broken ankle
III. A 35 year-old client who cut her hand with a knife
preparing for food
IV. A 60 year-old client who is dyspneic and has
swollen lips after being stung by a bee
a. IV, I, III, II
b. IV, I, II, III
c. IV, III, II, I
d. IV, III, I, II
Situation: As a care specialist, a nurse should be
knowledgeable on socio-political aspects of health care.
41. The Philippine Health Agenda, a national health
development plan created during the period of the DOH
Secretary Paulyn Ubial, aims to attain the health-related
Sustainable Development Goal (SDG) Targets. With its
development, goals were defined by formulating its so-called
“Guarantees”. Which of the following statements are NOT
included in the Guarantees?
a. Services for Both Well and Sick
b. Functional Network of Health Facilities
c. Financial Freedom When Accessing Health Services
d. Advance Quality, Health Promotion, and Primary Care
42. The SDG in which the PHA is patterned from is the:
a. SDG 1
b. SDG 2
c. SDG 3
d. SDG 4
43. PHA’s Guarantee 1 ensures that all life stages and the triple
burden of disease is addressed. This includes attention to
Non-Communicable Disease (NCD) and Malnutrition. In the
Philippines, what is the protocol used to screen, diagnose and
manage NCDs in the primary health care level?
a. PFA
b. PhilPEN
c. OSHS
d. mhGAP
44. Communicable diseases are a problem that continues to
threaten child health. To combat the rise in morbidity, the
Philippines is implementing what is known as the National
Immunization Program. This program is mandated by:
a. RA 10152
b. PD 996
c. RA 7305
d. PD 856
45. The current administration has appointed a new DOH
secretary. He wants to use a strategic approach that will
“enable the health department and the public to monitor how
the health sector is working to achieve better timeliness,
better responsiveness, better quality, and better outcomes for
patients”. This strategic approach is thereby dubbed as:
a. Duterte Health Agenda (DHA)
b. Fourmula One for Health (F1)
c. F1 Plus
d. DHA Plus
Situation: As a nurse well-versed in the holism of care, you
provide care to people in various places and situations.
46. You are walking to the Rural Health Unit when a jeepney
hit two persons walking on the pedestrian lane. Client A, an
adult, was bleeding from the abdomen, and is visibly having a
difficulty in breathing. As the first responder, you identified
yourself as a health care professional and proceeded to the
scene. What is the first nursing action that you should do as
you approach the client?
a. Assess the client for cervical injuries
b. Stop the client’s bleeding
c. Check if the scene is safe
d. Insert a 23G IV cannula for PNSS to replace blood lost
47. As you assess client A, you noticed that the client is
unable to move his upper and lower limbs and the airway is
not open. You are suspecting a cervical spine injury. Which of
the following methods should you use to open the airway?
a. Head-tilt/chin-lift technique
b. Modified jaw-thrust maneuver
c. Ritgen’s Maneuver
d. Crede’s Maneuver
48. You noticed that there is a glass shard stuck in the client’s
abdomen. What is the nurse’s priority action with regard to
the glass shard?
a. Remove the glass shard
b. Stabilize and secure the impaling object in place
c. Push it deeper to prevent bleeding
d. Let the surgeon handle it
49. After 15 minutes, the client is still bleeding out, despite
nursing interventions. The EMT has still not arrived in the
scene. You noticed that the client is having respirations of 30
4 | Page
CPM, PR of 120 BPM, and BP of 70/50. You are now
suspecting that the client is in:
a. Cardiogenic Shock
b. Anaphylactic Shock
c. Hypovolemic shock
d. Electric Shock
50. If a person is already in shock and has no head and/or
abdominal injuries, what is the most appropriate position for
the client?
a. Supine with legs elevated
b. Trendelenberg
c. Dorsal Recumbent
d. Lithotomy
Situation: Research is essential to the nursing practice. It
enables a nurse to have continuing professional development
and to provide quality, safe, and up-to-date care for clients.
51. You, a very successful and intelligent nurse, decides to
research on the effects of music therapy in pain relief on
children during phlebotomy. Which of the following is the
dependent variable?
a. Amount of music therapy
b. Pain relief during phlebotomy
c. Children
d. Indiscernible from the given data
52. Which of the following is the independent variable?
a. Amount of music therapy
b. Pain relief during phlebotomy
c. Children
d. Indiscernible from the given data
53. If the study is quantitative and the standard deviation is
known, which of the following statistical tests should the
nurse use in the research?
a. One-Sample Z-Test
b. One-Sample T-Test
c. Chi-Square Test of Association
d. ANOVA
54. The responses that the nurse will analyze comes directly
from the perceptions of the children in the study. These
responses are research data that are taken from a:
a. Primary Data Source
b. Secondary Data Source
c. Tertiary Data Source
d. Quaternary Data Source
55. You wanted to use a measure of central tendency to
summarize information about the distribution of data. Which
of the following measures of central tendency has a tendency
to be affected by data outliers?
a. Median
b. Mode
c. Mean
d. Standard deviation
Situation: As a health care professional, whether you are
working in the community or in the hospital, you are tasked to
provide nursing care when unforeseeable crises occur.
56. A few minutes after you made a reservation for massage,
you heard something hard hit the pavement. Immediately
after he lied down, you saw him with what appears as jerking
movements from all over his body. As per assessment, he has
lost his consciousness. You know that the client is
experiencing:
a. Simple partial seizures
b. Complex partial seizures
c. Generalized seizures
d. All of the above
57. Which of the following nursing interventions are
inappropriate for the client during the attack?
a. Do not restrain the client
b. Loosen his clothing
c. Place a small, folded blanket under the head
d. Place a tongue guard in his mouth
58. What is the position of choice for the client during the
seizure attack?
a. Dorsal recumbent
b. Side-lying
c. Supine
d. Trendelenburg
59. The Emergency Medical Team has arrived at the scene.
You identified yourself as a registered nurse explained the
situation and gave a brief background on the EMT.
Assessment parameters were given and recommendations to
take the client to EVRMC were reiterated. This type of referral
communication most commonly used in nursing is called:
a. ISBAR
b. CABC
c. AVPU
d. ABCDE
60. One of the EMT rescuers took the client’s blood pressure.
He records it at 200/120 mmHg. As per the 8th Joint National
Commission Guidelines, this is classified as:
a. Hypotension
b. Normotension
c. Stage I Hypertension
d. Stage II Hypertension
Situation: You are a clinic nurse providing care to clients with
chronic and terminal illnesses.
61. You are teaching an 18-year-old diabetic client to perform
self-administration of insulin. The nurse notes that each time
the client makes even a small mistake, the client constantly
apologizes for getting it wrong. The nurse observes that the
client also profusely apologizes when making a minimal
mistake in other activities. The nurse concludes that,
according to Erikson’s development stages, the adult may
have an unresolved development task of:
a. Infancy.
b. Early childhood.
c. School-age childhood.
d. Adolescence.
62. A client states, “If I could live until my grandson’s wedding
in 2 months, then I would be ready to die.” Based on this
statement, you should interpret that the client is in which
stage of grief?
a. Denial
b. Depression
c. Bargaining
d. Acceptance
63. You are caring for a middle-aged client who is disabled
due to a recent motor vehicle accident. The client has few
interests, spends most days watching TV, and has become
estranged from the family. Which of Erikson’s developmental
stages should the nurse conclude that the client is NOT
meeting?
a. Industry versus inferiority
b. Initiative versus guilt
c. Generativity versus stagnation
d. Intimacy versus isolation
64. 25-year-old client, who had a hysterectomy due to uterine
cancer tells you, “My husband will probably leave me now
because I won’t be able to have any more children. I am so
glad I have one child already.” Which response by you is most
appropriate?
a. “That probably won’t happen. He’ll likely be thankful
that you already have one child.”
b. “Are you afraid your husband will leave you because
he wants more children?”
c. “There are support groups you and your husband
could attend to help cope with your loss.”
d. “Your husband should be thankful that you are alive
and didn’t bleed to death!”
65. A 60-year-old client, admitted to a hospital with chest
pain, has been functioning independently at home. During the
night, the client is found wandering in the hallway and states,
“I can’t find my kitchen. I need a glass of milk.” Your best
interpretation of the client’s behavior is:
a. The client likely had a stroke.
b. The stress of being in unfamiliar surroundings has
caused the client’s confusion.
c. The decline in mental status, especially at night, is a
normal part of aging.
d. This is an insidious change and it likely means the
client has early dementia.
Situation: In the Philippines, there has been a rise in mental
health illnesses. About 1 in 3 Filipinos die every year from
suicide.
5 | Page
66. Which nursing diagnosis should a nurse give highest
priority when caring for a client with major depressive
disorder?
a. Powerlessness
b. Compromised Human Dignity
c. Risk for Self and Other- Directed Violence
d. Disturbed Sleeping Patterns
67. A nurse is meeting with a client who is being discharged
after hospitalization for suicidal ideation. Based on knowledge
of expert consensus of warning signs for suicide, the nurse
should plan to advise the client to seek help by contacting a
mental health professional or calling the national suicide
prevention hotline if experiencing: (SELECT ALL THAT APPLY
by encircling all possible letters of the correct answers).
a. Sadness.
b. Hopelessness.
c. Severe Anxiety and Agitation.
d. Feeling of Being Trapped.
e. Increasing Alcohol or Drug Use.
a. B,C,D,E
b. A,B,C,D,E
c. B,C,E
d. A,C,D
68. You are reviewing diet restrictions with a suicidal client
taking a monoamine oxidase inhibitor (MAOI). Which
symptom could occur with non-adherence to diet restrictions
while taking a MAOI?
a. Agranulocytosis
b. Explosive Occipital Headache
c. Severe Hypotension
d. Akathisia
69. An experienced nurse is teaching a new nurse about
establishing therapeutic relationships with clients on a mental
health unit. Which intervention should the nurse suggest
when attempting to establish a therapeutic relationship with a
client diagnosed with major depressive disorder?
a. Sit with the client in silence.
b. Ask the client to join others to watch a 2- hour
movie.
c. Invite the client to attend an exercise class.
d. Ask the client how his or her day should be
scheduled.
70. A depressed client tells a nurse, “Nothing gives me joy.
Things seem hopeless.” Which actions should be you take
when caring for this client? Prioritize the nurse’s actions order.
I. Demonstrate genuine empathy and caring in
discussing client’s feelings about suicide.
II. Evaluate the client’s risk for suicide by direct
questioning (asking about
suicide intent and plan).
III. Initiate suicide precautions as needed, according
to policy and standards of care.
IV. Continue to support and monitor prescribed
medical and psychosocial
treatment plans.
V. Assist client in maintaining nutritional needs,
hygiene, and grooming.
VI. Contact the client’s support system in
collaboration with case manager
and/or social services.
a. II, III, V, I, IV, VI
b. III, II, I, V, IV, VI
c. II, III, I, V, IV, VI
d. III, II, V, I, IV, VI
Situation: You are a newly hired registered nurse taking care
of clients with mental illnesses.
71. You are assessing a recently admitted client who is
exhibiting agitation that appears to be related to acute mania.
Which action should a nurse plan to utilize when caring for a
client experiencing agitation related to acute mania?
a. Apply restraints to prevent the client from harming
self or others
b. Involve the client in group activities to provide
structure
c. Leave the client alone
d. Maintain a low level of stimuli in the client’s
environment
72. You are assessing a client recently admitted to a
psychiatric unit who is experiencing acute mania. Which
nursing action should the nurse plan when caring for a client
with acute mania?
a. Sustain conversations to improve the client’s
concentration.
b. Provide finger foods that the client can carry while
moving around the unit.
c. Teach the client and family about available
community resources.
d. Help the family understand that anger directed at
them is likely to escalate unless they confront the
client’s behavior.
73. You are caring for a client diagnosed with acute mania.
You observe coarse hand tremors and learns that the client’s
serum lithium level is 1.8 mEq/L. Which action should be you
take?
a. Continue to administer lithium as ordered.
b. Advise the client to limit fluids.
c. Withhold the medication and notify the physician.
d. Acknowledge that the side effects are unpleasant.
74. Which goals should be included in the plan of care for a
client with dementia? (SELECT ALL THAT APPLY by encircling
all possible letters of the correct answers).
a. The client will remain physically safe.
b. The client will receive emotional support.
c. The client will receive physical health care.
d. The client will show cognitive improvement.
e. The client will function at highest level of independence.
f. The client will perform activities of daily living
independently.
A. B,C,D,E
B. A,B,C,E
C. C,D,E,F
D. B,C,E
75. A client diagnosed with delirium is restrained in order to
prevent the removal of a Foley catheter and an intravenous
fluid line. Which response should you expect after the client is
restrained?
a. The client rests better at night.
b. The client becomes visibly agitated.
c. The client requires less pain medication.
d. The client experiences a decrease in blood
pressure.
Situation: In all fields, a nurse’s foundation is key to
providing adequate and safe care.
76. A nurse reviews the record of a client who has been
immobile because of a degenerative neurological condition.
The nurse reads that the client has bilateral foot drop. Which
finding during the nurse’s assessment supports the presence
of foot drop?
a. The great toe is dorsiflexed and the other toes are
fanned out.
b. The feet are unable to be maintained
perpendicular to the legs.
c. The client is unable to move feet into a position
of plantar flexion.
d. The client is only able to dorsiflex the feet
bilaterally.
77. A client reports pain at an intravenous infusion site that
has infiltrated. When a nurse applies a warm, moist
compress to the site, the client asks how the treatment will
help the condition. The nurse answers the client based on
the understanding that the application of moist heat will:
a. Alter tissue sensitivity by producing numbness.
b. Decrease the metabolic needs of the involved
tissues.
c. Stop the local release of histamine in the tissues.
d. Increase blood flow and improve capillary
permeability.
78. A client is transferred to a medical center from a local
hospital and undergoes emergency treatment related to
acute coronary syndrome. The client has slept little over the
past 24 hours. Which assessment finding is consistent with
sleep deprivation?
a. Periods of apnea lasting greater than 5 seconds
b. Slowing of thought processes
c. Hyperventilation
6 | Page
 d. Cool extremities 87. A presidential decree was enacted providing penalty for
79. A nurse takes a client’s blood pressure with an improper disposal of garbage. This is dubbed as:
automatic blood pressure machine. The blood pressure is a. PD 996
86/56 mm Hg with a pulse rate of 64 beats per minute. b. PD 651
Which action should the nurse do first? c. PD 856
a. Assess the client for dizziness and assess the d. PD 825
skin on the extremities for warmth 88. A presidential decree was enacted recognizing the
b. Obtain a manual blood pressure cuff and retake importance of sanitation and its effects on public health and
the client’s blood pressure welfare. This is dubbed as
c. Elevate the head of the client’s bed a. PD 996
d. Read the client’s medical record and determine b. PD 651
the client’s normal range of blood pressure c. PD 856
80. Which signs should indicate to a nurse that a client is d. PD 825
experiencing a surgical site infection? (SELECT ALL THAT 89. A presidential decree was enacted to protect children
APPLY by encircling all possible letters of the correct against death, disease, and disability through an integrated
answers). and comprehensive basic immunization program. This is also
a. Temperature of 100.4°F (38°C) the basis for the new law on the national immunization
b. Localized pain and tenderness program. This is dubbed as:
c. Well-approximated wound edges a. PD 996
d. Redness or warmth at the affected site b. PD 651
e. Purulent drainage at the incision site c. PD 856
f. Thick, white drainage in the Jackson-Pratt (JP) tubing d. PD 825
a. A,B,D,E,F 90. A law was enacted to establish a system and defines
b. A,B,C,D,E,F powers of the provincial, city, municipal, and barangay
c. A,C,E,F governments in the Philippine, including control over the
d. B,D,E,F health offices in areas of rule. This is dubbed as:
Situation: The Filipino registered nurse, believing in the a. RA 9173
worth and dignity of each human being, recognizes the b. RA 7600
primary responsibility to preserve health at all costs. c. RA 7160
d. EO 51
81. As an ethical and professional nurse, which of the Situation: Moreover, there are laws existing in the Philippines
following is NOT a part of your primary responsibilities? guiding nurses in the promotion of health in the primary level.
a. Promotion of Health
b. Prevention of Illness 91. This is a law that adopts a national code of marketing of
c. Alleviation of Suffering breastmilk substitutes, supplements, and related products.
d. None of the above This is dubbed as:
82. In the community setting, which of the following ensures a. RA 9173
the nurse’s success in the delivery of health programs? b. RA 7600
a. Appropriate collaboration with the local government c. RA 7160
officials d. EO 51
b. Pakikisama and respect to values, customs and 92. This is an act that provides incentives to all government
spiritual beliefs and private health institutions with rooming-in and
c. Good communication skills breastfeeding practices. This dubbed as:
d. Professional working relationship with co workers a. RA 9173
83. Nurses, whether in the hospital or in the community, are b. RA 7600
accountable for all nursing actions done on the clients and c. RA 7160
their measured outcomes. Which of the following serves as d. EO 51
the hallmark of nursing accountability? 93. This is an act that guarantees universal access to methods
a. Accurate Documentation of contraception, fertility control, sexual education, and
b. Patient Advocacy maternal care. This is dubbed as:
c. Professionalism a. RA 10354
d. Safeguarding the rights and privileges of all clients b. RA 10351
84. It is the due responsibility of the nurse to the profession c. RA 10643
to be a member of an accredited professional organization d. None of the above
(APO). In the Philippines, which of the following is the APO 94. This is an act effectively instilling health consciousness
for nurses? through graphic health warnings on tobacco products. This is
a. Philippine Nurses’ Association (PNA) dubbed as:
b. Critical Care Nurses’ Association of the Philippines, a. RA 10354
Inc. (CCNAPI) b. RA 10351
c. Association of Nursing Service Administrators in the c. RA 10643
Philippines (ANSAP) d. None of the above
d. Operating Room Nurses Association of the Philippines 95. This is an act restricting the excise tax on alcohol and
(ORNAP) tobacco products. This is dubbed as:
85. Ethically, nurses should respect individual freedom of any a. RA 10354
client to make a rational and unconstrained decision. This b. RA 10351
ethical principle is thereby termed as: c. RA 10643
a. Trust d. None of the above
b. Autonomy Situation: Environmental health is the field of health studying
c. Initiative how the environment influences human health and disease.
d. Industry Nurses must be knowledgeable about the existing laws
Situation: Nurses must be aware of the legal bases of their concerning environmental health.
roles and responsibilities in caring for clients.
86. A presidential decree was enacted that requires the 96. This is an act establishing a comprehensive air quality
registration of births and deaths in the Philippines from management policy and program in the Philippines. This is
January 1, 1974 and thereafter. This is dubbed as: dubbed as:
a. PD 996 a. RA 9003
b. PD 651 b. RA 8749
c. PD 856 c. RA 9275
d. PD 825 d. RA 6969

7 | Page
97. This is an act declaring the policy of the state in adopting a
systematic, comprehensive, and ecological solid waste
management program. This is dubbed as:
a. RA 9003
b. RA 8749
c. RA 9275
d. RA 6969
98. This is an act controlling toxic substances and hazardous
and nuclear wastes. This is dubbed as:
a. RA 9003
b. RA 8749
c. RA 9275
d. RA 6969
99. This is an act providing for a comprehensive water quality
management. This is dubbed as:
a. RA 9003
b. RA 8749
c. RA 9275
d. RA 6969
100. The law governing your practice of the profession as
nurse is called:
a. RA 9731
b. RA 9713
c. RA 9173
d. RA 9371

8 | Page