RECALLS 4: NURSING PRACTICE 5
Situation: Your patient, Mrs. Lyka, who was diagnosed with
Alzheimer’s Disease, is soon to be discharged. You scheduled
a family conference to discuss some concerns regarding Mrs.
Lyka’s condition.
1. You explained to the family members that there will be times
Mrs. Lyka will feel agitated and fatigued. To MINIMIZE if not
totally prevent this situation, you would suggest _______.
A. Make mealtime pleasant - for adequate nutrition
B. Provide activities for her
C. Avoid noisy activities in the house and schedule rest period
for her
D. Provide a consistent routine for her
Rationale: patients with Alzheimer’s want familiarization
because they are easily confused → easily disoriented
2. A family member asked how they can help minimize Mrs.
Lyka’s disorientation to time. Your answer would be to:
A. Encourage talking with friends on the phone
B. Place clocks and calendars at prominent places
C. Keep windows wide open
D. Provide adequate lighting especially in hallways, stairways
and bathrooms - for safety
Rationale: so that they can always see time and date
3. A concern regarding physical safety came up during the
conference. You would recommend to________.
A. Always close the doors and windows - no light can enter;
could also aggravate the client’s disorientation
B. Provide adequate lighting especially in hallways,
stairways and bathrooms
C. Use non-verbal communication
D. Reduce noises and distractions
Rationale: no adequate lighting → at risk for falls/injury
4. A family member expressed that they may not have the ability
to care for Mrs. Lyka. Your MOST APPROPRIATE answer would
be ________.
A. “I will call Mrs. Lyka’s doctor to explain to you more about
Alzheimer’s Disease”.
B. “What information regarding Alzheimer Disease has been
given to you by her doctor.
C. “Do you want to discuss with me specific concerns that
bother you most?”
D. “I will refer your case to the social worker” - nurse’s should
still guide the family not just referring them
Rationale: once the family verbalizes their concerns and
provision of information and answer from the nurse happens,
that’s the time that the family can reconsider their decisions
and come up with better plans
5. You pointed out to the family that an important aspect of Mrs.
Lyka’ is the promotion of adequate nutrition. To address this
concern, you would suggest to:
A. Provide adequate lightning in the dining room - for safety
B. Reduce noises and distractions during mealtime
C. Do some active exercise before mealtime
D. Keep mealtime pleasant and serve foods similar to her
Rationale: provision of food that is familiar to the client can
increase their appetite
Additional Notes:
→ Sundowning - decrease in energy; patient becomes
easily agitated
Situation: As a beginning professional nurse one of the
competencies expected of you is to engage in research. Basic
knowledge in research, therefore, is very important. The
following questions related to these statements.
6. What element distinguishes true experimental research from
quasi-experimental research?
A. The use of non-probability sampling - picking out of samples
B. Lack of random assignment of subject to group
C. Size of the sample
D. The introduction of experimental treatment.
Rationale: true experimental research has randomization,
manipulation and control
7. You want to determine the effect of a planned exercise on
low-back pain. Which of the following research designs would
be MOST APPROPRIATE to use in this study?
A. Posttest only control group design
B. One-shot case study - single group observed in a single
occasion after an event
C. Pretest-posttest control group design
D. One group pretest-posttest design - can be used to
determine the effect of an intervention on a sample; no
control group
Rationale: pretest (serves as baseline data) → intervention
given → assess the participants again to determine for
changes
8. Which of the following is a type of probability sampling?
A. Cluster
B. Purposive
C. Quota
D. Convenience - who’s nearest or available at the time of
selecting participants
Rationale: probability sampling is random; Options BCD are
non probability sampling
9. You want all people who are currently institutionalized for
psychiatric problems to participate in your study. This is an
example of ____________.
A. Universal population
B. Target population
C. Element - 1% only
D. Sample - a group of people from the target population
Rationale: ALL people - target population
10. You want to determine the difference of the anxiety level
between male and female patients scheduled for abdominal
surgery. The first 30 males and the first 30 females who are
admitted to the hospital at the time of the study would be asked
as study participants. This is an example of what sampling
technique?
A. Fishbowl technique
B. Simple random
C. Quota sampling
D. Purposive sampling
Rationale: inclusion-exclusion criteria but with a number that
the researchers have to meet; Options AB are the same
Situation: You’re assigned as a staff nurse in the Stroke Unit
of the Medical Ward. One of your responsibilities is to provide
health teachings to the stroke patients and to the other
members of the family. The following questions refer to these
statements.
RECALLS 4: NURSING PRACTICE 5
 RECALLS 4: NURSING PRACTICE 5
11. You are teaching a patient about taking prophylactic warfarin
sodium (Coumadin). Which of these statements indicate that the
patient understands how to take the drug. SELECT all that apply:
1. “The drug's action peak in two hours” - peak action is
3 hours
2. “Maximum dosage is not achieved until 3-4 days after
starting the medication”
3. Effects of the drug continue for 4-5 days after
discontinuing the medication”
4. “Protamine sulfate is the antidote for Warfarin”
5. “I should have my blood levels tested periodically” -
check for PT, leukocytes
a. 2, 4, 5
b. 2, 3, 5
c. 1, 4, 5
d. 1, 3, 4
Additional Notes: PTT is monitored for Heparin
12. Maintaining oral hygiene for a stroke patient is important in
his care. You are teaching a family member how to give oral care
to the stroke patient. Which of the following nursing measures is
NOT APPROPRIATE when giving oral care to such a patient?
a. Cleaning the patient’s mouth and teeth with a soft-bristled
toothbrush
b. Keeping portable suctioning equipment at the bedside - for
increased secretion
c. Opening the patient’s mouth with a padded tongue
depressor
d. Placing the patient on his back with a small pillow under
the head
Rationale: d/t aspiration; but ideally, patients should not be
placed anything on the mouth because they would bite down
on it → might result to injury
13. Your patient has paraplegia. In giving instruction to the
watcher when changing the patient’s position in bed, which of
the following is NOT APPROPRIATE?
a. Lifting the patient when moving him up in bed
b. Rolling the patient unto the side
c. Using a trapeze to help the patient lift off the bed
d. Sliding the patient to move up in bed
Rationale: paraplegia → paralysis on the lower extremities;
sliding would cause friction and increases the risk for
pressure ulcers. Patient should instead be lifted or be
logrolled with their arms crossed in their chest
14. A patient is experiencing mood swings after a stroke.
Oftentimes she has episodes of crying that are distressed to the
family members. What is the BEST TECHNIQUE that you will
advise the family members when the patient is having crying
spells?
a. Ignore the patient during this time
b. Sit quietly with the patient until the crying episode is over
c. Tell the patient that the behavior is unacceptable
d. Attempt to divert the patient’s attention
Rationale: offering self → to make the patient that s/he is not
alone
15. To prevent joint deformities of the arm and hands of a
hemiplegic patients, what APPROPRIATE position will you
include in your health teachings of the family member? SELECT
all that apply.
1. Placing a pillow in the axilla so the arm is way from the
body - ❌ mangangalay ang patient and may cause
injury at the upper arm
2. Inserting a pillow under the slightly flexed arm so the
hand is higher than the elbow - dependent positioning
but the arms are elevated to prevent venous pooling
3. Immobilize the extremity with a sling - passive range of
motion; do not immobilize the client; promote
movement
4. Placing a hand cone so the finger are barely flexed - to
prevent contractures; hand cone should keep the
hands in neutral position
5. Keeping the arm at the sides using a pillow
a. 2, 3, 4
b. 1, 3, 5
c. 1, 2, 4
d. 2, 4, 5
Rationale: hemiplegia → paralysis on the one side of the
body
Situation: One of the competencies expected of you as a
beginning professional nurse is to have a positive attitude
toward research.
16. You plan to study the effectiveness of films in teaching active
exercises to post stroke patients. Which of the following
research designs will give you the most confidence to answer
the research problem?
A. time- series design - checking on the participants multiple
times throughout the study
B. non-equivalent control group design - assignment of
participants to groups are not controlled by the researcher
C. one-group pre-test, post-test design - one group receives
the intervention; assesses them for the effect of the
intervention; (pretest → intervention → posttest)
D. post-test only, control group design - intervention is given
immediately but has 2 groups; either one will not receive or
have placebo only
17. Which of the following sampling techniques is the most
appropriate to answer a research question on the effectiveness
of active exercise on the mobility of post stroke patients?
a. convenience sampling
b. purposive sampling
c. quota sampling
d. random sampling
Rationale: researcher has criteria; participants are
handpicked; inclusion-exclusion criteria
18. You want to develop a tool for measuring the level of
consciousness of stroke patients. This is what type of research?
a. Historical study - study of the past
b. Case study - in-depth study of a topic
c. Comparative study - comparing of two variables
d. Methodological study
19. You want to examine the difference in the eating behaviors
between two groups of high school students. Which of the
following research designs would you use to answer the
research question?
A. Case study
B. Correlation study - studies relationship between two
variables and how do they affect each other
C. Comparative design
D. Survey study - use of interviews and questionnaires for
public opinion
20. In a study on the relationship between personality make-up
and obesity, a Pearson r=.8 would mean:
a. a high, negative correlation
b. a moderate, positive correlation
c. a high, positive correlation
d. a low, positive correlation
Rationale:
Pearson R Interpretation:
→ Low: 0.1 - 0.3
→ Moderate: 0.31 - 0.5
→ High: 0.5 - 1.0
→ 0.8 is a high positive correlation → positive relationship
of the variables (variable A increases as variable B
increases); in the above study, personality make up and
obesity has a strong relationship; DIRECTLY
RECALLS 4: NURSING PRACTICE 5
 RECALLS 4: NURSING PRACTICE 5
PROPORTIONAL
→ If negative correlation → INVERSELY PROPORTIONAL;
(variable A decreases as variable B decreased; vice
versa)
Situation: You are a staff nurse in the Out-Patient
Department. Mrs. F brought her 9-year-old daughter Elaine
for consultation. Elaine is complaining of sore throat, muscle
tenderness, weakness of the arms and a general feeling of not
being well. The attending physician’s impression is Infectious
Polyneuritis.
Additional Notes:
→ Infectious Polyneuritis - Guillain Barre Syndrome
• Most common virus causing: Campylobacter jejuni
→ Acute Glomerulonephritis/Rheumatic Heart Disease -
GABHS
• (+) Streptococcal infection at least 2 weeks ago
21. Initially, what assessment data would be the BEST
IMPORTANT for you to make?
a. Exposure to an infectious disease
b. Difficulty in swallowing - risk for aspiration
c. Difficulty in urinating
d. Diet intake for the last 24 hours
Rationale: GBS - ascending paralysis
22. Elaine was admitted to the Pediatric ward. What would be
your PRIORITY nursing action when caring for her?
a. Providing a diversional activity for Elaine
b. Evaluating Elaine’s bilateral muscle strength
c. Making a game of range-of motion exercise
d. Assessing Elaine’s ability to follow simple commands
Rationale: Option C is an intervention and diversional activity
at the same time; promotion of movement d/t muscular
affectation
23. The pediatric ward nurse asks Elaine to cough every now
and then. She also assesses Elaine’s speech for decreased
volume and clarity, the underlying rationale for these
assessments is to determine the ________.
a. regression to an earlier developmental phase
b. involvement of facial and cranial nerves
c. increased intracranial pressure
d. inflammation of the larynx and epiglottis
Rationale: GBS affects nerves
24. Assessment findings revealed that Elaine has weak gag and
cough reflexes. During this acute phase of Elaine’s illness, which
of the following problems should receive the HIGHEST
PRIORITY?
A. Impaired swallowing related to neuromuscular
impairment.
B. Risk for infection due to an altered immune system - patient
is not immunocompromised
C. Ineffective breathing pattern to neuromuscular impairment
- weak gag and cough reflexes is the focus
D. Total urinary incontinence related to fluid losses
Rationale: swallowing ability must be the highest priority
because of the possibility for aspiration
25. Elaine was placed on a medical ventilator. Which of the
following nursing actions should the ward nurse give emphasis
to?
A. Turning Elaine slowly and gently from side to side to
prevent respiratory complication
B. Engaging Elaine in vigorous passive range-of- motion
C. Maintaining Elaine in a supine position to prevent
unnecessary nerve stimulation
D. Transferring Elaine to a bedside chair three times a day to
prevent postural hypotension.
Rationale: turn q2 to prevent stasis of secretions and prevent
pneumonia (respiratory complication) from happening; for
elderly, turning prevents pressure sores
Situation: Inadequate resources in health care and unhealthy
conditions in the workplace cause work stress among nurses.
The nurse’s work environment plays a vital role in her ability
to provide quality patient care. The following questions relate
to this situation.
26. Burnout is a phenomenon that is best characterized by
____________.
A. Conflict between personal and professional life
B. Emotional exhaustion, depersonalization, and reduced
personal accomplishment
C. Increased absenteeism and fast turn-over of nurses due to
toxic work environment
D. Growing dissatisfaction due to changing career
expectations
27. Lifestyle modification begins with _______.
A. Learning how to read food labels and eating the right kinds
of food
B. Recognizing the impact of unhealthy habits
C. Constructive and positive attitudes in life
D. Regular daily exercise
Rationale: self-awareness; reassessment of the lifestyle to
determine which aspects to change
28. Jerry is a young adult nurse who smokes 5 to 10 cigarette
sticks a day. He is a well-informed nurse on the “smoking
cessation program”. As a next step to his lifestyle change, Jerry
needs _______.
A. Information
B. Motivation
C. Skills to implement change
D. Commitment
Rationale: he has to have the motivation to have the skills to
implement the change → if skills have developed,
commitment should come right after
29. A common response to an unhealthy work environment is
physical tension which can be overcome by progressive muscle
relaxation. Basically, this involves:
A. Listening to a relaxation audio program for auto-suggestion
- music therapy
B. Releasing muscles from tension
C. Active physical exercise to unwind like aerobics exercise -
physical activity
D. Focusing to an image to relax - guided imagery
30. Nurses and patients are increasingly getting empowered by
learning stress management. All of these are bio-behavioral
interventions in stress management EXCEPT:
A. Progressive muscle relaxation
B. Pharmacotherapy - medications
C. Mindful meditation
D. Guided imagery
Rationale: Options ACD are non-pharmacologic
Situation: Mrs. Korina, a 77-year-old widow came in with the
chief complaints of difficulty hearing high pitched sounds. Ear
examination revealed damage to the middle ear.
31. Which of the following ear assessments is a rough estimate
of the ability to hear?
A. Weber test - assesses for sound lateralization
B. Whisper test
C. Audiometry
RECALLS 4: NURSING PRACTICE 5
 RECALLS 4: NURSING PRACTICE 5
D. Rinne test - bone or air conduction
Additional Notes:
Weber Test:
→ Conductive Hearing Loss: Heard in affected side
→ Sensorineural Hearing Loss: heard in unaffected side
Rinne Test:
→ Conductive Hearing Loss: Bone conduction is heard
longer and louder
→ Sensorineural Hearing Loss: Air conduction is heard
longer and louder
→ Sensorineural Hearing Loss is irreversible
32. When there is damage to the middle ear it will result to:
A. Conductive loss
B. Nerve deafness
C. Mixed loss - damage is for both middle and inner ear
D. Sensorineural loss - damage is in the inner ear
33 Which of the following is a predisposing factor for a
sensorineural hearing loss?
A. Perforation of the eardrum - tympanic membrane is in the
middle ear; conductive hearing loss
B. Ototoxic agents
C. Otosclerosis - formation of new bones in the ossicles
(maleus, incus, and stapes)
D. Serous otitis media - inflammation in the middle ear;
conductive hearing loss
34. Which of the following statements is TRUE in correcting a
sensorineural hearing loss?
A. Sensorineural hearing loss is irreversible
B. Sensorineural hearing loss can be corrected by
stapedectomy - for otosclerosis
C. Sensorineural hearing loss can be corrected by ossicular
reconstruction
D. Sensorineural hearing loss can be corrected by
myringotomy - for eardrum; drainage of fluid
35. What is a high priority risk for the older adult with age-related
changes in the vestibular structure of the ear?
A. Infection
B. Medication errors
C. Falls
D. Food intolerance
Rationale: vestibular system is in charge of balance, head
position, and spatial orientation → if damaged, patient could
lose balance → at risk for falls
Situation: Mr. Parker, a 75-year-old retired politician has
been recently diagnosed as legally blind. His driver’s license
has been revoked. You have seen him driving alone to the
local grocery store several times.
36. Which of the following nursing actions would be your priority
during your initial interaction with Mr. Parker?
A. Free the environment obstacles
B. Offer to read written information
C. Ask Mr. Parker, “How can I help you?”
D. Identify yourself as you approach Mr. Parker and before
you make a physical contact.
Rationale: patient is legally blind, identify first yourself so that
the patient would not be defensive
37. Which of the following ethical principles are in conflict with
this case?
A. Autonomy and nonmaleficence
B. Respect for person and non-maleficence
C. Distributive justice and respect for person
D. Autonomy and beneficence
Rationale: autonomy → the patient has the right for self-
determination by allowing him to drive; non-maleficence →
inflicting harm to other people or to himself
38. Mr. Parker’s driving without license can result in a violation
of which ethical principle?
A. Respect for person
B. Beneficence
C. Autonomy
D. Non-maleficence
Rationale: driving could pose harm to others and to himself
39. Mr. Parker had a fall needing hospitalization. All his benefits
were given to him just like any senior citizen with the same
condition. This ethical principle is upheld in this situation:
A. Beneficence - to do good
B. Respect for person
C. Autonomy
D. Distributive justice
Rationale: fair allocation of resources
40. Which principle should have pre-eminence as you proceed
to work with Mr. Parker
A. Autonomy
B. Respect for person
C. Nonmaleficence
D. Beneficence
Rationale: fundamental principle - respect between the nurse
and the patient
Situation: Mrs. Yap, a 78-year-old widow, was brought to the
clinic by her son with the chief complaint of constant
confusion, incontinence, and tendency to wander. Mrs. Yap
has a diagnosis of cognitive impairment disorder.
41. The son of Mrs. Yap informed the nurse that his mother
seemed to be inventing stories about certain personal
achievements. The nurse identifies this as confabulation and
interprets it correctly as ________.
A. Indicates a lack of ego-integration
B. Results to tendency to lie
C. Helps to maintain self-esteem
D. Results in poor judgment
Rationale: inventing of stories - confabulation; because the
patient cannot remember and maybe because she doesn’t
want others to feel pity towards her
42. The nurse asked Mrs. Yap for her children’s and
grandchildren’s names. This is to assess Mrs. Yap’s:
A. Remote Memory
B. Recent Memory
C. Attention Span
D. Orientation Status - patient is asked about time and date
Rationale: remote memories are old memories
43. Which of the following outcome criteria would be the MOST
APPROPRIATE for Mrs. Yap?
A. Follow an established schedule for activities for daily
living.
B. Learn new coping mechanisms to handle anxiety.
C. Return to an adequate level of functioning.
D. Seek out resources in the community for support.
RECALLS 4: NURSING PRACTICE 5
 RECALLS 4: NURSING PRACTICE 5
Rationale: consistency, routine, and familiarization
44. The nurse spent time talking to Mrs. Yap’s son. She gathered
that the son is the primary caregiver. To explore and to prevent
burn-out in the sun, which of the following nursing actions must
the nurse do?
A. Assess degree of understanding of family systems and
coping mechanisms.
B. Explore individual dynamics and personal coping.
C. Explore the support system available for Mrs. Yap’s son.
D. Identify the spiritual support system of the family.
Rationale: allow the son to verbalize; the nurse can then help
him with coping mechanisms to prevent burn-out
45. The nursing diagnosis MOST APPROPRIATE for Mrs. Yap’s
son would be _____.
A. Sleep pattern disturbance
B. Caregiver role strain
C. Social isolation
D. Risk violence
Situation: You are a community health nurse assisting a
family in the care of their daughter suffering from the post-
traumatic stress disorder.
46. While caring for this client, the family notices that loud noises
cause a serious anxiety response. Which of the following
explanations by you would help the family understand the
client’s response?
A. After a trauma, the client cannot respond to stimuli in an
appropriate manner
B. Clients often experience extreme fear about normal
environmental stimuli
C. Environmental triggers can cause the client to react
emotionally
D. The response indicates that another emotion problem
needs investigation
Rationale: patient can still respond to a stimuli it’s just that
they have triggers that increases their anxiety response d/t
trauma especially to soldiers (sound of fireworks, gunshots)
47. Which of the following instructions should you include about
relationships for this client with post-traumatic stress disorder?
A. Assess the client’s discomfort when talking about
feelings to family members.
B. Explain that avoiding emotional attachment protects against
anxiety. - form emotional attachment to help talk about the
problem; verbalization will help the patient decrease anxiety
C. Warn the client that she will have a tendency to be
overdependent in relationships
D. Encourage the client to resume former roles as soon as
possible - do not force the client; let him/her resume at
his/her own pace
Rationale: assess if the client doesn’t want to talk about what
happen to him
48. Which of the following nursing interventions would best help
this client and her family handle interpersonal conflict at home?
Have the family:
a. Discuss how to change dysfunctional family patterns
b. Teach the client to identify defensive behavior.
c. Agree not to tell the client what to do about problem
d. Arrange for the client to participate in social activities.
Rationale: assess for the root cause of dysfunctional family
patterns → talk about how to change it to lessened
interpersonal conflict
49. Which of the following nursing actions would be more
appropriate when speaking with this client about the trauma she
experienced?
a. Listen attentively
b. Request the client write what is being said
c. Ask question to convey an interest in the details
d. Obtain validation of what the client says from another party
Rationale: listening skills allows the patient to
ventilate/verbalize → nurse understands the patient and take
care of them better
50. Which of the following nursing actions would you include in
the plan of care for this client who keeps saying that the trauma
she experienced was just a case of bad luck?
a. Assist the client in defining the experience as a trauma
b. Encourage the client to verbalize the experience
c. Work with the client to accept positive and negative feelings
Rationale: the patient is downplaying of what had happened
to her; s/he does not realize the gravity of the experience
Situation: Kim is 19 years old, a grade 12 student. She
recently confessed to Nurse Grace that she had sexual
intercourse with her boyfriend (BF), 18 years old classmate of
hers. She believes that she is pregnant because she missed
menstruating for 3 months. She also related that her BF has
recently been confined for pneumonia after on and off flu-like
symptoms. She suspects he has HIV because of his
“closeness to a guy who has overtly expressed his feelings on
him.”
51. Kim wants to know his BF’s real diagnosis even through a
private message on Facebook. The following information that all
employees are enjoined to observe strictly.
1. Operate and hold diagnosis under strict confidentiality
2. Sign a non-disclosure agreement (NDA) between
nurses and their parents
3. Abide with the institution’s privacy and security policies
4. Disclose only the result of the test to the patient himself
- the patient has the only right what’s the real condition
A. II, III, IV
B. I, II, III
C. I, II, III, IV
D. I, II, IV
52. Nurse Grace can also explain the purpose of security
measures for data protection which is to maintain the
availability, integrity and confidentiality of personal data of all
patients.
I. Unlawful destruction
II. Alteration
III. Disclosure
IV. Unlawful processing - there should be a consent form
the patient that the data will be released
A. I,II, III
B. II, III, IV
C. I, II, III, IV
D. I, III, IV
53. To erase the doubt of Kim as to whether she has been
infected with HIV by her BF, what is the BEST advice of the
nurse?
A. Wait until you have access to the diagnosis of your BF.
B. Submit herself for Elisa Test considering window period.
C. Wait until the baby is born.
D. Go for Elisa Test immediately - the patient has been
already within the window period (3 months)
Rationale:
EIA window period: 3-12 weeks (3 months)
→ It checks if the antibodies has formed against HIV
RECALLS 4: NURSING PRACTICE 5
 RECALLS 4: NURSING PRACTICE 5
54. In case the personal data of Kim’s BF has been accessed
accidentally by “somebody”, who has the right to file a
complaint?
A. Kim’s BF - he is the owner of the data
B. The other guy
C. the parents
D. Kim
55. How long should personal data of an HIV patient be stored
on laptops or other portable devices which permits his
identification? For as long as __________.
A. The patient likes
B. His doctor likes
C. It is needed as part of an international or national research
D. It is necessary for the purpose for which it was collected
and processed
Additional Note:
→ Medical records - 10 years
→ Medico legal - 10 years after the case has been closed
Situation: Mr. Elmo, a 43 years old writer, was diagnosed with
narcolepsy.
Narcolepsy:
→ Excessive daytime sleepiness
→ Sleep attacks
→ Compromised safety: when driving possibility of sleeping
56. All of the following are characteristic signs/symptoms of
Narcolepsy EXCEPT:
A. Excessive daytime sleepiness
B. Sleep-onset Rapid Eye Movement (REM) periods - enters
REM after 15 minutes
C. Disturbed nocturnal sleep
D. Cessation of breathing for 10 seconds
Rationale: Obstructive Sleep Apnea (OSA)
→ Causes:
• Obesity
• Nasal polyps
• Enlarged tonsils
57. Patients diagnosed with Narcolepsy are given
Methylphenidate (Ritalin). The rationale for giving this drug is
to _______.
A. Lengthen sleep hours
B. Improve alertness
C. Improve daytime drowsiness
D. Control cataplexy
58. Good sleep hygiene is given emphasis when counseling a
narcoleptic patient. Which of the following is NOT considered
as such? Encourage the patient to _______.
A. Do active exercises
B. Ensure a quality sleep environment
C. Avoid daytime naps - it's okay to take daytime naps
D. Avoid stimulants such as caffeine, nicotine and alcohol near
Rationale: Options ABD are practices for good sleeping
hygiene
Additional Note: : Insomnia patients should NOT have
daytime naps, lalo lang di makakatulog paggabi
59. Depression and decreased quality of life are frequently
reported to be experienced by narcoleptic patients. Which of the
following is NOT a major contributory factor to these two
conditions?
A. A healthy ego
B. Disrupted social and occupational roles
C. A strong superego
D. Low self-esteem - pertains to depression and quality of life
Rationale: Options BC makes you feel guiltier
60. Cataplexy is experienced by many narcoleptic patients.
Which of the following BEST DESCRIBES this condition?
A. Lapse of awareness
B. Occurs at sleep onset
C. Experienced upon awakening
D. Sudden loss of muscle tone
Situation: You are a staff nurse in the Musculo-skeletal Unit
of the hospital. You are taking care of the patients with varied
musculo-skeletal conditions.
61. Which of the following inflammatory conditions commonly
occurs in the shoulder?
1. Bursitis - inflammation of the bursae (sac between
bones that reduces friction)
2. Carpal tunnel syndrome
3. Tendonitis - inflammation of the tendons
4. Dupuytren's - contractures/stiffening of one finger
(pulling)
a. 1 and 2
b. 2 and 3
c. 3 and 4
d. 1 and 3
62. Which of the following is NOT considered a conservative
treatment for inflammatory conditions of the shoulder?
A. Non-steroid Anti-inflammatory Drugs - e.g., naproxen,
ibuprofen
B. Intermittent ice and heat application to the joint
C. Laser photo-therapy - it uses light energy to repair tissues,
reduce pain and improve tissue healing
D. Resting of the extremity
63. Impaired movement of the rotator cuff of the shoulder is
generally termed as Impingement Syndrome. Edema, which is
an early manifestation of this syndrome, is due to ________.
a. acute trauma of the shoulder
b. muscle spasm
c. hemorrhage of the structures involved
d. atrophy due to disuse
Rationale: It involves tendonitis, painful during movement of
the shoulder d/t tendonitis
64. For persistent shoulder pain and weakness, this usual
treatment modality is performed _______.
A. Pulse-magnetic field - stimulates exercise cells to resolve
cellular dysfunction
B. Laser photo-therapy - it uses light energy to repair tissues,
reduce pain and improve tissue healing
C. Radio-frequency ablation - shrinks the sizes of tumors,
nodules, growths in the body
D. Arthroscopic Synovectomy - opens synovial space to
relieve the pressure inside
65. One of the most common foot problems is Callus. This
condition precedes the formation of a Callus _____.
a. External pressure on the foot
b. Faulty foot mechanics
c. Flexion deformity of the interphalangeal joint
d. Penetrating nail plate in the surrounding skin of the foot
RECALLS 4: NURSING PRACTICE 5
 RECALLS 4: NURSING PRACTICE 5

Rationale: Callus found in the sole (kalyo) d/t repeated Situation: Jill, a 10-year-old grade four pupil in a private
pressure school has just lost her best friend, Hazel, who died of
Leukemia. Her mother brought her to the emergency room
who reported that Jill has been gloomy and often expresses
Situation: You are a staff nurse working in a hospital and feelings of joining Hazel in heaven.
encounter situations with ethico-moral implications.
71. Which of the following is the precipitating factor for Jill’s
66. Which of the following nursing actions will you do if the feeling of wanting to die?
patient is unconscious and unable to make decisions? This a. The death of Hazel
fact should be: b. Her age
a. reported to the nurse supervisor c. Her authoritative mother
b. reported to the attending physician d. Her fear of death
c. documented in the patient’s chart
d. reported to the police 72. Jill’s feeling of joining Hazel in heaven is manifestation of:
A. Suicidal intent - it has 2 types (direct - I will hang my self;
Rationale: indirect - giving of valuables)
B. Suicidal threat - general, where intent is covered
C. Paranoia
67. A patient came in from prison for emergency treatment. D. Suicidal ideation
Which of the following precautionary measures will you
institute to ensure the safety of the hospital staff and the other
patients? Rationale: thinking of Jill’s wanting to go to heaven with Hazel
A. Provide the same assessment and care to the client
B. Use restraints 73. Jill states “I will hang myself”. This is a manifestation of:
C. Lock the ER door against entry if security is in question a. Denial
D. Never release the hand or ankle restraint (last resort) - b. Suicidal threat
there should also be guard in the room or some patients are c. Suicidal intent (Vidibeck)
faced down to prevent head butting, spitting or biting the d. Paranoia
nurse (depending on the condition)
74. Which of the following is the best predictor of adolescents
68. In using restraints to patients, which of the following attempting suicide?
guidelines will you follow? a. Depressed mood
A. Apply restraints because the patient needs it b. Joyful mood
B. Apply restraints according to the hospital policy c. Feeling of euphoria
C. Restraint is the most effective nursing intervention to d. feeling of hopelessness - having the energy to do the suicide
minimize aggressive behavior
D. Maintain respect for the client when applying restraints
Rationale: Options BC - patient is already in depressed mood

Rationale: when applying restraints, it depends on the

75. Jill states “I wish I were dead. I cannot stand anymore not
hospital policy (different hospital, different policies)
having Hazel around.” Your most appropriate nursing action
would be:
69. You have observed that a group of students are a. Do nothing because Jill will not do it
implementing their research project on the effect of hot and cold b. Refer Jill to your supervisor
application to febrile patients without informing the participants c. Stay with Jill
properly. What ethical principle was violated by the students? d. Explore Jill’s feeling
a. Nonmaleficence
b. Autonomy
Rationale: Let Jill VERBALIZE why she is saying that; offering
c. Justice
self
d. Respect for person

Rationale: not giving enough information → patient’s Situation: Rosaria, 40-years old woman, has a history of
autonomy was compromised Rheumatoid Arthritis for the last ten years. The following
questions refer to this situation.
70. A researcher should pay particular attention in protecting the
rights of certain vulnerable groups. Which of the following is 76. Which of the following is a common sign/symptom of
NOT considered vulnerable? rheumatoid arthritis?
A. Prisoners A. Presence of crepitus over joints - osteoarthritis
B. Children B. Symptoms aggravated by humidity
C. Mentally-challenged persons C. Deformity and displacement of proximal joints -
D. Postpartum mother with normal delivery - d/t normal Bouchard’s
delivery without complications D. Presence of Heberden’s nodes - distal

Rationale: Additional Note:

→ Prisoners - one place, masikip, prone to infections and
diseases
→ Children
→ Mentally-challenged persons
→ Immunocompromised
→ Eledelry people
→ Low-income families (poverty is a big factor for
vulnerability)

→ RA - Bilateral; Systemic (an autoimmune disease)

→ OA - Unilateral/Asymmetrical; Wear and tear

RECALLS 4: NURSING PRACTICE 5

 RECALLS 4: NURSING PRACTICE 5
77. Which of the following would NOT be common laboratory
findings in rheumatoid arthritis?
A. Low hemoglobin - autoimmune disease shortens RBC life;
medications are being taken
B. Positive RA factor - seen on RA
C. Positive Lupus Erythematosus (LE) prep - for SLE
D. Increase white blood count - it is an autoimmune condition
(there are a lot of inflammatory processes going on)
Additional Note: Pathognomonic Sign of SLE - Butterfly rash
78. Rosaria has been taking steroids for the last five years to
control her arthritis. Which of the following are common side
effects of steroid therapy?
a. Hyponatremia
b. Hyperkalemia
c. Increase blood glucose
d. Protein anabolism
Rationale: 3 S in steroids:
→ Sex
→ Salt (Mineralocorticoids)
→ Sugar (Glucocorticoids)
79. Which of the following diets is best suited to decrease the
side effects of Rosaria’s steroid therapy?
a. Normal carbohydrate, high protein, high potassium
b. Low carbohydrate, high protein, high potassium
c. Low carbohydrate, high protein, low potassium
d. High carbohydrate, low protein, low potassium
Rationale:
→ High potassium: patient experiences,
• Hypokalemia (excretes K)
• Hypernatremia (high mineralocorticoids) → In the unit’s last meeting it was discussed that there has been
increased aldosterone → retains H2O and salt
80. Rosaria was on Ibuprofen which had stopped when the
steroid therapy was started. Which was the main reason for
stopping the Ibuprofen once the steroid therapy was started?
A. The two drugs taken together increase the risk of GI
bleeding
B. The Ibuprofen would interfere with the action of the steroid
C. The Ibuprofen was not needed with the steroid
D. The two drugs together would cause severe liver damage
Situation: As a professional nurse, you meet patients with
problems related to sexuality and identity. The following
questions relate to this statement.
81. Sex is one topic patients feel uncomfortable discussing with
the nurse for which of the following reasons? Patients _______.
A. Prefer to discuss sex with health care provider of the same
sex
B. Assume that sex is something that is not discussed with
strangers - nahihiya, sex is a conservative matter
C. Are mostly knowledgeable about sex and the
accompanying problems
D. Feel to be embarrassed to introduce the topic of sex
82. A patient tells you that he is transsexual. Knowledge of which
of the following is MOST representative as the basis for
APPROPRIATE care for this patient?
A. Sexual anatomy is not consistent with gender identity
B. Sexual attraction is to the individuals with different gender
C. GonSelmal gender, internal organs, and external genitals
are contradictory
D. Gender identity is altered by acute psychosis
Rationale: Gender identity is on your own perception either if
you are a man, woman, both or neither
83. A patient tells you that he has a problem related to
masturbation. Which of the following is TRUE regarding
masturbation?
A. Masturbation is a manifestation of psychological imbalance
B. Masturbation is a way people learn about their sexual
response - drives the curiosity of a person
C. Most people do not masturbate when they become adults
D. Teen-age masturbation affects academic achievement
84. A male patient is beginning to take an antidepressant
medication. What information should the nurse include in her
health teaching as to its side effects?
A. Decreased sexual desire
B. Better performance in sexual activities
C. Premature ejaculation
D. Better performance in bed
Rationale: decreases sexual desire - phenytoin, beta
blockers
85. A female patient reports having dyspareunia. The MOST
APPROPRIATE for the nurse to ask is ______.
A. “Do you have pains in your breast when you have coitus?”
B. “Have you had these spasms since you became sexually
active?”
C. “Do you usually have pains before your period begins?”
D. “Have you talked with your partner about this
discomfort?”
Additional Note: dyspareunia - pain during sexual
intercourse
Situation: You are a staff nurse in the Stroke Unit of the
Medical ward. You have a stroke patient with a tracheostomy.
increasing complaints on the nurse incompetence in caring
for a patient with tracheostomy. The following questions
related to this situation.
86. In providing tracheostomy care, which of the following is the
nurse’s PRIORITY nursing action? The nurse _____.
a. cut the dressing using sterile scissors
b. cleans the incision with iodine-based antiseptic
c. secure clean ties before removing soiled ones
d. used clean technique
Rationale: removing soiled ties first, and the inpatient coughs
it increases the possibility of dislodgement of the
tracheostomy
87. Which of the following nursing actions should the nurse
TEACH the patient’s caregiver regarding tracheostomy care?
A. Remove the tracheostomy tube if obstruction occurs
B. Leave the tracheostomy ties in place until the physician
change them
C. Remove and clean the inner cannula daily
D. Never put a covering over the tracheostomy stoma -
AIRWAY (don’t kill the patient, okay lang magkainfection
basta hindi mamatay si patient lmao)
88. After a tracheostomy procedure, the nurse documents
important observations made during the procedures such as
_______.
A. response of the patient after the procedure
B. vital signs of the patient during the procedure
C. amount, color, and consistency of sputum and appearance
of the incision
D. behavior of the patient during the procedure
89. What is the purpose of a tracheostomy? To _____.
A. establish an airway
B. establish a pathway for nutrition
C. monitor respiratory functions
D. maintain the patency of the airway - ETT, intubations are
used here
RECALLS 4: NURSING PRACTICE 5
 RECALLS 4: NURSING PRACTICE 5

90. Which of the following can be a MAJOR PROBLEM for a

patient with tracheostomy?
a. Breathing
b. Ambulating
c. Swallowing
d. Singing
Rationale: d/t cuff inflation INSIDE
Situation: You are a staff nurse in the Neurologic Unit of the
Pediatric Department. Several problems have been reported
in relation to ventriculo-peritoneal shunt for hydrocephalus
patients. The initial investigation on the care of patients with
this shunt revealed that the majority of the staff nurses have
little experience on caring for such patients. It was decided to
look into their level of knowledge and skills to serve as
baseline data for improving the nursing care of hydrocephalic
patients on ventriculo-peritoneal shunt. The following
questions refer to this situation.
91. A four-year old hydrocephalic preschooler is scheduled to
have a ventriculo-peritoneal shunt at the right side of the head.
Which of the following positions should the child be placed
immediately after surgery?
A. Supine, with the head of the bed flat
B. On the left side with the head of the flat - but should be
slightly elevated to promote venous drainage (this is the
closest answer)
C. Prone, with the head of the bed elevated
D. On the right side, with the foot of the bed elevated
92. What nursing action should the nurse do when providing
post-operative nursing care to a child after insertion of a
ventriculo-peritoneal shunt?
A. Monitoring for the increased temperature
B. Check the urine for glucose and protein
C. Administer narcotics for pain control
D. Test cerebrospinal fluid leakage for protein - normally it
flows out through the nose and ears
Situation: Mr. Sean, a 35-year-old dancer consulted at the
Out-Patient Department with the chief complaints of
disorientation, abdominal pain, nausea, and excessive
perspiration. He claimed to be seeing his mother and heard
her calling his name. Upon admission the vital signs were: T
= 38.5 degrees centigrade; PR = 110/min; BP = 130/90. Mr.
Sean is a known alcoholic.
96. Which of the following frameworks does not support the
cause of substance abuse?
A. Physiologic framework
B. Psychological framework
C. Biologic framework
D. Socio-cultural framework
Rationale: 3 Theoretical Framework are:
→ Neurobiological - neurotransmitters → dopamine → if
increased in basal ganglia (reward area)
→ Psychological - offers them an escape from reality →
substance abuse
→ Sociocultural - friends, external forces (peer pressure)
97. For the nurse to establish a therapeutic relationship with
and providing treatment for a client with substance related
disorder, he/she must have:
A. Knowledge of assessment tools used to determine if
substance abuse exist
B. Knowledge of existing programs to help people with
substance abuse disorder
C. Self-awareness about substance use and abuse -
NAMBAHWAN!
D. Information on patient’s beliefs about drug and alcohol use
98. Mr. Sean’ clinical manifestation were manifestations of:
A. Impending brain attack
B. Impending heart attack
C. Severe alcohol withdrawal - delirium tremens: excessive
perspiration, visual disturbances, seizures
D. Severe anxiety

93. An infant who has hydrocephalus is irritable, lethargic, and 99. For cases like that of Mr. Sean’, the physician will most likely
difficult to feed before the ventriculo-peritoneal shunt is placed. order ______.
To maintain the infant’s nutritional status, which of the following A. Ativan - lorazepam; for alcohol withdrawal
nursing actions is the MOST APPROPRIATE? B. Serax
A. Feeding the infant just before doing any procedures C. Naltrexone
B. Giving the infant small, frequent feedings - they cannot D. Diazepam
tolerate large feedings to maintain nutritional status (giving
breastfeed every now and then, to be tolerated) 100. You want to find out the coping skills among young adults
C. Scheduling the feeding every six hours with substance abuse disorder. Which research method will you
D. Feeding the infant in a horizontal position utilize to answer the research question?
A. Survey
94. The parents of a school-age child with ventriculo-peritoneal B. Mixed methods
shunt were given discharge teaching. Which of the following C. Quantitative
signs of a blocked shunt would the parents be able to identify D. Qualitative - coping skills; cannot quantify the coping skills
that the discharge teaching is successful?
A. Irritability and increase difficulty with eating - increased
ICP causes changes in sensorium
B. Elevated temperature and reddened incisional site
C. Decreased urine output with stable intake
D. Tensed fontanel and increased head circumference

95. After a six-year-old child underwent placement of ventriculo-

peritoneal shunt, he was put on I.V. medication. The head nurse
observed that many of the staff nurses are disconnecting the
flush syringe first and then clamping the intermittent infusion
device. The staff nurse seems not to understand the benefits of
positive pressure techniques. Which of the following strategies
would be the MOST EFFECTIVE way to improve the staff
nurses technique in giving I.V. medication?
A. Post an evidence-based article on the topic in the unit -
for them to read the article and be done to improve giving
IV medications
B. Create a poster presentation on the topic with a required
post test
C. Send a memorandum on the importance of clamping the
device first
D. Ask each nurse if they are aware that their practice is not
current

RECALLS 4: NURSING PRACTICE 5