RECALLS 3 – NP1

1. Mr. Dustin Henderson has to undergo a

Billroth II surgical operation due to multiple a.Feeling hungry
gastric ulcers. Which of the following is done b.Feeling of warmth in the room -
in this procedure? PARASTHESIA
a.A partial removal of the distal 2/3 of the c.Pin pricks in the toes
stomach and anastomosis of gastric stump d.Going to the toilet
to the duodenum
b.A partial removal of the distal 2/3 of the 5. After Billroth II surgery, Mr. Dustin reported
stomach and anastomosis of the stump to that he was having diarrhea after meals. What
the jejunum should the nurse recommend to prevent this
c.Removal of the large portion of the condition:
stomach and the pyloric sphincter
d.Removal of the whole stomach - COMPLICATION: DUMPING SYNDROME
* DIARRHEA, DIAPHORESIS
BILLROTH II – PARTIAL GASTRECTOMY +
JEJUNUM a.Take antacids before mealtime
b.Eat more sources of carbohydrates
2. Prior to surgery, you were asked by Mr. c.Avoid taking fluids with meals
Dustin why atropine sulfate is ordered, your d.Observe fasting overnight
BEST response is:
6. Joyce Byers came to the ER for abdominal
a."Atropine causes your laryngeal spasm and pain. She is a smoker and an alcoholic drinker
will inhibit relaxation of the muscle" for 10 years when her husband cheated on
b."Anesthetic agents can increase mucus her. Duodenal ulcer is being considered.
secretion and atropine will counteract this Which of the following is a typical pain
effect" pattern of a patient with duodenal ulcer?
c."Anesthetic agents can cause bradycardia
and atropine will counteract this effect" a.Pain is felt after 2-3 hours after meals
d."Atropine relaxes the spinal cord and will b.Burning, cramping pressure like pain
relieve the pain" c.Pain is not relieved with antacids
d.Burning in the high left epigastrium, back
ANTICHOLINERGIC – DEC. PNS – DEC and upper abdomen
SALIVATION – DEC. RISK FOR ASPIRATION
7. Joyce Byers was ordered to have blood
3. You just finished your pre-operative typing. The nurse is aware that the higher
teaching to Mr. Dustin. Which of the following incidence of duodenal ulcer belongs to what
statements indicates that further teaching is blood type?
needed? a.A
b.0
a."The pre-operative medications will allay my c.B
fear of the operation" d.AB
b." The breathing exercises will help expand
my lungs after surgery" - RISK FOR INJURY 8. Gastrointestinal endoscopy was ordered in
c." I will try to ambulate after the anesthesia order to have better visualization of the
has worn off' gastric mucosa. After the procedure, the
d." I am glad I can rest and be relaxed of my patient developed high grade fever of 40
office work" degrees Centigrade with acute abdominal
pain. What PRIORITY nursing intervention
4. Which of the following assessment would should the nurse
be your indication that Mr. Dustin has
recovered from anesthesia. A sense of? a.Assess the patient at once for possible
RECALLS 3 – NP1

perforation currently prescribed with Propranolol for his

b.Take vital signs every two hours hypertension. As you browsed through this
c.Give tepid sponge bath patient’s chart, you noted history of bronchial
d.Give relief medication as ordered asthma. Which of the following is the next
step?
9. Which of the following patients should not
be inserted with a nasogastric tube? a. Measure the apical pulse rate for a full
minute
a. Elisa, a post- craniofacial surgery b. Instruct the patient to change position
b. All of the options slowly
c. With hypophysectomy – REMOVAL OF c. Contact the physician to verify order
PITUITARY GLAND d. Give drug with meals
d. Recovering from gastric surgery
- NON-SELECTIVE BETA BLOCKER
10. Which of the following is an EXPECTED *BRONCHOCONSTRICTION
outcome in a patient with duodenal ulcer? *DEC. BP, HR
The patient will
14. Upon receiving a client with status
a. Join friends for social drinks every weekend asthmaticus, your priority intervention should
b. Engage self with smoking cessation include:
program - MAJOR RISK FACTOR: SMOKING a. Start infusion of Theophylline IV
c. No longer join sports program b. Monitoring of breath sounds every 5-1o
d. Use Tylenol for control of pain minutes
c. Give the client a short-acting beta
11. Max Mayfield is a patient with adrenergic agonist
emphysema. Upon physical assessment,you d. Administer Solu-medrol, a glucocorticoid, IV
noted the following: RR 37 breaths per minute,
dyspneic and dusky- colored skin. Which of 15. Eleven is a patient with Reactive Airway
the following should you perform initially? - Disease. Which manifestation would indicate
COPD to the nurse that it has been exacerbated?

a.Monitor the client’s ECG tracing a. Complaints of chest tightness and difficulty
b.Attach Mr. De Leon to an oxygen source via of breathing
nasal cannula regulated at 10lpm b. Crackles head upon auscultation of the lung
c.Position the patient to High-Fowler’s fields, and presence of red raised areas on the
d.Contact the doctor immediately chest
c. Symmetrical expansion of the thoracic
12. While assessing Max Mayfield, which cavity during inspiration
assessment finding would require the nurse to d. Temperature reading of 37.8C with feelings
refer to the physician? of nausea

a. Presence of barrel chest and dyspnea Situation: A 78-kg patient is rushed to the ER
b. Oxygen flow meter set at 2lpm while the due to scald burns. It was noted that he had
client is ambulating full-thickness burns on his right arm and right
c. Rust-colored specimen collected early in thigh. You are assigned to care for the patient.
the morning
d. Use of accessory muscles during inspiration 16. During the resuscitation phase, which of
these do you expect the nurse to do?
- EXAMPLE: STERNOCLEIDOMASTOID
a. Administer insulin to treat hyperglycemia.
13. Mr. Jim Hopper, a 53-year-old client, is
RECALLS 3 – NP1

b. Start furosemide therapy to increase 20. Over-resuscitation is not uncommon

potassium excretion. during the first days following burn treatment.
c. Start clear-liquid diet to increase nutrient Which of these signs may indicate over-
intake. resuscitation? – FVE CIRCULATORY OVERLOAD
d. Starting the patient on an isotonic
crystalloid- infusion for resuscitation. a. Shortness of breath – PULMONARY EDEMA
DOC: DIURETIC
PARKLAND FORMULA b. Urine output of 1L/day
TBSA x Wt. x 4 – FOR 24 HOURS c. Temperature of 38.5C
d. Increased lethargy
17. What should the nurse monitor first to
determine the effectiveness of the fluid 21. A qualitative study is undertaken by the
challenge? research team.If the study focuses on how
indigenous barangay health workers view
a. Skin turgor their work as grass root professionals, the
b. Urine output – BEST INDICATOR FOR FLUID team is using what ethnographic perspective?
BALANCE (IF IN FLUID RESUSCITATION)
c. Heart rate a. Etic perspective – RESEARCHER/OUTSIDER’S
d. IV site VIEW
b. Emic perspective – INSIDER’S VIEW
- DAILY WEIGHTS – BEST INDICATOR OF FLUID c. Tacit perspective
BALANCE (IF W/OUT FLUID RESUS) d. Exo perspective

18. A nurse is about to administer an H2 22. Who developed the interpretive

blocker for the patient. She knows that this phenomenology methodologic school of
medication addresses which complication of thought?
burn injury?
a. Husserl
a. Pruritus of the affected areas b. Parse
b. Loss of gastric motility following burn injury c. Heidegger
c. Severe pain caused by the exposed nerves d. Glaser and Strauss
on burn areas
d. Gastric mucosal sloughing from loss of 23. Which of the following phenomenological
plasma volume analytic methods require a validation of
results by returning to the study participants?
19. Which of these manifestations is an early
indication of compartment syndrome? a. Van Kaam
b. Colaizzi
a. Absent capillary refill c. Giorgi
b. Pain with passive ROM d. Strutfest
c. Drainage on burnt areas
d. Paralysis 24. Coombs (2007) explored the phenomenon
of spousal care giving from the perspective of
Neurovascular Assessment: the spousal caregivers (the lived experience of
spousal caregivers). The research question of
Neuro ----- Vascular (6Ps) the study was: “What is it like for older
Pain ---- Pallor caregivers to care for a spouse who has
Paresthesia ----- Poikilothermia (dec temp) survived a stroke?” What type of research was
Paralysis ----- Pulselessness done by the author? - OTHER KEYWORD:
“MEANING”
RECALLS 3 – NP1

a. Phenomenology b.Spirometer
b. Ethnographic study c.Pulse oximeter
c. Grounded theory d.Blood Pressure apparatus
d. Feminist research
29.Romeo is a patient with chronic bronchitis
25. What is the correct order of preparing who was about to get discharged. He was
qualitative data before analysis? advised to avoid shifts in temperature and
I. Transcribing Qualitative Data humidity. It should be emphasized
II. Managing/ Organizing Qualitative that heat increases body temperature and
Data thereby raising the:
III. Developing a Category Scheme
IV. Coding Qualitative Data a. Risk for infection
b. Anxiety level
a. III, I, IV, II c. The oxygen requirements
b. I, III, IV, II d. Fluid intake
c. III, I, II, IV
d. III, II, I, IV 30.Nurse Pauline is currently conducting a
discharge teaching on how to do pulmonary
26.Nurse Kelly instructs Mario, a patient with hygiene measures at home. The following
emphysema to use purse-lip breathing. The improve clearance of airway secretion, except:
client inquires the nurse about the advantage
of this kind of breathing. The nurse answers a. Postural drainage
that the main purpose of purse-lip is to: b. Complete bed rest – SHOULD BE
AMBULATION
a. Prevent bronchial collapse - ATELECTASIS c. Effective coughing
b. Strengthen the intercostals muscle d. Measure fluid intake
c. Achieve maximum inhalation
d. Allows air trapping 31. Nurse Anne is a nurse in the Central ICU.
CVP monitoring could provide the following
27. Nurse Albert teaches a patient about the information, but one:
use of respiratory inhaler. Arrange the steps
in using an inhaler chronologically. a. Vascular tone
I. Press the canister down with your b. Blood volume
fingers as you breathe in c. Ability of the heart to receive and pump
II. Wait one minute between puffs if blood
more than one puff is prescribed d. Glomerular filtration rate
III. Inhale the mist, hold your breath at
least 5 to 10 seconds before exhaling CENTRAL VENOUS PRESSURE
IV. Remove the cap and shake the – INDICATES FLUID STATUS
inhaler - INVASIVE
- VENA CAVA
a. 4, 1, 2, 3
b. 4, 1, 3, 2 Inc CVP = FVE
c. 3, 4, 2, 1 Dec CVP = FVD
d. 1, 2, 3, 4
32. While monitoring CVP of critically ill
28. In order to monitor the oxygen saturation patients. The normal CVP reading is:
of Lia, a patient with pleural effusion,which of
the following will you prepare? a. 8 – 12 cm of H2O
b. 13 – 17 cm of H2O
a.Electrocardiogram machine c. 18 – 25 cm of H2O
RECALLS 3 – NP1

d. 4 – 10 cm of H2O 36. Now that you have finally passed the NLE,
it becomes “YOU, who is a professional nurse”
NORMAL CVP: which means:
- 4-10 cm of H2O
- 8-12 mmHg a. I have simply fine tuned myself, my needs,
my wants, my idiosyncrasies, to fit in the
33. Nurse Cecil wants to measure the central profession of nursing.
venous pressure of a burn patient. In taking b. The I in me and the nurse in me are two
the CVP reading, the nurse knows that the distinct identities that even my patients have
stopcock shall be manipulated in a manner to learn to respect.
that: c. I have simply retained my former self but
a. There is a communication between the acquired the knowledge, skills, attitudes, and
client and the manometer values expected of a nurse.
b. There is a communication between the d. The person I am and the professional nurse
manometer and the client and closed to the I aspire to be have now developed into one
IV – OPEN TO PATIENT, CLOSED TO IV (CVP Filipino Nurse. We are one and the same
reading) identity.
c. There is a communication between the IV
and the client and closed to the manometer 37. Now that you are a professional nurse,
d. There is a communication between the IV you start to plan a career-path according to
and manometer and closed to the client the culture and design of Philippine Nursing.
This means:

34. Lardo P was put under continuous a. Serving in other countries and learning new
mandatory ventilation. Which of the following and modern ways of doing nursing and
does not indicate that the client is adequately sharing these back in the Philippines.
ventilated? b. Progressing as nurse-generalist in a
multitude of choice-practice settings to that
a. Absence of hyper – and hypoventilations of expert nurse-practitioner also in choice-
b. Skin is normal in color practice- settings
c. Blood pressure is normal c. Avoiding personal and professional
d. Presence of neurologic signs – EX: stagnation by updating and upgrading one’s
AGITATION. RESTLESSNESS (ALOC/DLOC) self – CONTINUING PROFESSIONAL
DEVELOPMENT
35. Possible means of verifying proper d. Constantly upgrading one’s self through
placement of Lanie’s catheter (CVP line)? advanced technological means and strategies
a. Palpation
b. Auscultation 38. Securing a tenure is important because
c. Chest X-ray – other term: radiography or the years in service spell variety of
chest radiography experiences in nursing practice, it is far more
d. Cystoscopy – FOR BLADDER valuable to consider that tenure-years are
nothing if these are not parallel with one’s
Situation: As you journey through nursing, you personal professional growth and maturity.
saw yourselves transform “from the person This implies:
you were” to the “aspiring nurse ”you have
become. Now that you have graduated and a. Simply earning years of job-related service
now taking your Nurse Licensure Examination until we retire from service.
(NLE) there is only the “YOU, who is the nurse.” b. Extending assistance to our less-fortunate
fellow nurses
RECALLS 3 – NP1

c. Progressive upgrading of competencies in OXYGEN

terms of knowledge, skills, attitudes, and NITROGLYCERIN
values as professional nurse. ASPIRIN
d. Volunteering our services wherever needed.
42. Edgar S came to the ER due to a chest pain.
39. The care of a Filipino nurse is unique. Our An admission assessment was done by Nurse
brand and core values of nursing will always Faye. Which of the following descriptions
extend beyond the ordinary levels of would the nurse consider as a classical pain of
promotive, preventive, curative, and acute myocardial infarction?
rehabilitative care. This culturally-bound,
Filipino values of nursing likewise needs to be a. Pain radiates to the jaw, back, and left arm
nurtured: – REFERRED PAIN
a. Psychological care b. Crushing mediastinal pain
b. Emotional care c. Sudden chest pain associated with activity
c. Spiritual care d. Gnawing pain unrelieved by rest – should
d. Relational care be crushing pain

caring attitude 43. Thinking that the probability of the case

being a myocardial infarction, oxygen at 2-4
40. More than attaining the prescribed CPD L/min via nasal cannula was prescribed. Nurse
units, it is also important to equip one’s self Faye understands that the primary purpose of
with holistic personal and professional this order is to:
development believing that:
a. Increase myocardial oxygen supply
a. we are also God’s angels of mercy on earth b. Decrease cardiac workload
b. we may also find real holism in the service c. Reduce pain due to ischemia
we render d. Relieve difficulty of breathing
c. we and the beneficiaries of our care are
made up of body, soul, and spirit and each 44. Nurse Mely administered Morphine
component do have health needs intertwined sulfate to a patient with myocardial infarction
– HOLISTIC CARE to reduce pain and anxiety. Which of the
d. should we encounter terminal patients, we following vital signs should Nurse Mely
may understand how to support them to their monitor carefully to specifically determine
dying stage cardiac responses?

41. Mariana M came to the ER due to a. Temperature – not cardiac

unrelieved chest pain. She verbalized, “I b. Pulse rate – faster response
followed your instructions carefully. I already c. Blood pressure
took 3 NTG SL tablets at 5-minute intervals d. Respiratory rate – not cardiac
from my pillbox. But the pain is still there.”
The nurse’s best action would be: 45. While doing a history taking of a client
suspected with MI, you would expect that
a. Oxygenate the patient immediately pain in MI may occur without cause primarily
b. Get NGT SL tab from the E-cart and give to during what time of the day?
patient
c. Call the doctor and report infarction a. Anytime of the day
d. Administer Morphine stat as ordered – b. Usually after a day’s work
potent vasodilator c. Early at night before retiring
d. Early in the morning – BC OF INC. PLATELET
Myocardial Infarction: AGGREGATION
MORPHINE
RECALLS 3 – NP1

Situation: Serena suffers from severe skin. If you are the nurse, what the best
menorrhagia. She was rushed to the ER when technique of administration will you use?
she collapsed. She is pale and easily fatigued.
The admitting diagnosis is iron deficiency a. Z-track
anemia. b. IV bolus
c. Vigorous rubbing of the injection site after
46. The nurse prepared the client for injection
complete blood count (CBC) testing. Which of d. Use the gluteus maximus muscle
the following is a normal finding?
51. Remy was diagnosed with acute
a. Red blood cells – 9 million/mm3 – 4.5-6 cholecystitis (inflamm of gallbladder) . She
b. Hematocrit – 50 mg/Dl – 36-54% came to the ER with which characteristic of
c. Hemoglobin – 14 g/dL – 12-18 pain?
d. Hematocrit – 15 %
a. Tenderness that is generalized in the upper
47. After a thorough assessment and based on epigastric area
the laboratory findings, the diagnosis of iron b. Tenderness and rigidity at the left epigastric
deficiency anemia is confirmed. The client area radiating to the back
asks the nurse what is the role of iron in the c. Tenderness and rigidity of the upper right
body? The correct response of the nurse is: abdomen radiating to the midsternal area –
RUQ PAIN
a. Iron prevents bleeding d. Pain of the left upper quadrant radiating to
b. Iron gives the red color of our blood the left shoulder
c. The body cannot synthesize hemoglobin
without iron 52. Remy asks how is the doctor going to
d. Iron helps in the conduction of nutrients to make sure that her pain is really due to
the body gallstones and not some other disease. You
tell her which specific and common diagnostic
48. Serena was prescribed with daily iron procedure to confirm presence of gallstones?
supplements. Which of the following food
should be advised to enhance absorption of a. Cholangiography
iron? b. Gall bladder series
a. Cereals c. Oral cholecystogram
b. Citrus fruits d. Ultrasonography – other term:
c. Dairy products ultrasound/utz
d. Green leafy vegetables
53. The diagnosis was confirmed as
49.Cara was prescribed Ferrous sulfate as iron cholecystitis with gallstones. The doctor
supplement. For better absorption, the nurse prepared the client for the removal of his
would instruct the client to take this gallbladder. The client asks the nurse: “How
supplement: will this procedure affect my digestion?” The
nurse’s most correct response would be:
a. With meals.
b. 1 hour before meals. – EMPTY STOMACH, a. “Your body system will adjust in due time.”
IMPROVES ABSORPTION (FULL STOMACH, b. “The removal of the gallbladder usually
GASTRIC IRRITANT) interferes with digestion but can be remedied
c. After breakfast by dietary modifications.” – DIET: LOW FAT
d. Before going to bed c. “The removal of the gallbladder would
significantly interfere only with the digestion
50. Intramuscular supplementation of Iron of fatty food.”
causes local pain and can cause stain in the
RECALLS 3 – NP1

d. “The removal of gallbladder does not 58. Dr. Perez prescribed phlebotomy to Wilma.
usually interfere with digestion.” Wilma was a little bit reluctant. The client
inquired, “What is the primary aim of the
- GALLBLADDER PURPOSE – STORAGE OF BILE procedure?” Your appropriate response is:
(PURPOSE: EMULSIFICATION OF FATS)
a. “Remove the excess blood and donate to
54. Remy’s laboratory results have arrived. patients of the same blood type.”
Which of the following parameters is b. “Prevent headache and dizziness.”
expected to be elevated? c. “Keep the BP reading within normal range.”
I. White blood cell count d. “Keep the hematocrit within normal range.”
II. Total serum bilirubin
III. Alkaline phosphate 59. Remy asks if she can take Iron
IV. Red blood cell count supplements to address her ruddy complexion.
V. Cholesterol However, Nurse Leila told her that this is not
VI. Serum amylase advised. This is because:

a. 3,5,6 a. “These supplements enhance the

b. 1,2,6 production of RBC.”
c. 1,2,3 b. “The vitamins and iron can suppress bone
d. 2,3,4 marrow function.”
c. “Actually, the patient does not need these
55. Post-operatively, a t-tube was inserted to supplements.”
help drain Remy’s bile after cholecystectomy. d. “It is best that the client gets these
Which of the following procedures concerning supplements from natural sources.”
the T-tube can the nurse perform without the
doctor’s order? 60. Rachel E complained of generalized
pruritus. The following are appropriate
a. Clamping nursing interventions, except:
b. Emptying
c. Aspirating a. Administer routine oral antihistamine.
d. Irrigating b. Regulate room temperature to 25 degrees
56. Wilma was diagnosed with polycythemia or lower
vera. During assessment, which of the c. Bathe in tepid or cool water followed by
following manifestations should Nurse Ellen coca- based lotion application
NOT expect? d. Wearing light material, loose-fitting wool
shirt – WRONG BC OF WOOL. WOOL IS
a. Splenomegaly IRRITATING FABRIC
b. Ruddy complexion
c. Generalized pruritus 61. Aya S is hospitalized with acute
d. Hepatomegaly glomerulonephritis (AGN) Which aspect of the
client’s history is most significant to her
57. The nursing student reviews laboratory diagnosis? - RISK FACTOR: GROUP A BETA
findings and finds which blood results are HEMOLYTIC STREPTOCOCCUS
elevated?
a. Sitting next to a student with
a. RBC, WBC, platelet count mononucleosis
b. WBC, platelet and cholesterol b. Immunization with VZIG after exposure to
c. bilirubin, RBC and platelet varicella
d. BP, WBC, and hematocrit c. Experiencing a bout of cystitis within the
past year
RECALLS 3 – NP1

d. Having an untreated sore throat two weeks

ago – history of GABHS 66. Ronald is a patient with chronic renal
failure and is on a restricted protein diet. An
62. Helena H is a patient with nephrolithiasis. understanding of the rationale for this diet is
She has just returned from having demonstrated when the client states that high
extracorporeal shock wave lithotripsy (ESWL) -biologic-value protein foods are:
to the right kidney. Following the procedure,
the nurse should: a. Necessary to prevent muscle wasting
b. Used to increase urea blood products
a. Limit the client’s fluid intake for the next c. Needed to promote weight gain
eight hours d. Responsible for controlling hypertension
b. Monitor the nephrostomy tube for kinking
or occlusion - HIGH BIOLOGIC VALUE PROTEIN:
c. Strain the urine to detect any stone - ANIMAL SOURCES (MEAT, POULTRY,
fragments – FOR LABORATORY to determine FISH, EGGS)
the type of stone - LOW BIOLOGIC VALUE:
d. Apply anesthetic cream over the client’s - PLANT SOURCES (LEGUMES, NUTS,
right flank BEANS)

63. Boyet is a patient with gout. Which food 67. A 18 year old, healthy patient asked you
should be avoided by the client on a purine- which of the following food is a common and
restricted diet? - AVOID ORGAN MEATS economical source of carbohydrates?

a. Liver a. Rice – starch

b. Tapioca b. Papaya
c. Milk c. Chicken
d. Peanut butter d. Beef

High Purine Food (inc uric acid): Organ Meats 68. The nurse notes that the latest potassium
level for a client in renal failure is 7 mEq
64. Andrew J. Which of the following would (hyperkalemia). The first action by the nurse
be most important for the nurse to include in should be to:
this client’s discharge instructions?
a. Call the laboratory and repeat the test
a. warm sitz bath with bath salts b. Alert the cardiac arrest team
b. eliminates phosphorous-rich food c. Obtain an ECG strip and have lidocaine
c. daily application of a vaginal deodorant available
spray d. Take the vital signs and notify the physician
d. avoid sexual intercourse until symptoms – ASSESS THEN REFER
subside - BONUS, NO SITUATION
NORMAL: 3.5- 5.5 mEq
65. A nurse caring for a patient who has an - HYPERKALEMIA/HYPOKALEMIA arrythmia
ileal conduit (ileal loop) following a -> CARDIAC ARREST
cystectomy for bladder cancer should teach
the patient that the type of drainage expected 69. Sam was diagnosed with acute renal
from the stoma is: failure and moves into the diuretic phase after
one week of therapy. During this phase the
a. urine and mucus shreds client must be assessed for sign of developing:
b. clear urine RISK FOR FVD (inc UO FVD)
c. urine streaked with blood
d. both urine and feces a. Renal failure
RECALLS 3 – NP1

b. Hyperkalemia 73. Which of these drugs would cause an

c. Hypovolemia interaction and serious effect with
d. Metabolic acidosis Furosemide?
a. Atorvastatin
70. Dennis received a transplanted kidney b. Digoxin
from his sister. Which of the following signs c. Clopidogrel
indicate transplant rejection? - DEC. UO – FVE d. Tramadol
– INC. BP – WEIGHT GAIN
- FUROSEMIDE – LOOP DIURETIC (potassium
a. An increased urinary output wasting)
b. A subnormal temperature – SHOULD BE INC. - COMPLICATION – HYPOKALEMIA –> EFFECTS:
TEMP INC. DIGOXIN TOXICITY
c. An elevated blood pressure
d. Weight loss NURSING CARE: ASSESS SERUM POTASSIUM

Situation: Mr. Arevalo, 45 years old, is a 74. Lanthanum carbonate (phosphate binder)
patient under your care in the Pay Ward. She is given to the patient to address which
is a known hypertensive with poor compliance electrolyte imbalance:
to her pharmacologic treatment. During your
rounds, your VS of Mrs. Jones are as follows: T a. Hypocalcemia
37.3C, HR 97bpm, RR 15 breaths/min, and BP b. Hypernatremia
140/95. Your physical assessment also c. Hyperkalemia
showed that she has pitting edema on her d. Hyperphosphatemia
lower extremities.
LANTHANUM CARBONATE – IS A PHOSPHATE
71. Nurse Janna is currently monitoring his BINDER – BINDS PHOSPHATE THEN EXCRETES
serum electrolytes. Which of these
manifestations is not related to the 75. Low-dose dopamine was ordered for
electrolyte imbalances occurring in CKD? Marina, a patient with Acute Kidney Injury
secondary to drug overdose. Which of these
a. Trousseau’s sign - HYPOCALCEMIA would you monitor to measure its
b. Calcification of major blood vessels effectiveness?
c. Tremors - HYPOCALCEMIA
d. U-wave - hypokalemia a. Heart rate
b. Urine output – inc GFR, inc UO
HYPERKALEMIA – PEAK T WAVE c. Capillary time refill
d. Respiratory rate
72. Mr. Arevalo has also suffered from
impaired secretion of aldosterone (inc, - LOW DOSE DOPAMINE – LEADS TO RENAL
sodium, dec potassium), which eventually VASODILATION
manifested in:
76. Nurse Minty is the head nurse of the
a. Anorexia surgical ward. Nurse Brigiding is a new nurse
b. Jugular vein distention under training. During the assessment, Nurse
c. Vomiting Minty noted some areas needing
d. Sunken eyeballs – sign of dehydration improvement. Which action is MOST
appropriate for the nurse manager to
DEC. ALDOSTERONE – DEC. SODIUM – DEC. undertake/plan for this new nurse in her unit?
WATER/FLUID -> DEHYDRATED
a. Discuss with the new nurse her alternatives
RECALLS 3 – NP1

b. Counsel the new nurse that if her to the laboratory.” – CLEAREST, MOST
performance doesn’t improve in 2 months, SPECIFIC (what, where, who, when)
she will be replaced. b. “A STAT urinalysis was ordered for client in
c. Refer the new nurse to the Human room 102. Would you get it please.”
Resource department for re-evaluation c. “We need a STAT urinalysis for Pedro in
d. Plan with the new nurse to work on how to room 102.”
improve her skills – GET INVOLVED d. “Please get the urine sample for urinalysis
in room 102 client.”
77. Nurse Minty wants to assess improvement
of the new nurse. She asks which of the 80. During the staff lunch break, Nurse Melba
following characteristics of client goal setting overheard a conversation between a few staff
in the care plan is CORRECT. The goal should about their frustration towards the new
be: nurse’s tardiness. Which action is BEST for the
nurse manager (to resolved the conflict) to
a. Client focused, realistic and flexible take?
b. Nurse focused, time-limited, realistic and
measurable a. Dismiss the problem as nothing as it is not
c. Nurse focused flexible, measurable and interfering with the ward activity
realistic b. Ignore the observation and proceeds to her
d. Client focused, measurable and allowing office
the client to understand what needs to be c. Discuss the observation with the staff
done d. Report to the nurse supervisor

C-SMART IF INDIVIDUAL: CONFFRONT!

- CLIENT-CENTERED, SPECIFIC, MEASURABLE, IF GROUP: MEETING!
ATTAINABLE, REALISTIC, TIME-BOUND
81. Olivia rushed to the ER for pleuritic pain,
fever, and cough. The attending physician had
78. The new nurse is asked to review the a chest x-ray taken STAT. Result revealed
medication list for a client who will undergo presence of lung infiltrates. Which of the
pulmonary function test. The nurse manager following lung sounds would you expect?
asks: “Which of the following drug class
should be withheld prior to the test”. The a. Friction rub
CORRECT answer of the new nurse is: b. Murmur
c. Wheezes
a. Antiussives d. Crackles – fluid in alveoli - popping sound
b. Bronchodilators – falsely improve
respirations 82. The priority nursing diagnosis is
c. Antiemetics “Ineffective airway clearance related to
d. Antibiotics increased secretions and ineffective coughing.”
Which nursing intervention would be
79. Dr. Martin Brenner orders a urine considered to facilitate coughing with least
specimen for urinalysis STAT for Totoy in discomfort?
room 102. The nurse manager delegated the
function to the new nurse. a. Splinting chest wall with pillow when
Which of the following statements is the coughing – decrease pain
MOST appropriate for the nurse manager to b. Putting the client in semi-Fowler’s position
say to initiate delegation of task? all the time
c. Taking cough med q4 hours round the clock
a. “We need urine for urinalysis STAT for d. Utilizing the purse-lip technique of
Totoy in room 102. Tell me when you send it breathing
RECALLS 3 – NP1

c. Insulin causes potassium ions to transport

83. The physician prescribes oral penicillin 500 into the cell – to prevent hypoglycemia
mg every six hours for seven days. On the fifth d. Insulin increases the affinity of glucose to
day, before Nurse Emma administers the first potassium
dose for the day, she computed for the total
amount in the milligrams of the oral penicillin 87. In caring for Marina who has fluid volume
that has been received by the client. Which of deficit, which among these evaluations would
the following is the correct amount? indicate that the patient is recovering from
the fluid imbalance?
a. 2,500 mg
b. 15,000 mg a. Urine specific gravity 1.025 – (1.010-1.020)
c. 10,000 mg b. CVP 8 mmHg – (8 – 12 mmHg)
d. 8,000 mg c. Urine output 10mL/hr – (30 – 60/hr)
d. Hematocrit 55% - (36 – 54%)
500 mg x 4 doses x 4 days = 8000 mg

84. Standard precaution dictates that the 88. Later on, she developed hypernatremia
nurse observes which of the following when What is the primary and initial manifestation
caring for a client with streptococcal of hypernatremia?
pneumonia? - DROPLET PREC
a. Increased DTRs
a. Use of face mask b. Delusions
b. Use of sterile gloves c. Thirst – Na+ > 145mEq/L. to attempt to
c. Observe two-feet distance when giving care dilute sodium concentration
d. Use clean gloves d. Peripheral edema

85. Sputum cultures are to be obtained to 89. Alyssa is a bipolar patient who develops
establish the client’s specific antibiotic hyponatremia due to excessive vomiting.
treatment. Nurse Emma would BEST collect Which of these medications of the patient
the specimen: could cause toxicity induced by hyponatremia?
- HYPONATREMIA – LITHIUM TOXICITY
a. Early in the morning – accumulation of
secretions a. Valproate
b. Early morning after an antiseptic gargle b. Clozapine
c. After brushing the client’s teeth c. Lithum
d. Anytime of the day after a warm salt d. Risperidone
solution gargle
90. Calcium gluconate is ordered for a patient
86. Marina is a renal patient with whose serum calcium falls under 8.6mg/dL.
hyperkalemia. A glucose-insulin solution was Which of the following actions would
prescribed. How does insulin work in treating necessitate intervention?
hyperkalemia? - GLUCOSE INSULIN SOLUTION
– WILL OPEN THE CELL THEN GLUCOSE a. Incorporating the calcium gluconate in
INSULIN WILL GO INSIDE TOGETHER WITH sodium bicarbonate
THE POTASSIUM. b. Administering calcium gluconate via slow IV
bolus
a. Insulin binds with potassium for excretion c. Monitoring the patient for postural
in the urine hypotension
b. Insulin causes the pituitary gland to d. Using D5W as a diluent for calcium
produce aldosterone to increase sodium and gluconate
water absorption and potassium excretion
RECALLS 3 – NP1

Normal CA: 8.6-10 mg/dL = 30, 5 kg/m2

Situation: You are a school nurse in the public BMI CLASSIFICATION:

school of Municipality of Cebu. As part of your Underweight: ,18.5
nutrition program you will give a talk on Normal: 18.6-22.9
"Nutrition and Body Image." At Risk: 23-24.9
Obese I: 25-29.9
91. As a school nurse, part of your Obses II: >=30
responsibility is as a/an:
At Risk, Obese I and II =
a. Health educator
b. Event coordinator 94. Jade is a 17 year old with a binge eating
c. Researcher disorder. She asked you on the risk factor for
d. Advocate of a healthy lifestyle obesity. Using a psycho-biologic theory your
answer would be:
92. Aquaria is a 16-year-old high school
student with body image issues. She asked a. Peer pressure and low self-confidence
you if she is overweight or not. What b. Eating disorder as the results of living in a
information would you solicit from her for you diet-conscious society
to be able to answer her question? c. Eating disorder as a genetic trait
d. Eating disorder as a fixation at the oral
a. her age stage
b. her height and age
c. her height and weight 95. Jade plans to take an appetite suppressant,
d. her weight and age and asks you if it is safe to take. Your response
was:
BMI= Kg/m2
FIRST STEP IN HEALTH TEACHING IS:
93. She told you that she is 16 years old, ASSESS LEARNING NEEDS!
weighs 176 lbs and she stands 5 ft. and 4
inches. Your answer to her would be: a. "I will refer you to the dietician so she can
incorporate the drug in the diet plan for obese
a. "You are classified as obese" client"
b. "You are overweight" b. "What information have you gathered
c. "You are underweight" regarding the drug?"
d. "You are within the normal range" c. "There are known adverse side effects of
the drug, headache being the most common
176 lb complaint"
------ = 80kg d. "I will refer you to the pharmacist so he can
2.2 discuss further the action of the drug"

5ft x 12 = 60in + 4in = 64in 96. Erica Sinclair came to the ER due to pain
and abdominal distension. Doctor’s
64in x 2.54 = 162. 56cm impression is kidney stone. The client is asked
162.56 cm to describe the pain she is experiencing.
----- = 1.62 m Which of the following should the nurse
100 expect?

BMI = kg/m2 I. Intense deep ache in the costo-

= 80kg/1.62 m2 vertebral region
= 80kg/ 2.62 m2 II. Pain usually radiates anteriorly and
RECALLS 3 – NP1

towards the bladder

III. Wavelike pain that radiates down to a. Engage in outside activity so she can sweat
the thigh and genitalia – ureteral stones a lot – prevent dehydration
IV. Acute excruciating pain, colicky in b. Drink 8-10 glasses per day
nature that radiates to genitalia – ureteral c. Restrict intake of protein to 60 g/day
stones d. Take non steroid drugs for pain

a. 1 and 2
b. 1 only
c. 2 and 3
d. 1,2,3 and 4

97. Which of the following questions should

Nurse Robin ask to determine the
PREDISPOSING factor of stone formation?
RF – DEHYDRATION

a. How much water do you drink every day? –

2-3L of water
b. Do you engage in outdoor sports?
c. What kind of medications do you take?
d. Do you have a family history of stone
formation?

98. A 24-hour urine collection was ordered for

Billy. This is a done to measure which
substance in the urine:

a. Calcium
b. Creatinine - CLEARANCE
c. Magnesium
d. Potassium

99. Extracorporeal shockwave Lithotripsy was

ordered for Billy and she was anxious about
the procedure. To help relieve the anxiety,
Nurse Tere explains that it:

a. Will break up the stones in the calyces of

the kidney
b. "Is a procedure to extract renal stones"
c. Will create electrical discharge to break the
stones in the kidney" – NON INVASIVE
d. Will visualize the stone and destroy it"

100. Billy is preparing to go home. Which of

the following is NOT an essential component
of your health instruction? - AVOID
DEHYDRATION