NURSING PRACTICE V

Care of Clients with Physiologic and Psychosocial Alterations (Part C)

GENERAL INSTRUCTIONS:
1. This test booklet contains 100 test questions.
2. Read INSTRUCTIONS TO EXAMINEES printed on your answer sheet.
3. Shade only one (1) box for each question on your answer sheet. Two or more boxes shaded will invalidate your answer.
4. AVOID ERASURES.
5. This is BRAINHUB REVIEW SPECIALIST Property, Unauthorized possession, reproduction, and/or sale of this test
booklet is punishable by law (R.A. 8981).

INSTRUCTIONS:
1. Detach one (1) answer sheet from the bottom of your Examinee ID/Answer Sheet Set
2. Write the subject title “Nursing Practice V” on the box provided.
3. Shade Set Box “A” on your answer sheet if your test booklet is Set A; Shade Set Box “B” if your test booklet is Set B;
Shade Set Box “C” if your test booklet is Set C.

Situation 1
Patient Abraham from the Mountain Province is admitted in the psychiatric facility for his treatment of depression. Nurse Ana
is assigned in the delivery of holistic care to Patient Abraham. She is mindful about the principles of managing patients with
major depression.

1. Nurse Ana is planning care with Patient Abraham who is diagnosed with depression. Her patient believes in “mal ojo” (the
evil eye) and uses treatment by a root healer. Nurse Ana should do which of the following?
A. Avoid talking to Patient Abraham about the root healer.
B. Explain to Patient Abraham that root healing has a scientific, not mystical basis.
C. Explain to Patient Abraham that such beliefs are superstitious and should be forgotten.
D. Involve the root healer in a consultation with Patient Abraham, primary health care provided, and Nurse Ana.

2. After a period of unsuccessful treatment with Elavil (amitriptyline), Patient Abraham diagnosed with depression is
switched to Parnate (tranylcypromine). Which statement by Patient Abraham indicates that he understands the side
effects of Parnate?
A. “I need to increase my intake of sodium.”
B. “I must refrain from strenuous exercise.”
C. “I must refrain from eating aged cheese or yeast products.”
D. “I should decrease my intake of foods containing sugar.”

3. Patient Abraham is scheduled for the first electroconvulsive therapy (ECT) treatment in the morning. The patient has been
unable to sleep but at 10 PM refused to take Restoril as Nurse Ana suggested. The patient is still unable to sleep at 11:15
PM. In what order should Nurse Ana do the following?
1. Sit quietly with Patient Abraham.
2. Encourage the use of Restoril.
3. Offer use of MP3 player with relaxing music.
4. Discuss specific concerns.

A. 1, 4, 3, 2 C. 1, 2, 4, 3
B. 1, 3, 2, 4 D. D, 1, 4, 2, 3

4. Patient Abraham is receiving 6 mg of selegiline transdermal system every 24 hours for major depression. Nurse Ana
should judge teaching about Emsam to be effective when the client makes which statement?
A. “I need to avoid using the sauna at the gym.”
B. “I can cut the patch and use a smaller piece.”
C. “I need to wait until the next day to put on a new patch if it falls off.”
D. “I might gain at least 10 lb (4.5 kg) from the medication.”

5. Patient Abraham has been taking 30 mg of duloxetine hydrochloride (Cymbalta) twice daily for 2 months because of
depression and vague aches and pains. While interacting with Nurse Ana, Patient Abraham discloses a pattern of
drinking a six-pack of beer daily for the past 10 years to help with sleep. What should Nurse Ana do first?
A. Refer Patient Abraham to the dual diagnosis program at the clinic.
B. Share the information at the next interdisciplinary treatment conference.
C. Report Patient Abraham’s beer consumption to the primary health care provider.
D. Teach Patient Abraham relaxation exercises to perform before bedtime.
Situation 2
Bernarda is diagnosed with bipolar disorder and is manifesting mania. Nurse Benedict is responsible in delivering therapeutic
management to Bernarda in his unit for the shift.

6. In a predischarge program to educate Bernarda with bipolar disorder and his family members, the Nurse Benedict
emphasizes that the most significant indicators for the onset of relapse include which of the following symptoms?
A. A sense of pleasure and motivation for new endeavors.
B. Decreased need for sleep and racing thoughts.
C. Self-concern about increase in energy.
D. Leaving a good job to start a new business.

7. Bernarda has just been admitted to the hospital for medication adjustment after outpatient treatment failure of his bipolar
disorder and returning mania. He tells Benedict as his primary nurse about his medications and treatment. Which of his
following statements would raise the most urgent need for more medication instruction about his lithium therapy?
A. “My doctor tells me that my lithium level is 1.0 so I don't have to worry about my levels.”
B. “I've been getting a lot of good exercise playing on a local soccer team.”
C. “I'm trying hard to watch my diet and eat healthy.”
D. “I have learned to take my lithium even when I'm not feeling well, like when I had the stomach flu.”

8. Bernarda has been married for 2 years and reports that she and her husband are ready to start a family. She has a
diagnosis of bipolar I disorder and has been well managed on divalproex sodium (Depakote) for at least 3 years. What is
the most essential counsel for Nurse Benedict to give her?
A. “Schedule an appointment for a complete gynecological exam if you have not had one in the past year.”
B. “Pay careful attention to eating healthy from this point on in order to maximize the health of both mother and baby.”
C. “Check with your prescriber today as Depakote carries an increased risk for birth defects, especially during the first 3
months of pregnancy.”
D. “It is very important for you to take steps to reduce your stress, and this will help you to stay in balance during your
pregnancy and reduce your chances of developing post-partum depression.”

9. A health care provider has prescribed valproic acid for Bernarda with bipolar disorder who has achieved limited success
with lithium carbonate. Nurse Benedict should instruct Bernarda about which of the following?
A. Follow-up blood tests are necessary while on this medication.
B. The extended-release tablet can be crushed if necessary for ease of swallowing.
C. Tachycardia and upset stomach are common side effects.
D. Consumption of a moderate amount of alcohol is safe if the medication is taken in the morning.

10. Bernarda diagnosed with bipolar disorder has been managing the disorder effectively with medication and treatment for
several years. She suddenly becomes manic. Nurse Benedict reviews the medication record of Bernarda. Which of the
following medications may have contributed to the development of her manic state?
Medication Record:
Amitriptyline 50 mg PO daily at bedtime
Prednisolone 20 mg PO daily
Buspirone HCl 5 mg PO three time a day
Gabapentin 300 mg PO three times a day

A. Amitriptyline. C. Buspirone.
B. Prednisone. D. Gabapentin.

Situation 3
Chloe is admitted in the Psychiatric Facility. Nurse Conrad promotes security and safety of Chloe while she in the facility.

11. Nurse Conrad overhears two nursing attendants talking in the snack room. One of the attendants’ states, “Her superficial
cuts are just a means of getting our attention. She never should have been admitted. I hope she's out of here soon.”
Which of the following responses by Nurse Conrad is most appropriate?
A. “It's our job to help her no matter how we feel about her or what she did. She'll be discharged soon.”
B. “I won't tolerate that kind of discussion from my staff. Now, it is time for you to go back to work.”
C. “I know it's hard to understand, but we need to do the best we can even though she'll be back.”
D. “No matter what the intent, all suicidal behavior is serious and deserves our serious consideration.”

12. The history of Chloe who has just been admitted to the unit and is very depressed reveals a weight loss of 10 lb (4.5 kg)
in 2 weeks, sleeping 3 hours a night, and poor hygiene. Chloe states, “I'm no good to anyone. Everyone would be better
off without me.” Which of the following questions should Nurse Conrad ask first?
A. “What do you mean?”
B. “Are you thinking about hurting yourself?”
C. “Doesn't your family care about you?”
D. “What happened to make you think that?”
13. When developing the plan of care for Chloe with suicidal ideation, developing goals to address which of the following is a
priority?
A. Self-esteem.
B. Sleep.
C. Hygiene.
D. Safety.

14. Which of the following questions should Nurse Conrad ask to best determine the seriousness of a Chloe's suicidal
ideation?
A. “How are you planning on harming yourself?”
B. “Have you made out a will?”
C. “Does your family know you're here?”
D. “How long have you been thinking about harming yourself?”

15. The nursing attendant states to Nurse Conrad, “Chloe talks about how awful and useless she is. Sometimes she sounds
angry for no reason. I'm tired of listening to her.” Which of the following responses by Nurse Conrad is most appropriate?
A. “I'll switch your assignment to someone who's less depressed and less tiring.”
B. “It's important for you to listen to her because she needs to verbalize how she is feeling.”
C. “Don't worry about it. I know you haven't done anything to make her angry.”
D. “Clients with depression are hard to deal with, but don't take what they say seriously.”

Situation 4
Nurse Dan is assigned to assist Patient Dennis with paranoid schizophrenia. Therapeutic environment is provided that
promotes safety while the patient is in the facility.

16. A newly admitted Patient Dennis describes his mission in life as one of saving his son by eliminating the “provocative
sluts” of the world. There are several attractive young women on the unit. What should Nurse Dan do first?
A. Ask Patient Dennis for her definition of “provocative sluts.”
B. Ask the young female clients on the unit to dress less provocatively.
C. Ask Patient Dennis to discuss his concerns in the next group session.
D. Ask Patient Dennis to inform the staff if he has negative thoughts about other clients.

17. Patient Dennis diagnosed with paranoid schizophrenia is talking with Nurse Dan. “You know, when I thought everyone
was out to get me, I was staying in my apartment all the time. Now, I'd like to get out and do things again.” What is the
best initial response by Nurse Dan?
A. “With whom do you want to do things?”
B. “What activities did you enjoy in the past?”
C. “What kind of transportation do you use?”
D. “How much money can you spend?”

18. Patient Dennis is becoming agitated during a discussion group. He states, “I know that all of you hate me.” He leaves the
group and goes to his room. Which action by Nurse Dan is most therapeutic for Patient Dennis?
A. After group, ask Patient Dennis to talk to Nurse Dan about his concerns.
B. Ask Patient Dennis to return to group and share his feelings.
C. Explain to group members about Patient Dennis’ problems.
D. Ask the group members to apologize to Patient Dennis individually.

19. Patient Dennis who is neatly dressed and clutching a leather briefcase tightly in his arms scans the adult inpatient unit on
his arrival at the hospital and backs away from the window. Patient Dennis requests that Nurse Dan move away from the
window. Nurse Dan recognizes that doing as Patient Dennis requested is contraindicated for which of the following
reasons?
A. The action will make Patient Dennis feel that Nurse Dan is humoring him.
B. The action indicates nonverbal agreement with the Patient Dennis’ false ideas.
C. Patient Dennis will then think that he will have his way when he wishes.
D. Nurse Dan will be demonstrating a lack of composure over the situation.

20. Patient Dennis reports having thoughts of being followed by foreign agents who are after his secret papers. Which
response by Nurse Dan is most appropriate when responding to the Patient Dennis’ disturbed thought process?
A. “I don't see any foreign agents.”
B. “I think these thoughts are frightening to you.”
C. “I don't know what you mean.”
D. “I'd like you to come to group with me right now.”
Situation 5: Nurse Ethan is assigned to care for Patient Erica in his unit. Patient Erica is admitted with undifferentiated
schizophrenia associated with other psychotic disorders. Nurse Ethan also is in-charged in the admission process of patients
in the facility.

21. As hospital-based care has become more oriented to crisis intervention, criteria for admission to the hospital have also
changed. Which patients have priority for admission to an acute care facility as evaluated by Nurse Ethan?
1. Clients who live alone.
2. Clients who are acutely psychotic.
3. Clients who are acutely depressed.
4. Clients who are dangerous to self or others.
5. Clients who are not sleeping and have a lack of appetite.
6. Clients who are not complying with medication regimens.

A. 1,5 B. 2,4 C. 3,6 D. 1,3

22. A 79-year-old Patient Erica is brought to the outpatient clinic by her daughter for a routine medication evaluation. The
daughter reports that her mother is quite stable and has no adverse effects from the risperidone (Risperdal) she is taking.
Then the daughter says, “I just think my mother could be even better if she was on a larger dosage. My son takes 1 mg of
Risperdal every day and my mother is only on 0.5 mg.” What is the most helpful response by Nurse Ethan?
A. “Maybe your son is sicker than your mother is.”
B. “We could increase your mother's dosage if you want.”
C. “Older clients generally need only one-third to one-half the dose of younger people.”
D. “I'm not seeing any symptoms of illness in your mother. Let's wait until the next visit.”

23. At an outpatient visit 3 months after discharge from the hospital, Patient Erica says he has stopped his olanzapine
(Zyprexa) even though it controls his symptoms of schizophrenia better than other medications. “I have gained 20 lb (9.1
kg) already. I can't stand anymore.” Which response by Nurse Ethan is most appropriate?
A. “I don't think you look fat; why do you think so?”
B. “I can help you with a diet and exercise plan to keep your weight down.”
C. “You can be switched to another medicine.”
D. “Your weight gain will level off if you stay on the medication 3 more months.”

24. Patient Erica diagnosed with schizophrenia is being switched to risperidone long-acting injection (Risperdal Consta). She
is told that she will remain on her oral dose of risperidone (Risperdal) daily for approximately 1 month. Patient Erica says,
“I didn't have to take pills when I was on fluphenazine decanoate (Prolixin Decanoate / Modecate) shots in the past.”
Nurse Ethan should tell Patient Erica that:
A. “Taking fluphenazine orally and by injection would not be as effective as the injection alone.”
B. “Risperdal Consta is less potent than Prolixin Decanoate / Modecate.”
C. “The doctor didn't believe you would take both the pills and Prolixin Decanoate / Modecate.”
D. “Risperdal Consta initially takes a little longer to reach the ideal blood level.”

25. One of the important aspects of the client's rights is the right to treatment in the least restrictive environment. Nurse Ethan
observes this principle when making which decisions?
1. Referring Patient Erica to a group home or supervised apartment living.
2. Releasing Patient Erica’s information to a primary care physician or a relative.
3. Placing a Patient Erica in seclusion or restraints.
4. Respecting Patient Erica's right to accept or refuse treatment.
5. Placing a committed Patient Erica in a daily outpatient group or a weekly self-help group.

A. 1,3,5 B. 1,4,5 C. 2,4,5 D. 2,3,5

Situation 6: Nurse Franuly is a newly hired psychiatric nurse in the facility. He is assigned to care for patients and families
affected by chronic mental illnesses. One of his patients in the area is Patient Franky.
26. Nurse Franuly is working at an outpatient mental health center primarily with chronically mentally ill clients receives a
telephone call from the mother of a client who lives at home. The mother reports that Patient Franky has not been taking
her medication and now is refusing to go to the sheltered workshop where she has worked for the past year. What should
Nurse Franuly do first?
A. Call the director of the workshop for information about Patient Franky.
B. Reserve an inpatient bed in preparation for Patient Franky's admission.
C. Ask to speak to Patient Franky directly on the phone.
D. Make an appointment for Patient Franky to see the doctor.

27. Nurse Franuly is teaching the families of Patient Franky with chronic mental illnesses about causes of relapse and
rehospitalization. What should Nurse Franuly include as the primary cause?
A. Loss of family support. C. Sudden changes in medications.
B. Noncompliance with medications. D. Nonattendance at treatment programs.
28. The director of a workshop program tells the Nurse Franuly that Patient Franky with schizophrenia had done well for 6
months until last week, when a new person started at the workshop. This new person worked faster than Patient Franky
did and took his place as leader of the group. Based on this information, which of the following interventions is most
appropriate?
A. Make a home visit and tell Patient Franky that if she does not return to the workshop, she will lose her place there.
B. Ask the director to assign Patient Franky to another work group when she returns to the workshop.
C. Make an appointment to meet Patient Franky at the mental health center and ask her about the situation.
D. Arrange for the placement of Patient Franky in a skill-training program.

29. A 25-year-old Patient Franky diagnosed with chronic schizophrenia states, “I stopped my medications a week ago. I was
just tired of not being able to drink with my friends. Besides, I feel fine without them.” Which of the following responses by
Nurse Franuly is most appropriate?
A. “It's important for you to go back on your medicines.”
B. “I hear how difficult it must be to live with the changes caused by your illness.”
C. “You will have to talk to your doctor about stopping your medications.”
D. “Your buddies will understand that you can't drink anymore.”

30. Patient Franky diagnosed with schizophrenia cheerfully announces, “My mom and I are so excited that I'm pregnant.
She's willing to help us take care of the baby too.” Which of the following reasons should cause Nurse Franuly to be
concerned about this situation?
A. Patient Franky did not say that the father of the baby was excited about this.
B. The mother is not likely to provide enough help for what Patient Franky needs.
C. Symptom management will be difficult in early pregnancy without medications.
D. Patient Franky will have difficulty financially supporting the baby.

Situation 7
Patient George is admitted in the psychiatric facility brought about by his dementia. He is under the care of Nurse Gen upon
his admission in the unit.

31. Patient George who prefers to stay in his room has been brought to the dayroom. After 10 minutes, Patient George
becomes agitated and retreats to his room again. Nurse Gen decides to assess the conditions in the dayroom. Which is
the most likely occurrence that is disturbing to Patient George?
A. There is only one other client in the dayroom; the rest are in a group session in another room.
B. There are three staff members and one primary health care provider in the nurse's station working on charting.
C. A relaxation tape is playing in one corner of the room, and a television airing a special on crime is playing in the
opposite corner.
D. A housekeeping staff member is washing off the countertops in the kitchen, which is on the far side of the dayroom.

32. Nurse Gen and other nursing staff are trying to provide for the safety of an elderly Patient George with moderate
dementia. He is wandering at night and has trouble keeping his balance. He has fallen twice but has had no resulting
injuries. Nurse Gen should:
A. Move Patient George to a room near the nurse's station and install a bed alarm.
B. Have Patient George sleep in a reclining chair across from the nurse's station.
C. Help Patient George to bed and raise all four bedrails.
D. Ask a family member to stay with Patient George at night.

33. During a home visit to Patient George with mild dementia, his daughter reports that he has one major problem with his
father. She says, “He sleeps most of the day and is up most of the night. I can't get a decent night's sleep anymore.”
Which suggestions should Nurse Gen make to the daughter?
1. Ask Patient George's primary health care provider for a strong sleep medicine.
2. Establish a set routine for rising, hygiene, meals, short rest periods, and bedtime.
3. Engage Patient George in simple, brief exercises or a short walk when she gets drowsy during the day.
4. Promote relaxation before bedtime with a warm bath or relaxing music.
5. Have the daughter encourage the use of caffeinated beverages during the day to keep her mother awake.

A. 2,4,5 B. 2,3,4 C. 1,2,4 D. 1,4,5

34. Patient George is experiencing agnosia as a result of vascular dementia. He is staring at dinner and utensils without
trying to eat. Which intervention should Nurse Gen attempt first?
A. Pick up the fork and feed Patient George slowly.
B. Say, “It's time for you to start eating your dinner.”
C. Hand the fork to Patient George and say, “Use this fork to eat your green beans.”
D. Save Patient George's dinner until his family comes in to feed him.

35. Patient George with early dementia exhibits disturbances in his mental awareness and orientation to reality. Nurse Gen
should expect to assess a loss of ability in which of the following other areas?
A. Speech. C. Endurance.
B. Judgment. D. Balance.
Situation 8
Nurse Hidilyn is conducting an assessment program in the community psychiatric facility. She is assigned in evaluating
behaviors of clients with personality disorder.

36. Patient Hover has been diagnosed with Avoidant Personality Disorder. He reports loneliness but has fears about making
friends. He also reports anxiety about being rejected by others. In designing a long-term treatment plan, in what order,
from first to last, should Nurse Hidilyn include the following?
1. Teach the client anxiety management and social skills.
2. Ask the client to join one of his chosen activities with the nurse and two other clients.
3. Talk with the client about his self-esteem and his fears.
4. Help the client make a list of small group activities at the center he would find interesting.

A. 3,1,4,2 C. 3,1,2,4
B. 3,4,1,2 D. 3,4,2,1

37. Patient Honey diagnosed with borderline personality disorder has self-inflicted cuts on her arms. Nurse Hidilyn is
assessing Patient Honey for the risk of suicide. What should Nurse Hidilyn ask Patient Honey first?
A. About medications she has taken recently. C. If she has a suicide plan.
B. If she is taking antidepressants. D. Why she cut herself.

38. When developing the plan of care for Patient Hover diagnosed with a personality disorder, Nurse Hidilyn plans to assist
Patient Hover primarily with which of the following?
A. Specific dysfunctional behaviors. C. Examination of developmental conflicts.
B. Psychopharmacologic compliance. D. Manipulation of the environment.

39. Patient Henry diagnosed with paranoid personality disorder is hospitalized for physically threatening his wife because he
suspects her of having an affair with a coworker. Which of the following approaches should Nurse Hidilyn employ with
Patient Henry?
A. Authoritarian. B. Parental. C. Matter of fact. D. Controlling.

40. When planning care for Patient Hillary diagnosed with schizotypal personality disorder, which of the following helps
Patient Hillary become involved with others?
A. Participating solely in group activities. C. Leading a sing-along in the afternoon.
B. Being involved with primarily one-to-one activities. D. Attending an activity with Nurse Hidilyn.

Situation 9
Patient Ian is admitted in the hospital and is under the care of Nurse Intan upon his admission in the unit.

41. An intoxicated Patient Ian is admitted to the hospital for alcohol withdrawal. Which of the following should Nurse Intan do
to help Patient Ian become sober?
A. Give Patient Ian black coffee to drink.
B. Walk Patient Ian around the unit.
C. Have Patient Ian take a cold shower.
D. Provide Patient Ian with a quiet room to sleep in.

42. Patient Ian is admitted to the hospital for alcohol detoxification. Which of the following interventions should Nurse Intan
use?
1. Taking vital signs.
2. Monitoring intake and output.
3. Placing Patient Ian in restraints as a safety measure.
4. Reinforcing reality if Patient Ian is disoriented or hallucinating.
5. Explaining to Patient Ian that the symptoms of withdrawal are temporary.

A. 1,2,4,5 C. 1,2,3,5
B. 1,3,4,5 D. 1,2,3,4

43. Nurse Intan is assessing Patient Ian who has fallen twice in the last 2 days. Patient Ian has been diagnosed with delirium
tremens (DTs) following withdrawal from alcohol use. Nurse Intan should further evaluate Patient Ian for which of the
following?
1. Disorientation.
2. Paralysis.
3. Elevated temperature.
4. Diaphoresis.
5. Visual or auditory hallucinations.

A. 1,2,4,5 C. 1,2,3,5
B. 1,3,4,5 D. 1,2,3,4
44. Patient Ian was discharged from an alcohol rehabilitation program on clonazepam 0.5 mg three times a day. Several
months later he reports having insomnia, shakiness, sweating, and one seizure. Nurse Intan should first ask Patient Ian if
he:
A. Has been drinking alcohol with the clonazepam.
B. Has developed tolerance to the clonazepam and needs to increase the dose.
C. Has stopped taking the clonazepam suddenly.
D. Is having a panic attack and needs to take an extra clonazepam.

45. Patient Ian is entering the chemical dependency unit for treatment of alcohol dependency. Which of Patient Ian's
possessions should Nurse Intan place in a locked area?
A. Toothpaste. C. Shaving cream.
B. Dental floss. D. Antiseptic mouthwash.

Situation 10
Nurse Jeric is attending the needs of Patient Junri in his unit in managing his symptoms of disorders related to addictive
substances.

46. The friend of Patient Junri brought to the emergency department states, “I guess he had some bad junk (heroin) today.”
Patient Junri is drowsy and verbally nonresponsive. Which of the following assessment findings is of immediate concern
to Nurse Jeric?
A. Respiratory rate of 9 breaths/min. C. Hypotension.
B. Urinary retention. D. Reduced pupil size.

47. Patient Junri is brought to the emergency department by a friend who states, “He was using a lot of heroin until he ran out
of money about 2 days ago.” Nurse Jeric judges the client to be in opioid withdrawal if he exhibits which of the following?
1. Rhinorrhea. 4. Synesthesia.
2. Diaphoresis. 5. Formication.
3. Piloerection.

A. 1,2,3,4,5 B. 1,3,4,5 C. 1,2,3 D. 1,2,4,5

48. An unconscious Patient Junri in the emergency department is given IV naloxone (Narcan) due to an overdose of heroin.
Which of the following would indicate a therapeutic response to the Narcan?
1. Decreased pulse rate. 4. Increased respirations.
2. Warm skin. 5. Consciousness.
3. Dilated pupils.

A. 1,3,5 B. 4,5 C. 1,3,4 D. 3,4,5

49. Which of the following should Nurse Jeric expect to assess for Patient Junri who is exhibiting late signs of heroin
withdrawal?
A. Vomiting and diarrhea. C. Lacrimation and rhinorrhea.
B. Yawning and diaphoresis. D. Restlessness and irritability.

50. After administering naloxone (Narcan), an opioid antagonist, Nurse Jeric should monitor the client carefully for which of
the following?
A. Cerebral edema.
B. Kidney failure.
C. Seizure activity.
D. Respiratory depression.

Situation 11
Patient Kathy a 17-year-old girl is in the outpatient department of a psychiatric facility for management of anxiety related
disorders. She is being cared for by Nurse Kenneth on her basic needs while being hospitalized.

51. Patient Kathy who has been treated for an anxiety disorder since middle school with behavioral treatment and as-needed
(PRN) anxiety medication is preparing to go to college. The parents are concerned that she will experience an
exacerbation of symptoms if she attends college out of town and want the daughter to attend the local community college
and live at home. The girl believes she can handle the challenge of leaving home for college. How should Nurse Kenneth
in the outpatient clinic respond to the family's concerns?
A. “Your parents have a point; transitions have been hard for you in the past.”
B. “There are many pros and cons here that we all need to discuss together.”
C. “Every high school graduate deserves the chance to take on new challenges.”
D. “It may be premature for you to think of college at this point in time.”
52. Patient Kathy who is academically gifted is about to graduate from high school early since she has completed all courses
needed to earn a diploma. Within the last 3 months she has begun to experience panic attacks that have forced her to
leave classes early and occasionally miss a day of school. She is concerned that these attacks may hinder her ability to
pursue a college degree. What would be the best response by Nurse Kenneth who has been helping her deal with her
panic attacks?
A. “It is natural to be worried about going into a new environment. I am sure with your abilities you will do well once you
get settled.”
B. “You are putting too much pressure on yourself. You just need to relax more and things will be alright.”
C. “It might be best for you to postpone going to college. You need to get these panic attacks controlled first.”
D. “It sounds like you have real concern about transitioning to college. I can refer you to a health care provider for
assessment and treatment.”

53. Patient Kathy has been diagnosed with posttraumatic stress disorder (PTSD) because she experienced childhood sexual
abuse (CSA) by her babysitter and her boyfriend from ages 4 to 10. She is admitted for the second time after physically
assaulting a woman she said was a prostitute. “He is no better than my babysitter and deserves to be dead. I'd like to kill
the sitter too.” With the knowledge of PTSD and CSA, which of the following nursing interventions should be implemented
at admission?
1. Institute precautions for suicide, assault, and escape.
2. Ask her to sign a no harm contract.
3. Provide safe outlets for her anger and rage.
4. Encourage her to express her attitude toward prostitutes during unit group sessions.
5. In one-to-one staff talks, encourage her to safely verbalize her anger towards her babysitter and his boyfriend.

A. 1,2,3,5 C. 2,3,4,5
B. 1,3,4,5 D. 2,4,5

54. Patient Kathy is taking diazepam (Valium) for generalized anxiety disorder. Which instruction should Nurse Kenneth give
to Patient Kathy?
1. To consult with her health care provider before she stops taking the drug.
2. To avoid eating cheese and other tyramine-rich foods.
3. To take the medication on an empty stomach.
4. Not to use alcohol while taking the drug.
5. To stop taking the drug if he experiences swelling of the lips and face and difficulty breathing.

A. 1,2,4,5 C. 1,4,5
B. 1,3,4,5 D. 1,2,3,5

55. Patient Kathy diagnosed with anxiety disorder becomes anxious when she touches fruits and vegetables. What should
Nurse Kenneth do?
A. Instruct the woman to avoid touching these foods.
B. Ask the woman why she becomes anxious in these situations.
C. Assist the woman to make a plan for her family to do the food shopping and preparation.
D. Teach the woman to use cognitive behavioral approaches to manage her anxiety.

Situation 12
Nurse Loella is assigned in the Crisis Intervention Unit (CIU) of a psychiatric facility as her first rotation after passing the
Nurse-Licensure Examination.

56. Nurse Loella cares for a middle-aged Patient Lordan with a below-the-knee amputation. Which statement indicates the
need for further assessment of Patient Lordan's body image?
A. “When I get my prosthesis, I want to learn to walk so I can participate in walkathons.”
B. “I hope to get skilled enough at using my prosthesis to help others like me adjust.”
C. “Whenever I start to feel sorry for myself, I remember that my buddy died in that accident.”
D. “I hope I can handle having a prosthesis, but I'm really wondering what my wife will think.”

57. Patient Lordan demonstrates moderate anxiety regarding a pending medical procedure. Nurse Loella should do which of
the following to minimize Patient Lordan's anxiety about the procedure?
A. Assuring Patient Lordan that pain is not associated with the procedure.
B. Providing a brief explanation and then doing the procedure quickly.
C. Giving a demonstration of what is to be done.
D. Indicating to Patient Lordan that it is normal to feel anxious and fearful before such a procedure.

58. Patient Lordan is newly diagnosed with diabetes. The nurse is instructing him about blood glucose testing. After the
session, Patient Lordan states, “I can't be expected to remember all this stuff.” Nurse Loella should recognize this
response as most likely related to which of the following?
A. Moderate to severe anxiety. C. Early-onset dementia.
B. Disinterest in the illness. D. Normal reaction to learning a new skill.
59. Patient Lordan in a general hospital is to undergo surgery in 2 days. He is experiencing moderate anxiety about the
procedure and its outcome. To help Patient Lordan reduce his anxiety, Nurse Loella should:
A. Tell Patient Lordan to distract himself with games and television.
B. Reassure Patient Lordan that he will come through surgery without incident.
C. Explain the surgical procedure to Patient Lordan and what happens before and after surgery.
D. Ask the surgeon to refer Patient Lordan to a psychiatrist who can work with Patient Lordan to diminish his anxiety.

60. Anxiety occurs in degrees, from a level that stimulates productive problem solving to a level that is severely debilitating. At
a mild, productive level of anxiety, Nurse Loella should expect to see which of the following as a cognitive characteristic of
mild anxiety?
A. Slight muscle tension. C. Accurate perceptions.
B. Occasional irritability. D. Loss of contact with reality.

Situation 13
Patient Marian seeks help at the Crisis Intervention Unit (CIU) for her immediate management of her ongoing psychological
crisis. She is under the care of Nurse Mico during her stay in the facility.

61. A potentially pregnant 16-year-old Patient Marian says that she has been “hooking up” with a boy she considers to be her
boyfriend. Which of the following responses should Nurse Mico make first?
A. “You mean you have had sexual intercourse?”
B. “Describe what you mean by hooking up.”
C. “I think we need to talk about what's involved in sexual intercourse.”
D. “All you have been doing with your boyfriend is hooking up?”

62. Patient Marian who is quite anxious says that she would “rather die than be pregnant.” Which of the following responses
by Nurse Mico is most helpful?
A. “Try not to worry until after the pregnancy test.”
B. “You know, pregnancy is a normal event.”
C. “You're only 16 years old and not too young to have a baby.”
D. “I see you're upset. Take some deep breaths to relax a little.”

63. On a crisis shelter hotline, Nurse Mico talks to two 11-year-old boys who think a friend sniffs glue. They say his breath
sometimes smells like glue and he acts drunk. They say they are afraid to tell their parents about the friend. When
formulating a reply, Nurse Mico should consider which of the following?
A. The boys probably fear punishment.
B. Sniffing glue is illegal.
C. The boys' observations could be wrong.
D. Glue sniffing is a minor form of substance abuse.

64. While teaching a group of volunteers for a crisis hotline, a volunteer asks, “What if I'm not sure why someone is calling?”
Which of the following statements by Nurse Mico is most helpful?
A. “Ask the caller to tell you why he or she is calling you today.”
B. “Tell the caller to make an appointment at the walk-in crisis clinic.”
C. “Instruct the caller to go to the nearest emergency room.”
D. “Tell the caller to let you speak to anyone else in the house.”

65. After teaching a group of students who are volunteering for a local crisis hotline, Nurse Mico judges that further education
about crisis and intervention is needed when a student state which of the following?
A. “Callers to a crisis line use this service when they're overwhelmed and exhausted.”
B. “People use crisis hotlines when they're in the most pain and nothing is working for them.”
C. “Most people in crisis will be calling the line once every day for at least a year.”
D. “One benefit is that a person will know how to handle stressful situations better in the future.”

Situation 14
Patient Nenita is brought to your facility and is being managed in your unit. She was suspected of being a victim of abuse.
Nurse Norodin is assigned in delivering the appropriate care to Patient Nenita.

66. A married female Patient Nenita has been referred to the mental health center because she is depressed. Nurse Norodin
notices bruises on her upper arms and asks about them. After denying any problems, Patient Nenita starts to cry and
says, “He didn't really mean to hurt me, but I hate for the kids to see this. I'm so worried about them.” Which of the
following is the most crucial information for Nurse Norodin to determine?
A. The type and extent of abuse occurring in the family.
B. The potential of immediate danger to Patient Nenita and her children.
C. The resources available to Patient Nenita.
D. Whether Patient Nenita wants to be separated from her husband.
67. Patient Nenita with suspected abuse describes her husband as a good man who works hard and provides well for his
family. She does not work outside the home and states that she is proud to be a wife and mother just like her own mother.
Nurse Norodin interprets the family pattern described by Patient Nenita as best illustrating which of the following as
characteristic of abusive families?
A. Tight, impermeable boundaries. C. Role stereotyping.
B. Unbalanced power ratio. D. Dysfunctional feeling tone.

68. When planning the care for Patient Nenita who is being abused, which of the following measures is most important to
include?
A. Being compassionate and empathetic.
B. Teaching Patient Nenita about abuse and the cycle of violence.
C. Explaining to Patient Nenita about the client's personal and legal rights.
D. Helping Patient Nenita develop a safety plan.

69. Nurse Norodin is assessing Patient Nenita who is being abused. Nurse Norodin should assess the client for which
characteristic?
1. Assertiveness. 4. Suicidal thoughts.
2. Self-blame. 5. Guilt.
3. Alcohol abuse.

A. 1,2,3,4,5 C. 1,2,3,4
B. 2,3,4,5 D. 2,4,5

70. After months of counseling, Patient Nenita abused by her husband tells Nurse Norodin that she has decided to stop
treatment. There has been no abuse during this time, and she feels better able to cope with the needs of her husband
and children. In discussing this decision with the Patient Nenita, Nurse Norodin should:
A. Tell Patient Nenita that this is a bad decision that she will regret in the future.
B. Find out more about Patient Nenita’s rationale for her decision to stop treatment.
C. Warn Patient Nenita that abuse commonly stops when one partner is in treatment, only to begin again later.
D. Remind Patient Nenita of her duty to protect her children by continuing treatment.

Situation 15
Nurse Oragen is assigned in the Psychiatric Facility and is in-charged of rendering care to Patient Obrey diagnosed with
eating disorder.

71. Nurse Oragen is planning an eating disorder protocol for hospitalized Patient Obrey experiencing bulimia and anorexia.
Which elements should be included in the protocol?
1. Patient Obrey must eat within view of a staff member.
2. Patient Obrey are not told their weight and cannot see their weight while being weighed.
3. Patient Obrey are not allowed to discuss food or eating in groups or informal conversation with peers.
4. Patient Obrey must rest within view of a staff member and not go to the bathroom for one-half hour to an hour after
eating.
5. Patient Obrey cannot participate in any groups after admission until they gain 1 lb (0.45 kg).

A. 1,2,3,4,5 C. 1,2,4
B. 1,2,4,5 D. 1,3,5

72. A hospitalized Patient Obrey diagnosed with anorexia nervosa refuses to comply with her daily before-breakfast weigh-in.
She states that she just drank a glass of water, which she feels will unfairly increase her weight. What is Nurse Oragen’s
best response to the client?
A. “You are here to gain weight so that will work in your favor.”
B. “Don't drink or eat for 2 hours and then I'll weigh you.”
C. “You must weigh in every day at this time. Please step on the scale.”
D. “If you don't get on the scale, I will be forced to call your doctor.”

73. Nurse Oragen discovers that an Patient Obrey with anorexia nervosa is taking diet pills rather than complying with the
diet. What should Nurse Oragen do first?
A. Explain to Patient Obrey how diet pills can jeopardize health.
B. Listen to Patient Obrey about fears of losing control of eating while being treated.
C. Talk with Patient Obrey about how weight loss and emaciation worry the health care providers.
D. Inquire about worries of Patient Obrey’s family concerning Patient Obrey’s physical and emotional health.

74. When teaching Patient Obrey about anorexia nervosa, Nurse Oragen should describe this disorder as being
characterized by which of the following?
A. Excessive fear of becoming obese, near-normal weight, and a self-critical body image.
B. Obsession with the weight of others, chronic dieting, and an altered body image.
C. Extreme concern about dieting, calorie counting, and an unrealistic body image.
D. Intense fear of becoming obese, emaciation, and a disturbed body image.
75. When developing a teaching plan for Patient Obrey about anorexia nervosa, which of the following should Nurse Oragen
include as the primary group affected by this disease?
A. Women, age at onset between 12 and 20 years. C. Women, onset typically after 30 years.
B. Men, onset during the college years. D. Men, onset after 20 years.

Situation 16
Nurse Philip is a school nurse and is responsible in assessing students in his school for behavior problems.

76. Nurse Philip assesses a 10-year-old girl who excessively cleans and categorizes. Her parents report that she has always
been orderly, but since her brother died of cancer 6 months ago, her cleaning and categorizing have escalated. In school,
she reads instead of playing with other children. These behaviors are now interfering with homework and leisure activities.
To bolster her self-esteem, Nurse Philip should encourage the child to:
A. Be a library helper. C. Be in charge of a group project with four peers.
B. Organize a party for the class. D. Be captain of the kickball team.

77. A 13-year-old junior high school student has come to the school nurse, stating that her father has physically abused her
for 3 years. Initially, the client accepted the abuse, thinking it was because her father had been laid off, but the abuse
continued after he got a job 4 months ago. She fears that her mother will not believe her and her father will reject her if
they discover she has revealed the abuse. Nurse Philip should first:
A. Inform the mother in a face-to-face meeting without the girl present.
B. Call the father, confront him, and then call the police to have him arrested.
C. Meet with both parents together. Include the daughter in the meeting so she can speak for herself.
D. Report the alleged abuse to Child Protective Services (Ministry of Children and Family) that day, and then provide for
the child's safety.

78. A 15-year-old is a heavy user of marijuana and alcohol. When Nurse Philip confronts the client about his drug and alcohol
use, he admits previous heavy use in order to feel more comfortable around peers and achieve social acceptance. He
says he has been trying to stay clean since his parents found out and had him seek treatment. When Nurse Philip
develops a plan of care with the client, what should be the highest priority to help him maintain sobriety?
A. Peer recognition that does not involve substance use.
B. Support and guidance from his parents.
C. A strict no-drug policy at his high school.
D. The threat of legal charges if caught drinking or smoking marijuana.

79. A 17-year-old is admitted to a psychiatric day treatment program due to severe lower back pain since her mother's death
3 years ago. Medical examinations have not discovered a physical cause for her pain. She cares for her four younger
siblings after school and on weekends because of her father's long work hours. Which predischarge statement indicates
that treatment for her condition has been successful?
A. “I understand now why my father spends so much time away from home.”
B. “My back pain is worse on weekends with more chores and homework.”
C. “I don't want to talk about my family. It's my back that is hurting.”
D. “I just need more rest and relaxation and then my back will feel fine.”

80. When collaborating with the health care provider to develop the plan of care for a child diagnosed with attention deficit
hyperactivity disorder (ADHD), the treatment plan will likely include which of the following?
A. Antianxiety medications, such as buspirone (BuSpar), and homeschooling.
B. Antidepressant medications, such as imipramine (Tofranil), and family therapy.
C. Anticonvulsant medications, such as carbamazepine (Tegretol), and monthly blood levels.
D. Psychostimulant medications, such as methylphenidate (Ritalin), and behavior modification.

Situation 17: Nurse Quenny is re-assigned in the Emergency Department as her new assignment for the month. She reviews
her knowledge, skill, and attitude in rendering quick decision making in caring for emergency situations.

81. Three hours ago, Patient Quiring was thrown from a car into a ditch, and he is now admitted to the emergency
department in a stable condition with vital signs within normal limits, alert and oriented with good coloring and an open
fracture of the right tibia. For which signs and symptoms should Nurse Quenny be especially alert?
A. Hemorrhage. B. Infection. C. Deformity. D. Shock.

82. Patient Quiring is admitted to the emergency department with a full thickness burn to the right arm. Upon assessment, the
arm is edematous, fingers are mottled, and radial pulse is now absent. Patient Quiring states that the pain is 8 on a scale
of 1 to 10. Nurse Quenny should:
A. Administer morphine sulfate IV push for the severe pain.
B. Call the physician to report the loss of the radial pulse.
C. Continue to assess the arm every hour for any additional changes.
D. Instruct Patient Quiring to exercise his fingers and wrist.
83. Patient Quiring is brought to the emergency department with abdominal trauma following an automobile accident. The
vital signs are as follows: HR 132, RR 28, BP 84/58, temp 97.0°F (36.1°C), and oxygen saturation 89% on room air.
Which of the following prescriptions from the health care provider should Nurse Quenny implement first?
A. Administer 1 L 0.9% normal saline IV.
B. Draw a complete blood count (CBC) with hematocrit and hemoglobin.
C. Obtain an abdominal x-ray.
D. Insert an indwelling urinary catheter.

84. A middle-aged man collapses in the emergency department waiting room. Nurse Quenny as the triage nurse should first:
A. Gently shake the victim and ask him to state his name.
B. Perform the chin-tilt to open the victim's airway.
C. Feel for any air movement from the victim's nose or mouth.
D. Watch the victim's chest for respirations.

85. Patient Quiring is experiencing an allergic response. Nurse Quenny should do which of the following in order from first to
last?
1. Assess for urticaria.
2. Assess the airway and breathing pattern.
3. Notify the physician.
4. Activate the rapid response team.

A. 2,1,4,3 B. 2,3,4,1 C. 2,1,3,4 D. 2,3,1,4

Situation 18
Nurse Randy is on his morning shift at the Medical Unit. He is a member of the Code Blue Team of the hospital.

86. Nurse Randy working on a medical unit finds the client unresponsive in the bed. After establishing the client is not
breathing and giving two rescue breaths with a mask, which action should Nurse Randy implement next?
A. Check the client for airway obstruction. C. Begin chest compressions.
B. Assess the carotid artery for a pulse. D. Call a code via the call light.

87. Which behavior by the nursing assistant who is performing cardiac compressions during a code warrants immediate
intervention by Nurse Randy?
A. The nursing assistant has two hands on the upper half of the sternum.
B. The nursing assistant notifies the team when getting tired of performing compressions.
C. The nursing assistant depresses the sternum 1.5–2 inches during compressions.
D. The nursing assistant counts out loud to keep the rhythm of compressions.

88. Which is the primary responsibility of the supervising nurse during a code?
A. Escort family members from the room.
B. Ensure that all roles are being performed.
C. Notify the client’s health-care provider (HCP) of the event.
D. Document what happened in the code.

89. Nurse Randy is caring for clients on a telemetry floor. Which client is most likely to experience sudden cardiac death?
A. Patient Romolo who is exhibiting uncontrolled atrial fibrillation at a rate of 136 bpm.
B. Patient Raymark who is exhibiting symptomatic sinus bradycardia who received a pacemaker.
C. Patient Rheannie who is exhibiting multifocal premature ventricular contractions.
D. Patient Remedios who is exhibiting supraventricular tachycardia at a rate of 110 bpm.

90. Patient Romolo is experiencing a cardiac arrest, and his wife is distraught. Which intervention should Nurse Randy
implement at this time?
A. Notify hospital security to keep an eye on the wife.
B. Stay with the significant other until Patient Romolo’s minister arrives.
C. Ask the UAP to talk to the wife.
D. Request the hospital chaplain to come to the station and support the wife.

Situation 19; Nurse Sabel is a member of the Code Blue Team in the hospital she is currently working. She is mindful of the
principles and guidelines in managing patients once Code Blue is raised within the institution.

91. Which medication intervention is the most important for Nurse Sabel to implement when functioning as the medication
nurse in a code?
A. Check the armband against the medication administration record (MAR).
B. Administer the medications rapidly and then raise the client’s arm.
C. Feel for a pulse to make sure the medications are being delivered.
D. Document the amount of medication administered and the route.
92. Nurse Sabel is teaching cardiopulmonary resuscitation (CPR) to a group of new nurses. Which statement best explains
the definition of sudden cardiac death?
A. Death that occurs after being removed from a mechanical ventilator.
B. Cardiac death is the time that the physician declares the heart has stopped.
C. Unexpected death occurring within 1 hour of onset of cardiovascular symptoms.
D. The client is found unresponsive without a pulse or respirations.

93. Which statement explains the scientific rationale for administering epinephrine, a catecholamine, to a client during a
code?
A. It will prevent gastric distention resulting from overventilation with the ambu-bag.
B. Epinephrine will treat any potential anaphylactic reaction to the medications administered.
C. Epinephrine dries secretions and makes it easier for the HCP to intubate the client.
D. It vasoconstricts the peripheral circulation and shunts the blood to the central circulation.

94. Nurse Sabel is responding to a code on a surgical unit. Which personal protective equipment should Nurse Sabel utilize?
A. Nurse Sabel should glove and gown before entering the room.
B. Nurse Sabel should use a bag/mask to ventilate the client.
C. Nurse Sabel may not need any personal protective equipment.
D. Nurse Sabel should don a face shield and mask when in a code.

95. The client who is 1-day postoperative abdominal surgery has a blood pressure (BP) of 88/60 and an apical pulse of 122;
is diaphoretic; and has pale, cold, and clammy skin. Which intervention would Nurse Sabel implement first?
A. Increase the client’s intravenous fluid rate. C. Obtain arterial blood gases (ABGs).
B. Administer an intravenous dopamine drip. D. Assess the client’s abdominal dressing.

Situation 20: The power to regulate the established professions in the Philippines and to examine the applicants to practice
the same is vested upon the Professional Regulations Commission. R.A. 9173 provides for the creation of a Professional
Regulatory Board of Nursing

96. Members of the Board are appointed by the President of the Philippines and confirmed by the Commission on
Appointments. In this type of appointment, a board member is appointed in the meantime to fill a vacancy or perform the
duties of an office during the absence of the regular incumbent:
A. Regular appointment C. Ad Interim appointment
B. Doctrine of Hold-over D. Appointment by election

97. The following are the qualifications of the Chairperson and the Members, of the Board except:
A. A natural born citizen and resident of the Philippines
B. A member of good standing of the accredited professional organization of nurses
C. Must have at least 5 years of continuous practice of the profession prior to appointment
D. A registered nurse and holder of a master's degree in nursing, education or allied medical profession conferred by a
college or university duly recognized by the government

98. The Chairperson and his/her Members shall hold office for a period of how many years?
A. 4years B. 3 years C. 2 years D. 5 years

99. What are the grounds for non-registration or non-issuance of a certificate of registration or professional license?
1. those convicted of a crime involving moral turpitude
2. those who have pending case of child abuse in court
3. those who are guilty of immoral or dishonorable conduct
4. those persons declared by the court to be of unsound mind
5. those who have unprofessional and unethical conduct

A. 1, 2, 3, 4 B. 1, 3, 4, 5 C. 2, 3, 4, 5 D. 1, 2, 3, 4, 5

100.A certificate of registration contains all of the following except:

A. Full name of registrant C. Number and date of registration
B. Name of school, college and university D. Board exam rating

THIS IS BRAINHUB REVIEW SPECIALIST PROPERTY. UNAUTHORIZED POSSESSION, REPRODUCTION, AND/OR

SALE OF THIS TEST BOOKLET ARE PUNISHABLE BY LAW (R.A. 8981).

***END***