THIS IS MERGE PROPERTY ONLY NURSE LICENSURE EXAMINATION

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M U L T I - E D U C A T I O N A L R E V I E W G R O U P E X P E R T S, I N C .
MAKATI CITY * PAMPANGA * CABANATUAN * BAGUIO * VIGAN * GENERAL SANTOS * DAVAO CITY *
MANILA HEAD OFFICE
MERGE PRE - BOARD EXAMINATION NLE – NOVEMBER 2023
NURSING PRACTICE V
“CARE OF CLIENT WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATION (PART C)”
GENERAL INSTRUCTIONS:
1. This test booklet contains 100 test questions.
2. Read INSTRUCTIONS TO EXAMINEES printed on your answer sheets.
3. Shade only (1) box for each question on your answer sheets. Two or more boxes shaded will invalidate your answer.
4. AVOID ERASURES
5. This is MERGE property only Unauthorized possession, reproduction, and/or sale of this test is punishable by law Per
R.A 8981.

INSTRUCTIONS:
1. Detach one (1) answer sheet from the bottom of your Examinee ID/Answer Sheet Set.
2. Each test set will be provided with an answer sheet. Write the subject title “NURSING PRACTICE I” 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.

Situation 1 - Nurse BON-SAN is assessing a client with dementia in the OPD.

1. The demented client has frequent injuries and accidents. The most common is
A. Rheumatic fever C. Hip fracture
B. Gall stones D. UTI

2. The most common psychogenic problem of the elderly is

A. Depression C. Anorexia
B. Insomnia D. Inability to concentrate.

3. The most common type of dementia is

A. Parkinson’s C. ALS
B. Alzheimer’s D. Vascular ischemia

4. Common symptoms for both presenile and senile dementia associated with Alzheimer’s?
A. Increased appetite C. inappropriate behavior
B. loss of short-term memory D. Inability to provide self-care.

5. The client suffers from “sundown syndrome”. Which nursing action is appropriate?
A. Maintain a consistent schedule and sequencing of daily activities
B. Increase nap time in the afternoon
C. Remove feedings if patient becomes agitated
D. Place her in the seclusion room.

Situation 2 – Nurse BONASKI is assigned to a client with Bulimia.

6. Bulimia nervosa is defined as

A. Abnormal vomiting after eating
B. Pathological loss of appetite
C. Pathological eating disorder of binging and vomiting
D. Increased starving self

7. Which one will not occur in Bulimia?

A. Hyperkalemia D. Gastric ulcer
B. Rectal bleeding E. Esophageal varices
C. Tooth decay

8. The most common cause of death in Bulimia is

A. hypokalemia, arrhythmia, arrest B. hyponatremia

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C. renal failure D. CHF

9. This client was given Amitriptyline. Nurse BONASKI knows that the most common side effects are:
A. Cholinergic effects C. Urinary frequency
B. Diarrhea D. Anticholinergic effects

10. Endocrine changes in bulimia:

A. Increased TSH C. Increased FSH
B. Increased ACTH D. Decreased gonadal hormones

Situation 3 – Nurse Donnie is caring for client with Glaucoma and history of HPN.
11. The patient is for the measurement of IOP using non-contact tonometer. This procedure is
A. the application of atropine before C. the application of drug to dilate the eyes
measurement D. the test is painless and no side effects.
B. causes pain after the test

12. Symptom associated with glaucoma:

A. Diplopia C. Episodes of blindness and no pain
B. Blurred vision and colored rings around D. Sense of curtain
lights

13. Pilocarpine eyedrops are prescribed. This drug causes

A. dryness of cornea C. drainage of aqueous humor to decrease IOP
B. dilation of pupils D. reduction of inflammation

14. The client is scheduled to undergo Peripheral Iridectomy. The doctor ordered atropine sulfate. Your nursing
responsibility is:
A. Administer to dilate the pupil C. Administer as part of the OR routine
B. Administer to prevent dryness of mouth D. Notify the MD and question the order.

15. Priority nursing diagnosis if the client’s vision is impaired:

A. Self-care deficit C. Risk for injury
B. Grooming deficit D. Self-esteem disturbance

Situation 4 – BON-BON, 24-years-old contracted traumatic brain injury after an MVA. The nurse is assessing him to
determine the extent of injury.

16. BON-BON speaks rambling words and unable to repeat words spoken to him. This language problem is a
damage to the:
A. Broca’s C. Foramen magnum
B. Wernicke’s D. Brodmann’s area

17. A client is to undergo CAT scanning. Your nursing responsibility is to

A. Prepare the client for the injection of contrast into the arm
B. A spinal tap is done to aspirate CSF
C. Tell the client that this procedure is non-invasive and painless
D. explain that VS are monitored before and after the test

18. The earliest sign of increase ICP is

A. restlessness and change in LOC C. rising BP and bradypnea
B. elevated temperature and decerebrate D. WPP and dilated pupils

19. Which one is not a sign of increased ICP?

A. Decreased LOC D. Projectile vomiting
B. Tachypnea E. Pain or headache
C. Papilledema

20. The patient has otorrhea. Your nursing action is to

A. suction it immediately
B. blot the drainage and look for a ring
C. swab the opening of the ear with sterile applicator and send immediately to the lab for CSF analysis
D. Use a Test-tape to check negative for sugar.

Situation 5 – Nurse HEN-BON is assessing a client with CVA.

21. When obtaining history of the client, the most significant is

A. Consistent HPN and dizziness C. Emotional response to illness
B. Family history D. Palpitations and hypotension

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22. Priority
A. sensory
nursing
stimulation
care during acute attack is C. maintain proper nutrition
B. respiratory and airway function D. prevention of deformity

23. Which of the following will show sign of increased ICP?

A. Tachycardia, hypotension C. Bradycardia, hypotension
B. Tachycardia, hypertension D. Bradycardia, rising blood pressure

24. The best position for increased ICP is

A. HOB elevated, supine, neck midline C. right lateral position

B. HOB elevated, lateral D. left lateral position

25. The wife of the patient is so hopeless and upset. She said, “Is there any hope for my husband to recover?” Your
best reply is,
A. “Recover? Do you think with that status he will recover?”
B. “Only God can tell.”
C. “It is too soon to tell what the outcome will be.”
D. “Actually, manifestations may even get worse.”

Situation 6 – Safety and infection control.

26. The most important intervention in infection control is:

A. Hand hygiene of all healthcare staff C. proper disposal of sharps
B. Use of PP Gown D. prevention of catheter-related infection

27. Splashes of blood and or contamination of non-intact skin is

A. Airborne C. Inoculation
B. Ingestion D. Direct/indirect contact

28. Transfer of microorganisms from contaminated equipment is

A. Airborne C. Inoculation
B. Ingestion D. Direct/indirect contact

29. Contaminated food is under:

A. Airborne C. Inoculation
B. Ingestion or enteric D. Direct/indirect contact

30. Which of the following is not a standard precaution?

A. Hand hygiene C. PPE
B. Injection safety D. Respiratory hygiene

Situation 7 – A client underwent cataract surgery.

31. Which of the following is the correct statement about home care?
A. I will avoid laxatives C. I will not touch my dressing
B. I will use an eye shield ay night D. I will curtail most heavy activities

32. After phacoemulsification, some patient will wear cataract glasses to:
A. restrict their visual magnification C. remove cloudiness and have a clear vision
B. prevent glare D. decrease the visual acuity.

33. The client with cataract has an underlying disease condition. It is usually related to
A. SLE D. Bell’s Palsy
B. GBS E. Diabetes Mellitus
C. ALS

34. Diabetes Mellitus in the eyes can cause:

A. Neuropathy C. Erectile dysfunction
B. Retinopathy D. Macrovascular angiopathy

35. The appropriate surgery for retinal detachment is

A. Laser Trabeculoplasty D. Stapedectomy with Piston prosthesis
B. LASIK E. Scleral Buckling
C. Labyrinthectomy with shunting

Situation 8 – You are assigned to musculoskeletal problems with surgical management.

36. A client has scoliosis. Which of the following surgical approach is done for the patient?
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A. Osteotomy C. Arthroplasty
B. Spinal fusion D. Hip replacement

37. The client with rheumatoid arthritis is prepared for surgery. Which one is correct?
A. Cervical fusion C. Arthroplasty
B. APR D. Debulking of the osteoma

38. After surgery, the patient developed osteomyelitis. The most common bacterium for this infection is:
A. E. coli C. Klebsiella
B. Pseudomonas D. Staphylococcus aureus

39. Knowing the complication of osteomyelitis, this can cause:

A. Hypovolemic shock D. Distributive shock
B. Spinal shock E. Septic shock
C. Cardiogenic shock

40. What acid-base imbalance is related to No. 39?

A. Respiratory alkalosis C. Metabolic alkalosis
B. Respiratory acidosis D. Metabolic acidosis

Situation 9 - Mrs. Hershel brought his son, Juanito, age 3 to the Pediatric clinic. She noticed that her son is not
speaking and tend to repeat everything she says. The mother also told the nurse that Juanito prefers to be alone, will
cry when someone will come near him and tend to rock himself from morning till, he will fell asleep.

41. An essential clinical feature of autistic disorder is:

A. Inability to concentrate in any task. C. Stereotyped motor behaviors
B. Easily Distracted D. Poor motor skills

42. There is no definite cause identified for autism, but a strong link has been found on:
A. Environmental factors C. Genetic factors
B. Upbringing D. MMR vaccination

43. Typically, if there is a change in the environment, the child will manifest which of the following?
A. Clinging behavior C. Temper tantrums
B. Suicide D. Talks incoherently.

44. The best treatment approach for autistic children is encouraging their desired behavior through positive
reinforcement. This is:
A. Milieu Therapy C. Play Therapy
B. Psychoanalysis D. Behavior Therapy

45. Chlorpromazine was given Juanito because he becomes aggressive. Which is true with regards to this
medication?
A. Expect that the child will be unusually alert and hyperactive during the therapeutic period.
B. The mother should decrease the fluid intake of the child as this drug causes fluid retention.
C. That the drug is given to decrease the child’s hyperactivity
D. The mother should avoid overexposing the child to sunlight for the child might develop rashes due to
photosensitivity.
.
Situation 10 - Lupin, a 12-year-old boy with Down’s syndrome. He stands 5’1/2”, and weighs 100 lbs. He is slim and
walks sluggishly with a limp. He wears a neck brace as a support for his neck. X-ray of cervical spine showed
“subluxation of C1 in relation to C2 with cord compression”. He attends school for special education.

46. The classroom teacher consults the school nurse for guidance on how to take care of Lupin while inside the
classroom. The nurse considers as priority, Lupin:
A. Physiological needs C. Needs for safety and security.
B. Needs for belonging D. Need for self-esteem.

47. The possible nursing diagnosis for a mentally retarded child who is hyperactive is:
A. Impaired physical mobility C. Impaired social adjustment
B. Potential for injury D. Ineffective coping

48. The nurse should expect that a client who cheeks the medication is a non-complaint patient. Knowing the
non-compliance is the single most important factor for exacerbation and rehospitalization, the doctor ordered
Prolixin [Fluphenazine Decanoate]. The nurse knows that is it given:
A. Orally C. IV
B. Sublingually D. IM

49. Which of the following is considered as an anxiolytic?

A. Haldol (Haloperidol) C. Tofranil (Imipramine HCl)
B. Triazolam (Halcion) D. Trilafon (Pherpenazine)

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50. A male nurse reminds the client that is already time for group activities, The client responded by yelling to the
nurse “You are always telling me what to do! Just like my father!” This is an example of:
A. Symbolization C. Reaction Formation
B. Transference D. Counter Transference
Situation 11 - Mang Carlo, Age 72, is a widower with moderate Alzheimer’s disease. Was brought to the home for the
Aged by his married daughter. On admission, she says to the nurse, “I never thought this would happen to us. I really
feel guilty about bringing him here, I can’t bear to part with him.”
51. The nurse’s therapeutic response to Mang Carlo’s daughter is:
A. “You have indeed made a sound decision; your father needs professional care which you cannot provide
at home.”
B. “Why are you feeling guilty bringing him here?”
C. “I know that his has been a difficult time for you. You seemed troubled about bringing him here.”
D. “You have done well everything for your father, do not be upset. We will take care of him.”

52. Initially, the nursing diagnosis would be:

A. Impaired communication C. Impaired social interaction
B. Altered thought process. D. Altered family process.

53. To guide the nurse in planning activities for Mang Carlos, the nurse should prioritize soliciting which
information?
A. Support system from the significant others C. Routine activities at home
B. Coping mechanism D. The extent of memory impairment.

54. One morning, Mang Carlo has difficulty putting his pajamas. In Alzheimer’s disease, this is known as:
A. Aphasia D. Anhedonia
B. Agnosia E. Asexual
C. Apraxia

55. Which of the following is the exact cause of Dementia of the Alzheimer’s type?
A. Unknown C. Decreased Acetylcholine
B. Increasing Age D. Senile plaques deposition
Situation 12 - A nurse is working with an aggressive client in the psychiatric unit.
56. All the following concepts are true EXCEPT:
A. Hostility is destructive.
B. Frustration develops in response to unmet needs, wants and desire.
C. Anger is always incompatible with love.
D. Aggression can be expressed in a constructive as well as a destructive manner.

57. Carlo is acting out hostile and aggressive feeling by kicking the chairs in the room. the MOST effective way to
deal with Carlo’s behavior is initially to:
A. Set limits on the behavior by verbal command.
B. Administer PRN tranquilizer.
C. Remove the chairs from the room.
D. Restrain the patient and place him in the “Isolation Room.”

58. Mrs. Dizon was visiting her son at the Psychiatry Ward. Which of the following items will the nurse not allow to
be brought inside the ward?
A. iPad cable charger C. X-ACTO
B. Box of cake D. Rubber shoes

59. Which of the following will probably be most therapeutic for a patient on a behavioral modification ward?
A. If the client is agitated, discuss the feelings especially anger.
B. Insist to stop obscene language by verbal reprimand.
C. Give client support and positive feedback for controlling use of obscene language.
D. Provide a punching bag as an alternative to express upset emotions.

60. Which of the following must be considered while planning activities for the depressed patient?
A. Activities which require exertion of energy C. Structured activities that the client can
B. Challenging activities to get him out of participate.
his depression. D. Variety of unstructured activities

Situation 13 - The World Health Organization predicts that within 20 years more people will be affected by depression
than any other health problem. Depression will be the biggest health burden on society both economically and
sociologically.

61. To maintain a therapeutic eye contact and body posture while interacting with angry and aggressive
individual, the nurse should:
A. keep an eye contact while staring at the client.
B. keep his/her hands behind his/her back or in one’s pockets.
C. fold his/her arms across his/her chest.

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D. keep an “open” posture, e.g., Hands by sides but palms turned outwards.

62. A patient in the ward suddenly slapped you in the face and spitted on your face and is obviously agitated and
violent. Which of the following is the best nursing action?
A. Tell the client: “Because of that, you are not going to eat your lunch, dinner and breakfast anymore.”
B. Slap the client back and say, “I am your nurse, you are a patient, and you have no right to hurt me.”
C. Prepare a 5-member team to restraint the client.
D. Respond by saying “You are losing control of yourself, you slapped me and you spitted on me and you
are way out of control.”
63. Which of the following is an accurate way of reporting and recording an incident?
A. “When asked about his relationship with his father, client became anxious.”
B. “When asked about his relationship with his father, client clenched his jaw/teeth, made a fist and turned
away from the nurse.”
C. “When asked about his relationship with his father, client was resistant to respond.”
D. “When asked about his relationship with his father, his anger was suppressed.”
64. To encourage thought, which of the following approaches is NOT therapeutic?
A. “Why do you feel angry?” C. “How do you usually express anger?”
B. “When do you usually feel angry? D. “What situations provoke you to be angry?”
65. A patient grabs and about to throw a chair. The nurse best responds saying.
A. “Stop! Put that chair down.” C. “Stop! The security will be here in a minute.”
B. “Don’t be silly.” D. “Calm down.”
Situation 14 - In your professional nursing role, it is essential to establish a meaningful nurse-patient relationship.
66. A helping nurse patient relationship is characterized by which of the following?
A. Recovery promoting C. Mutual interaction.
B. Growth facilitating D. Health enhancing.
67. Demonstrating a helping relationship enables you to establish in the patient:
A. Compliance to treatment C. Gratitude to your services
B. Positive response to illness D. Some sense of trust in you
68. Therapeutic communication begins with:
A. Knowing the patient C. Trust
B. Interacting with the patient D. Knowing yourself
69. Which of the following approaches will most likely make your patient accept your help?
A. Attending to all his needs C. Calling him by first name
B. Demonstrating a relaxed and attending D. Asking personal questions for health
attitude information
70. The client said, “I am troubled that my son is starting to use drugs.” The nurse replied, “It’s troubling and
painful for you, I feel sorry about this.” The nurse’s reply is an example of:
A. Empathy C. Telepathy
B. Sympathy D. Self-awareness
Situation 15 - A mental disorder or mental illness is a psychological or behavioral pattern generally associated with
subjective distress or disability that occurs in an individual, and which is not a part of normal development or culture. Such
a disorder may consist of a combination of affective, behavioral, cognitive and perceptual components.
71. Nurse Abe is developing a plan of care for a client who is scheduled to have ECT. Which nursing diagnosis is a
priority for this client?
A. Fear C. Risk for aspiration
B. Anxiety D. Body image disturbance
72. A client is admitted to a medical nursing unit with a diagnosis of acute blindness. Many tests are performed, and
there seems to be no organic reason why this client cannot see. Nurse Jay later learns that the client became
blind after witnessing a hit-and-run accident, when a family of three was killed. Nurse Jay suspects that the client
maybe experiencing which of the following?
A. Psychosis C. Bipolar disorder
B. Conversion disorder D. Repression
73. A client with a diagnosis of “major depression recurrent with psychotic features” is admitted to the mental health
center. To create a safe environment for the client, Nurse Charisse most importantly devises a plan of care that
deals specifically with the clients.
A. Altered thought processes. C. Self-care deficit
B. Altered nutrition. D. Knowledge deficit
74. Nurse Yoga assesses a client with the admitting diagnosis of “bipolar affective disorder, mania.” Which of the
following symptoms presented by the client requires Nurse Yoga’s immediate intervention?
A. Outlandish behaviors and inappropriate dress
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B. Grandiose delusions of being a royal descendant of Queen Elizabeth

C. Nonstop physical activity and poor nutritional intake
D. Incessant talking that includes sexual fantasies and teasing off the staff.
75. Informing the patient about termination of the nurse-patient relationship begins during the:
A. Termination phase C. Working phase
B. Pre-orientation phase D. Orientation phase

Situation 16 - Increasing problems of substance abuse continue to challenge the competencies of professional
nurses.

76. The client’s past reactions to ending relationships is withdrawal. The nurse assists her to practice better ways
of coping termination by providing opportunities to:
A. Test new patterns of behavior C. Plan for alternatives
B. Conceptualize her problem. D. Value and find meaning in experience.

77. The longest and the most productive phase of the NPR is:
A. Termination phase C. Pre-orientation phase
B. Working phase D. Orientation phase

78. The objection of the nurse-patient relationship is to provide an opportunity of the patient to:
A. Clarify problems C. Have a corrective emotional experience.
B. Develop insights D. Develop interpersonal relationship.

79. Nurse Yve is teaching a community group about substance abuse. She explains that a genetic component has
been implicated with which of the following commonly abused substances?
A. Alcohol C. Heroin
B. Barbiturates D. Marijuana

80. Nurse John recommends that the family of a client with substance-related disorder attend a support group, such
as Al Anon and A lateen. The purpose of these groups is to help family members understand the problem and to:
A. change the problem behaviors of the abuser.
B. learn how to assist the abuser in getting help.
C. maintain focus on changing their own behaviors.
D. prevent substance problems in vulnerable family members.

Situation 17 - Mental Retardation or IDD (Intellectual Disability Disorder) is an increasingly common childhood
disorder that impairs learning.

81. Mental retardation is:

A. a delay in normal growth and development caused by an inadequate environment.
B. a lack of development of sensory abilities
C. a condition of subaverage intellectual functioning that originates during the developmental period and is
associated with impairment in adaptive behavior.
D. a severe lag in neuromuscular development and motor abilities

82. An important principle for the nurse to follow in interacting with retarded children is:
A. seen that if the child appears contented, his needs are being met.
B. provide an environment appropriate to their development task as scheduled.
C. treat the child according to his chronological age.
D. treat the child according to his developmental level.

83. The child was classified as having an IQ of 55. This is said to be:
A. Mild Mental Retardation C. Severe Mental Retardation
B. Moderate Mental Retardation D. Profound Mental Retardation

84. Which of the following is true with regards to Mild Mental Retardation?
A. Trainable, can reach up to 2nd grade and can reach the maturity of a 7-year-old.
B. Custodial and barely trainable
C. Requires total care throughout life, Mental age of a young infant.
D. Educable, can reach up to grade 6 and has a maturity of a 12-year-old.

85. The onset of mental retardation is before the child reaches what age?
A. 17 C. 15
B. 16 D. 18

Situation 18 - Margie has been diagnosed with Bipolar I disorder. The client demonstrates extreme psychomotor
agitation, flight of ideas, loud talking and elated mood.

86. Which of the following is true about manic reaction?

A. It is an expression of destructive impulse.

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B. A means of coping with frustrations and disappointments

C. A means of ignoring reality
D. An attempt to ward of feelings of underlying depression.

87. Nursing care plan for a client with Mania like Margie should give priority to:
A. Discourage him from manipulating the staff. C. Protect him against suicidal attempts.
B. Prevent him from assaulting another patient. D. Provide adequate food and fluid intake.

88. During a nurse patient interaction, Margie jumps rapidly from one topic to another, this is known as:
A. Flight of Ideas C. Ideas of reference
B. Clang association D. Neologism

89. Which of the following is a suitable activity that a nurse should assign for a Manic client?
A. delivering supply of linen to other rooms C. engaging in activity therapy and group exercises
B. conducting a drama workshop
D. painting a mural with other patients

90. The doctor ordered lithium. You know that this is indicated in patients with:
A. Depression C. Schizophrenia
B. Mania D. Anxiety disorders

Situation 19 - The nurse considers factors related to safety effectiveness in the planning and delivery of nursing services.
Nurse Jason give Lithium to manic depressive patient.

91. Nurse Jason knows that Lithium has a narrow therapeutic range of:
A. 0.1 to 1.0 mEq/L C. 10 to 50 mEq/L
B. 0.6 to 1.2 mEq/L D. 50 to 100 mEq/L

92. Another nurse mention that which of the following is a side effect of lithium toxicity she will expect that may
occur?
A. Anuria C. Sudden burst of muscle strength
B. Oliguria D. Polyuria

93. What specimen is taken from a client when checking the lithium level of the body?
A. Blood C. Urine
B. Stool D. Sweat

94. The nurse has a standing order of Lithium for Margie. If the lithium level is 1.5 mEq/L, the nurse knows that
she should:
A. Administer the next dose and continue monitoring the client.
B. Report this to the physician
C. Recheck the lithium level and validate first before doing any action.
D. Withhold the next dose and notify the physician.

95. As a nurse, you are expecting that the crisis experienced by patients should be resolved within:
A. 4 – 6 hours C. 4 – 6 weeks
B. 4 – 6 days D. 4 – 6 months

Situation 20 – Nurse Jayson is assessing a client with rheumatoid arthritis and borderline personality.

96. The classic behavior is

A. OCPD C. Elated and euphoric
B. Splitting and dividing off the staff D. Suicidal and depressed.

97. The patient complained to nurse Jayson that she is tired. Your nursing diagnosis for this is:
A. Activity intolerance C. Fear
B. Powerlessness D. Body image disturbance

98. During acute phase, the following management are included except:
A. Preventing deformity C. Relieving pain
B. Preserving joint function D. Maintaining usual task

99. The patient with osteoarthritis developed coagulopathy due to long terms NSAIDS.Coagulopathy means
A. decreased platelets adhesiveness C. impaired Vitamin k synthesis
B. block prothrombin conversion D. factor VIII destruction

100. Lifestyle change in osteoarthritis means

A. abstain from alcohol
B. reduce weight
C. avoid exercise
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D. restrict caffeine.
E. End of the Test. Congratulations RNs � �

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