NP3-DIAGNOSTIC EXAM WITH
COMPLETE RATIONALS 2026/2027
UPDATE.
Situation - As a staff nurse in a government hospital, you have been exposed to varied cases of
clients with endocrine problems. Your nursing responsibility starts from admission to discharge
which is a domain of your competencies.
1. Which of the following questions should you ask during an admission interview for a client
with a diagnosis of pheochromocytoma?
A. Do you always feel like you are suffocating, you want to rest and sleep
B. Do you suddenly feel warm and flushed when you get out of bed
C. Do you notice an increase in your heart beat?
D. Do you have an increase in urination lately? - Answer C. Do you notice an increase in your
heart beat?
2. When the sympathetic nervous system is stimulated in the case of pheochromocytoma, you
expect which of the following signs?
i. Hypertension
ii. Headache
iii. Hyperhidrosis
iv. Hypermetabolism
A. 3 and 4
B. 1 only
C. 1, 2, 3, and 4
D. 2 and 3 - Answer C. 1, 2, 3, and 4
3. Which of the following drugs can induce hypertensive crisis in Pheochromocytoma?
A. Tricyclic antidepressant
B. Corticosteroid
C. Respiratory stimulant
D. Radioiodine therapy - Answer A. Tricyclic antidepressant
,4. In the presence of pheochromocytoma, the diagnostic test which is expected to be elevated
is ___________.
A. Serum thyroid hormone levels
B. Albumin globulin test
C. Urine cyclic adenosine monophosphate
D. 24 hours urine collection for vanillylmandelic acid (VMA) - Answer D. 24 hours urine
collection for vanillylmandelic acid (VMA)
5. Palpation, as a modality for physical examination is AVOIDED when diagnosed with
pheochromocytoma because of this action_______________.
A. Will cause sudden release of norepinephrine and severe hypotension
B. Will cause a sudden release of cathecolamines and severe hypertension
C. Will displace the location of the tumor
D. Will cause sudden release of epinephrine and severe palpitation - Answer 5
Situation - Janine is the Nurse on duty in the medical ward and many of Her patients are
suffering from problems with oxygenation.
6. The following are relevant data to be documented when taking the health history of a client
with anemia EXCEPT:
A. Alcohol intake
B. Fatigue and weakness
C. Dietary intake
D. Episodes of bleeding - Answer D. Episodes of bleeding
7. A client with congenital heart disease is suffering from thickening of the skin under his fingers
due to chronic hemoglobin desaturation. Which of the following specific terms should Ime use
to accurately describe MOST the client's condition in the chart?
A. Peripheral cyanosis
B. Pallor of the fingertips
C. Peripheral neuropathy
D. Clubbing of the fingers - Answer D. Clubbing of the fingers
, 8. When the Nurse is assessing a client with Congestive Heart failure with pitting edema, the
Nurse's documentation will include which of the following:
A. Degree of pitting edema
B. Time of indention recovery
C. Depth of edema
D. All of the options - Answer D. All of the options
9. Mr. Gabby has left sided heart failure. Janine's documentation of her assessment findings will
include the following, EXCEPT:
A. Dependent edema
B. Pulmonary crackles
C. Difficulty of breathing
D. Cough - Answer A. Dependent edema
10. A client is on diuretic therapy. Expected entry in patient's chart should include the following
information, EXCEPT:
A. Serum electrolytes monitored
B. Intake and output recorded
C. Lasix administered at 8 0'clock in the evening
D. Weight is taken before drug is given - Answer C. Lasix administered at 8 o'clock in the
evening
Situation — The TQM nurse reported to their director that there are a lot of medication errors
committed by nurses and doctors in the hospital for the past 3 months. They made a decision to
conduct a review of all the cases with these errors. A clinical enhancement on drug
administration was strongly
recommended by going back to the basics. The following questions apply:
11. Which of the following techniques in injection should the nurse use to minimize pain when
administering imferon (Iron drugs).
1 . Z_track technique
2. "Darting" needle quickly
COMPLETE RATIONALS 2026/2027
UPDATE.
Situation - As a staff nurse in a government hospital, you have been exposed to varied cases of
clients with endocrine problems. Your nursing responsibility starts from admission to discharge
which is a domain of your competencies.
1. Which of the following questions should you ask during an admission interview for a client
with a diagnosis of pheochromocytoma?
A. Do you always feel like you are suffocating, you want to rest and sleep
B. Do you suddenly feel warm and flushed when you get out of bed
C. Do you notice an increase in your heart beat?
D. Do you have an increase in urination lately? - Answer C. Do you notice an increase in your
heart beat?
2. When the sympathetic nervous system is stimulated in the case of pheochromocytoma, you
expect which of the following signs?
i. Hypertension
ii. Headache
iii. Hyperhidrosis
iv. Hypermetabolism
A. 3 and 4
B. 1 only
C. 1, 2, 3, and 4
D. 2 and 3 - Answer C. 1, 2, 3, and 4
3. Which of the following drugs can induce hypertensive crisis in Pheochromocytoma?
A. Tricyclic antidepressant
B. Corticosteroid
C. Respiratory stimulant
D. Radioiodine therapy - Answer A. Tricyclic antidepressant
,4. In the presence of pheochromocytoma, the diagnostic test which is expected to be elevated
is ___________.
A. Serum thyroid hormone levels
B. Albumin globulin test
C. Urine cyclic adenosine monophosphate
D. 24 hours urine collection for vanillylmandelic acid (VMA) - Answer D. 24 hours urine
collection for vanillylmandelic acid (VMA)
5. Palpation, as a modality for physical examination is AVOIDED when diagnosed with
pheochromocytoma because of this action_______________.
A. Will cause sudden release of norepinephrine and severe hypotension
B. Will cause a sudden release of cathecolamines and severe hypertension
C. Will displace the location of the tumor
D. Will cause sudden release of epinephrine and severe palpitation - Answer 5
Situation - Janine is the Nurse on duty in the medical ward and many of Her patients are
suffering from problems with oxygenation.
6. The following are relevant data to be documented when taking the health history of a client
with anemia EXCEPT:
A. Alcohol intake
B. Fatigue and weakness
C. Dietary intake
D. Episodes of bleeding - Answer D. Episodes of bleeding
7. A client with congenital heart disease is suffering from thickening of the skin under his fingers
due to chronic hemoglobin desaturation. Which of the following specific terms should Ime use
to accurately describe MOST the client's condition in the chart?
A. Peripheral cyanosis
B. Pallor of the fingertips
C. Peripheral neuropathy
D. Clubbing of the fingers - Answer D. Clubbing of the fingers
, 8. When the Nurse is assessing a client with Congestive Heart failure with pitting edema, the
Nurse's documentation will include which of the following:
A. Degree of pitting edema
B. Time of indention recovery
C. Depth of edema
D. All of the options - Answer D. All of the options
9. Mr. Gabby has left sided heart failure. Janine's documentation of her assessment findings will
include the following, EXCEPT:
A. Dependent edema
B. Pulmonary crackles
C. Difficulty of breathing
D. Cough - Answer A. Dependent edema
10. A client is on diuretic therapy. Expected entry in patient's chart should include the following
information, EXCEPT:
A. Serum electrolytes monitored
B. Intake and output recorded
C. Lasix administered at 8 0'clock in the evening
D. Weight is taken before drug is given - Answer C. Lasix administered at 8 o'clock in the
evening
Situation — The TQM nurse reported to their director that there are a lot of medication errors
committed by nurses and doctors in the hospital for the past 3 months. They made a decision to
conduct a review of all the cases with these errors. A clinical enhancement on drug
administration was strongly
recommended by going back to the basics. The following questions apply:
11. Which of the following techniques in injection should the nurse use to minimize pain when
administering imferon (Iron drugs).
1 . Z_track technique
2. "Darting" needle quickly
