1
NP4 NURSING BOARD EXAM NURSING CARE OF
CLIENT WITH PHYSIOLOGICAL AND PSYCHOSOCIAL
ALTERATION 2026-27 EXAM VERSION
MULTIPLE CHOICE
Situation 1 – Because of the serious consequences of severe
burns, management requires a multidisciplinary approach.
You have important responsibilities as a nurse.
1. While Sergio was lighting a barbecue grill with a lighter
fluid, his shirt burns into flames. The most effective way to
extinguish the flames with as little further damage as
possible is to:
A. log roll on the grass/ground
B. slap the flames with his hands
C. remove the burning clothes
D. pour cold liquid over the flames
2. Once the flames are extinguished, it is most important to:
A. cover Sergio with a warm blanket
B. give him sips of water
C. calculate the extent of his burns
D. assess the Sergio’s breathing
3. Sergio is brought to Emergency Room after the barbecue
grill accident. Based on the assessment of the physician,
Sergio sustained superficial partial thickness burns on his
trunk, right upper extremities and right lower extremities.
His wife asks what that means? Your most accurate response
would be:
,2
A. Structures beneath the skin are damage
B. Dermis is partially damaged
C. Epidermis and dermis are both damaged
D. Epidermis is damaged
4. During the first 24 hours after the thermal injury, you
should asses Sergio for:
A. hypokalemia and hypernatremia
B. hypokalemia and hyponatremia
C. hyperkalemia and hyponatremia
D. hyperkalemia and hypernatremia
5. Teddy, who sustained deep partial thickness and full
thickness burns of the face, whole anterior chest and both
upper extremities two days ago begins to exhibit extreme
restlessness. You recognize that this most likely indicates
that Teddy is developing:
A. Cerebral hypoxia
B. Hypervolemia
C. metabolic acidosis
D. Renal failure
Situation 2 – You are now working as a staff nurse in a
general hospital. You have to
be prepared to handle situations with ethico-legal and moral
implifications.
6. You are in night duty in surgical ward. One of your
patients Martin is a prisoner who sustained an abdominal
gunshot wound. He is being guarded by policeman from the
, 3
local police unit. During your rounds you heard a commotion.
You saw the policeman trying to hit Martin. You asked why
he was trying to hit Martin. He denied the matter. Which
among the following activities will you do first?
A. Write an accident report
B. Call security officer and report the incident
C. Call your nurse supervisor and report the incident
D. Call the physician on duty
7. You are on morning duty in the medical ward. You have 10
patients assigned to you. During your endorsement rounds,
you found out that one of your patients was not in bed. The
patient next to him informed you that he went home without
notifying the nurses. Which among the following will you
do first?
A. Make an incident report
B. Call security to report the incident
C. Wait for 2 hours before reporting
D. Report the incident to your supervisor
8. You are on duty in the medical ward. You were asked to
check the narcotics cabinet.
You found out that what is on record does not tally with the
drugs used. Which among the following will you do first?
A. Write an incident report and refer the matter to the
nursing director
B. Keep your findings to yourself
C. Report the matter to your supervisor
D. Find out from the endorsement any patient who might
have been given narcotics
NP4 NURSING BOARD EXAM NURSING CARE OF
CLIENT WITH PHYSIOLOGICAL AND PSYCHOSOCIAL
ALTERATION 2026-27 EXAM VERSION
MULTIPLE CHOICE
Situation 1 – Because of the serious consequences of severe
burns, management requires a multidisciplinary approach.
You have important responsibilities as a nurse.
1. While Sergio was lighting a barbecue grill with a lighter
fluid, his shirt burns into flames. The most effective way to
extinguish the flames with as little further damage as
possible is to:
A. log roll on the grass/ground
B. slap the flames with his hands
C. remove the burning clothes
D. pour cold liquid over the flames
2. Once the flames are extinguished, it is most important to:
A. cover Sergio with a warm blanket
B. give him sips of water
C. calculate the extent of his burns
D. assess the Sergio’s breathing
3. Sergio is brought to Emergency Room after the barbecue
grill accident. Based on the assessment of the physician,
Sergio sustained superficial partial thickness burns on his
trunk, right upper extremities and right lower extremities.
His wife asks what that means? Your most accurate response
would be:
,2
A. Structures beneath the skin are damage
B. Dermis is partially damaged
C. Epidermis and dermis are both damaged
D. Epidermis is damaged
4. During the first 24 hours after the thermal injury, you
should asses Sergio for:
A. hypokalemia and hypernatremia
B. hypokalemia and hyponatremia
C. hyperkalemia and hyponatremia
D. hyperkalemia and hypernatremia
5. Teddy, who sustained deep partial thickness and full
thickness burns of the face, whole anterior chest and both
upper extremities two days ago begins to exhibit extreme
restlessness. You recognize that this most likely indicates
that Teddy is developing:
A. Cerebral hypoxia
B. Hypervolemia
C. metabolic acidosis
D. Renal failure
Situation 2 – You are now working as a staff nurse in a
general hospital. You have to
be prepared to handle situations with ethico-legal and moral
implifications.
6. You are in night duty in surgical ward. One of your
patients Martin is a prisoner who sustained an abdominal
gunshot wound. He is being guarded by policeman from the
, 3
local police unit. During your rounds you heard a commotion.
You saw the policeman trying to hit Martin. You asked why
he was trying to hit Martin. He denied the matter. Which
among the following activities will you do first?
A. Write an accident report
B. Call security officer and report the incident
C. Call your nurse supervisor and report the incident
D. Call the physician on duty
7. You are on morning duty in the medical ward. You have 10
patients assigned to you. During your endorsement rounds,
you found out that one of your patients was not in bed. The
patient next to him informed you that he went home without
notifying the nurses. Which among the following will you
do first?
A. Make an incident report
B. Call security to report the incident
C. Wait for 2 hours before reporting
D. Report the incident to your supervisor
8. You are on duty in the medical ward. You were asked to
check the narcotics cabinet.
You found out that what is on record does not tally with the
drugs used. Which among the following will you do first?
A. Write an incident report and refer the matter to the
nursing director
B. Keep your findings to yourself
C. Report the matter to your supervisor
D. Find out from the endorsement any patient who might
have been given narcotics
