5 Nursing Practice Questions with Rationales
PNLE-Style Questions in Medical-Surgical, CHN, Psychiatric & Maternal Nursing
Preparing for the Philippine Nurse Licensure Examination (PNLE) requires consistent practice and a strong understanding of fundamental nursing concepts.
One effective way to prepare for the nursing board examination is by answering nursing practice questions with rationales. Instead of simply memorizing the correct answer, nurses should understand the principle behind each question and learn how to eliminate incorrect choices.
This nursing reviewer features 5 practice questions covering important topics such as alcohol withdrawal assessment, hypothyroidism, Community Organizing Participatory Action Research (COPAR), obsessive-compulsive disorder (OCD), and pregnancy.
Try to answer each question before checking the correct answer. Afterward, read the rationale and identify the nursing concept being tested.
1. Alcohol Detoxification: Priority Assessment
Situation: A client who is dependent on alcohol is admitted to a detoxification unit. The nurse needs to obtain important information immediately to help assess the client's current condition and risk during withdrawal.
Which of the following questions is essential for the nurse to ask the patient immediately?
A. How does her husband react to her problem?
B. When did she have her last drink?
C. How old was she when she began to drink?
D. What did she eat during the past four hours?
✅ Correct Answer: B. When did she have her last drink?
Determining the time of the patient's last alcoholic drink is an important part of assessing a client admitted for alcohol detoxification. The timing helps the nurse determine how long the patient has been without alcohol and assess the potential stage and severity of withdrawal.
Alcohol withdrawal may produce symptoms ranging from anxiety, tremors, sweating, nausea, and insomnia to severe complications such as seizures and delirium tremens.
Knowing when the patient last consumed alcohol therefore provides important information for ongoing assessment and monitoring.
📝 PNLE Tip: For substance-withdrawal questions, pay close attention to the time of the last substance use, current symptoms, and risk for withdrawal complications.
2. Hypothyroidism: Medication
Situation: Zeny is admitted to the medical ward because of tiredness, cold intolerance, constipation, and weight gain. After examination, the physician diagnoses her with hypothyroidism.
Which medication should the nurse anticipate administering?
A. Levothyroxine
B. Lidocaine
C. Lipitor
D. Levophed
✅ Correct Answer: A. Levothyroxine
Levothyroxine is a synthetic form of thyroxine (T4) and is commonly used as thyroid hormone replacement therapy for patients with hypothyroidism.
The symptoms in the situation—including fatigue, cold intolerance, constipation, and weight gain—are characteristic of decreased thyroid hormone activity.
Levothyroxine replaces the thyroid hormone that the body is unable to produce adequately.
Why are the other choices incorrect?
- Lidocaine – primarily used as a local anesthetic and in certain cardiac arrhythmias.
- Lipitor (atorvastatin) – used primarily to lower cholesterol and reduce cardiovascular risk.
- Levophed (norepinephrine) – a vasopressor used to support blood pressure in certain critically ill patients.
📝 PNLE Tip: Remember: Hypothyroidism → thyroid hormone replacement → Levothyroxine.
3. Community Health Nursing: COPAR
Situation: Community Organizing Participatory Action Research (COPAR) is used in implementing Primary Health Care in depressed and underserved communities with the goal of helping communities become self-reliant.
Jonathan, a community health nurse, immerses himself by living in the community and assists community members in identifying their problems.
In which phase of COPAR does this activity occur?
A. Process Phase
B. Entry Phase
C. Diagnostic Phase
D. Community Building Phase
✅ Correct Answer: B. Entry Phase
The Entry Phase involves the nurse or community organizer entering and becoming familiar with the community. Immersion allows the organizer to establish relationships, understand the community's situation, and begin identifying community concerns.
The nurse works with community members rather than simply imposing solutions from outside the community.
This process is important in building trust and encouraging community participation.
📝 PNLE Tip: For COPAR questions, remember that community immersion and initial relationship-building are associated with the Entry Phase.
4. Psychiatric Nursing: Obsessive-Compulsive Disorder
Situation: Jim, age 25, recalls that his problem began around age 15 or 16. He repeatedly counts pencils in a mug because he believes that stopping the behavior could result in something bad happening.
All of the following are therapeutic interventions EXCEPT:
A. Impose limits every time the behavior becomes repetitive
B. Establish a routine for him
C. Assign a task that can be done repetitively
D. Facilitate self-expression
⚠️ Correct Answer: C. Assign a task that can be done repetitively
The behavior described in the situation is consistent with an obsessive-compulsive pattern, in which repetitive behaviors or rituals are performed to reduce anxiety associated with intrusive thoughts or fears.
A therapeutic approach should avoid reinforcing compulsive rituals. Assigning another task that can be performed repetitively may reinforce the patient's repetitive behavior rather than helping the patient develop healthier coping mechanisms.
Establishing a predictable routine and facilitating appropriate self-expression may help decrease anxiety and provide structure.
📝 PNLE Tip: In psychiatric nursing questions, identify whether an intervention reduces anxiety and promotes adaptive coping or unintentionally reinforces maladaptive behavior.
5. Maternal Nursing: Fatigue During Pregnancy
Situation: Nette, a nurse, palpates the abdomen of Mrs. Medina, a primigravida. Mrs. Medina is unsure of the date of her last menstrual period. Leopold's maneuver is performed, and the obstetrician estimates that she is approximately 20 weeks pregnant.
During her pregnancy, she experiences fatigue and drowsiness.
This probably occurs because:
A. Of high blood pressure
B. She is experiencing pressure
C. The fetus utilizes her glucose stores and leaves her with low blood glucose
D. Of the rapid growth of the fetus
✅ Correct Answer: D. Of the rapid growth of the fetus
During pregnancy, maternal fatigue can be influenced by the physical and metabolic demands associated with pregnancy. The developing fetus grows rapidly and the mother's body undergoes substantial physiologic changes to support fetal development.
At around the second trimester, changes in maternal metabolism, circulation, and the increasing demands of pregnancy can contribute to feelings of tiredness.
The source identifies the rapid growth of the fetus as the best answer for this question.
📝 PNLE Tip: When answering pregnancy questions, consider the normal physiologic changes occurring in the mother's body as the fetus develops.
📋 Nursing Practice Questions Answer Key
| Question | Answer | Topic |
|---|---|---|
| 1 | B | Alcohol Detoxification |
| 2 | A | Hypothyroidism |
| 3 | B | COPAR |
| 4 | C | Psychiatric Nursing |
| 5 | D | Maternal Nursing |
🎯 Quick Nursing Review
- Alcohol Detoxification: Determine when the patient had the last alcoholic drink when assessing withdrawal risk.
- Hypothyroidism: Levothyroxine is used as thyroid hormone replacement.
- COPAR: Community immersion and initial community involvement are associated with the Entry Phase.
- OCD: Avoid interventions that reinforce compulsive or repetitive rituals.
- Pregnancy: Physiologic and metabolic demands of pregnancy can contribute to maternal fatigue.
How to Improve Your Nursing Board Exam Preparation
Answering practice questions is only one part of effective nursing board exam preparation. To maximize the value of every question, focus on the rationale behind the correct answer.
- Understand the concept. Don't memorize only the answer letter.
- Look for keywords. Words such as priority, first, immediately, best, except, and most appropriate can determine the correct approach.
- Eliminate incorrect choices. Identify answers that do not address the patient's immediate problem.
- Review your mistakes. Wrong answers can show you which topics require additional study.
- Practice consistently. Regular practice can help improve your familiarity with board-style questions.
🩺 Prepare for the PNLE with SLRC
Looking for more PNLE practice questions, nursing rationales, and nursing review resources?
St. Louis Review Center (SLRC) provides nursing review resources designed to help aspiring nurses strengthen their nursing knowledge and test-taking strategies.
TAKE THE FREE ONLINE NURSING REVIEWERSLRC — Board Exams Made Easy.
📌 Related Nursing Review Topics
PNLE practice questions, nursing practice questions with rationales, nursing board exam reviewer, NLE reviewer, alcohol withdrawal nursing questions, hypothyroidism nursing questions, levothyroxine, COPAR nursing questions, community health nursing reviewer, psychiatric nursing questions, obsessive-compulsive disorder nursing care, maternal nursing questions, pregnancy nursing reviewer, and Philippine Nurse Licensure Examination reviewer.
Disclaimer: This article is provided for educational and nursing review purposes only. The questions and explanations are intended to support learning and examination preparation. They are not a substitute for formal nursing education, clinical training, current evidence-based references, official examination materials, or professional medical advice. Always consult current authoritative nursing references and applicable guidelines when preparing for the Philippine Nurse Licensure Examination.