Galen NUR280 - 2026/2027 Comprehensive Exam
Review | Transition to RN Practice | Complete Guide
with Verified Answers | 100% Correct
MODULE 1: CURRICULUM-WIDE CONSOLIDATED REVIEW
A. Galen Priority Action Framework (2026/2027)
Step 1 – Airway: Is it patent? Any obstruction → immediate action (suction, airway
adjunct, intubation).
Step 2 – Breathing: Rate, depth, SpO₂ < 90 % → high-flow O₂, assist ventilation, ABG.
Step 3 – Circulation: HR, BP, pulse presence, bleeding → control hemorrhage, 2
large-bore IVs, IVF, blood.
Step 4 – Disability: GCS < 15 → blood glucose, naloxone, neurologic checks.
Step 5 – Exposure: Head-to-toe, environmental threats, maintain normothermia.
Step 6 – Systemic vs Local: Life-threatening systemic issues (sepsis, MI, CVA) before
localized (fracture).
Step 7 – Acute vs Chronic: Acute always wins (new chest pain vs chronic arthritis).
Step 8 – Unstable vs Stable: Unstable (vital-sign change) takes precedence.
B. Mega-Medication Grid (2026/2027) – 25 High-Yield Classes
, 1. ACE-I (-pril): HTN, HF, DM nephropathy; SE: cough, hyper-K, angioedema; NC:
monitor K, Cr, orthostatic BP; Teach: rise slowly, avoid salt substitutes.
2. ARBs (-sartan): similar, no cough; SE: dizziness.
3. Beta-blockers (-olol): angina, post-MI, HF; SE: bradycardia, fatigue; NC: hold if HR
< 50 or SBP < 90; teach: no abrupt stop.
4. Calcium-channel blockers (-dipine): HTN, angina; SE: peripheral edema, flush; NC:
check HR, edema.
5. Diuretics – Loop (furosemide): acute pulmonary edema; SE: hypo-K, ototoxic; NC:
K supplements, daily wt, I&O.
6. Thiazides (HCTZ): SE: hyper-Gly, hyper-Uricemia.
7. K-sparing (spironolactone): SE: gynecomastia, hyper-K; avoid salt sub.
8. Digoxin: HF, a-fib; narrow TI; SE: visual halos, bradycardia; NC: check apical 1 min,
K > 4 (hypo-K potentiates toxicity).
9. Nitroglycerin: angina; SE: headache, hypotension; teach: sit, 5-min intervals max 3
tabs.
10. Anticoagulants – Heparin IV: SE: bleeding, HIT; NC: PTT q6h, neuro checks.
11. Warfarin: SE: bleeding; NC: INR q1-3 d, vitamin K antidote.
12. DOACs: apixaban; no labs; SE: bleeding; andexanet alfa reversal.
13. Antiplatelets – Aspirin: SE: GI bleed; Clopidogrel: SE: TTP rare.
14. Opioids – Morphine: SE: resp depression, constipation; NC: naloxone 0.4 mg
available.
15. Benzodiazepines – Lorazepam: SE: resp depression, fall; NC: taper.
16. Antipsychotics – Haloperidol: SE: EPS, QT prolongation; NC: ECG.
17. SSRIs – Fluoxetine: SE: sexual dysfx, serotonin syndrome; NC: 2-4 wk effect.
18. Insulins – Rapid (aspart): onset 15 min; NC: give 0-15 min before meal; mix
clear→cloudy.
19. Long-acting (glargine): no peak; give same time daily.
20. Corticosteroids – Prednisone: SE: hyper-Gly, mood, infection; NC: taper, give AM.
21. Bronchodilators – Albuterol: SE: tachy, tremor; NC: rinse mouth if steroid combo.
22. Antibiotics – Penicillin: ask allergy; SE: rash; Aminoglycosides: peak/trough,
nephro/oto.
23. PPIs – Omeprazole: SE: C.diff, hypomag; NC: long-term use monitor Mg.
24. Anticonvulsants – Phenytoin: narrow TI, SE: nystagmus, gingival hyperplasia; NC:
check level, give with NS (precipitate with D5W).
25. Chemo – Cisplatin: SE: nephro, oto; NC: pre-hydration, monitor BUN/Cr.
C. Lab Value & Diagnostic Test Compendium (2026/2027 Normal Adults)
CBC: WBC 4-11 k/µL, Hgb F 12-16 M 14-18, Hct F 36-48 % M 42-52 %, Plt 150-400 k.
,CMP: Na 136-145, K 3.5-5.1, Cl 98-107, CO₂ 22-29, BUN 7-20, Cr 0.6-1.2, Glu 70-100, Ca
9-10.5, Mg 1.7-2.2, Phos 2.5-4.5.
ABG: pH 7.35-7.45, PaCO₂ 35-45, HCO₃ 22-26, PaO₂ 80-100, O₂ sat ≥95 %.
Cardiac: Troponin I <0.04 ng/mL, BNP <100 pg/mL.
Coag: aPTT 30-40 s, INR 0.8-1.2.
Pancreas: Lipase 0-160 U/L, Amyl 30-110 U/L.
Inflammation: CRP <1 mg/dL, Procalcitonin <0.05 ng/mL.
Type & cross-match required for transfusion; Rh compat essential.
MRI: no ferrous metal; check pacemaker conditional status 2026.
CT with contrast: Cr <1.5 or eGFR >30 mL/min/1.73 m²; pre-hydrate if borderline.
Endoscopy: NPO 6-8 h; consent risks (perf, bleed).
D. Lifespan & Special Population Highlights
Peds: Weight (kg) × 2 = approximate lb; growth charts WHO <2 yr, CDC ≥2 yr; vaccines at
2, 4, 6 mo (DTaP, IPV, Hib, PCV, RV, HepB).
Maternity: Intrapartum phases – Latent <4 cm, Active 4-7 cm, Transition 8-10 cm; fetal
monitoring category I normal, III abnormal.
Newborn: APGAR 1 & 5 min; eye prophylaxis erythromycin 1 cm ribbon; Vit K 0.5-1 mg
IM.
Geriatrics: Beers criteria 2026 – avoid diphenhydramine, long-acting sulfonylureas; fall
risk score ≥4 → interventions.
, MODULE 2: COMPREHENSIVE EXAM SIMULATION (150 Items)
Multiple-Choice. The RN on a medical floor receives report that an 82-year-old patient’s
morning K⁺ is 2.8 mEq/L. Which action should the RN implement first?
A) Notify the provider immediately
B) Place the patient on continuous cardiac monitoring
C) Obtain a repeat potassium specimen
1. D) Administer oral potassium supplement
SATA. A client is being discharged on warfarin. Which teachings are essential? (Select
all that apply.)
A) Use a soft-bristle toothbrush
B) Eat consistent green leafy vegetables
C) Take aspirin for headaches
D) Wear a medical-alert bracelet
E) Have INR checked as scheduled
2. F) Avoid contact sports
Ordered Response. Arrange steps for donning sterile gloves. (1 = first, 5 = last.)
A) Open outer wrapper
B) Perform hand hygiene
C) Pick up dominant glove by cuff
D) Slide non-dominant hand into glove
3. E) Interlock fingers to adjust
Multiple-Choice. A 5-year-old is admitted with possible sepsis. Which finding is most
concerning?
A) Temp 38.2 °C
B) HR 140
C) Capillary refill 5 seconds
4. D) irritability
Multiple-Choice. The nurse is delegating to an AP. Which task can be assigned?
A) Insert a urinary catheter
B) Measure intake and output
C) Give colostomy teaching
5. D) Assess breath sounds
Review | Transition to RN Practice | Complete Guide
with Verified Answers | 100% Correct
MODULE 1: CURRICULUM-WIDE CONSOLIDATED REVIEW
A. Galen Priority Action Framework (2026/2027)
Step 1 – Airway: Is it patent? Any obstruction → immediate action (suction, airway
adjunct, intubation).
Step 2 – Breathing: Rate, depth, SpO₂ < 90 % → high-flow O₂, assist ventilation, ABG.
Step 3 – Circulation: HR, BP, pulse presence, bleeding → control hemorrhage, 2
large-bore IVs, IVF, blood.
Step 4 – Disability: GCS < 15 → blood glucose, naloxone, neurologic checks.
Step 5 – Exposure: Head-to-toe, environmental threats, maintain normothermia.
Step 6 – Systemic vs Local: Life-threatening systemic issues (sepsis, MI, CVA) before
localized (fracture).
Step 7 – Acute vs Chronic: Acute always wins (new chest pain vs chronic arthritis).
Step 8 – Unstable vs Stable: Unstable (vital-sign change) takes precedence.
B. Mega-Medication Grid (2026/2027) – 25 High-Yield Classes
, 1. ACE-I (-pril): HTN, HF, DM nephropathy; SE: cough, hyper-K, angioedema; NC:
monitor K, Cr, orthostatic BP; Teach: rise slowly, avoid salt substitutes.
2. ARBs (-sartan): similar, no cough; SE: dizziness.
3. Beta-blockers (-olol): angina, post-MI, HF; SE: bradycardia, fatigue; NC: hold if HR
< 50 or SBP < 90; teach: no abrupt stop.
4. Calcium-channel blockers (-dipine): HTN, angina; SE: peripheral edema, flush; NC:
check HR, edema.
5. Diuretics – Loop (furosemide): acute pulmonary edema; SE: hypo-K, ototoxic; NC:
K supplements, daily wt, I&O.
6. Thiazides (HCTZ): SE: hyper-Gly, hyper-Uricemia.
7. K-sparing (spironolactone): SE: gynecomastia, hyper-K; avoid salt sub.
8. Digoxin: HF, a-fib; narrow TI; SE: visual halos, bradycardia; NC: check apical 1 min,
K > 4 (hypo-K potentiates toxicity).
9. Nitroglycerin: angina; SE: headache, hypotension; teach: sit, 5-min intervals max 3
tabs.
10. Anticoagulants – Heparin IV: SE: bleeding, HIT; NC: PTT q6h, neuro checks.
11. Warfarin: SE: bleeding; NC: INR q1-3 d, vitamin K antidote.
12. DOACs: apixaban; no labs; SE: bleeding; andexanet alfa reversal.
13. Antiplatelets – Aspirin: SE: GI bleed; Clopidogrel: SE: TTP rare.
14. Opioids – Morphine: SE: resp depression, constipation; NC: naloxone 0.4 mg
available.
15. Benzodiazepines – Lorazepam: SE: resp depression, fall; NC: taper.
16. Antipsychotics – Haloperidol: SE: EPS, QT prolongation; NC: ECG.
17. SSRIs – Fluoxetine: SE: sexual dysfx, serotonin syndrome; NC: 2-4 wk effect.
18. Insulins – Rapid (aspart): onset 15 min; NC: give 0-15 min before meal; mix
clear→cloudy.
19. Long-acting (glargine): no peak; give same time daily.
20. Corticosteroids – Prednisone: SE: hyper-Gly, mood, infection; NC: taper, give AM.
21. Bronchodilators – Albuterol: SE: tachy, tremor; NC: rinse mouth if steroid combo.
22. Antibiotics – Penicillin: ask allergy; SE: rash; Aminoglycosides: peak/trough,
nephro/oto.
23. PPIs – Omeprazole: SE: C.diff, hypomag; NC: long-term use monitor Mg.
24. Anticonvulsants – Phenytoin: narrow TI, SE: nystagmus, gingival hyperplasia; NC:
check level, give with NS (precipitate with D5W).
25. Chemo – Cisplatin: SE: nephro, oto; NC: pre-hydration, monitor BUN/Cr.
C. Lab Value & Diagnostic Test Compendium (2026/2027 Normal Adults)
CBC: WBC 4-11 k/µL, Hgb F 12-16 M 14-18, Hct F 36-48 % M 42-52 %, Plt 150-400 k.
,CMP: Na 136-145, K 3.5-5.1, Cl 98-107, CO₂ 22-29, BUN 7-20, Cr 0.6-1.2, Glu 70-100, Ca
9-10.5, Mg 1.7-2.2, Phos 2.5-4.5.
ABG: pH 7.35-7.45, PaCO₂ 35-45, HCO₃ 22-26, PaO₂ 80-100, O₂ sat ≥95 %.
Cardiac: Troponin I <0.04 ng/mL, BNP <100 pg/mL.
Coag: aPTT 30-40 s, INR 0.8-1.2.
Pancreas: Lipase 0-160 U/L, Amyl 30-110 U/L.
Inflammation: CRP <1 mg/dL, Procalcitonin <0.05 ng/mL.
Type & cross-match required for transfusion; Rh compat essential.
MRI: no ferrous metal; check pacemaker conditional status 2026.
CT with contrast: Cr <1.5 or eGFR >30 mL/min/1.73 m²; pre-hydrate if borderline.
Endoscopy: NPO 6-8 h; consent risks (perf, bleed).
D. Lifespan & Special Population Highlights
Peds: Weight (kg) × 2 = approximate lb; growth charts WHO <2 yr, CDC ≥2 yr; vaccines at
2, 4, 6 mo (DTaP, IPV, Hib, PCV, RV, HepB).
Maternity: Intrapartum phases – Latent <4 cm, Active 4-7 cm, Transition 8-10 cm; fetal
monitoring category I normal, III abnormal.
Newborn: APGAR 1 & 5 min; eye prophylaxis erythromycin 1 cm ribbon; Vit K 0.5-1 mg
IM.
Geriatrics: Beers criteria 2026 – avoid diphenhydramine, long-acting sulfonylureas; fall
risk score ≥4 → interventions.
, MODULE 2: COMPREHENSIVE EXAM SIMULATION (150 Items)
Multiple-Choice. The RN on a medical floor receives report that an 82-year-old patient’s
morning K⁺ is 2.8 mEq/L. Which action should the RN implement first?
A) Notify the provider immediately
B) Place the patient on continuous cardiac monitoring
C) Obtain a repeat potassium specimen
1. D) Administer oral potassium supplement
SATA. A client is being discharged on warfarin. Which teachings are essential? (Select
all that apply.)
A) Use a soft-bristle toothbrush
B) Eat consistent green leafy vegetables
C) Take aspirin for headaches
D) Wear a medical-alert bracelet
E) Have INR checked as scheduled
2. F) Avoid contact sports
Ordered Response. Arrange steps for donning sterile gloves. (1 = first, 5 = last.)
A) Open outer wrapper
B) Perform hand hygiene
C) Pick up dominant glove by cuff
D) Slide non-dominant hand into glove
3. E) Interlock fingers to adjust
Multiple-Choice. A 5-year-old is admitted with possible sepsis. Which finding is most
concerning?
A) Temp 38.2 °C
B) HR 140
C) Capillary refill 5 seconds
4. D) irritability
Multiple-Choice. The nurse is delegating to an AP. Which task can be assigned?
A) Insert a urinary catheter
B) Measure intake and output
C) Give colostomy teaching
5. D) Assess breath sounds
