Galen NUR280 Exam 3 - 2026/2027 Comprehensive
Review | Transition to RN Practice | Complete Guide
with Verified Answers | 100% Correct
PHASE 1: HIGH-STAKES EXAM SIMULATION (100 Integrative Questions)
Section A: The Multi-Patient Load (Questions 1-30)
Patient Matrix 0730 Shift Report (use for Q1-30)
Room 418: Mr. Castillo, 66, post-MI day 2, stent to LAD, on heparin 14 units/kg/h, aPTT
54 sec, tele NSR 82, BP 118/76, denies chest pain, anxious about “another blockage.”
Room 419: Ms. Green, 29, newly diagnosed T1DM, DKA resolved, insulin drip 3 units/h,
glucose 140, K 3.2, pH 7.34, ready for transfer to med-surg but needs education.
Room 420: Mr. Huff, 77, COPD + CHF (EF 30%), admitted for dyspnea, on BiPAP, FiO2
0.5, PaO2 62, PaCO2 58, pH 7.32, crackles bilaterally, 3+ edema, lasix 40 mg IV q12h last
given 0600.
Room 421: Ms. Dover, 54, acute cholecystitis, Lap-chole yesterday, morphine PCA 1 mg
q10min, O2 sat 94% RA, RR 18, reports 6/10 pain, has not voided since surgery 14 h ago,
800 mL NS running at 125 mL/h.
[Q1] Multi-patient/SATA. Which patients require immediate RN assessment at 0730?
(Select all)
A) Castillo
,B) Green
C) Huff
D) Dover
[Q2] Multi-patient/MC. The charge nurse asks which patient should be assigned to the
float RN who arrives at 0800 and has no cardiac experience. Your best response:
A) Assign Castillo because he is stable
B) Assign Green because DKA is resolved
C) Assign Huff because COPD is straightforward
D) Assign Dover because post-op care is routine
[Q3] Multi-patient/SATA. Which tasks can be delegated to AP at 0730? (Select all)
A) Obtain daily weight on Huff
B) Check Castillo’s groin site
C) Fingerstick glucose on Green
D) Bladder scan on Dover
E) Listen to breath sounds on Huff
[Q4] Multi-patient/MC. At 0745 Castillo reports chest pain 4/10. ST unchanged. BP
130/80. Which action do you take first?
A) Give SL nitroglycerin 0.4 mg
B) Call the cardiologist
,C) Obtain 12-lead ECG within 10 min
D) Increase heparin drip
[Q5] Multi-patient/Ordered Response. Rank these interventions for Huff (1 = first, 4 =
last).
A) Increase Lasix to 80 mg IV
B) Obtain ABG in 30 min
C) Elevate HOB to 45°
D) Change to 100% FiO2 via non-rebreather
[Q6] Multi-patient/SATA. Which findings indicate Green is ready for med-surg transfer?
(Select all)
A) pH 7.34
B) Glucose 140
C) K 3.2
D) Able to verbalize hypoglycemia S/S
E) Receiving <2 units/h insulin
[Q7] Multi-patient/MC. Dover has not voided 14 h post-op. Bladder scan shows 650 mL.
Which action first?
A) Insert Foley straight cath once
B) Encourage ambulation to bathroom
, C) Increase IV rate to 200 mL/h
D) Notify surgeon for possible retention
[Q8] Multi-patient/SATA. At 0830 Huff removes BiPAP mask and says “I can’t breathe.”
SpO2 70%. Which actions are urgent? (Select all)
A) Reapply mask and coach breathing
B) Increase FiO2 to 1.0
C) Call respiratory for intubation cart
D) Obtain STAT ABG
E) Give morphine 2 mg IV
[Q9] Multi-patient/MC. Green asks why her potassium is low. Your best response:
A) “Insulin shifts potassium into cells.”
B) “You lost it through vomiting.”
C) “Your kidneys are failing.”
D) “It’s a side effect of saline.”
[Q10] Multi-patient/SATA. Which data indicate Castillo may be experiencing stent
re-occlusion? (Select all)
A) Elevated troponin I
B) New ST elevations in anterior leads
C) BP drop to 90/60
Review | Transition to RN Practice | Complete Guide
with Verified Answers | 100% Correct
PHASE 1: HIGH-STAKES EXAM SIMULATION (100 Integrative Questions)
Section A: The Multi-Patient Load (Questions 1-30)
Patient Matrix 0730 Shift Report (use for Q1-30)
Room 418: Mr. Castillo, 66, post-MI day 2, stent to LAD, on heparin 14 units/kg/h, aPTT
54 sec, tele NSR 82, BP 118/76, denies chest pain, anxious about “another blockage.”
Room 419: Ms. Green, 29, newly diagnosed T1DM, DKA resolved, insulin drip 3 units/h,
glucose 140, K 3.2, pH 7.34, ready for transfer to med-surg but needs education.
Room 420: Mr. Huff, 77, COPD + CHF (EF 30%), admitted for dyspnea, on BiPAP, FiO2
0.5, PaO2 62, PaCO2 58, pH 7.32, crackles bilaterally, 3+ edema, lasix 40 mg IV q12h last
given 0600.
Room 421: Ms. Dover, 54, acute cholecystitis, Lap-chole yesterday, morphine PCA 1 mg
q10min, O2 sat 94% RA, RR 18, reports 6/10 pain, has not voided since surgery 14 h ago,
800 mL NS running at 125 mL/h.
[Q1] Multi-patient/SATA. Which patients require immediate RN assessment at 0730?
(Select all)
A) Castillo
,B) Green
C) Huff
D) Dover
[Q2] Multi-patient/MC. The charge nurse asks which patient should be assigned to the
float RN who arrives at 0800 and has no cardiac experience. Your best response:
A) Assign Castillo because he is stable
B) Assign Green because DKA is resolved
C) Assign Huff because COPD is straightforward
D) Assign Dover because post-op care is routine
[Q3] Multi-patient/SATA. Which tasks can be delegated to AP at 0730? (Select all)
A) Obtain daily weight on Huff
B) Check Castillo’s groin site
C) Fingerstick glucose on Green
D) Bladder scan on Dover
E) Listen to breath sounds on Huff
[Q4] Multi-patient/MC. At 0745 Castillo reports chest pain 4/10. ST unchanged. BP
130/80. Which action do you take first?
A) Give SL nitroglycerin 0.4 mg
B) Call the cardiologist
,C) Obtain 12-lead ECG within 10 min
D) Increase heparin drip
[Q5] Multi-patient/Ordered Response. Rank these interventions for Huff (1 = first, 4 =
last).
A) Increase Lasix to 80 mg IV
B) Obtain ABG in 30 min
C) Elevate HOB to 45°
D) Change to 100% FiO2 via non-rebreather
[Q6] Multi-patient/SATA. Which findings indicate Green is ready for med-surg transfer?
(Select all)
A) pH 7.34
B) Glucose 140
C) K 3.2
D) Able to verbalize hypoglycemia S/S
E) Receiving <2 units/h insulin
[Q7] Multi-patient/MC. Dover has not voided 14 h post-op. Bladder scan shows 650 mL.
Which action first?
A) Insert Foley straight cath once
B) Encourage ambulation to bathroom
, C) Increase IV rate to 200 mL/h
D) Notify surgeon for possible retention
[Q8] Multi-patient/SATA. At 0830 Huff removes BiPAP mask and says “I can’t breathe.”
SpO2 70%. Which actions are urgent? (Select all)
A) Reapply mask and coach breathing
B) Increase FiO2 to 1.0
C) Call respiratory for intubation cart
D) Obtain STAT ABG
E) Give morphine 2 mg IV
[Q9] Multi-patient/MC. Green asks why her potassium is low. Your best response:
A) “Insulin shifts potassium into cells.”
B) “You lost it through vomiting.”
C) “Your kidneys are failing.”
D) “It’s a side effect of saline.”
[Q10] Multi-patient/SATA. Which data indicate Castillo may be experiencing stent
re-occlusion? (Select all)
A) Elevated troponin I
B) New ST elevations in anterior leads
C) BP drop to 90/60
