NUR283 Transition to RN ALL
COMPREHENSIVE EXAMS REVIEW - Galen
College 2026/2027 | RN Role Integration &
Competency Assessment
DOMAIN 1 – Safe & Effective Care Environment: MANAGEMENT OF CARE (50 Q)
Q1. (Prioritization) The charge nurse receives these four reports. Which client requires
immediate assessment?
A. Post-op day 1 abdominal surgery, pain 6/10, denies SOB.
B. CHF admission, RR 32, O₂ sat 92 % on 2 L NC, fine crackles ↑.
C. NPO pancreatitis, nausea 4/10, bowel sounds present.
D. Hip replacement POD 1, PCA in use, VS stable.
Verified Answer: B
Solution: ABC framework → Breathing/circulation issue (tachypnea, desaturation, fluid
overload) is an acute threat. Others are expected discomforts.
Q2. (SATA) The nurse plans to delegate tasks to an experienced UAP. Which tasks are
appropriate? (Select All)
A. Reinforce low-Na diet teaching.
,B. Obtain VS on stable pneumonia client.
C. Assess pain 30 min after IV analgesia.
D. Document I&O for HF client.
E. Assist first ambulation post-major surgery.
Verified Answers: B, D
Rationale: UAPs perform routine, non-invasive care; teaching, assessment, first
ambulation require RN clinical judgment.
Q3. (Ethics) An alert 17-year-old primigravida refuses cesarean for fetal distress. The
nurse’s best action is:
A. Obtain a court order.
B. Notify risk management & document.
C. Restrain the adolescent for surgery.
D. Have parents sign consent.
Verified Answer: B
Rationale: Minors who are pregnant are emancipated for consent in all states;
autonomy prevails unless imminent maternal death → follow agency policy & legal
consultation.
Q4. (Delegation) Which client must remain on an RN assignment?
A. 2-day post-MI awaiting discharge teaching.
B. Newly diagnosed DM learning SQ insulin.
,C. 2-h post-thyroidectomy with Jackson-Pratt.
D. All of the above.
Verified Answer: D
Rationale: All require teaching, ongoing assessment, possible complications → cannot
delegate to LPN/UAP.
Q5. (Legal) During bedside hand-off, the nurse accidentally discloses a client’s HIV
status to a visitor. The priority nursing action is:
A. Complete incident report.
B. Apologize to client & assess harm.
C. Notify infection-control nurse.
D. Document visitor’s name.
Verified Answer: B
Rationale: Client-centered care & HIPAA breach → immediate remedy & rapport precede
administrative tasks.
Q6. (Leadership) The unit is over capacity. Which action best demonstrates servant
leadership?
A. Cancel staff breaks.
B. Assign float nurse to unfamiliar ICU.
C. Leader takes 4-client assignment.
D. Discharge clients early.
, Verified Answer: C
Rationale: Servant leaders model workload & support staff; maintains safety & morale.
Q7. (Prioritization – OR) Place these interventions in order for a code blue on med-surg
unit:
1. Start chest compressions
2. Call for help & crash cart
3. Assess responsiveness
4. Open airway
Verified Order: 3 → 2 → 4 → 1
Rationale: AHA BLS sequence; assess → call → airway → compressions.
Q8. (SATA) The nurse receives a new admission with hyperglycemic hyperosmolar state
(HHS). Which orders are priority?
A. 0.9 % NS 1 L bolus
B. Regular insulin 0.1 unit/kg/h
C. Stat basic metabolic panel
D. Dextrose 5 % when glucose 250 mg/dL
E. Intubation for airway protection
Verified Answers: A, B, C
Rationale: HHS needs fluids, insulin, labs; dextrose added later (not yet), intubation only
if altered airway.
Q9. (Informed consent) A cognitively intact 88-year-old client speaks only Spanish. The
son (English) insists on signing consent. The nurse should:
A. Allow son to interpret & sign.
COMPREHENSIVE EXAMS REVIEW - Galen
College 2026/2027 | RN Role Integration &
Competency Assessment
DOMAIN 1 – Safe & Effective Care Environment: MANAGEMENT OF CARE (50 Q)
Q1. (Prioritization) The charge nurse receives these four reports. Which client requires
immediate assessment?
A. Post-op day 1 abdominal surgery, pain 6/10, denies SOB.
B. CHF admission, RR 32, O₂ sat 92 % on 2 L NC, fine crackles ↑.
C. NPO pancreatitis, nausea 4/10, bowel sounds present.
D. Hip replacement POD 1, PCA in use, VS stable.
Verified Answer: B
Solution: ABC framework → Breathing/circulation issue (tachypnea, desaturation, fluid
overload) is an acute threat. Others are expected discomforts.
Q2. (SATA) The nurse plans to delegate tasks to an experienced UAP. Which tasks are
appropriate? (Select All)
A. Reinforce low-Na diet teaching.
,B. Obtain VS on stable pneumonia client.
C. Assess pain 30 min after IV analgesia.
D. Document I&O for HF client.
E. Assist first ambulation post-major surgery.
Verified Answers: B, D
Rationale: UAPs perform routine, non-invasive care; teaching, assessment, first
ambulation require RN clinical judgment.
Q3. (Ethics) An alert 17-year-old primigravida refuses cesarean for fetal distress. The
nurse’s best action is:
A. Obtain a court order.
B. Notify risk management & document.
C. Restrain the adolescent for surgery.
D. Have parents sign consent.
Verified Answer: B
Rationale: Minors who are pregnant are emancipated for consent in all states;
autonomy prevails unless imminent maternal death → follow agency policy & legal
consultation.
Q4. (Delegation) Which client must remain on an RN assignment?
A. 2-day post-MI awaiting discharge teaching.
B. Newly diagnosed DM learning SQ insulin.
,C. 2-h post-thyroidectomy with Jackson-Pratt.
D. All of the above.
Verified Answer: D
Rationale: All require teaching, ongoing assessment, possible complications → cannot
delegate to LPN/UAP.
Q5. (Legal) During bedside hand-off, the nurse accidentally discloses a client’s HIV
status to a visitor. The priority nursing action is:
A. Complete incident report.
B. Apologize to client & assess harm.
C. Notify infection-control nurse.
D. Document visitor’s name.
Verified Answer: B
Rationale: Client-centered care & HIPAA breach → immediate remedy & rapport precede
administrative tasks.
Q6. (Leadership) The unit is over capacity. Which action best demonstrates servant
leadership?
A. Cancel staff breaks.
B. Assign float nurse to unfamiliar ICU.
C. Leader takes 4-client assignment.
D. Discharge clients early.
, Verified Answer: C
Rationale: Servant leaders model workload & support staff; maintains safety & morale.
Q7. (Prioritization – OR) Place these interventions in order for a code blue on med-surg
unit:
1. Start chest compressions
2. Call for help & crash cart
3. Assess responsiveness
4. Open airway
Verified Order: 3 → 2 → 4 → 1
Rationale: AHA BLS sequence; assess → call → airway → compressions.
Q8. (SATA) The nurse receives a new admission with hyperglycemic hyperosmolar state
(HHS). Which orders are priority?
A. 0.9 % NS 1 L bolus
B. Regular insulin 0.1 unit/kg/h
C. Stat basic metabolic panel
D. Dextrose 5 % when glucose 250 mg/dL
E. Intubation for airway protection
Verified Answers: A, B, C
Rationale: HHS needs fluids, insulin, labs; dextrose added later (not yet), intubation only
if altered airway.
Q9. (Informed consent) A cognitively intact 88-year-old client speaks only Spanish. The
son (English) insists on signing consent. The nurse should:
A. Allow son to interpret & sign.
