NUR 283 Comprehensive Nursing Actual Exam
Questions and Answers with Rationales 2026/2027
|Priority Setting, Pharmacology, Acid-Base Balance, And
Clinical Judgment
1. The nurse working in the ED has received the following prescriptions for a
newly admitted client. Which prescription should the nurse implement FIRST?
*Initiate IV sodium and potassium for a client admitted with diarrhea and
dehydration who has a serum potassium level of 2.9 mEq/L.*
A) Initiate IV sodium
B) Initiate IV potassium
C) Administer oral potassium
D) Recheck potassium level in 4 hours
Correct Answer: B) Initiate IV potassium
Rationale: A serum potassium of 2.9 mEq/L indicates severe hypokalemia, which
is life-threatening due to cardiac dysrhythmias. Potassium replacement is the
priority.
2. A nurse is caring for a male client who has deep partial-thickness and
full-thickness burns to 45% of the lower body. It would be a PRIORITY for the
nurse to notify the provider if the client has:
A) A urine output of 45 mL over the past two hours
B) Pain rated 6 on a 0-10 scale
C) Heart rate of 110 bpm
D) Temperature of 37.8°C (100.0°F)
Correct Answer: A) Urine output of 45 mL in 2 hours
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,Rationale: In a major burn, adequate urine output should be at least 0.5
mL/kg/hour. 45 mL over 2 hours (22.5 mL/hour) is insufficient and suggests
hypovolemia or acute kidney injury.
3. The nurse is assessing clients at the scene of a mass casualty disaster and is
prioritizing care based on the disaster triage tag system. Which client should be
transported to the health care facility FIRST?
A) Client with multiple compound fractures reporting pain
B) Client with a minor laceration to the arm
C) Client who is ambulatory with minor abrasions
D) Client with a small superficial burn to the hand
Correct Answer: A) Client with multiple compound fractures reporting pain
Rationale: In disaster triage, a client with multiple compound fractures is
classified as “immediate” (red tag) because injuries are life-threatening but
survivable with prompt intervention.
4. The charge nurse in the ED is reviewing the care provided for recently admitted
clients. Which reflects implementation of an accepted standard of care?
A) Placing a client with suspected Haemophilus influenzae on droplet precautions
B) Administering oral fluids to a client with severe pancreatitis
C) Using contact precautions for a client with C. diff
D) Placing a client with a simple fracture in a private room
Correct Answer: A) Placing a client with suspected Haemophilus influenzae on
droplet precautions
Rationale: Haemophilus influenzae can cause meningitis, epiglottitis, and
pneumonia; droplet precautions are indicated to prevent transmission.
5. The nurse is working on a crisis hotline speaking with a client who states, “I just
took an entire bottle of amitriptyline.” Which response should the nurse INITIALLY
make?
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,A) “Why did you take that medication?”
B) “I’m glad you called, and I want to send an ambulance to help you.”
C) “Try to make yourself vomit right now.”
D) “Call me back in an hour if you still feel ill.”
Correct Answer: B) “I’m glad you called, and I want to send an ambulance to help
you.”
Rationale: A tricyclic antidepressant overdose is a medical emergency. The
priority is to ensure the client receives immediate emergency care.
6. The nurse is monitoring a client following a thoracentesis. It would be a priority
for the nurse to notify the primary health care provider if the client develops:
A) Heart rate that has increased from 95 to 110 bpm
B) Mild pain at the puncture site
C) Small amount of serous drainage on dressing
D) Respiratory rate of 18 breaths per minute
Correct Answer: A) Heart rate increased from 95 to 110 bpm
Rationale: Tachycardia after thoracentesis may indicate hypovolemia,
pneumothorax, or bleeding, requiring immediate evaluation.
7. A nurse is caring for a client receiving chemotherapy. The client is not eating
well but denies any nausea or vomiting. Which of the following would be best for
the nurse to suggest?
A) Green beans and cottage cheese
B) Chicken and cottage cheese
C) Ice cream and soda
D) Fried chicken and french fries
Correct Answer: B) Chicken and cottage cheese
Rationale: Chemotherapy patients need high-protein, nutrient-dense foods.
Chicken provides lean protein, and cottage cheese adds protein and calcium
without being heavy.
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, 8. Which medication should be given for a patient in ventricular tachycardia
(VTach) as seen on the rhythm strip?
A) Amiodarone
B) Adenosine
C) Atropine
D) Epinephrine
Correct Answer: A) Amiodarone
Rationale: Amiodarone is a first-line antiarrhythmic for stable ventricular
tachycardia.
9. The nurse is talking with a patient who has multiple sclerosis (MS). Which
statement would need follow-up by the nurse?
A) “I take hot showers every morning to relax my muscles.”
B) “I try to stay cool and avoid overheating.”
C) “I rest frequently during the day.”
D) “I perform range-of-motion exercises daily.”
Correct Answer: A) “I take hot showers every morning to relax my muscles.”
Rationale: Heat exposure can exacerbate MS symptoms (Uhthoff phenomenon).
Hot showers may worsen fatigue, weakness, and visual disturbances.
10. A patient had a colostomy created 6 hours ago. The stoma appears dark red,
dry, flaccid, with a small amount of mucous drainage in the bag. What is the first
priority?
A) Irrigate the stoma
B) Apply a new ostomy bag
C) Call the provider
D) Document the findings as normal
Correct Answer: C) Call the provider
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Questions and Answers with Rationales 2026/2027
|Priority Setting, Pharmacology, Acid-Base Balance, And
Clinical Judgment
1. The nurse working in the ED has received the following prescriptions for a
newly admitted client. Which prescription should the nurse implement FIRST?
*Initiate IV sodium and potassium for a client admitted with diarrhea and
dehydration who has a serum potassium level of 2.9 mEq/L.*
A) Initiate IV sodium
B) Initiate IV potassium
C) Administer oral potassium
D) Recheck potassium level in 4 hours
Correct Answer: B) Initiate IV potassium
Rationale: A serum potassium of 2.9 mEq/L indicates severe hypokalemia, which
is life-threatening due to cardiac dysrhythmias. Potassium replacement is the
priority.
2. A nurse is caring for a male client who has deep partial-thickness and
full-thickness burns to 45% of the lower body. It would be a PRIORITY for the
nurse to notify the provider if the client has:
A) A urine output of 45 mL over the past two hours
B) Pain rated 6 on a 0-10 scale
C) Heart rate of 110 bpm
D) Temperature of 37.8°C (100.0°F)
Correct Answer: A) Urine output of 45 mL in 2 hours
1|Page
,Rationale: In a major burn, adequate urine output should be at least 0.5
mL/kg/hour. 45 mL over 2 hours (22.5 mL/hour) is insufficient and suggests
hypovolemia or acute kidney injury.
3. The nurse is assessing clients at the scene of a mass casualty disaster and is
prioritizing care based on the disaster triage tag system. Which client should be
transported to the health care facility FIRST?
A) Client with multiple compound fractures reporting pain
B) Client with a minor laceration to the arm
C) Client who is ambulatory with minor abrasions
D) Client with a small superficial burn to the hand
Correct Answer: A) Client with multiple compound fractures reporting pain
Rationale: In disaster triage, a client with multiple compound fractures is
classified as “immediate” (red tag) because injuries are life-threatening but
survivable with prompt intervention.
4. The charge nurse in the ED is reviewing the care provided for recently admitted
clients. Which reflects implementation of an accepted standard of care?
A) Placing a client with suspected Haemophilus influenzae on droplet precautions
B) Administering oral fluids to a client with severe pancreatitis
C) Using contact precautions for a client with C. diff
D) Placing a client with a simple fracture in a private room
Correct Answer: A) Placing a client with suspected Haemophilus influenzae on
droplet precautions
Rationale: Haemophilus influenzae can cause meningitis, epiglottitis, and
pneumonia; droplet precautions are indicated to prevent transmission.
5. The nurse is working on a crisis hotline speaking with a client who states, “I just
took an entire bottle of amitriptyline.” Which response should the nurse INITIALLY
make?
2|Page
,A) “Why did you take that medication?”
B) “I’m glad you called, and I want to send an ambulance to help you.”
C) “Try to make yourself vomit right now.”
D) “Call me back in an hour if you still feel ill.”
Correct Answer: B) “I’m glad you called, and I want to send an ambulance to help
you.”
Rationale: A tricyclic antidepressant overdose is a medical emergency. The
priority is to ensure the client receives immediate emergency care.
6. The nurse is monitoring a client following a thoracentesis. It would be a priority
for the nurse to notify the primary health care provider if the client develops:
A) Heart rate that has increased from 95 to 110 bpm
B) Mild pain at the puncture site
C) Small amount of serous drainage on dressing
D) Respiratory rate of 18 breaths per minute
Correct Answer: A) Heart rate increased from 95 to 110 bpm
Rationale: Tachycardia after thoracentesis may indicate hypovolemia,
pneumothorax, or bleeding, requiring immediate evaluation.
7. A nurse is caring for a client receiving chemotherapy. The client is not eating
well but denies any nausea or vomiting. Which of the following would be best for
the nurse to suggest?
A) Green beans and cottage cheese
B) Chicken and cottage cheese
C) Ice cream and soda
D) Fried chicken and french fries
Correct Answer: B) Chicken and cottage cheese
Rationale: Chemotherapy patients need high-protein, nutrient-dense foods.
Chicken provides lean protein, and cottage cheese adds protein and calcium
without being heavy.
3|Page
, 8. Which medication should be given for a patient in ventricular tachycardia
(VTach) as seen on the rhythm strip?
A) Amiodarone
B) Adenosine
C) Atropine
D) Epinephrine
Correct Answer: A) Amiodarone
Rationale: Amiodarone is a first-line antiarrhythmic for stable ventricular
tachycardia.
9. The nurse is talking with a patient who has multiple sclerosis (MS). Which
statement would need follow-up by the nurse?
A) “I take hot showers every morning to relax my muscles.”
B) “I try to stay cool and avoid overheating.”
C) “I rest frequently during the day.”
D) “I perform range-of-motion exercises daily.”
Correct Answer: A) “I take hot showers every morning to relax my muscles.”
Rationale: Heat exposure can exacerbate MS symptoms (Uhthoff phenomenon).
Hot showers may worsen fatigue, weakness, and visual disturbances.
10. A patient had a colostomy created 6 hours ago. The stoma appears dark red,
dry, flaccid, with a small amount of mucous drainage in the bag. What is the first
priority?
A) Irrigate the stoma
B) Apply a new ostomy bag
C) Call the provider
D) Document the findings as normal
Correct Answer: C) Call the provider
4|Page
