NUR 283 Comprehensive Exam Actual Exam
2026/2027: Complete Exam-Style Questions with
Detailed Rationales | 100% Verified | Pass
Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | Medical-Surgical Nursing | Q1 – Q10
Section 2 | Pharmacology and Medication Administration | Q11 – Q20
Section 3 | Mental Health Nursing | Q21 – Q30
Section 4 | Maternity and Pediatric Nursing | Q31 – Q40
Section 5 | Leadership, Delegation, and Prioritization | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
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SECTION 1: MEDICAL-SURGICAL NURSING Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 68-year-old client is admitted to the medical unit with a new diagnosis of heart failure.
During the morning assessment, the nurse notes bilateral crackles in the lung bases, 2+
pitting edema in the lower extremities, and an oxygen saturation of 88% on room air.
The client reports feeling short of breath when walking to the bathroom.
A. Encourage the client to perform ankle pumps every hour while awake
B. Administer the prescribed furosemide and place the client in a high-Fowler position
✓ CORRECT
C. Increase the client's oral fluid intake to 3 liters per day
D. Obtain a stat chest x-ray before initiating any interventions
Correct Answer: B
Rationale: Furosemide will promote diuresis to reduce pulmonary congestion and
peripheral edema, while high-Fowler positioning maximizes lung expansion and
,decreases venous return to the heart. Option A is tempting because ankle pumps are
appropriate for edema, but they will not address the acute respiratory compromise and
hypoxemia this client is experiencing. In practice, nurses often cluster these
interventions together, but diuresis and positioning take priority when saturation drops
below 90%.
Question 2 of 50
A 54-year-old client with a history of type 2 diabetes is postoperative day 2 following a
right total knee replacement. The nurse reviews the morning laboratory results and
notes a blood glucose of 248 mg/dL. The client is currently on a clear liquid diet and
reports incision pain rated 6/10.
A. Hold the client's scheduled insulin until a regular diet is resumed
B. Notify the surgeon immediately to request sliding-scale insulin only
C. Recheck the glucose in four hours before making any medication adjustments
D. Administer the prescribed basal-bolus insulin regimen and reassess pain control ✓
CORRECT
Correct Answer: D
Rationale: Postoperative hyperglycemia is common due to stress and pain, and
maintaining glycemic control with the prescribed basal-bolus regimen supports wound
healing and reduces infection risk. Option A is a common mistake because holding
insulin during illness or stress can lead to dangerous hyperglycemia and poor
outcomes. In the orthopedic population, uncontrolled glucose significantly increases the
risk of prosthetic joint infection.
Question 3 of 50
A 72-year-old client is transferred to the step-down unit after coronary artery bypass
grafting. On arrival, the nurse notes the mediastinal chest tube is draining 150 mL of
,bright red blood in the past hour. The client's blood pressure is 94/58 mmHg, heart rate
is 118 beats/min, and skin is cool and clammy.
A. Prepare the client for potential return to the operating room ✓ CORRECT
B. Milk the chest tube gently to ensure patency and continue to monitor
C. Increase the wall suction to -40 cm H₂O to improve drainage
D. Administer a 500 mL bolus of normal saline and reassess in 30 minutes
Correct Answer: A
Rationale: Drainage exceeding 100–150 mL/hour of bright red blood, combined with
hypotension and tachycardia, indicates active hemorrhage and requires immediate
surgical intervention. Option B is incorrect because milking the tube wastes precious
time when the client is already showing signs of hypovolemic shock. In cardiac
recovery, early recognition of tamponade or hemorrhage often determines survival.
Question 4 of 50
A 45-year-old client with Crohn disease is admitted with a partial small-bowel
obstruction. The nurse inserts a nasogastric tube to low intermittent suction and notes
400 mL of dark green fluid returned in the first two hours. The client reports increasing
abdominal cramping and has not passed flatus in 24 hours.
A. Advance the nasogastric tube an additional 5 cm to improve decompression
B. Clamp the nasogastric tube and assess for bowel sounds every four hours
C. Maintain suction, monitor output hourly, and keep the client NPO with IV fluids ✓
CORRECT
D. Remove the nasogastric tube and begin a clear liquid diet to stimulate peristalsis
Correct Answer: C
Rationale: Continued nasogastric decompression, NPO status, and fluid replacement
are the standard conservative management for a partial small-bowel obstruction while
monitoring for resolution or surgical need. Option D is a dangerous choice because oral
intake will worsen distension and increase the risk of complete obstruction or
, perforation. Many partial obstructions resolve within 24 to 48 hours with proper
decompression and bowel rest.
Question 5 of 50
A 39-year-old client is admitted with acute pancreatitis secondary to heavy alcohol use.
The nurse notes the client is guarding the abdomen, has a temperature of 101.2°F, and
is receiving lactated Ringer solution at 125 mL/hour. The client asks for something to
eat because they are hungry.
A. Offer a low-fat, high-protein snack to support tissue repair
B. Explain that the client must remain NPO until pain and nausea have fully resolved ✓
CORRECT
C. Provide sips of ginger ale to settle the stomach and prevent dehydration
D. Call the provider to request a clear liquid diet order for the client
Correct Answer: B
Rationale: Pancreatic rest is essential in acute pancreatitis, and oral intake stimulates
pancreatic enzyme secretion that can worsen autodigestion and inflammation. Option D
seems reasonable because providers often advance diets, but in acute pancreatitis the
nurse should advocate for continued NPO status until clinical markers improve. Most
clients require NPO status for at least 24 to 72 hours with IV hydration and pain
management.
Question 6 of 50
A 61-year-old client with end-stage renal disease receives hemodialysis three times
weekly. During the morning assessment, the nurse notes a 3-kg weight gain since the
last treatment two days ago, 2+ pitting edema, and the client reports difficulty breathing
when lying flat.
A. Instruct the client to restrict sodium intake and recheck weight tomorrow
B. Administer a loop diuretic to promote fluid loss before the next dialysis session
2026/2027: Complete Exam-Style Questions with
Detailed Rationales | 100% Verified | Pass
Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | Medical-Surgical Nursing | Q1 – Q10
Section 2 | Pharmacology and Medication Administration | Q11 – Q20
Section 3 | Mental Health Nursing | Q21 – Q30
Section 4 | Maternity and Pediatric Nursing | Q31 – Q40
Section 5 | Leadership, Delegation, and Prioritization | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
══════════════════════════════════════
SECTION 1: MEDICAL-SURGICAL NURSING Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 68-year-old client is admitted to the medical unit with a new diagnosis of heart failure.
During the morning assessment, the nurse notes bilateral crackles in the lung bases, 2+
pitting edema in the lower extremities, and an oxygen saturation of 88% on room air.
The client reports feeling short of breath when walking to the bathroom.
A. Encourage the client to perform ankle pumps every hour while awake
B. Administer the prescribed furosemide and place the client in a high-Fowler position
✓ CORRECT
C. Increase the client's oral fluid intake to 3 liters per day
D. Obtain a stat chest x-ray before initiating any interventions
Correct Answer: B
Rationale: Furosemide will promote diuresis to reduce pulmonary congestion and
peripheral edema, while high-Fowler positioning maximizes lung expansion and
,decreases venous return to the heart. Option A is tempting because ankle pumps are
appropriate for edema, but they will not address the acute respiratory compromise and
hypoxemia this client is experiencing. In practice, nurses often cluster these
interventions together, but diuresis and positioning take priority when saturation drops
below 90%.
Question 2 of 50
A 54-year-old client with a history of type 2 diabetes is postoperative day 2 following a
right total knee replacement. The nurse reviews the morning laboratory results and
notes a blood glucose of 248 mg/dL. The client is currently on a clear liquid diet and
reports incision pain rated 6/10.
A. Hold the client's scheduled insulin until a regular diet is resumed
B. Notify the surgeon immediately to request sliding-scale insulin only
C. Recheck the glucose in four hours before making any medication adjustments
D. Administer the prescribed basal-bolus insulin regimen and reassess pain control ✓
CORRECT
Correct Answer: D
Rationale: Postoperative hyperglycemia is common due to stress and pain, and
maintaining glycemic control with the prescribed basal-bolus regimen supports wound
healing and reduces infection risk. Option A is a common mistake because holding
insulin during illness or stress can lead to dangerous hyperglycemia and poor
outcomes. In the orthopedic population, uncontrolled glucose significantly increases the
risk of prosthetic joint infection.
Question 3 of 50
A 72-year-old client is transferred to the step-down unit after coronary artery bypass
grafting. On arrival, the nurse notes the mediastinal chest tube is draining 150 mL of
,bright red blood in the past hour. The client's blood pressure is 94/58 mmHg, heart rate
is 118 beats/min, and skin is cool and clammy.
A. Prepare the client for potential return to the operating room ✓ CORRECT
B. Milk the chest tube gently to ensure patency and continue to monitor
C. Increase the wall suction to -40 cm H₂O to improve drainage
D. Administer a 500 mL bolus of normal saline and reassess in 30 minutes
Correct Answer: A
Rationale: Drainage exceeding 100–150 mL/hour of bright red blood, combined with
hypotension and tachycardia, indicates active hemorrhage and requires immediate
surgical intervention. Option B is incorrect because milking the tube wastes precious
time when the client is already showing signs of hypovolemic shock. In cardiac
recovery, early recognition of tamponade or hemorrhage often determines survival.
Question 4 of 50
A 45-year-old client with Crohn disease is admitted with a partial small-bowel
obstruction. The nurse inserts a nasogastric tube to low intermittent suction and notes
400 mL of dark green fluid returned in the first two hours. The client reports increasing
abdominal cramping and has not passed flatus in 24 hours.
A. Advance the nasogastric tube an additional 5 cm to improve decompression
B. Clamp the nasogastric tube and assess for bowel sounds every four hours
C. Maintain suction, monitor output hourly, and keep the client NPO with IV fluids ✓
CORRECT
D. Remove the nasogastric tube and begin a clear liquid diet to stimulate peristalsis
Correct Answer: C
Rationale: Continued nasogastric decompression, NPO status, and fluid replacement
are the standard conservative management for a partial small-bowel obstruction while
monitoring for resolution or surgical need. Option D is a dangerous choice because oral
intake will worsen distension and increase the risk of complete obstruction or
, perforation. Many partial obstructions resolve within 24 to 48 hours with proper
decompression and bowel rest.
Question 5 of 50
A 39-year-old client is admitted with acute pancreatitis secondary to heavy alcohol use.
The nurse notes the client is guarding the abdomen, has a temperature of 101.2°F, and
is receiving lactated Ringer solution at 125 mL/hour. The client asks for something to
eat because they are hungry.
A. Offer a low-fat, high-protein snack to support tissue repair
B. Explain that the client must remain NPO until pain and nausea have fully resolved ✓
CORRECT
C. Provide sips of ginger ale to settle the stomach and prevent dehydration
D. Call the provider to request a clear liquid diet order for the client
Correct Answer: B
Rationale: Pancreatic rest is essential in acute pancreatitis, and oral intake stimulates
pancreatic enzyme secretion that can worsen autodigestion and inflammation. Option D
seems reasonable because providers often advance diets, but in acute pancreatitis the
nurse should advocate for continued NPO status until clinical markers improve. Most
clients require NPO status for at least 24 to 72 hours with IV hydration and pain
management.
Question 6 of 50
A 61-year-old client with end-stage renal disease receives hemodialysis three times
weekly. During the morning assessment, the nurse notes a 3-kg weight gain since the
last treatment two days ago, 2+ pitting edema, and the client reports difficulty breathing
when lying flat.
A. Instruct the client to restrict sodium intake and recheck weight tomorrow
B. Administer a loop diuretic to promote fluid loss before the next dialysis session
