NUR 283 COMP 2 MOCK EXAM | QUESTIONS
AND ANSWERS|2026 UPDATE|100% CORRECT.
| **1** | A nurse receives report on 4 patients. Which patient should be assessed **first**?
A) Patient with a broken hip requesting pain medication B) Patient with a tracheostomy and
O₂ saturation of 88% C) Patient needing warfarin teaching D) Patient scheduled for an
abdominal CT scan | **B) Patient with a tracheostomy and O₂ saturation of 88%** |
**Rationale:** Airway and breathing are always the priority. An SpO₂ of 88% indicates
hypoxemia, and the tracheostomy patient is at high risk for airway obstruction or mucus
plugging. Pain, teaching, and diagnostic tests can wait until the airway is stable. |
| **2** | An RN delegates a task to an LPN/LVN. Which task is appropriate? A) Initial
assessment of a new admission with chest pain B) Administration of IV push morphine C)
Administering oral metoprolol to a stable hypertensive patient D) Creating a care plan for a
diabetic patient | **C) Administering oral metoprolol to a stable hypertensive patient** |
**Rationale:** LPNs/LVNs can administer oral medications to stable patients. Initial
assessment, IV push opioids, and care plan creation require RN scope of practice. |
| **3** | A client had an ERCP 30 minutes ago and reports difficulty swallowing. Which action
is the priority? A) Notify the provider about the pain B) Assess for abdominal distention C)
Place the client on NPO status and assess the gag reflex D) Administer antiemetic for nausea |
**C) Place the client on NPO status and assess the gag reflex** | **Rationale:** After an
ERCP, the gag reflex may be absent. Difficulty swallowing indicates a risk of aspiration, an
immediate airway threat. Placing the patient NPO and assessing the gag reflex takes priority
over pain management or teaching. |
| **4** | The nurse is preparing a client for a paracentesis. Which action is essential? A) Have
the client sign the consent form B) Ensure the client has a full bladder C) Position the client in
a high-Fowler's position D) Administer a sedative 30 minutes prior | **B) Ensure the client has
a full bladder** | **Rationale:** A full bladder elevates the bladder dome and helps
protect it from accidental puncture during needle insertion. The health care provider obtains
consent; the patient is positioned sitting up or on the side of the bed. |
| **5** | A patient with a chest tube has continuous bubbling in the water seal chamber.
What should the nurse do first? A) Clamp the chest tube near the insertion site B) Assess for
an air leak and notify the provider C) Increase suction pressure D) Document the finding as
normal | **B) Assess for an air leak and notify the provider** | **Rationale:** Continuous
bubbling indicates an air leak in the system. The nurse should first assess for loose
connections or cracks in the tubing, then notify the provider. Clamping the tube without an
order is unsafe. |
, | **6** | Which finding in a patient with a new tracheostomy requires **immediate**
intervention? A) Blood-tinged mucus suctioned from the tube B) Tracheostomy ties are snug
but not tight C) Client has a fever of 101°F (38.3°C) D) Pulse oximetry reading of 88% on room
air | **D) Pulse oximetry reading of 88% on room air** | **Rationale:** Hypoxemia is a
life-threatening condition. A SpO₂ of 88% indicates inadequate oxygenation and must be
addressed immediately by assessing airway patency and increasing oxygen as ordered. Small
amounts of blood-tinged mucus can be normal post-procedure. |
| **7** | A charge nurse assigns an experienced RN rather than a new graduate to which
patient? A) Pneumonia on room air B) Appendicitis scheduled for surgery C) Unstable atrial
fibrillation on a new heparin drip D) UTI receiving oral antibiotics | **C) Unstable atrial
fibrillation on a new heparin drip** | **Rationale:** Unstable dysrhythmia and a titratable
IV anticoagulant require critical thinking and experience. Stable patients can be managed by
new graduates under supervision. |
| **8** | The nurse is admitting a client with chronic kidney disease (CKD). The client's
potassium level is 6.8 mEq/L, and ECG shows tall, peaked T waves. Which intervention should
the nurse anticipate **first**? A) Administer sodium polystyrene sulfonate (Kayexalate) orally
B) Infuse a 1-liter bolus of 0.9% normal saline C) Administer 10% calcium gluconate IV over 2-3
minutes D) Start regular insulin IV with dextrose 50% | **C) Administer 10% calcium
gluconate IV over 2-3 minutes** | **Rationale:** In severe hyperkalemia with ECG
changes, calcium gluconate is the priority. It immediately stabilizes the myocardial cell
membrane, reducing the risk of life-threatening arrhythmias. It does not lower potassium but
protects the heart while other therapies work. |
| **9** | A client with cirrhosis is becoming confused and combative. Which lab value should
the nurse evaluate **first**? A) Serum ammonia B) Serum bilirubin C) Serum albumin D)
International normalized ratio (INR) | **A) Serum ammonia** | **Rationale:** Hepatic
encephalopathy is caused by accumulation of ammonia, which the liver cannot convert to
urea. Elevated ammonia levels are toxic to the brain and cause confusion, lethargy, and
asterixis. While the other labs are important, ammonia is most directly linked to neurological
changes. |
| **10** | A client in the ICU is receiving mechanical ventilation. The ventilator's
high-pressure alarm sounds. Which is the most likely cause? A) Disconnection of the
ventilator tubing B) Client biting the endotracheal tube or excessive secretions C) An oxygen
sensor malfunction D) The ventilator being turned off | **B) Client biting the endotracheal
tube or excessive secretions** | **Rationale:** High-pressure alarms indicate increased
resistance in the circuit. Common causes include the client biting the tube, kinks in the tubing,
thick secretions that require suctioning, or coughing. Disconnections or cuff leaks trigger
**low-pressure** alarms. |
AND ANSWERS|2026 UPDATE|100% CORRECT.
| **1** | A nurse receives report on 4 patients. Which patient should be assessed **first**?
A) Patient with a broken hip requesting pain medication B) Patient with a tracheostomy and
O₂ saturation of 88% C) Patient needing warfarin teaching D) Patient scheduled for an
abdominal CT scan | **B) Patient with a tracheostomy and O₂ saturation of 88%** |
**Rationale:** Airway and breathing are always the priority. An SpO₂ of 88% indicates
hypoxemia, and the tracheostomy patient is at high risk for airway obstruction or mucus
plugging. Pain, teaching, and diagnostic tests can wait until the airway is stable. |
| **2** | An RN delegates a task to an LPN/LVN. Which task is appropriate? A) Initial
assessment of a new admission with chest pain B) Administration of IV push morphine C)
Administering oral metoprolol to a stable hypertensive patient D) Creating a care plan for a
diabetic patient | **C) Administering oral metoprolol to a stable hypertensive patient** |
**Rationale:** LPNs/LVNs can administer oral medications to stable patients. Initial
assessment, IV push opioids, and care plan creation require RN scope of practice. |
| **3** | A client had an ERCP 30 minutes ago and reports difficulty swallowing. Which action
is the priority? A) Notify the provider about the pain B) Assess for abdominal distention C)
Place the client on NPO status and assess the gag reflex D) Administer antiemetic for nausea |
**C) Place the client on NPO status and assess the gag reflex** | **Rationale:** After an
ERCP, the gag reflex may be absent. Difficulty swallowing indicates a risk of aspiration, an
immediate airway threat. Placing the patient NPO and assessing the gag reflex takes priority
over pain management or teaching. |
| **4** | The nurse is preparing a client for a paracentesis. Which action is essential? A) Have
the client sign the consent form B) Ensure the client has a full bladder C) Position the client in
a high-Fowler's position D) Administer a sedative 30 minutes prior | **B) Ensure the client has
a full bladder** | **Rationale:** A full bladder elevates the bladder dome and helps
protect it from accidental puncture during needle insertion. The health care provider obtains
consent; the patient is positioned sitting up or on the side of the bed. |
| **5** | A patient with a chest tube has continuous bubbling in the water seal chamber.
What should the nurse do first? A) Clamp the chest tube near the insertion site B) Assess for
an air leak and notify the provider C) Increase suction pressure D) Document the finding as
normal | **B) Assess for an air leak and notify the provider** | **Rationale:** Continuous
bubbling indicates an air leak in the system. The nurse should first assess for loose
connections or cracks in the tubing, then notify the provider. Clamping the tube without an
order is unsafe. |
, | **6** | Which finding in a patient with a new tracheostomy requires **immediate**
intervention? A) Blood-tinged mucus suctioned from the tube B) Tracheostomy ties are snug
but not tight C) Client has a fever of 101°F (38.3°C) D) Pulse oximetry reading of 88% on room
air | **D) Pulse oximetry reading of 88% on room air** | **Rationale:** Hypoxemia is a
life-threatening condition. A SpO₂ of 88% indicates inadequate oxygenation and must be
addressed immediately by assessing airway patency and increasing oxygen as ordered. Small
amounts of blood-tinged mucus can be normal post-procedure. |
| **7** | A charge nurse assigns an experienced RN rather than a new graduate to which
patient? A) Pneumonia on room air B) Appendicitis scheduled for surgery C) Unstable atrial
fibrillation on a new heparin drip D) UTI receiving oral antibiotics | **C) Unstable atrial
fibrillation on a new heparin drip** | **Rationale:** Unstable dysrhythmia and a titratable
IV anticoagulant require critical thinking and experience. Stable patients can be managed by
new graduates under supervision. |
| **8** | The nurse is admitting a client with chronic kidney disease (CKD). The client's
potassium level is 6.8 mEq/L, and ECG shows tall, peaked T waves. Which intervention should
the nurse anticipate **first**? A) Administer sodium polystyrene sulfonate (Kayexalate) orally
B) Infuse a 1-liter bolus of 0.9% normal saline C) Administer 10% calcium gluconate IV over 2-3
minutes D) Start regular insulin IV with dextrose 50% | **C) Administer 10% calcium
gluconate IV over 2-3 minutes** | **Rationale:** In severe hyperkalemia with ECG
changes, calcium gluconate is the priority. It immediately stabilizes the myocardial cell
membrane, reducing the risk of life-threatening arrhythmias. It does not lower potassium but
protects the heart while other therapies work. |
| **9** | A client with cirrhosis is becoming confused and combative. Which lab value should
the nurse evaluate **first**? A) Serum ammonia B) Serum bilirubin C) Serum albumin D)
International normalized ratio (INR) | **A) Serum ammonia** | **Rationale:** Hepatic
encephalopathy is caused by accumulation of ammonia, which the liver cannot convert to
urea. Elevated ammonia levels are toxic to the brain and cause confusion, lethargy, and
asterixis. While the other labs are important, ammonia is most directly linked to neurological
changes. |
| **10** | A client in the ICU is receiving mechanical ventilation. The ventilator's
high-pressure alarm sounds. Which is the most likely cause? A) Disconnection of the
ventilator tubing B) Client biting the endotracheal tube or excessive secretions C) An oxygen
sensor malfunction D) The ventilator being turned off | **B) Client biting the endotracheal
tube or excessive secretions** | **Rationale:** High-pressure alarms indicate increased
resistance in the circuit. Common causes include the client biting the tube, kinks in the tubing,
thick secretions that require suctioning, or coughing. Disconnections or cuff leaks trigger
**low-pressure** alarms. |
