NUR 283/ NUR283
Comprehensive Exam 1 – (New
2026/ 2027 Update) Transition
to Registered Nursing Practice|
Questions & Answers | Grade A|
100% Correct (Verified
Solutions)- Galen
SECTION 1: Prioritization & ABCs (Questions 1-15)
1. The nurse working on a pediatric unit has received the hand-off
report and is reviewing client data and orders. Which client should the
nurse plan to see first?
A. A toddler with bronchiolitis on room air and mild wheezing
B. The infant who has a diagnosis of pertussis and is receiving oxygen
via nasal cannula
C. A preschooler with otitis media awaiting discharge
D. A school-age child with a simple fracture in a cast
,Rationale: Infants with pertussis are at high risk for apnea and severe
respiratory compromise. Any child on supplemental oxygen with a
respiratory diagnosis is a higher priority than stable conditions. Early
recognition and intervention are essential in pediatric safety.
2. The nurse working on a medical-surgical unit has been made aware
of the following client situations. Which client should the nurse first
plan to assess?
A. A client scheduled for discharge later today needing final medication
teaching
B. A client receiving preparation for a colonoscopy whose BP was
128/74 mm Hg and is now 106/60 mm Hg
C. A client who had knee arthroscopy yesterday reporting pain at 4/10
D. A client who is NPO for an abdominal ultrasound this morning
Rationale: A drop in blood pressure may indicate hypovolemia from bowel
prep or other hemodynamic instability and can quickly progress to shock
if not addressed. Recognizing unstable trends and prioritizing potentially
unstable clients is critical in the transition-to-RN role.
3. A nurse on a medical-surgical unit receives report on four clients.
Which client should the nurse assess FIRST?
A. A client with chest pain radiating to the left arm who is diaphoretic
B. A client with a superficial laceration on the forearm
C. A client with a temperature of 100.2°F reporting sore throat
D. A client requesting a prescription refill for an inhaler
Rationale: Chest pain radiating to the arm with diaphoresis is highly
suspicious for acute myocardial infarction. This client is unstable and
requires immediate assessment, ECG, and intervention. This follows the
emergent/urgent/non-urgent triage system.
,4. The nurse working in an outpatient care clinic is assessing clients
waiting to be seen. Which client should the nurse have the primary
health care provider (PHCP) see first?
A. A 28-year-old with a sprained ankle and mild swelling
B. A 45-year-old who has pleurisy and is reporting worsening shortness
of breath
C. A 32-year-old with seasonal allergies and nasal congestion
D. A 55-year-old with chronic low-back pain requesting a refill
Rationale: Worsening dyspnea in a client with pleuritic pain may indicate
pneumonia, pulmonary embolus, or respiratory failure and demands
immediate evaluation. Stable musculoskeletal pain and chronic issues
can safely wait.
5. The nurse has been made aware of the following client situations.
Which client should the nurse first plan to see?
A. A client with cervical cancer receiving internal radiation therapy
whose partner has been visiting at the bedside the past 2 hours
B. A client with COPD on 2 L/min oxygen with SpO₂ of 93%
C. A client with type 2 diabetes with glucose of 220 mg/dL before dinner
D. A client with a stage II pressure injury needing a dressing change
Rationale: Visitors to clients with internal radiation must be limited in
time and distance due to radiation exposure. The nurse should assess and
enforce safety precautions. The other clients are relatively stable.
6. A client with a history of seizures begins experiencing a generalized
tonic-clonic seizure. What is the nurse's PRIORITY action?
A. Restrain the client's limbs
B. Place a tongue blade in the mouth
, C. Turn the client to the side
D. Leave the client to call a rapid response
Rationale: Turning the client to the side (lateral recumbent position)
helps maintain a patent airway and allows secretions to drain, preventing
aspiration. Restraining or placing objects in the mouth can cause injury.
An assistant should call for help while the nurse stays with the client.
7. The emergency department receives four clients simultaneously.
Which client should the triage nurse see FIRST?
A. A client with chest pain radiating to the left arm, diaphoretic
B. A client with chest pain that worsens with deep inspiration
C. A client with bilateral leg swelling and shortness of breath when
walking
D. A client with nausea and epigastric pain after a large meal
Rationale: Chest pain radiating to the arm with diaphoresis is highly
suspicious for acute MI and requires immediate assessment. The other
clients have symptoms that suggest less urgent conditions.
8. A nurse is caring for a client with a tracheostomy. Which finding
requires IMMEDIATE intervention?
A. Small amount of bloody secretions
B. Client requesting suctioning every 4 hours
C. Respiratory rate of 28 breaths per minute
D. Thick, yellow secretions extending from the stoma
Rationale: Thick, yellow secretions can indicate infection and may
obstruct the airway. While a respiratory rate of 28 is elevated, the
presence of thick secretions poses an imminent risk of complete airway
obstruction and requires immediate suctioning and assessment.
Comprehensive Exam 1 – (New
2026/ 2027 Update) Transition
to Registered Nursing Practice|
Questions & Answers | Grade A|
100% Correct (Verified
Solutions)- Galen
SECTION 1: Prioritization & ABCs (Questions 1-15)
1. The nurse working on a pediatric unit has received the hand-off
report and is reviewing client data and orders. Which client should the
nurse plan to see first?
A. A toddler with bronchiolitis on room air and mild wheezing
B. The infant who has a diagnosis of pertussis and is receiving oxygen
via nasal cannula
C. A preschooler with otitis media awaiting discharge
D. A school-age child with a simple fracture in a cast
,Rationale: Infants with pertussis are at high risk for apnea and severe
respiratory compromise. Any child on supplemental oxygen with a
respiratory diagnosis is a higher priority than stable conditions. Early
recognition and intervention are essential in pediatric safety.
2. The nurse working on a medical-surgical unit has been made aware
of the following client situations. Which client should the nurse first
plan to assess?
A. A client scheduled for discharge later today needing final medication
teaching
B. A client receiving preparation for a colonoscopy whose BP was
128/74 mm Hg and is now 106/60 mm Hg
C. A client who had knee arthroscopy yesterday reporting pain at 4/10
D. A client who is NPO for an abdominal ultrasound this morning
Rationale: A drop in blood pressure may indicate hypovolemia from bowel
prep or other hemodynamic instability and can quickly progress to shock
if not addressed. Recognizing unstable trends and prioritizing potentially
unstable clients is critical in the transition-to-RN role.
3. A nurse on a medical-surgical unit receives report on four clients.
Which client should the nurse assess FIRST?
A. A client with chest pain radiating to the left arm who is diaphoretic
B. A client with a superficial laceration on the forearm
C. A client with a temperature of 100.2°F reporting sore throat
D. A client requesting a prescription refill for an inhaler
Rationale: Chest pain radiating to the arm with diaphoresis is highly
suspicious for acute myocardial infarction. This client is unstable and
requires immediate assessment, ECG, and intervention. This follows the
emergent/urgent/non-urgent triage system.
,4. The nurse working in an outpatient care clinic is assessing clients
waiting to be seen. Which client should the nurse have the primary
health care provider (PHCP) see first?
A. A 28-year-old with a sprained ankle and mild swelling
B. A 45-year-old who has pleurisy and is reporting worsening shortness
of breath
C. A 32-year-old with seasonal allergies and nasal congestion
D. A 55-year-old with chronic low-back pain requesting a refill
Rationale: Worsening dyspnea in a client with pleuritic pain may indicate
pneumonia, pulmonary embolus, or respiratory failure and demands
immediate evaluation. Stable musculoskeletal pain and chronic issues
can safely wait.
5. The nurse has been made aware of the following client situations.
Which client should the nurse first plan to see?
A. A client with cervical cancer receiving internal radiation therapy
whose partner has been visiting at the bedside the past 2 hours
B. A client with COPD on 2 L/min oxygen with SpO₂ of 93%
C. A client with type 2 diabetes with glucose of 220 mg/dL before dinner
D. A client with a stage II pressure injury needing a dressing change
Rationale: Visitors to clients with internal radiation must be limited in
time and distance due to radiation exposure. The nurse should assess and
enforce safety precautions. The other clients are relatively stable.
6. A client with a history of seizures begins experiencing a generalized
tonic-clonic seizure. What is the nurse's PRIORITY action?
A. Restrain the client's limbs
B. Place a tongue blade in the mouth
, C. Turn the client to the side
D. Leave the client to call a rapid response
Rationale: Turning the client to the side (lateral recumbent position)
helps maintain a patent airway and allows secretions to drain, preventing
aspiration. Restraining or placing objects in the mouth can cause injury.
An assistant should call for help while the nurse stays with the client.
7. The emergency department receives four clients simultaneously.
Which client should the triage nurse see FIRST?
A. A client with chest pain radiating to the left arm, diaphoretic
B. A client with chest pain that worsens with deep inspiration
C. A client with bilateral leg swelling and shortness of breath when
walking
D. A client with nausea and epigastric pain after a large meal
Rationale: Chest pain radiating to the arm with diaphoresis is highly
suspicious for acute MI and requires immediate assessment. The other
clients have symptoms that suggest less urgent conditions.
8. A nurse is caring for a client with a tracheostomy. Which finding
requires IMMEDIATE intervention?
A. Small amount of bloody secretions
B. Client requesting suctioning every 4 hours
C. Respiratory rate of 28 breaths per minute
D. Thick, yellow secretions extending from the stoma
Rationale: Thick, yellow secretions can indicate infection and may
obstruct the airway. While a respiratory rate of 28 is elevated, the
presence of thick secretions poses an imminent risk of complete airway
obstruction and requires immediate suctioning and assessment.
