NUR 283/ NUR283
Comprehensive Exam 3 – (New
2026/ 2027 Update) Transition
to Registered Nursing Practice|
Questions & Answers | Grade A|
100% Correct (Verified
Solutions)- Galen
1. The nurse is caring for the following assigned clients who are 24
hours postoperative. The nurse performed a change-of-shift
assessment 4 hours ago. Which change in client condition should the
nurse identify as a priority?
A. The client who reports an increased pain level of 8 on a scale of 0 to 10
after receiving an opioid analgesic
B. The client who reports nausea after receiving prescribed antibiotics
C. The client whose dressing has a small amount of new serosanguineous
drainage
D. The client who has voided 200 mL in the last 4 hours
,,,answer,,,,: A. The client who reports an increased pain level of 8 on a
scale of 0 to 10 after receiving an opioid analgesic
,Rationale: Unrelieved or increasing pain after opioids may signal
complications such as hemorrhage, compartment syndrome, or
anastomotic leak. This change from baseline is the most concerning and
needs prompt evaluation .
2. The nurse preceptor is teaching a newly hired nurse about legal
principles. Which situation should the nurse preceptor use as an
example of malpractice?
A. A nurse documents care at the end of the shift instead of in real time
B. A nurse delays administering a routine oral medication by 30 minutes
C. A client who is competent refuses an antidepressant medication.
The nurse dissolves the medication in food and administers it to the
client without the client's knowledge
D. A nurse forgets to orient a new client to the call-bell system
,,,answer,,,,: C. A client who is competent refuses an antidepressant
medication. The nurse dissolves the medication in food and
administers it to the client without the client's knowledge
Rationale: Giving medication against a competent client's wishes and
disguising it violates autonomy, informed consent, and constitutes
battery and malpractice because harm can result from this intentional
deception .
3. The nurse is caring for assigned clients. It is a priority for the nurse to
follow up with a client who:
,A. Is receiving furosemide and reports frequent urination
B. Is receiving pyridostigmine and reports nausea and congested cough
C. Is receiving metoprolol and reports a heart rate of 68 bpm
D. Is receiving insulin and reports blood glucose of 130 mg/dL
,,,answer,,,,: B. Is receiving pyridostigmine and reports nausea and
congested cough
Rationale: Pyridostigmine (Mestinon) is used for myasthenia gravis.
Nausea is common, but a congested cough may indicate cholinergic
crisis (excessive medication) or worsening weakness, requiring
immediate assessment. Frequent urination with furosemide is expected .
4. The nurse is serving on a continuous quality improvement (CQI)
committee. The committee is developing a program to reduce
medication errors. Which strategy should the committee plan to
initiate FIRST?
A. Provide mandatory medication-safety education to all staff
B. Implement a double-check policy for all high-alert medications
C. Review the events that led to the medication administration error by
creating a flow diagram
D. Require staff involved in the error to complete self-reflection reports
,,,answer,,,,: C. Review the events that led to the medication
administration error by creating a flow diagram
Rationale: CQI begins with analyzing the process that led to the error. A
flow diagram maps each step, helping the team identify system and
, process issues before implementing solutions like education or double-
checks .
5. The nurse has attended a conference on informed consent. Which
statement indicates correct understanding of the conference?
A. May be obtained verbally if the client is anxious
B. Can be waived, per facility policy, for urgent medical or surgical
treatment if the client is unconscious
C. Can be signed by a family member even if the client is competent
D. Is not needed if the procedure is minimally invasive
,,,answer,,,,: B. Can be waived, per facility policy, for urgent medical or
surgical treatment if the client is unconscious
Rationale: In a true emergency with an unconscious client and no
surrogate, lifesaving treatment can proceed under implied consent
according to facility policy and law. Routine procedures still require
informed consent from a competent patient .
6. The nurse is prioritizing client care after receiving the hand-off
report. The nurse should FIRST plan to see the client who:
A. Has cirrhosis, reports several new areas of ecchymosis, and has a
PTT of 76 seconds
B. Is postoperative day 2 following hip replacement and reports pain 4/10
C. Has COPD and oxygen saturation of 90% on 2 L nasal cannula
D. Has type 2 diabetes and capillary blood glucose of 220 mg/dL
Comprehensive Exam 3 – (New
2026/ 2027 Update) Transition
to Registered Nursing Practice|
Questions & Answers | Grade A|
100% Correct (Verified
Solutions)- Galen
1. The nurse is caring for the following assigned clients who are 24
hours postoperative. The nurse performed a change-of-shift
assessment 4 hours ago. Which change in client condition should the
nurse identify as a priority?
A. The client who reports an increased pain level of 8 on a scale of 0 to 10
after receiving an opioid analgesic
B. The client who reports nausea after receiving prescribed antibiotics
C. The client whose dressing has a small amount of new serosanguineous
drainage
D. The client who has voided 200 mL in the last 4 hours
,,,answer,,,,: A. The client who reports an increased pain level of 8 on a
scale of 0 to 10 after receiving an opioid analgesic
,Rationale: Unrelieved or increasing pain after opioids may signal
complications such as hemorrhage, compartment syndrome, or
anastomotic leak. This change from baseline is the most concerning and
needs prompt evaluation .
2. The nurse preceptor is teaching a newly hired nurse about legal
principles. Which situation should the nurse preceptor use as an
example of malpractice?
A. A nurse documents care at the end of the shift instead of in real time
B. A nurse delays administering a routine oral medication by 30 minutes
C. A client who is competent refuses an antidepressant medication.
The nurse dissolves the medication in food and administers it to the
client without the client's knowledge
D. A nurse forgets to orient a new client to the call-bell system
,,,answer,,,,: C. A client who is competent refuses an antidepressant
medication. The nurse dissolves the medication in food and
administers it to the client without the client's knowledge
Rationale: Giving medication against a competent client's wishes and
disguising it violates autonomy, informed consent, and constitutes
battery and malpractice because harm can result from this intentional
deception .
3. The nurse is caring for assigned clients. It is a priority for the nurse to
follow up with a client who:
,A. Is receiving furosemide and reports frequent urination
B. Is receiving pyridostigmine and reports nausea and congested cough
C. Is receiving metoprolol and reports a heart rate of 68 bpm
D. Is receiving insulin and reports blood glucose of 130 mg/dL
,,,answer,,,,: B. Is receiving pyridostigmine and reports nausea and
congested cough
Rationale: Pyridostigmine (Mestinon) is used for myasthenia gravis.
Nausea is common, but a congested cough may indicate cholinergic
crisis (excessive medication) or worsening weakness, requiring
immediate assessment. Frequent urination with furosemide is expected .
4. The nurse is serving on a continuous quality improvement (CQI)
committee. The committee is developing a program to reduce
medication errors. Which strategy should the committee plan to
initiate FIRST?
A. Provide mandatory medication-safety education to all staff
B. Implement a double-check policy for all high-alert medications
C. Review the events that led to the medication administration error by
creating a flow diagram
D. Require staff involved in the error to complete self-reflection reports
,,,answer,,,,: C. Review the events that led to the medication
administration error by creating a flow diagram
Rationale: CQI begins with analyzing the process that led to the error. A
flow diagram maps each step, helping the team identify system and
, process issues before implementing solutions like education or double-
checks .
5. The nurse has attended a conference on informed consent. Which
statement indicates correct understanding of the conference?
A. May be obtained verbally if the client is anxious
B. Can be waived, per facility policy, for urgent medical or surgical
treatment if the client is unconscious
C. Can be signed by a family member even if the client is competent
D. Is not needed if the procedure is minimally invasive
,,,answer,,,,: B. Can be waived, per facility policy, for urgent medical or
surgical treatment if the client is unconscious
Rationale: In a true emergency with an unconscious client and no
surrogate, lifesaving treatment can proceed under implied consent
according to facility policy and law. Routine procedures still require
informed consent from a competent patient .
6. The nurse is prioritizing client care after receiving the hand-off
report. The nurse should FIRST plan to see the client who:
A. Has cirrhosis, reports several new areas of ecchymosis, and has a
PTT of 76 seconds
B. Is postoperative day 2 following hip replacement and reports pain 4/10
C. Has COPD and oxygen saturation of 90% on 2 L nasal cannula
D. Has type 2 diabetes and capillary blood glucose of 220 mg/dL
