, NSG 4800 all Comprehensive Exam Review 2026/2027 | Practice Questions & Answers |
Nursing Study Guide PDF-Galen College of Nursing
1. The nurse working in the ED has received the following prescriptions for a newly
admitted client. Which prescription should the nurse implement FIRST?
A. Initiate IV sodium and potassium for a client admitted with diarrhea and dehydration who has
a serum potassium level of 2.9 mEq/L
B. Obtain a stool specimen for culture from a client with bloody diarrhea
C. Administer an antidiarrheal medication to a client reporting frequent loose stools
D. Encourage oral fluids for a client with mild dehydration
Correct Answer: A. Initiate IV sodium and potassium for a client admitted with diarrhea
and dehydration who has a serum potassium level of 2.9 mEq/L
Rationale:
Using the ABCs and physiologic stability framework, severe hypokalemia (potassium level 2.9
mEq/L) places the client at immediate risk for life-threatening cardiac dysrhythmias and
neuromuscular dysfunction. Additionally, ongoing diarrhea and dehydration contribute to
continued electrolyte loss. Correcting fluid volume deficit and potassium depletion is the highest
priority intervention. The other actions are important but do not address an immediate threat to
life.
2. A nurse is caring for a male client who has a deep partial-thickness and a full-
thickness burn to 45% of the lower body. It would be a PRIORITY for the nurse to
notify the provider if the client has:
A. Urinary output of 45 mL over the past 2 hours
B. Heart rate of 108 beats/min
C. Temperature of 37.8°C (100°F)
D. Pain rating of 7 on a scale of 0 to 10
Correct Answer: A. Urinary output of 45 mL over the past 2 hours
Rationale:
Clients with extensive burns require aggressive fluid resuscitation. Adequate urine output is the
most reliable indicator of organ perfusion and effectiveness of fluid replacement. An adult burn
client should maintain urine output of at least 30–50 mL/hr. A total output of 45 mL over 2 hours
indicates inadequate renal perfusion and possible hypovolemic shock. This finding requires
immediate provider notification and intervention.
, 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. A client who has multiple compound fractures and is reporting chest pain
B. A client with superficial burns to both arms
C. A client with a closed tibial fracture and stable vital signs
D. A client with minor lacerations to the face and scalp
Correct Answer: A. A client who has multiple compound fractures and is reporting chest
pain
Rationale:
Disaster triage prioritizes clients based on survivability and urgency of treatment. Chest pain
following trauma may indicate life-threatening thoracic injury, myocardial injury, or
compromised oxygenation. This client would receive an immediate (red) tag due to the potential
for rapid deterioration. The remaining clients have injuries that are delayed (yellow) or minor
(green) priorities.
4. The charge nurse in the ED is reviewing the care provided for recently admitted
clients. Which action reflects implementation of an accepted standard of care?
A. Placing the client who has suspected Haemophilus influenzae on droplet precautions
B. Placing the client with tuberculosis on contact precautions
C. Placing the client with varicella on droplet precautions only
D. Placing the client with Clostridioides difficile on airborne precautions
Correct Answer: A. Placing the client who has suspected Haemophilus influenzae on
droplet precautions
Rationale:
Haemophilus influenzae is transmitted via respiratory droplets; therefore, droplet precautions are
indicated. Tuberculosis requires airborne precautions, varicella requires airborne and contact
precautions, and C. difficile requires contact precautions with soap-and-water hand hygiene. This
action demonstrates adherence to infection-control standards.
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?
A. “I'm glad you called, and I want to send an ambulance to help you.”
B. “Why did you decide to take the medication?”
, C. “Do you regret taking the pills?”
D. “Have you attempted suicide before?”
Correct Answer: A. “I'm glad you called, and I want to send an ambulance to help you.”
Rationale:
Amitriptyline overdose is a medical emergency that can rapidly cause fatal cardiac dysrhythmias,
seizures, and respiratory depression. The priority is immediate safety and emergency
intervention. While further assessment is necessary, activating emergency medical services takes
precedence over obtaining additional psychosocial information.
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. A heart rate that has increased from 95 to 110 beats/min
B. Mild discomfort at the insertion site
C. A respiratory rate of 20 breaths/min
D. Slight fatigue after the procedure
Correct Answer: A. A heart rate that has increased from 95 to 110 beats/min
Rationale:
Following thoracentesis, complications such as pneumothorax, hemorrhage, or respiratory
compromise can occur. An increasing heart rate may be an early sign of hypoxia, bleeding, or
hemodynamic instability and warrants prompt evaluation. Mild discomfort and fatigue are
expected findings after the procedure.
7. A nurse is caring for a client receiving chemotherapy. The client is not eating well
but denies nausea or vomiting. Which of the following would be best for the nurse to
suggest to the client?
A. Chicken, green beans, and cottage cheese
B. Fried chicken and french fries
C. Chocolate milkshake and potato chips
D. Carbonated beverages and spicy foods
Correct Answer: A. Chicken, green beans, and cottage cheese
Rationale:
Clients receiving chemotherapy require nutrient-dense, high-protein foods to support tissue
repair and maintain nutritional status. Chicken and cottage cheese provide excellent protein
Nursing Study Guide PDF-Galen College of Nursing
1. The nurse working in the ED has received the following prescriptions for a newly
admitted client. Which prescription should the nurse implement FIRST?
A. Initiate IV sodium and potassium for a client admitted with diarrhea and dehydration who has
a serum potassium level of 2.9 mEq/L
B. Obtain a stool specimen for culture from a client with bloody diarrhea
C. Administer an antidiarrheal medication to a client reporting frequent loose stools
D. Encourage oral fluids for a client with mild dehydration
Correct Answer: A. Initiate IV sodium and potassium for a client admitted with diarrhea
and dehydration who has a serum potassium level of 2.9 mEq/L
Rationale:
Using the ABCs and physiologic stability framework, severe hypokalemia (potassium level 2.9
mEq/L) places the client at immediate risk for life-threatening cardiac dysrhythmias and
neuromuscular dysfunction. Additionally, ongoing diarrhea and dehydration contribute to
continued electrolyte loss. Correcting fluid volume deficit and potassium depletion is the highest
priority intervention. The other actions are important but do not address an immediate threat to
life.
2. A nurse is caring for a male client who has a deep partial-thickness and a full-
thickness burn to 45% of the lower body. It would be a PRIORITY for the nurse to
notify the provider if the client has:
A. Urinary output of 45 mL over the past 2 hours
B. Heart rate of 108 beats/min
C. Temperature of 37.8°C (100°F)
D. Pain rating of 7 on a scale of 0 to 10
Correct Answer: A. Urinary output of 45 mL over the past 2 hours
Rationale:
Clients with extensive burns require aggressive fluid resuscitation. Adequate urine output is the
most reliable indicator of organ perfusion and effectiveness of fluid replacement. An adult burn
client should maintain urine output of at least 30–50 mL/hr. A total output of 45 mL over 2 hours
indicates inadequate renal perfusion and possible hypovolemic shock. This finding requires
immediate provider notification and intervention.
, 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. A client who has multiple compound fractures and is reporting chest pain
B. A client with superficial burns to both arms
C. A client with a closed tibial fracture and stable vital signs
D. A client with minor lacerations to the face and scalp
Correct Answer: A. A client who has multiple compound fractures and is reporting chest
pain
Rationale:
Disaster triage prioritizes clients based on survivability and urgency of treatment. Chest pain
following trauma may indicate life-threatening thoracic injury, myocardial injury, or
compromised oxygenation. This client would receive an immediate (red) tag due to the potential
for rapid deterioration. The remaining clients have injuries that are delayed (yellow) or minor
(green) priorities.
4. The charge nurse in the ED is reviewing the care provided for recently admitted
clients. Which action reflects implementation of an accepted standard of care?
A. Placing the client who has suspected Haemophilus influenzae on droplet precautions
B. Placing the client with tuberculosis on contact precautions
C. Placing the client with varicella on droplet precautions only
D. Placing the client with Clostridioides difficile on airborne precautions
Correct Answer: A. Placing the client who has suspected Haemophilus influenzae on
droplet precautions
Rationale:
Haemophilus influenzae is transmitted via respiratory droplets; therefore, droplet precautions are
indicated. Tuberculosis requires airborne precautions, varicella requires airborne and contact
precautions, and C. difficile requires contact precautions with soap-and-water hand hygiene. This
action demonstrates adherence to infection-control standards.
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?
A. “I'm glad you called, and I want to send an ambulance to help you.”
B. “Why did you decide to take the medication?”
, C. “Do you regret taking the pills?”
D. “Have you attempted suicide before?”
Correct Answer: A. “I'm glad you called, and I want to send an ambulance to help you.”
Rationale:
Amitriptyline overdose is a medical emergency that can rapidly cause fatal cardiac dysrhythmias,
seizures, and respiratory depression. The priority is immediate safety and emergency
intervention. While further assessment is necessary, activating emergency medical services takes
precedence over obtaining additional psychosocial information.
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. A heart rate that has increased from 95 to 110 beats/min
B. Mild discomfort at the insertion site
C. A respiratory rate of 20 breaths/min
D. Slight fatigue after the procedure
Correct Answer: A. A heart rate that has increased from 95 to 110 beats/min
Rationale:
Following thoracentesis, complications such as pneumothorax, hemorrhage, or respiratory
compromise can occur. An increasing heart rate may be an early sign of hypoxia, bleeding, or
hemodynamic instability and warrants prompt evaluation. Mild discomfort and fatigue are
expected findings after the procedure.
7. A nurse is caring for a client receiving chemotherapy. The client is not eating well
but denies nausea or vomiting. Which of the following would be best for the nurse to
suggest to the client?
A. Chicken, green beans, and cottage cheese
B. Fried chicken and french fries
C. Chocolate milkshake and potato chips
D. Carbonated beverages and spicy foods
Correct Answer: A. Chicken, green beans, and cottage cheese
Rationale:
Clients receiving chemotherapy require nutrient-dense, high-protein foods to support tissue
repair and maintain nutritional status. Chicken and cottage cheese provide excellent protein
