,NUR 283 Comp 1 Exam | Transition to Registered Nursing
Practice (2026) Q&A | Galen College
1. The nurse receives report on four clients. Using the ABC framework, which
client should the nurse assess first?
A) A client 30 minutes post-ERCP reporting difficulty swallowing.
B) A client with a stage II pressure injury scheduled for a dressing change.
C) A client with type 2 diabetes and a blood glucose of 220 mg/dL.
D) A client awaiting discharge teaching for a new ileostomy.
Correct Answer: A client 30 minutes post-ERCP reporting difficulty swallowing.
Rationale: Difficulty swallowing indicates potential airway compromise due to
residual sedation and absent gag reflex, the highest priority per the ABC
framework. Airway always takes precedence over stable glucose, chronic
wounds, or discharge teaching. Immediate assessment prevents aspiration and
respiratory arrest. The other clients have non-emergent needs.
2. The nurse is delegating tasks to a UAP. Which task is most appropriate to
assign?
A) Obtaining a capillary blood glucose from a client who is diaphoretic.
B) Flushing a Jackson-Pratt drain on a postoperative client.
C) Changing a sterile central line dressing.
D) Providing initial discharge teaching to a client after a hip replacement.
Correct Answer: Obtaining a capillary blood glucose from a client who is
diaphoretic.
,Rationale: UAPs can perform capillary blood glucose testing under RN
supervision, as it is a noninvasive point-of-care task. Flushing a drain, changing a
sterile dressing, and initial teaching require sterile technique or RN-level
assessment and education and cannot be delegated. The RN retains
accountability for safe delegation.
3. A client 3 days after abdominal surgery suddenly develops dyspnea,
tachypnea, and pleuritic chest pain. After applying oxygen, what should the
nurse do next?
A) Reposition the client flat.
B) Notify the provider immediately and prepare for a CT pulmonary angiogram.
C) Administer PRN morphine for pain.
D) Obtain a STAT 12-lead ECG.
Correct Answer: Notify the provider immediately and prepare for a CT
pulmonary angiogram.
Rationale: Sudden dyspnea and chest pain in a postoperative client suggest
pulmonary embolism. After stabilizing oxygenation, the nurse must alert the
provider for urgent diagnostic testing (CT angiogram) and potential
thrombolytic or anticoagulant therapy. Morphine and repositioning may worsen
respiratory depression; ECG is not diagnostic for PE.
4. An infant with pertussis is receiving oxygen via nasal cannula and has
frequent coughing paroxysms. Which observation by the nurse requires
immediate action?
A) The infant’s oxygen saturation is 94%.
B) The infant is breastfeeding well.
, C) The infant has an episode of apnea lasting 20 seconds.
D) The parents are at the bedside.
Correct Answer: The infant has an episode of apnea lasting 20 seconds.
Rationale: Apnea in an infant with pertussis is a life-threatening event requiring
immediate stimulation and possible bag-mask ventilation; it indicates severe
respiratory compromise. Oxygen saturation of 94% is acceptable, breastfeeding
indicates stability, and parental presence is not an emergency. Prompt
intervention prevents hypoxic brain injury.
5. The charge nurse is making assignments. Which client should be assigned to
an LPN/LVN?
A) A client with stable vital signs needing a sterile wound dressing change for a
surgical incision.
B) A client with new-onset chest pain and diaphoresis.
C) A client with acute kidney injury requiring initial hemodialysis education.
D) A client with a head injury needing hourly neurological checks.
Correct Answer: A client with stable vital signs needing a sterile wound dressing
change for a surgical incision.
Rationale: LPNs can perform sterile dressing changes on stable patients. New
chest pain, initial education, and frequent neuro checks require RN-level
assessment, clinical judgment, or initial teaching that cannot be delegated. The
LPN may reinforce teaching but cannot initiate it or manage unstable
conditions.
Practice (2026) Q&A | Galen College
1. The nurse receives report on four clients. Using the ABC framework, which
client should the nurse assess first?
A) A client 30 minutes post-ERCP reporting difficulty swallowing.
B) A client with a stage II pressure injury scheduled for a dressing change.
C) A client with type 2 diabetes and a blood glucose of 220 mg/dL.
D) A client awaiting discharge teaching for a new ileostomy.
Correct Answer: A client 30 minutes post-ERCP reporting difficulty swallowing.
Rationale: Difficulty swallowing indicates potential airway compromise due to
residual sedation and absent gag reflex, the highest priority per the ABC
framework. Airway always takes precedence over stable glucose, chronic
wounds, or discharge teaching. Immediate assessment prevents aspiration and
respiratory arrest. The other clients have non-emergent needs.
2. The nurse is delegating tasks to a UAP. Which task is most appropriate to
assign?
A) Obtaining a capillary blood glucose from a client who is diaphoretic.
B) Flushing a Jackson-Pratt drain on a postoperative client.
C) Changing a sterile central line dressing.
D) Providing initial discharge teaching to a client after a hip replacement.
Correct Answer: Obtaining a capillary blood glucose from a client who is
diaphoretic.
,Rationale: UAPs can perform capillary blood glucose testing under RN
supervision, as it is a noninvasive point-of-care task. Flushing a drain, changing a
sterile dressing, and initial teaching require sterile technique or RN-level
assessment and education and cannot be delegated. The RN retains
accountability for safe delegation.
3. A client 3 days after abdominal surgery suddenly develops dyspnea,
tachypnea, and pleuritic chest pain. After applying oxygen, what should the
nurse do next?
A) Reposition the client flat.
B) Notify the provider immediately and prepare for a CT pulmonary angiogram.
C) Administer PRN morphine for pain.
D) Obtain a STAT 12-lead ECG.
Correct Answer: Notify the provider immediately and prepare for a CT
pulmonary angiogram.
Rationale: Sudden dyspnea and chest pain in a postoperative client suggest
pulmonary embolism. After stabilizing oxygenation, the nurse must alert the
provider for urgent diagnostic testing (CT angiogram) and potential
thrombolytic or anticoagulant therapy. Morphine and repositioning may worsen
respiratory depression; ECG is not diagnostic for PE.
4. An infant with pertussis is receiving oxygen via nasal cannula and has
frequent coughing paroxysms. Which observation by the nurse requires
immediate action?
A) The infant’s oxygen saturation is 94%.
B) The infant is breastfeeding well.
, C) The infant has an episode of apnea lasting 20 seconds.
D) The parents are at the bedside.
Correct Answer: The infant has an episode of apnea lasting 20 seconds.
Rationale: Apnea in an infant with pertussis is a life-threatening event requiring
immediate stimulation and possible bag-mask ventilation; it indicates severe
respiratory compromise. Oxygen saturation of 94% is acceptable, breastfeeding
indicates stability, and parental presence is not an emergency. Prompt
intervention prevents hypoxic brain injury.
5. The charge nurse is making assignments. Which client should be assigned to
an LPN/LVN?
A) A client with stable vital signs needing a sterile wound dressing change for a
surgical incision.
B) A client with new-onset chest pain and diaphoresis.
C) A client with acute kidney injury requiring initial hemodialysis education.
D) A client with a head injury needing hourly neurological checks.
Correct Answer: A client with stable vital signs needing a sterile wound dressing
change for a surgical incision.
Rationale: LPNs can perform sterile dressing changes on stable patients. New
chest pain, initial education, and frequent neuro checks require RN-level
assessment, clinical judgment, or initial teaching that cannot be delegated. The
LPN may reinforce teaching but cannot initiate it or manage unstable
conditions.
