,NUR283/NUR 283 COMP 4 Exam | RN Transition
Practice | Galen College | Q & A | 2026 Edition (PDF)
**1. The nurse is prioritizing patient care after a change-of-shift report. Which patient should the nurse
see FIRST?**
A) A patient scheduled for discharge who needs final medication teaching
B) A patient who had a knee arthroscopy yesterday and reports pain at 4/10
C) A patient who had an ERCP 30 minutes ago and is reporting difficulty swallowing
D) A patient who is NPO for an abdominal ultrasound this morning
Correct Answer: C) A patient who had an ERCP 30 minutes ago and is reporting difficulty swallowing
Rationale: The ABC framework prioritizes airway compromise above all else. After an ERCP, the gag
reflex may be absent, putting the patient at risk for aspiration. Difficulty swallowing suggests the airway
might be compromised, requiring immediate bedside assessment.
**2. The nurse working on a pediatric unit has received the hand-off report. Which client should the
nurse plan to see FIRST?**
A) A toddler with bronchiolitis on room air and mild wheezing
B) An infant with pertussis who 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
Correct Answer: B) An infant with pertussis who is receiving oxygen via nasal cannula
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.
**3. A nurse on a medical-surgical unit receives report on four clients. Which client should the nurse
assess FIRST?**
,A) A client with acute pancreatitis reporting pain on deep inspiration
B) A client with COPD with SpO₂ of 93% on 2 L oxygen
C) A client with type 2 diabetes with glucose of 220 mg/dL
D) A client who is postoperative day 1 following a total knee replacement
Correct Answer: A) A client with acute pancreatitis reporting pain on deep inspiration
Rationale: Pain on deep inspiration in a client with pancreatitis may indicate pleuritic irritation,
pneumonia, or pulmonary embolism, which could compromise breathing. While the COPD client has
stable oxygenation and the diabetes client's glucose is elevated but not critical, the pancreatitis client's
symptom suggests a potential respiratory complication requiring immediate assessment.
**4. The nurse is caring for four patients. Which patient should the nurse assess FIRST?**
A) A client with diabetes requesting a refill of their insulin prescription
B) A client two hours post-op reporting pain level 6/10
C) A client with asthma who develops wheezing and increased work of breathing
D) A client scheduled for discharge tomorrow needing education on wound care
Correct Answer: C) A client with asthma who develops wheezing and increased work of breathing
Rationale: The client with asthma experiencing wheezing and increased work of breathing has a
potential airway and breathing compromise, which takes priority according to ABC (Airway, Breathing,
Circulation) framework. Airway and breathing issues are immediate life-threatening concerns requiring
urgent assessment.
**5. The charge nurse is assigning staff to patients on a medical-surgical unit. Which patient should be
assigned to the LPN?**
A) A patient with newly diagnosed diabetic ketoacidosis on an insulin drip
B) A patient with pneumonia who is hemodynamically stable and requires scheduled IV antibiotics
C) A patient post-cardiac arrest requiring frequent neurological assessments
D) A patient with an epidural catheter for post-op pain management
, Correct Answer: B) A patient with pneumonia who is hemodynamically stable and requires scheduled IV
antibiotics
Rationale: LPNs can care for stable patients with predictable outcomes and perform tasks like
administering IV antibiotics to stable patients. Unstable patients, those requiring frequent assessments,
or those with complex titratable drips (insulin, epidurals) require an RN.
**6. The nurse preceptor is observing a newly hired nurse care for assigned clients. Which action by the
newly hired nurse indicates correct care?**
A) Using a 25-gauge, 5/8-inch needle for a deltoid IM injection
B) Using a 23-gauge, 1-inch needle when administering a medication in the deltoid muscle
C) Using a 20-gauge, 1½-inch needle for a subcutaneous injection
D) Using an 18-gauge, 1½-inch needle for an IM injection in the ventrogluteal site
Correct Answer: B) Using a 23-gauge, 1-inch needle when administering a medication in the deltoid
muscle
Rationale: For deltoid IM injections, a 23-25 gauge, 1-inch needle is appropriate. A 25-gauge, 5/8-inch
needle is too short for IM deltoid (used for ID or subcutaneous). A 20-gauge, 1½-inch needle is
appropriate for IM but not subcutaneous. The ventrogluteal site requires a longer needle (1-1.5 inches).
**7. Which task is appropriate for the nurse to delegate to an unlicensed assistive personnel (UAP)?**
A) Administering oral medications
B) Obtaining a capillary blood glucose reading on a client who has become diaphoretic
C) Flushing a closed-wound drainage system (JP) drain
D) Teaching a client with a newly created ileostomy how to change the appliance
Correct Answer: B) Obtaining a capillary blood glucose reading on a client who has become diaphoretic
Practice | Galen College | Q & A | 2026 Edition (PDF)
**1. The nurse is prioritizing patient care after a change-of-shift report. Which patient should the nurse
see FIRST?**
A) A patient scheduled for discharge who needs final medication teaching
B) A patient who had a knee arthroscopy yesterday and reports pain at 4/10
C) A patient who had an ERCP 30 minutes ago and is reporting difficulty swallowing
D) A patient who is NPO for an abdominal ultrasound this morning
Correct Answer: C) A patient who had an ERCP 30 minutes ago and is reporting difficulty swallowing
Rationale: The ABC framework prioritizes airway compromise above all else. After an ERCP, the gag
reflex may be absent, putting the patient at risk for aspiration. Difficulty swallowing suggests the airway
might be compromised, requiring immediate bedside assessment.
**2. The nurse working on a pediatric unit has received the hand-off report. Which client should the
nurse plan to see FIRST?**
A) A toddler with bronchiolitis on room air and mild wheezing
B) An infant with pertussis who 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
Correct Answer: B) An infant with pertussis who is receiving oxygen via nasal cannula
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.
**3. A nurse on a medical-surgical unit receives report on four clients. Which client should the nurse
assess FIRST?**
,A) A client with acute pancreatitis reporting pain on deep inspiration
B) A client with COPD with SpO₂ of 93% on 2 L oxygen
C) A client with type 2 diabetes with glucose of 220 mg/dL
D) A client who is postoperative day 1 following a total knee replacement
Correct Answer: A) A client with acute pancreatitis reporting pain on deep inspiration
Rationale: Pain on deep inspiration in a client with pancreatitis may indicate pleuritic irritation,
pneumonia, or pulmonary embolism, which could compromise breathing. While the COPD client has
stable oxygenation and the diabetes client's glucose is elevated but not critical, the pancreatitis client's
symptom suggests a potential respiratory complication requiring immediate assessment.
**4. The nurse is caring for four patients. Which patient should the nurse assess FIRST?**
A) A client with diabetes requesting a refill of their insulin prescription
B) A client two hours post-op reporting pain level 6/10
C) A client with asthma who develops wheezing and increased work of breathing
D) A client scheduled for discharge tomorrow needing education on wound care
Correct Answer: C) A client with asthma who develops wheezing and increased work of breathing
Rationale: The client with asthma experiencing wheezing and increased work of breathing has a
potential airway and breathing compromise, which takes priority according to ABC (Airway, Breathing,
Circulation) framework. Airway and breathing issues are immediate life-threatening concerns requiring
urgent assessment.
**5. The charge nurse is assigning staff to patients on a medical-surgical unit. Which patient should be
assigned to the LPN?**
A) A patient with newly diagnosed diabetic ketoacidosis on an insulin drip
B) A patient with pneumonia who is hemodynamically stable and requires scheduled IV antibiotics
C) A patient post-cardiac arrest requiring frequent neurological assessments
D) A patient with an epidural catheter for post-op pain management
, Correct Answer: B) A patient with pneumonia who is hemodynamically stable and requires scheduled IV
antibiotics
Rationale: LPNs can care for stable patients with predictable outcomes and perform tasks like
administering IV antibiotics to stable patients. Unstable patients, those requiring frequent assessments,
or those with complex titratable drips (insulin, epidurals) require an RN.
**6. The nurse preceptor is observing a newly hired nurse care for assigned clients. Which action by the
newly hired nurse indicates correct care?**
A) Using a 25-gauge, 5/8-inch needle for a deltoid IM injection
B) Using a 23-gauge, 1-inch needle when administering a medication in the deltoid muscle
C) Using a 20-gauge, 1½-inch needle for a subcutaneous injection
D) Using an 18-gauge, 1½-inch needle for an IM injection in the ventrogluteal site
Correct Answer: B) Using a 23-gauge, 1-inch needle when administering a medication in the deltoid
muscle
Rationale: For deltoid IM injections, a 23-25 gauge, 1-inch needle is appropriate. A 25-gauge, 5/8-inch
needle is too short for IM deltoid (used for ID or subcutaneous). A 20-gauge, 1½-inch needle is
appropriate for IM but not subcutaneous. The ventrogluteal site requires a longer needle (1-1.5 inches).
**7. Which task is appropriate for the nurse to delegate to an unlicensed assistive personnel (UAP)?**
A) Administering oral medications
B) Obtaining a capillary blood glucose reading on a client who has become diaphoretic
C) Flushing a closed-wound drainage system (JP) drain
D) Teaching a client with a newly created ileostomy how to change the appliance
Correct Answer: B) Obtaining a capillary blood glucose reading on a client who has become diaphoretic
