,NUR 283 Comp 4 Exam | Transition to RN Practice
(2026) Q&A | Galen College
1. The nurse receives a change-of-shift report on four clients. Which client
should be seen first?
A) A client scheduled for discharge who needs final medication teaching
B) A client who had a knee arthroscopy yesterday and reports incisional pain of
4 on a 0–10 scale
C) A client who had an endoscopic retrograde cholangiopancreatography (ERCP)
30 minutes ago and reports difficulty swallowing
D) A client who is NPO for an abdominal ultrasound later this morning
Correct Answer: A client who had an endoscopic retrograde
cholangiopancreatography (ERCP) 30 minutes ago and reports difficulty
swallowing
Rationale: Airway is the highest priority. After an ERCP, the gag reflex may be
absent, and difficulty swallowing places the client at risk for aspiration. The
nurse must immediately assess for airway compromise. The other clients have
stable, non-urgent needs that can be addressed later.
2. The charge nurse is making patient assignments for a medical-surgical unit.
Which patient should be assigned to the registered nurse (RN) rather than the
licensed practical/vocational nurse (LPN/VN)?
A) A patient with pneumonia who is hemodynamically stable and receiving oral
antibiotics
B) A patient with a newly diagnosed diabetic ketoacidosis on an insulin infusion
C) A patient with chronic kidney disease who needs a routine dressing change
,D) A patient who had a cerebrovascular accident 5 days ago and is awaiting
transfer to rehabilitation
Correct Answer: A patient with a newly diagnosed diabetic ketoacidosis on an
insulin infusion
Rationale: The patient with DKA on an insulin infusion is unstable and requires
frequent assessment and titration of therapy, which falls within the RN's scope.
The LPN/VN cares for stable patients with predictable outcomes; the other
patients are stable.
3. While assessing a client’s sacral area, the nurse identifies a full-thickness
wound with exposed bone and tendons. How should the nurse document this
finding?
A) Stage I pressure injury
B) Stage II pressure injury
C) Stage III pressure injury
D) Stage IV pressure injury
Correct Answer: Stage IV pressure injury
Rationale: A Stage IV pressure injury involves full-thickness tissue loss with
exposed bone, tendon, or muscle. Slough or eschar may be present. This is the
most severe stage and requires extensive wound care and prevention of
infection.
4. A client with heart failure has bilateral crackles and 3+ pitting edema. The
nurse anticipates a prescription for which medication?
, A) Metoprolol
B) Furosemide
C) Digoxin
D) Lisinopril
Correct Answer: Furosemide
Rationale: Furosemide is a loop diuretic that rapidly reduces preload by
promoting fluid excretion, relieving pulmonary congestion and peripheral
edema. Metoprolol reduces heart rate, digoxin improves contractility, and
lisinopril reduces afterload; diuresis is the immediate need for volume overload.
5. The nurse is teaching a client about warfarin therapy. Which statement by the
client indicates a need for further teaching?
A) "I will report any signs of bleeding, including blood in my urine."
B) "I will use a soft-bristled toothbrush."
C) "I will increase my intake of leafy green vegetables to maintain vitamin K
levels."
D) "I will avoid taking ibuprofen for pain."
Correct Answer: "I will increase my intake of leafy green vegetables to maintain
vitamin K levels."
Rationale: Leafy green vegetables are high in vitamin K, which antagonizes
warfarin. The client should maintain a consistent, not increased, intake. The
other statements are correct: report bleeding, use a soft toothbrush, and avoid
NSAIDs.
(2026) Q&A | Galen College
1. The nurse receives a change-of-shift report on four clients. Which client
should be seen first?
A) A client scheduled for discharge who needs final medication teaching
B) A client who had a knee arthroscopy yesterday and reports incisional pain of
4 on a 0–10 scale
C) A client who had an endoscopic retrograde cholangiopancreatography (ERCP)
30 minutes ago and reports difficulty swallowing
D) A client who is NPO for an abdominal ultrasound later this morning
Correct Answer: A client who had an endoscopic retrograde
cholangiopancreatography (ERCP) 30 minutes ago and reports difficulty
swallowing
Rationale: Airway is the highest priority. After an ERCP, the gag reflex may be
absent, and difficulty swallowing places the client at risk for aspiration. The
nurse must immediately assess for airway compromise. The other clients have
stable, non-urgent needs that can be addressed later.
2. The charge nurse is making patient assignments for a medical-surgical unit.
Which patient should be assigned to the registered nurse (RN) rather than the
licensed practical/vocational nurse (LPN/VN)?
A) A patient with pneumonia who is hemodynamically stable and receiving oral
antibiotics
B) A patient with a newly diagnosed diabetic ketoacidosis on an insulin infusion
C) A patient with chronic kidney disease who needs a routine dressing change
,D) A patient who had a cerebrovascular accident 5 days ago and is awaiting
transfer to rehabilitation
Correct Answer: A patient with a newly diagnosed diabetic ketoacidosis on an
insulin infusion
Rationale: The patient with DKA on an insulin infusion is unstable and requires
frequent assessment and titration of therapy, which falls within the RN's scope.
The LPN/VN cares for stable patients with predictable outcomes; the other
patients are stable.
3. While assessing a client’s sacral area, the nurse identifies a full-thickness
wound with exposed bone and tendons. How should the nurse document this
finding?
A) Stage I pressure injury
B) Stage II pressure injury
C) Stage III pressure injury
D) Stage IV pressure injury
Correct Answer: Stage IV pressure injury
Rationale: A Stage IV pressure injury involves full-thickness tissue loss with
exposed bone, tendon, or muscle. Slough or eschar may be present. This is the
most severe stage and requires extensive wound care and prevention of
infection.
4. A client with heart failure has bilateral crackles and 3+ pitting edema. The
nurse anticipates a prescription for which medication?
, A) Metoprolol
B) Furosemide
C) Digoxin
D) Lisinopril
Correct Answer: Furosemide
Rationale: Furosemide is a loop diuretic that rapidly reduces preload by
promoting fluid excretion, relieving pulmonary congestion and peripheral
edema. Metoprolol reduces heart rate, digoxin improves contractility, and
lisinopril reduces afterload; diuresis is the immediate need for volume overload.
5. The nurse is teaching a client about warfarin therapy. Which statement by the
client indicates a need for further teaching?
A) "I will report any signs of bleeding, including blood in my urine."
B) "I will use a soft-bristled toothbrush."
C) "I will increase my intake of leafy green vegetables to maintain vitamin K
levels."
D) "I will avoid taking ibuprofen for pain."
Correct Answer: "I will increase my intake of leafy green vegetables to maintain
vitamin K levels."
Rationale: Leafy green vegetables are high in vitamin K, which antagonizes
warfarin. The client should maintain a consistent, not increased, intake. The
other statements are correct: report bleeding, use a soft toothbrush, and avoid
NSAIDs.
