NUR 283 Exam 2 & 3 | Comprehensive Study
Guide with Complete Practice Questions and
Rationales | Galen College of Nursing - Latest
Update 2026/2027 | Graded A+
Question 1
Which client condition should the nurse prioritize 24 hours postoperative?
Answer: The client who reports an increased pain level of 8 on a scale of 0 to 10 after
receiving an opioid analgesic. ✔✔
Rationale: An increased pain level of 8 despite opioid administration indicates
inadequate pain management or a potential complication such as surgical site infection,
nerve injury, or compartment syndrome. This requires immediate reassessment and
intervention.
Question 2
What is an example of malpractice in nursing?
Answer: 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: Administering medication to a competent client who has refused treatment
constitutes battery and malpractice. This violates the client's right to refuse treatment
and informed consent.
Question 3
Which client should the nurse follow up with regarding pyridostigmine?
Answer: The client receiving pyridostigmine who reports nausea and congested cough.
✔✔
Rationale: Pyridostigmine is a cholinesterase inhibitor used for myasthenia gravis.
Nausea and congested cough may indicate cholinergic crisis (overmedication) or
worsening of the disease. Respiratory complications require immediate attention.
pg. 1
,Question 4
What is the first strategy the CQI committee should initiate to reduce medication
errors?
Answer: Review the events that led to the medication administration error by creating
a flow diagram. ✔✔
Rationale: Root cause analysis through a flow diagram identifies system failures and
process breakdowns, enabling targeted interventions to prevent future errors.
Question 5
When can informed consent be waived?
Answer: For urgent medical or surgical treatment if the client is unconscious, per
facility policy. ✔✔
Rationale: Informed consent can be waived in life-threatening emergencies when the
client is unable to provide consent and a surrogate decision-maker is not immediately
available, and treatment cannot be delayed.
Question 6
Which client should the nurse prioritize after receiving the hand-off report?
Answer: The client with cirrhosis, several new areas of ecchymosis, and a partial
thromboplastin time (PTT) of 76 seconds. ✔✔
Rationale: New ecchymosis with elevated PTT indicates impaired clotting function,
likely due to liver failure and coagulopathy. This client is at high risk for spontaneous
bleeding, including intracranial hemorrhage.
Question 7
Which pediatric client should the nurse assess first based on telemetry?
Answer: A 1-month-old infant who is sleeping and has a pulse of 180. ✔✔
Rationale: A heart rate of 180 in a sleeping infant is significantly elevated (normal
resting HR for a 1-month-old is 100-160). This may indicate supraventricular
tachycardia, sepsis, or respiratory distress requiring immediate assessment.
Question 8
For which child should the nurse initiate an interdisciplinary conference?
pg. 2
, Answer: A 5-year-old diagnosed with cystic fibrosis (CF) at birth and hospitalized 4
times in the past 2 months. ✔✔
Rationale: Frequent hospitalizations for CF indicate poor disease management or
progressive decline, requiring collaboration among pulmonology, nutrition, respiratory
therapy, social work, and family.
Question 9
What is the most appropriate action for a nurse reviewing a client with pericarditis and
elevated WBC?
Answer: Update the nursing interventions as needed. ✔✔
Rationale: Elevated WBC with pericarditis may indicate infection. The care plan
should be updated to address the inflammatory and infection risk.
Question 10
Which documentation by a nurse indicates correct practice?
Answer: IV catheter site in left antecubital space is red and warm to touch. IV catheter
removed intact. 20-gauge catheter placed in right forearm. ✔✔
Rationale: This documentation is objective, accurate, includes the action taken
(removal and replacement), and describes the catheter size and site. It follows proper
charting guidelines.
Question 11
What should the nurse do with a client's CPAP machine brought from home?
Answer: Have the machine inspected by the facility's engineering department. ✔✔
Rationale: Personal equipment brought from home must be inspected for electrical
safety to prevent hazards and ensure it meets facility standards.
Question 12
Which client is safest for discharge during an emergency response plan?
Answer: The client who has a deep vein thrombosis (DVT), is receiving warfarin, and
has a prothrombin time (PT) of 28 seconds. ✔✔
pg. 3
Guide with Complete Practice Questions and
Rationales | Galen College of Nursing - Latest
Update 2026/2027 | Graded A+
Question 1
Which client condition should the nurse prioritize 24 hours postoperative?
Answer: The client who reports an increased pain level of 8 on a scale of 0 to 10 after
receiving an opioid analgesic. ✔✔
Rationale: An increased pain level of 8 despite opioid administration indicates
inadequate pain management or a potential complication such as surgical site infection,
nerve injury, or compartment syndrome. This requires immediate reassessment and
intervention.
Question 2
What is an example of malpractice in nursing?
Answer: 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: Administering medication to a competent client who has refused treatment
constitutes battery and malpractice. This violates the client's right to refuse treatment
and informed consent.
Question 3
Which client should the nurse follow up with regarding pyridostigmine?
Answer: The client receiving pyridostigmine who reports nausea and congested cough.
✔✔
Rationale: Pyridostigmine is a cholinesterase inhibitor used for myasthenia gravis.
Nausea and congested cough may indicate cholinergic crisis (overmedication) or
worsening of the disease. Respiratory complications require immediate attention.
pg. 1
,Question 4
What is the first strategy the CQI committee should initiate to reduce medication
errors?
Answer: Review the events that led to the medication administration error by creating
a flow diagram. ✔✔
Rationale: Root cause analysis through a flow diagram identifies system failures and
process breakdowns, enabling targeted interventions to prevent future errors.
Question 5
When can informed consent be waived?
Answer: For urgent medical or surgical treatment if the client is unconscious, per
facility policy. ✔✔
Rationale: Informed consent can be waived in life-threatening emergencies when the
client is unable to provide consent and a surrogate decision-maker is not immediately
available, and treatment cannot be delayed.
Question 6
Which client should the nurse prioritize after receiving the hand-off report?
Answer: The client with cirrhosis, several new areas of ecchymosis, and a partial
thromboplastin time (PTT) of 76 seconds. ✔✔
Rationale: New ecchymosis with elevated PTT indicates impaired clotting function,
likely due to liver failure and coagulopathy. This client is at high risk for spontaneous
bleeding, including intracranial hemorrhage.
Question 7
Which pediatric client should the nurse assess first based on telemetry?
Answer: A 1-month-old infant who is sleeping and has a pulse of 180. ✔✔
Rationale: A heart rate of 180 in a sleeping infant is significantly elevated (normal
resting HR for a 1-month-old is 100-160). This may indicate supraventricular
tachycardia, sepsis, or respiratory distress requiring immediate assessment.
Question 8
For which child should the nurse initiate an interdisciplinary conference?
pg. 2
, Answer: A 5-year-old diagnosed with cystic fibrosis (CF) at birth and hospitalized 4
times in the past 2 months. ✔✔
Rationale: Frequent hospitalizations for CF indicate poor disease management or
progressive decline, requiring collaboration among pulmonology, nutrition, respiratory
therapy, social work, and family.
Question 9
What is the most appropriate action for a nurse reviewing a client with pericarditis and
elevated WBC?
Answer: Update the nursing interventions as needed. ✔✔
Rationale: Elevated WBC with pericarditis may indicate infection. The care plan
should be updated to address the inflammatory and infection risk.
Question 10
Which documentation by a nurse indicates correct practice?
Answer: IV catheter site in left antecubital space is red and warm to touch. IV catheter
removed intact. 20-gauge catheter placed in right forearm. ✔✔
Rationale: This documentation is objective, accurate, includes the action taken
(removal and replacement), and describes the catheter size and site. It follows proper
charting guidelines.
Question 11
What should the nurse do with a client's CPAP machine brought from home?
Answer: Have the machine inspected by the facility's engineering department. ✔✔
Rationale: Personal equipment brought from home must be inspected for electrical
safety to prevent hazards and ensure it meets facility standards.
Question 12
Which client is safest for discharge during an emergency response plan?
Answer: The client who has a deep vein thrombosis (DVT), is receiving warfarin, and
has a prothrombin time (PT) of 28 seconds. ✔✔
pg. 3
