NUR 283
COMP 1–3 EXAMS
Tested Questions With Rationales
TRANSITION TO REGISTERED NURSING PRACTICE
Galen College Of Nursing
INTRODUCTION
Welcome to the ultimate academic preparation bundle for the NUR 283: Transition
to Registered Nursing Practice Comprehensive 1–3 Examinations. Transitioning
from a licensed practical nurse (LPN/LVN) or entering the final stages of a
professional registered nursing curriculum requires a profound mastery of
clinical judgment, legal delegation frameworks, and rapid triage systems.This
study guide has been explicitly curated to mirror the structural depth, critical
thinking rigor, and core clinical competencies tested across all three major
institutional exit assessments. By pairing every question directly with its updated,
verified answer and an uncompromised, system-by-system expert rationale, this
text transforms passive review into active clinical reasoning. Whether you are
using this document to secure a flawless pass on your institutional comps or
leveraging it as a top-tier digital asset for academic resale, this resource stands
as the definitive benchmark for advanced nursing excellence.
,NUR 283 Comp 1 Exam
Question 1
The nurse on a medical-surgical unit is preparing to receive a client from the
emergency department. Which client should the nurse assess first after receiving
the change-of-shift report?
A. A client with chronic obstructive pulmonary disease (COPD) who has an oxygen
saturation of 89% on 2 L/min via nasal cannula.
B. A client who is 2 days postoperative following a total hip arthroplasty and
reports sudden shortness of breath and chest pain.
C. A client diagnosed with acute cholecystitis who is requesting prescribed PRN
pain medication for right upper quadrant pain.
D. A client with diabetes mellitus whose morning fingerstick blood glucose reading
is 145 mg/dL.
Answer: B. A client who is 2 days postoperative following a total hip
arthroplasty and reports sudden shortness of breath and chest pain.
Expert Rationale: Postoperative clients are at high risk for deep vein
thrombosis (DVT) and subsequent pulmonary embolism (PE). Sudden onset
of shortness of breath and chest pain indicates a life-threatening
emergency requiring immediate assessment and intervention. The COPD
client’s oxygen saturation is within an expected range for chronic disease,
and the other clients represent stable or non-urgent needs.
Question 2
A registered nurse (RN) is planning care for the shift and delegating tasks to a
licensed practical nurse (LPN) and an assistive personnel (AP). Which task is most
,appropriate for the RN to delegate to the LPN?
A. Administering an initial dose of an intravenous antibiotic to a client with sepsis.
B. Completing the admission assessment and documentation for a newly admitted
client.
C. Providing discharge teaching regarding a new medication regimen to a client
going home.
D. Administering a scheduled subcutaneous injection of insulin glargine to a stable
client.
Answer: D. Administering a scheduled subcutaneous injection of insulin
glargine to a stable client.
Expert Rationale: The scope of practice for an LPN includes administering
medications via subcutaneous routes to stable clients. Initial assessments,
initial IV medication administrations, and client discharge teaching require
advanced nursing judgment and must be performed exclusively by the RN.
Question 3
The nurse is monitoring a client who is receiving a continuous intravenous
infusion of heparin for a deep vein thrombosis. Which laboratory value requires
immediate notification of the healthcare provider?
A. Activated partial thromboplastin time (aPTT) of 75 seconds.
B. Platelet count of 82,000/mm³.
C. Prothrombin time (PT) of 12 seconds.
D. Hemoglobin level of 12.5 g/dL.
Answer: B. Platelet count of 82,000/mm³.
, Expert Rationale: A platelet count below 100,000/mm³, or a drop of more
than 50% from baseline, indicates a high risk for Heparin-Induced
Thrombocytopenia (HIT). This is a severe, life-threatening immunologic
reaction that requires immediate cessation of heparin therapy and
alternative anticoagulation. The aPTT is within the therapeutic range for
heparin therapy.
Question 4
The nurse on a pediatric unit receives a hand-off report for four clients. Which
client should the nurse assess first?
A. A 4-year-old child with asthma who has intercostal retractions and an
expiratory wheeze.
B. A 10-month-old infant with gastroenteritis who has had 3 episodes of liquid
stool in 8 hours.
C. A 6-year-old child recovering from an appendectomy who has a temperature of
99.8°F (37.7°C).
D. A 12-year-old child with a femur fracture who is requesting an extra pillow for
leg elevation.
Answer: A. A 4-year-old child with asthma who has intercostal retractions
and an expiratory wheeze.
Expert Rationale: Intercostal retractions indicate increased work of
breathing and potential respiratory failure in a pediatric client with asthma.
Respiratory distress takes priority over mild fever, mild diarrhea, or
comfort measures based on the ABC (Airway, Breathing, Circulation)
framework.
COMP 1–3 EXAMS
Tested Questions With Rationales
TRANSITION TO REGISTERED NURSING PRACTICE
Galen College Of Nursing
INTRODUCTION
Welcome to the ultimate academic preparation bundle for the NUR 283: Transition
to Registered Nursing Practice Comprehensive 1–3 Examinations. Transitioning
from a licensed practical nurse (LPN/LVN) or entering the final stages of a
professional registered nursing curriculum requires a profound mastery of
clinical judgment, legal delegation frameworks, and rapid triage systems.This
study guide has been explicitly curated to mirror the structural depth, critical
thinking rigor, and core clinical competencies tested across all three major
institutional exit assessments. By pairing every question directly with its updated,
verified answer and an uncompromised, system-by-system expert rationale, this
text transforms passive review into active clinical reasoning. Whether you are
using this document to secure a flawless pass on your institutional comps or
leveraging it as a top-tier digital asset for academic resale, this resource stands
as the definitive benchmark for advanced nursing excellence.
,NUR 283 Comp 1 Exam
Question 1
The nurse on a medical-surgical unit is preparing to receive a client from the
emergency department. Which client should the nurse assess first after receiving
the change-of-shift report?
A. A client with chronic obstructive pulmonary disease (COPD) who has an oxygen
saturation of 89% on 2 L/min via nasal cannula.
B. A client who is 2 days postoperative following a total hip arthroplasty and
reports sudden shortness of breath and chest pain.
C. A client diagnosed with acute cholecystitis who is requesting prescribed PRN
pain medication for right upper quadrant pain.
D. A client with diabetes mellitus whose morning fingerstick blood glucose reading
is 145 mg/dL.
Answer: B. A client who is 2 days postoperative following a total hip
arthroplasty and reports sudden shortness of breath and chest pain.
Expert Rationale: Postoperative clients are at high risk for deep vein
thrombosis (DVT) and subsequent pulmonary embolism (PE). Sudden onset
of shortness of breath and chest pain indicates a life-threatening
emergency requiring immediate assessment and intervention. The COPD
client’s oxygen saturation is within an expected range for chronic disease,
and the other clients represent stable or non-urgent needs.
Question 2
A registered nurse (RN) is planning care for the shift and delegating tasks to a
licensed practical nurse (LPN) and an assistive personnel (AP). Which task is most
,appropriate for the RN to delegate to the LPN?
A. Administering an initial dose of an intravenous antibiotic to a client with sepsis.
B. Completing the admission assessment and documentation for a newly admitted
client.
C. Providing discharge teaching regarding a new medication regimen to a client
going home.
D. Administering a scheduled subcutaneous injection of insulin glargine to a stable
client.
Answer: D. Administering a scheduled subcutaneous injection of insulin
glargine to a stable client.
Expert Rationale: The scope of practice for an LPN includes administering
medications via subcutaneous routes to stable clients. Initial assessments,
initial IV medication administrations, and client discharge teaching require
advanced nursing judgment and must be performed exclusively by the RN.
Question 3
The nurse is monitoring a client who is receiving a continuous intravenous
infusion of heparin for a deep vein thrombosis. Which laboratory value requires
immediate notification of the healthcare provider?
A. Activated partial thromboplastin time (aPTT) of 75 seconds.
B. Platelet count of 82,000/mm³.
C. Prothrombin time (PT) of 12 seconds.
D. Hemoglobin level of 12.5 g/dL.
Answer: B. Platelet count of 82,000/mm³.
, Expert Rationale: A platelet count below 100,000/mm³, or a drop of more
than 50% from baseline, indicates a high risk for Heparin-Induced
Thrombocytopenia (HIT). This is a severe, life-threatening immunologic
reaction that requires immediate cessation of heparin therapy and
alternative anticoagulation. The aPTT is within the therapeutic range for
heparin therapy.
Question 4
The nurse on a pediatric unit receives a hand-off report for four clients. Which
client should the nurse assess first?
A. A 4-year-old child with asthma who has intercostal retractions and an
expiratory wheeze.
B. A 10-month-old infant with gastroenteritis who has had 3 episodes of liquid
stool in 8 hours.
C. A 6-year-old child recovering from an appendectomy who has a temperature of
99.8°F (37.7°C).
D. A 12-year-old child with a femur fracture who is requesting an extra pillow for
leg elevation.
Answer: A. A 4-year-old child with asthma who has intercostal retractions
and an expiratory wheeze.
Expert Rationale: Intercostal retractions indicate increased work of
breathing and potential respiratory failure in a pediatric client with asthma.
Respiratory distress takes priority over mild fever, mild diarrhea, or
comfort measures based on the ABC (Airway, Breathing, Circulation)
framework.
