NSG 4800 COMPS — Updated Practice Exam with verified answers and
rationales 2026/2027 version
1. A nurse receives report on four clients. Which client should the nurse assess
first?
A. Client with diabetes who has a glucose of 38 mg/dL and is difficult to arouse
B. Client with pneumonia and a temperature of 38.1°C (100.6°F)
C. Client with a UTI reporting urinary frequency
D. Client with appendicitis reporting pain of 4/10
Answer: A
Rationale: Severe hypoglycemia with altered level of consciousness is immediately life-
threatening. The nurse should prioritize airway, breathing, circulation, and acute neurologic
threats.
2. Which finding is most consistent with orthostatic hypotension?
A. Increase in systolic BP of 20 mmHg after standing
B. Decrease in systolic BP of 20 mmHg after position change
C. Increase in temperature after exercise
D. Decrease in respiratory rate while sleeping
Answer: B
Rationale: A significant drop in blood pressure after changing position can indicate orthostatic
hypotension and increases fall risk.
3. Which intervention is appropriate for a client experiencing orthostatic
hypotension?
A. Encourage rapid position changes
B. Assist the client when changing positions
C. Restrict all fluids
D. Encourage prolonged standing
Answer: B
Rationale: Slow position changes and assistance reduce the risk of dizziness, syncope, and falls.
,4. Which precaution is appropriate for a client with suspected pulmonary
tuberculosis?
A. Contact
B. Droplet
C. Airborne
D. Protective
Answer: C
Rationale: Tuberculosis is transmitted through airborne particles. Appropriate respiratory
protection and airborne infection-control measures are required.
5. Which intervention is appropriate for a client requiring contact precautions?
A. Gown and gloves according to facility protocol
B. N95 respirator for every interaction
C. No hand hygiene
D. Surgical mask only in all situations
Answer: A
Rationale: Contact precautions generally involve appropriate gown and glove use, along with
standard precautions and hand hygiene.
6. Which action demonstrates proper medication administration?
A. Administering a medication without checking the client's identity
B. Comparing the medication with the prescription and identifying the client correctly
C. Giving medication prepared by another nurse without verification
D. Documenting administration before giving the medication
Answer: B
Rationale: Medication safety requires verification of the order, patient identity, medication,
dose, route, timing, and other applicable rights before administration.
,7. A client receiving IV morphine becomes difficult to arouse with a respiratory
rate of 7/min. What is the priority action?
A. Give the next dose of morphine
B. Assess airway and breathing and initiate appropriate emergency intervention
C. Encourage the client to sleep
D. Offer oral fluids
Answer: B
Rationale: Severe respiratory depression is a potentially life-threatening opioid adverse effect
and requires immediate assessment and intervention.
8. Which laboratory value requires the most immediate attention?
A. Sodium 138 mEq/L
B. Potassium 6.2 mEq/L
C. Calcium 9.2 mg/dL
D. Glucose 96 mg/dL
Answer: B
Rationale: Severe hyperkalemia can cause dangerous cardiac dysrhythmias and requires prompt
evaluation and treatment.
9. Which task is generally appropriate for an RN to delegate to trained UAP?
A. Initial assessment
B. Patient teaching
C. Routine vital signs on a stable client
D. Development of the nursing care plan
Answer: C
Rationale: UAP can perform appropriate routine, predictable tasks on stable clients.
Assessment, teaching, and care planning remain nursing responsibilities.
10. Which finding should the nurse report immediately in a postoperative client?
, A. Urine output of 20 mL/hr
B. Pain rated 3/10
C. Temperature of 37°C (98.6°F)
D. Small amount of expected drainage
Answer: A
Rationale: Persistently low urine output may indicate inadequate renal perfusion, hypovolemia,
or another serious complication.
11. Which intervention is appropriate for preventing venous thromboembolism
in a postoperative client?
A. Prolonged bed rest
B. Early ambulation as appropriate
C. Restricting all fluids
D. Keeping the legs dependent continuously
Answer: B
Rationale: Early mobility, prescribed anticoagulation when appropriate, and mechanical
prophylaxis can reduce VTE risk.
12. A client with suspected hypovolemic shock is hypotensive and has a weak,
rapid pulse. Which finding would the nurse expect?
A. Increased urine output
B. Decreased urine output
C. Bounding pulse
D. Bradycardia
Answer: B
Rationale: Reduced circulating volume decreases renal perfusion, commonly resulting in
oliguria.
13. Which finding is most concerning in a client with COPD?
A. Oxygen saturation of 95%
B. Mild chronic cough
rationales 2026/2027 version
1. A nurse receives report on four clients. Which client should the nurse assess
first?
A. Client with diabetes who has a glucose of 38 mg/dL and is difficult to arouse
B. Client with pneumonia and a temperature of 38.1°C (100.6°F)
C. Client with a UTI reporting urinary frequency
D. Client with appendicitis reporting pain of 4/10
Answer: A
Rationale: Severe hypoglycemia with altered level of consciousness is immediately life-
threatening. The nurse should prioritize airway, breathing, circulation, and acute neurologic
threats.
2. Which finding is most consistent with orthostatic hypotension?
A. Increase in systolic BP of 20 mmHg after standing
B. Decrease in systolic BP of 20 mmHg after position change
C. Increase in temperature after exercise
D. Decrease in respiratory rate while sleeping
Answer: B
Rationale: A significant drop in blood pressure after changing position can indicate orthostatic
hypotension and increases fall risk.
3. Which intervention is appropriate for a client experiencing orthostatic
hypotension?
A. Encourage rapid position changes
B. Assist the client when changing positions
C. Restrict all fluids
D. Encourage prolonged standing
Answer: B
Rationale: Slow position changes and assistance reduce the risk of dizziness, syncope, and falls.
,4. Which precaution is appropriate for a client with suspected pulmonary
tuberculosis?
A. Contact
B. Droplet
C. Airborne
D. Protective
Answer: C
Rationale: Tuberculosis is transmitted through airborne particles. Appropriate respiratory
protection and airborne infection-control measures are required.
5. Which intervention is appropriate for a client requiring contact precautions?
A. Gown and gloves according to facility protocol
B. N95 respirator for every interaction
C. No hand hygiene
D. Surgical mask only in all situations
Answer: A
Rationale: Contact precautions generally involve appropriate gown and glove use, along with
standard precautions and hand hygiene.
6. Which action demonstrates proper medication administration?
A. Administering a medication without checking the client's identity
B. Comparing the medication with the prescription and identifying the client correctly
C. Giving medication prepared by another nurse without verification
D. Documenting administration before giving the medication
Answer: B
Rationale: Medication safety requires verification of the order, patient identity, medication,
dose, route, timing, and other applicable rights before administration.
,7. A client receiving IV morphine becomes difficult to arouse with a respiratory
rate of 7/min. What is the priority action?
A. Give the next dose of morphine
B. Assess airway and breathing and initiate appropriate emergency intervention
C. Encourage the client to sleep
D. Offer oral fluids
Answer: B
Rationale: Severe respiratory depression is a potentially life-threatening opioid adverse effect
and requires immediate assessment and intervention.
8. Which laboratory value requires the most immediate attention?
A. Sodium 138 mEq/L
B. Potassium 6.2 mEq/L
C. Calcium 9.2 mg/dL
D. Glucose 96 mg/dL
Answer: B
Rationale: Severe hyperkalemia can cause dangerous cardiac dysrhythmias and requires prompt
evaluation and treatment.
9. Which task is generally appropriate for an RN to delegate to trained UAP?
A. Initial assessment
B. Patient teaching
C. Routine vital signs on a stable client
D. Development of the nursing care plan
Answer: C
Rationale: UAP can perform appropriate routine, predictable tasks on stable clients.
Assessment, teaching, and care planning remain nursing responsibilities.
10. Which finding should the nurse report immediately in a postoperative client?
, A. Urine output of 20 mL/hr
B. Pain rated 3/10
C. Temperature of 37°C (98.6°F)
D. Small amount of expected drainage
Answer: A
Rationale: Persistently low urine output may indicate inadequate renal perfusion, hypovolemia,
or another serious complication.
11. Which intervention is appropriate for preventing venous thromboembolism
in a postoperative client?
A. Prolonged bed rest
B. Early ambulation as appropriate
C. Restricting all fluids
D. Keeping the legs dependent continuously
Answer: B
Rationale: Early mobility, prescribed anticoagulation when appropriate, and mechanical
prophylaxis can reduce VTE risk.
12. A client with suspected hypovolemic shock is hypotensive and has a weak,
rapid pulse. Which finding would the nurse expect?
A. Increased urine output
B. Decreased urine output
C. Bounding pulse
D. Bradycardia
Answer: B
Rationale: Reduced circulating volume decreases renal perfusion, commonly resulting in
oliguria.
13. Which finding is most concerning in a client with COPD?
A. Oxygen saturation of 95%
B. Mild chronic cough
