Practice
Galen College of Nursing - 2026/2027 Edition
50 Questions with Correct Answers and
Rationales
, Instructions
This comprehensive exam covers key concepts for the NUR 283
Transition to Registered Nursing Practice competency assessment. Each
question includes the correct answer and detailed rationale to reinforce
clinical judgment and evidence-based practice.
Question 1
The nurse is caring for the following assigned clients who are 24 hours postoperative.
The nurse performed a change-of-shift assessment 4 hours ago. Which of the following changes
in client condition should the nurse identify as a priority?
A. The client who reports an increased pain level of 8 on a scale of 0 to 10 after receiving
an opioid analgesic
B. The client who reports nausea after receiving prescribed antibiotics
C. The client whose dressing has a small amount of new serosanguineous drainage
D. The client who has voided 200 mL in the last 4 hours
Answer: A. The client who reports an increased pain level of 8 on a scale of 0 to 10
after receiving an opioid analgesic
, Rationale: Unrelieved or increasing pain after opioids may signal complications such as
hemorrhage, compartment syndrome, or anastomotic leak. This change from baseline is the most
concerning and requires prompt evaluation. Nausea, small amounts of drainage, and voiding 200
mL over 4 hours (which is adequate output) are expected findings that do not indicate immediate
life-threatening complications -2.
Question 2
The nurse preceptor is teaching a newly hired nurse about legal principles when
providing client care. Which of the following situations should the nurse preceptor use as an
example of malpractice?
A. A nurse documents care at the end of the shift instead of in real time
B. A nurse delays administering a routine oral medication by 30 minutes
C. 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
D. A nurse forgets to orient a new client to the call-bell system
Answer: C. 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: Giving medication against a competent client's wishes and disguising it
violates autonomy, informed consent, and constitutes battery and malpractice, because harm
can result from this intentional deception. Documentation timing, minor medication delays,
, and failure to orient to call-bell systems may represent negligence but do not rise to the level of
malpractice in these scenarios -2.
Question 3
The nurse is caring for a client who develops ventricular tachycardia on the cardiac
monitor. Which of the following actions should the nurse take first for a stable client?
A. Arrange for the client to have a cardiac catheter ablation
B. Prepare to administer amiodarone
C. Connect the client to a transcutaneous pacemaker
D. Measure the client for jugular vein distention (JVD)
Answer: B. Prepare to administer amiodarone
Rationale: Ventricular tachycardia (VT) in a stable client is treated with antiarrhythmic
medications, with amiodarone being first-line therapy. Cardiac ablation is a longer-term
treatment, transcutaneous pacing is for bradyarrhythmias, and JVD assessment is part of the
assessment but not the priority intervention for VT -7.
Question 4
The nurse is assessing an infant who has hyperbilirubinemia and is receiving
phototherapy. Which of the following findings indicates an adverse response to the therapy?
A. Lanugo to the back and shoulders
B. Urine output that has a dark-gold or brown appearance