NSG 4800 Comp actual final Exam | 2026/2027 | Complete Practice
Questions, Correct Answers & Detailed Rationales | Galen College of
Nursing
Questions 1–50: Professional Nursing Practice & Clinical Judgment
1.
A nurse receives report on four patients. Which patient should the nurse assess
first?
A. Patient with chronic arthritis reporting pain of 5/10
B. Patient with COPD whose oxygen saturation is 88% despite oxygen
C. Patient awaiting discharge instructions
D. Patient requesting assistance with bathing
Correct Answer: B. Patient with COPD whose oxygen saturation is 88% despite
oxygen
Rationale: Persistent hypoxemia represents an immediate threat to oxygenation
and requires rapid assessment and intervention.
2.
Which action best demonstrates professional accountability?
A. Asking another nurse to assume responsibility for an assigned task
B. Documenting an error according to organizational policy
C. Avoiding discussion of a medication error
D. Delegating all complex patients to another nurse
Correct Answer: B. Documenting an error according to organizational policy
Rationale: Accountability requires recognizing errors, reporting them
appropriately, and participating in corrective action.
3.
,A patient refuses a recommended surgical procedure. What should the nurse do
first?
A. Ask the family to convince the patient
B. Document the refusal and leave the room
C. Determine the patient's understanding of the procedure
D. Notify security
Correct Answer: C. Determine the patient's understanding of the procedure
Rationale: The nurse should assess whether the refusal is informed and whether
the patient understands risks, benefits, and alternatives.
4.
Which nursing action best supports patient autonomy?
A. Making decisions for an indecisive patient
B. Providing information needed for the patient to make a decision
C. Asking the family to select treatment
D. Encouraging the patient to accept the nurse's recommendation
Correct Answer: B. Providing information needed for the patient to make a
decision
Rationale: Autonomy requires supporting the patient's right and ability to make
informed decisions.
5.
A nurse discovers that a medication was administered to the wrong patient. What
is the priority action?
A. Complete the incident report
B. Assess the patient
C. Notify the pharmacy
D. Inform the next shift
,Correct Answer: B. Assess the patient
Rationale: The patient's immediate condition and safety take priority after a
medication error.
6.
Which situation requires immediate intervention?
A. Patient requesting a dietary change
B. Patient with potassium of 2.9 mEq/L and new ventricular ectopy
C. Patient waiting for physical therapy
D. Patient reporting chronic back discomfort
Correct Answer: B. Patient with potassium of 2.9 mEq/L and new ventricular
ectopy
Rationale: Severe hypokalemia combined with dysrhythmia can become life-
threatening.
7.
Which finding is most concerning in a postoperative patient?
A. Incisional pain of 4/10
B. Temperature of 37.4°C
C. Sudden dyspnea and chest pain
D. Decreased appetite
Correct Answer: C. Sudden dyspnea and chest pain
Rationale: Sudden dyspnea and chest pain may indicate pulmonary embolism,
requiring immediate evaluation.
8.
Which communication technique is most appropriate when giving a handoff?
A. Providing only abnormal findings
B. Using a structured format such as SBAR
C. Giving information from memory only
D. Asking the receiving nurse to read the chart independently
, Correct Answer: B. Using a structured format such as SBAR
Rationale: Structured communication promotes completeness, clarity, and patient
safety.
9.
Which statement reflects effective clinical reasoning?
A. “I always use the same intervention.”
B. “The patient's current findings must be interpreted with the clinical context.”
C. “The diagnosis determines every nursing intervention.”
D. “Vital signs are more important than patient symptoms.”
Correct Answer: B. “The patient's current findings must be interpreted with the
clinical context.”
Rationale: Clinical reasoning requires integrating assessment findings, history,
trends, and patient-specific factors.
10.
A nurse notices that a patient's condition is worsening. What should the nurse do
first?
A. Wait for the next scheduled assessment
B. Reassess the patient and relevant vital signs
C. Document the change after the shift
D. Ask another nurse to assess the patient later
Correct Answer: B. Reassess the patient and relevant vital signs
Rationale: A focused reassessment establishes the patient's current condition and
guides subsequent intervention.
11.
Which action demonstrates advocacy?
A. Accepting an inappropriate treatment without question
B. Communicating the patient's concerns to the healthcare team
Questions, Correct Answers & Detailed Rationales | Galen College of
Nursing
Questions 1–50: Professional Nursing Practice & Clinical Judgment
1.
A nurse receives report on four patients. Which patient should the nurse assess
first?
A. Patient with chronic arthritis reporting pain of 5/10
B. Patient with COPD whose oxygen saturation is 88% despite oxygen
C. Patient awaiting discharge instructions
D. Patient requesting assistance with bathing
Correct Answer: B. Patient with COPD whose oxygen saturation is 88% despite
oxygen
Rationale: Persistent hypoxemia represents an immediate threat to oxygenation
and requires rapid assessment and intervention.
2.
Which action best demonstrates professional accountability?
A. Asking another nurse to assume responsibility for an assigned task
B. Documenting an error according to organizational policy
C. Avoiding discussion of a medication error
D. Delegating all complex patients to another nurse
Correct Answer: B. Documenting an error according to organizational policy
Rationale: Accountability requires recognizing errors, reporting them
appropriately, and participating in corrective action.
3.
,A patient refuses a recommended surgical procedure. What should the nurse do
first?
A. Ask the family to convince the patient
B. Document the refusal and leave the room
C. Determine the patient's understanding of the procedure
D. Notify security
Correct Answer: C. Determine the patient's understanding of the procedure
Rationale: The nurse should assess whether the refusal is informed and whether
the patient understands risks, benefits, and alternatives.
4.
Which nursing action best supports patient autonomy?
A. Making decisions for an indecisive patient
B. Providing information needed for the patient to make a decision
C. Asking the family to select treatment
D. Encouraging the patient to accept the nurse's recommendation
Correct Answer: B. Providing information needed for the patient to make a
decision
Rationale: Autonomy requires supporting the patient's right and ability to make
informed decisions.
5.
A nurse discovers that a medication was administered to the wrong patient. What
is the priority action?
A. Complete the incident report
B. Assess the patient
C. Notify the pharmacy
D. Inform the next shift
,Correct Answer: B. Assess the patient
Rationale: The patient's immediate condition and safety take priority after a
medication error.
6.
Which situation requires immediate intervention?
A. Patient requesting a dietary change
B. Patient with potassium of 2.9 mEq/L and new ventricular ectopy
C. Patient waiting for physical therapy
D. Patient reporting chronic back discomfort
Correct Answer: B. Patient with potassium of 2.9 mEq/L and new ventricular
ectopy
Rationale: Severe hypokalemia combined with dysrhythmia can become life-
threatening.
7.
Which finding is most concerning in a postoperative patient?
A. Incisional pain of 4/10
B. Temperature of 37.4°C
C. Sudden dyspnea and chest pain
D. Decreased appetite
Correct Answer: C. Sudden dyspnea and chest pain
Rationale: Sudden dyspnea and chest pain may indicate pulmonary embolism,
requiring immediate evaluation.
8.
Which communication technique is most appropriate when giving a handoff?
A. Providing only abnormal findings
B. Using a structured format such as SBAR
C. Giving information from memory only
D. Asking the receiving nurse to read the chart independently
, Correct Answer: B. Using a structured format such as SBAR
Rationale: Structured communication promotes completeness, clarity, and patient
safety.
9.
Which statement reflects effective clinical reasoning?
A. “I always use the same intervention.”
B. “The patient's current findings must be interpreted with the clinical context.”
C. “The diagnosis determines every nursing intervention.”
D. “Vital signs are more important than patient symptoms.”
Correct Answer: B. “The patient's current findings must be interpreted with the
clinical context.”
Rationale: Clinical reasoning requires integrating assessment findings, history,
trends, and patient-specific factors.
10.
A nurse notices that a patient's condition is worsening. What should the nurse do
first?
A. Wait for the next scheduled assessment
B. Reassess the patient and relevant vital signs
C. Document the change after the shift
D. Ask another nurse to assess the patient later
Correct Answer: B. Reassess the patient and relevant vital signs
Rationale: A focused reassessment establishes the patient's current condition and
guides subsequent intervention.
11.
Which action demonstrates advocacy?
A. Accepting an inappropriate treatment without question
B. Communicating the patient's concerns to the healthcare team
