, NSG 4800 COMPREHENSIVE EXAM: ACTUAL QUESTIONS AND
ANSWERS LATEST UPDATED 2026/2027 (GRADED A+) - Galen
College of Nursing
SECTION I — FUNDAMENTALS, PRIORITIZATION & SAFETY
Question 1
The nurse receives report on four clients. Which client should the nurse assess first?
A. A client with pneumonia whose temperature is 38.1°C (100.6°F)
B. A client with type 1 diabetes who is difficult to arouse and has a glucose level of 38 mg/dL
C. A client with a urinary tract infection reporting urinary frequency
D. A client with appendicitis reporting pain of 4/10
Answer: B. A client with type 1 diabetes who is difficult to arouse and has a glucose level of
38 mg/dL
Rationale: Severe hypoglycemia can rapidly cause seizures, loss of consciousness, brain injury,
and death. The altered level of consciousness makes this client the highest priority.
Question 2
Which client should the nurse see first?
A. A client with chronic arthritis reporting pain of 6/10
B. A client with COPD whose oxygen saturation is 91% and is at baseline
C. A client with asthma who suddenly develops severe wheezing and difficulty speaking
D. A client awaiting discharge instructions
Answer: C. A client with asthma who suddenly develops severe wheezing and difficulty
speaking
Rationale: Acute respiratory compromise is an ABC priority. Difficulty speaking because of
respiratory distress suggests significant airway and breathing impairment.
Question 3
A postoperative client's blood pressure decreases from 128/78 mmHg to 92/56 mmHg. What
should the nurse do first?
,A. Document the finding
B. Assess the client and repeat vital signs
C. Administer the prescribed analgesic
D. Encourage ambulation
Answer: B. Assess the client and repeat vital signs
Rationale: A significant change in vital signs requires immediate assessment to determine
whether the client is experiencing bleeding, hypovolemia, medication effects, or another
complication.
Question 4
Which finding requires immediate intervention?
A. Respiratory rate of 16/min
B. Heart rate of 82/min
C. New-onset stridor
D. Temperature of 37.2°C
Answer: C. New-onset stridor
Rationale: Stridor indicates upper-airway obstruction and can rapidly progress to complete
airway obstruction.
Question 5
A client reports dizziness when standing. Which action is most appropriate?
A. Encourage rapid position changes
B. Assess orthostatic vital signs and institute fall precautions
C. Restrict fluids
D. Encourage immediate ambulation without assistance
Answer: B. Assess orthostatic vital signs and institute fall precautions
Rationale: Dizziness with position changes may indicate orthostatic hypotension. Safety and
assessment are priorities.
Question 6
Which task is appropriate for the nurse to delegate to trained unlicensed assistive personnel
(UAP)?
, A. Initial assessment of a newly admitted client
B. Teaching a client how to administer insulin
C. Obtaining routine vital signs on a stable client
D. Evaluating a client's response to medication
Answer: C. Obtaining routine vital signs on a stable client
Rationale: Routine, predictable tasks for stable clients may generally be delegated. Assessment,
teaching, and evaluation remain nursing responsibilities.
Question 7
Which task should the RN retain rather than delegate?
A. Assisting a stable client with bathing
B. Measuring intake and output
C. Evaluating a newly admitted client's condition
D. Obtaining a routine weight
Answer: C. Evaluating a newly admitted client's condition
Rationale: Nursing assessment and clinical judgment cannot be delegated to UAP.
Question 8
Which client is most appropriate for an LPN/LVN?
A. A newly admitted unstable client
B. A client requiring initial teaching about a new diagnosis
C. A stable client requiring routine wound care
D. A client experiencing acute respiratory failure
Answer: C. A stable client requiring routine wound care
Rationale: LPN/LVN assignments generally involve stable clients and predictable care within the
individual's scope and organizational policy.
Question 9
Which action demonstrates appropriate use of the nursing process?
A. Implementing interventions before collecting assessment data
B. Assessing, diagnosing, planning, implementing, and evaluating care
ANSWERS LATEST UPDATED 2026/2027 (GRADED A+) - Galen
College of Nursing
SECTION I — FUNDAMENTALS, PRIORITIZATION & SAFETY
Question 1
The nurse receives report on four clients. Which client should the nurse assess first?
A. A client with pneumonia whose temperature is 38.1°C (100.6°F)
B. A client with type 1 diabetes who is difficult to arouse and has a glucose level of 38 mg/dL
C. A client with a urinary tract infection reporting urinary frequency
D. A client with appendicitis reporting pain of 4/10
Answer: B. A client with type 1 diabetes who is difficult to arouse and has a glucose level of
38 mg/dL
Rationale: Severe hypoglycemia can rapidly cause seizures, loss of consciousness, brain injury,
and death. The altered level of consciousness makes this client the highest priority.
Question 2
Which client should the nurse see first?
A. A client with chronic arthritis reporting pain of 6/10
B. A client with COPD whose oxygen saturation is 91% and is at baseline
C. A client with asthma who suddenly develops severe wheezing and difficulty speaking
D. A client awaiting discharge instructions
Answer: C. A client with asthma who suddenly develops severe wheezing and difficulty
speaking
Rationale: Acute respiratory compromise is an ABC priority. Difficulty speaking because of
respiratory distress suggests significant airway and breathing impairment.
Question 3
A postoperative client's blood pressure decreases from 128/78 mmHg to 92/56 mmHg. What
should the nurse do first?
,A. Document the finding
B. Assess the client and repeat vital signs
C. Administer the prescribed analgesic
D. Encourage ambulation
Answer: B. Assess the client and repeat vital signs
Rationale: A significant change in vital signs requires immediate assessment to determine
whether the client is experiencing bleeding, hypovolemia, medication effects, or another
complication.
Question 4
Which finding requires immediate intervention?
A. Respiratory rate of 16/min
B. Heart rate of 82/min
C. New-onset stridor
D. Temperature of 37.2°C
Answer: C. New-onset stridor
Rationale: Stridor indicates upper-airway obstruction and can rapidly progress to complete
airway obstruction.
Question 5
A client reports dizziness when standing. Which action is most appropriate?
A. Encourage rapid position changes
B. Assess orthostatic vital signs and institute fall precautions
C. Restrict fluids
D. Encourage immediate ambulation without assistance
Answer: B. Assess orthostatic vital signs and institute fall precautions
Rationale: Dizziness with position changes may indicate orthostatic hypotension. Safety and
assessment are priorities.
Question 6
Which task is appropriate for the nurse to delegate to trained unlicensed assistive personnel
(UAP)?
, A. Initial assessment of a newly admitted client
B. Teaching a client how to administer insulin
C. Obtaining routine vital signs on a stable client
D. Evaluating a client's response to medication
Answer: C. Obtaining routine vital signs on a stable client
Rationale: Routine, predictable tasks for stable clients may generally be delegated. Assessment,
teaching, and evaluation remain nursing responsibilities.
Question 7
Which task should the RN retain rather than delegate?
A. Assisting a stable client with bathing
B. Measuring intake and output
C. Evaluating a newly admitted client's condition
D. Obtaining a routine weight
Answer: C. Evaluating a newly admitted client's condition
Rationale: Nursing assessment and clinical judgment cannot be delegated to UAP.
Question 8
Which client is most appropriate for an LPN/LVN?
A. A newly admitted unstable client
B. A client requiring initial teaching about a new diagnosis
C. A stable client requiring routine wound care
D. A client experiencing acute respiratory failure
Answer: C. A stable client requiring routine wound care
Rationale: LPN/LVN assignments generally involve stable clients and predictable care within the
individual's scope and organizational policy.
Question 9
Which action demonstrates appropriate use of the nursing process?
A. Implementing interventions before collecting assessment data
B. Assessing, diagnosing, planning, implementing, and evaluating care
