NSG 4800 COMPS EXAM WITH ACTUAL
CORRECT QUESTIONS AND VERIFIED
DETAILED ANSWERS| CURRENTLY TESTING
VERSION | ALREADY GRADED A+|EXPERT
VERIFIED FOR GUARANTEED PASS 2026-2027
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 diabetes who is difficult to arouse and has a blood glucose of 38 mg/dL
C. A client with a urinary tract infection reporting urinary frequency
D. A client with appendicitis reporting abdominal pain of 4/10
Correct Answer: B
Rationale: A blood glucose of 38 mg/dL represents severe hypoglycemia and can
rapidly progress to seizures, coma, and death. The client's decreased level of
consciousness indicates an immediate threat to neurologic function and requires
rapid intervention. This follows the ABCs and acute-versus-chronic prioritization
principles.
Question 2
Which client requires airborne precautions?
A. A client with Clostridioides difficile infection
B. A client with influenza
C. A client with active pulmonary tuberculosis
D. A client with MRSA wound infection
Correct Answer: C
Rationale: Active pulmonary tuberculosis requires airborne precautions, including
a fit-tested N95 or equivalent respirator and an appropriate airborne-infection
isolation room. C. difficile requires contact precautions, influenza generally
requires droplet precautions, and MRSA requires contact precautions.
Question 3
1|Page
,Which task is most appropriate for the RN to delegate to an experienced UAP?
A. Assessing a newly admitted client's skin
B. Teaching a client how to use an incentive spirometer
C. Measuring and documenting urine output
D. Evaluating a client's response to pain medication
Correct Answer: C
Rationale: Measuring urine output is a routine, predictable task that does not
require nursing judgment. Assessment, teaching, and evaluation require nursing
knowledge and clinical judgment and should remain with the RN.
Question 4 — Medication Safety
A client receiving digoxin has an apical pulse of 52/min. What should the nurse do?
A. Administer the medication as prescribed
B. Hold the medication and notify the provider
C. Administer half of the prescribed dose
D. Recheck the pulse after the medication is administered
Correct Answer: B
Rationale: Digoxin can decrease heart rate. An adult apical pulse below
approximately 60/min is generally a reason to hold digoxin and notify the provider,
according to common nursing medication-safety parameters. The nurse should
also assess for other manifestations of digoxin toxicity.
Question 5
Which finding is most concerning in a client taking lithium?
A. Mild thirst
B. Fine hand tremor
C. Severe diarrhea and vomiting
D. Increased appetite
Correct Answer: C
Rationale: Severe vomiting and diarrhea can cause dehydration and sodium/fluid
shifts, increasing lithium levels and the risk of toxicity. Lithium toxicity may
manifest as worsening tremor, ataxia, confusion, vomiting, diarrhea, and
neurologic changes.
2|Page
,Question 6
A client with COPD is receiving oxygen. Which prescription should the nurse question?
A. Encourage pursed-lip breathing
B. Monitor oxygen saturation
C. Administer oxygen as prescribed
D. Automatically increase oxygen to 15 L/min when saturation decreases
Correct Answer: D
Rationale: Oxygen should be titrated according to the prescription and the client's
clinical condition, rather than automatically increased to a very high flow rate.
Excessive oxygen administration in some patients with chronic CO₂ retention can
worsen ventilation. The nurse should follow the individualized oxygen target and
notify the provider for deterioration.
Question 7
Which assessment finding is most characteristic of diabetic ketoacidosis (DKA)?
A. Bradycardia
B. Kussmaul respirations
C. Severe hypothermia
D. Decreased respiratory rate
Correct Answer: B
Rationale: DKA causes metabolic acidosis. The body compensates through deep,
rapid Kussmaul respirations to eliminate carbon dioxide. Other findings can
include hyperglycemia, dehydration, abdominal pain, nausea/vomiting, and
fruity/acetone breath.
Question 8
Which finding is most consistent with left-sided heart failure?
A. Peripheral edema only
B. Jugular venous distention
C. Pulmonary crackles and dyspnea
D. Enlarged liver
Correct Answer: C
3|Page
, Rationale: Left-sided heart failure causes blood to back up into the pulmonary
circulation, producing pulmonary congestion, crackles, dyspnea, orthopnea, and
potentially pulmonary edema. Right-sided failure more commonly produces
systemic venous congestion such as peripheral edema and JVD.
Question 9
A client suddenly develops facial drooping and weakness of the right arm. What is the
nurse's priority action?
A. Give the client something to drink
B. Determine when the symptoms began
C. Place the client in Trendelenburg position
D. Administer a sedative
Correct Answer: B
Rationale: Sudden unilateral weakness and facial drooping suggest an acute
stroke. Determining the exact last-known-well time is crucial because eligibility for
time-sensitive reperfusion therapies depends on symptom onset and other clinical
criteria.
Question 10
A pregnant client has painless, bright-red vaginal bleeding in the third trimester. Which
condition should the nurse suspect?
A. Abruptio placentae
B. Placenta previa
C. Ectopic pregnancy
D. Uterine rupture
Correct Answer: B
Rationale: Placenta previa classically presents with painless, bright-red vaginal
bleeding. Vaginal examinations should be avoided until placenta previa has been
excluded because manipulation can precipitate severe hemorrhage.
Question 11
Which finding in an infant requires immediate intervention?
4|Page
CORRECT QUESTIONS AND VERIFIED
DETAILED ANSWERS| CURRENTLY TESTING
VERSION | ALREADY GRADED A+|EXPERT
VERIFIED FOR GUARANTEED PASS 2026-2027
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 diabetes who is difficult to arouse and has a blood glucose of 38 mg/dL
C. A client with a urinary tract infection reporting urinary frequency
D. A client with appendicitis reporting abdominal pain of 4/10
Correct Answer: B
Rationale: A blood glucose of 38 mg/dL represents severe hypoglycemia and can
rapidly progress to seizures, coma, and death. The client's decreased level of
consciousness indicates an immediate threat to neurologic function and requires
rapid intervention. This follows the ABCs and acute-versus-chronic prioritization
principles.
Question 2
Which client requires airborne precautions?
A. A client with Clostridioides difficile infection
B. A client with influenza
C. A client with active pulmonary tuberculosis
D. A client with MRSA wound infection
Correct Answer: C
Rationale: Active pulmonary tuberculosis requires airborne precautions, including
a fit-tested N95 or equivalent respirator and an appropriate airborne-infection
isolation room. C. difficile requires contact precautions, influenza generally
requires droplet precautions, and MRSA requires contact precautions.
Question 3
1|Page
,Which task is most appropriate for the RN to delegate to an experienced UAP?
A. Assessing a newly admitted client's skin
B. Teaching a client how to use an incentive spirometer
C. Measuring and documenting urine output
D. Evaluating a client's response to pain medication
Correct Answer: C
Rationale: Measuring urine output is a routine, predictable task that does not
require nursing judgment. Assessment, teaching, and evaluation require nursing
knowledge and clinical judgment and should remain with the RN.
Question 4 — Medication Safety
A client receiving digoxin has an apical pulse of 52/min. What should the nurse do?
A. Administer the medication as prescribed
B. Hold the medication and notify the provider
C. Administer half of the prescribed dose
D. Recheck the pulse after the medication is administered
Correct Answer: B
Rationale: Digoxin can decrease heart rate. An adult apical pulse below
approximately 60/min is generally a reason to hold digoxin and notify the provider,
according to common nursing medication-safety parameters. The nurse should
also assess for other manifestations of digoxin toxicity.
Question 5
Which finding is most concerning in a client taking lithium?
A. Mild thirst
B. Fine hand tremor
C. Severe diarrhea and vomiting
D. Increased appetite
Correct Answer: C
Rationale: Severe vomiting and diarrhea can cause dehydration and sodium/fluid
shifts, increasing lithium levels and the risk of toxicity. Lithium toxicity may
manifest as worsening tremor, ataxia, confusion, vomiting, diarrhea, and
neurologic changes.
2|Page
,Question 6
A client with COPD is receiving oxygen. Which prescription should the nurse question?
A. Encourage pursed-lip breathing
B. Monitor oxygen saturation
C. Administer oxygen as prescribed
D. Automatically increase oxygen to 15 L/min when saturation decreases
Correct Answer: D
Rationale: Oxygen should be titrated according to the prescription and the client's
clinical condition, rather than automatically increased to a very high flow rate.
Excessive oxygen administration in some patients with chronic CO₂ retention can
worsen ventilation. The nurse should follow the individualized oxygen target and
notify the provider for deterioration.
Question 7
Which assessment finding is most characteristic of diabetic ketoacidosis (DKA)?
A. Bradycardia
B. Kussmaul respirations
C. Severe hypothermia
D. Decreased respiratory rate
Correct Answer: B
Rationale: DKA causes metabolic acidosis. The body compensates through deep,
rapid Kussmaul respirations to eliminate carbon dioxide. Other findings can
include hyperglycemia, dehydration, abdominal pain, nausea/vomiting, and
fruity/acetone breath.
Question 8
Which finding is most consistent with left-sided heart failure?
A. Peripheral edema only
B. Jugular venous distention
C. Pulmonary crackles and dyspnea
D. Enlarged liver
Correct Answer: C
3|Page
, Rationale: Left-sided heart failure causes blood to back up into the pulmonary
circulation, producing pulmonary congestion, crackles, dyspnea, orthopnea, and
potentially pulmonary edema. Right-sided failure more commonly produces
systemic venous congestion such as peripheral edema and JVD.
Question 9
A client suddenly develops facial drooping and weakness of the right arm. What is the
nurse's priority action?
A. Give the client something to drink
B. Determine when the symptoms began
C. Place the client in Trendelenburg position
D. Administer a sedative
Correct Answer: B
Rationale: Sudden unilateral weakness and facial drooping suggest an acute
stroke. Determining the exact last-known-well time is crucial because eligibility for
time-sensitive reperfusion therapies depends on symptom onset and other clinical
criteria.
Question 10
A pregnant client has painless, bright-red vaginal bleeding in the third trimester. Which
condition should the nurse suspect?
A. Abruptio placentae
B. Placenta previa
C. Ectopic pregnancy
D. Uterine rupture
Correct Answer: B
Rationale: Placenta previa classically presents with painless, bright-red vaginal
bleeding. Vaginal examinations should be avoided until placenta previa has been
excluded because manipulation can precipitate severe hemorrhage.
Question 11
Which finding in an infant requires immediate intervention?
4|Page
