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NURS 280 FINAL EXAM QUESTIONS UPDATED ACTUAL EXAM
LATEST 2026 – 2027 VERSION SOLVED QUESTIONS &
ANSWERS
NURS 280 Final Exam - 250 Questions with Rationales
QUESTIONS 1-50: Safe & Effective Care Environment & Clinical Judgment
1. The charge nurse is observing a Licensed Practical Nurse (LPN) performing care
for assigned clients. Follow up will be required if the LPN:
A) Assesses a client's apical pulse before administering Digoxin (Lanoxin)
B) Elevates the client's stump on a pillow eight hours after amputation
C) Dons a clean glove on the dominant hand before tracheal suctioning
D) Positions a client on the operative side following a pneumonectomy
Answer: C
Rationale: A sterile glove, not a clean glove, should be used on the dominant hand
during tracheal suctioning to prevent infection . The apical pulse should be assessed for
one full minute prior to Digoxin administration; elevation of the stump following
amputation is performed for the first 24 hours only to prevent hip or knee flexion
contracture; clients should be positioned on the operative side to promote lung
expansion of the unaffected lung .
2. Four clients recently returned to the unit following invasive diagnostic testing.
The nurse should immediately intervene if one of the clients:
A) Reports blood-tinged sputum following a bronchoscopy
B) Has decreased abdominal girth following paracentesis
C) Reports a headache following a lumbar puncture
D) Is observed flexing and extending the legs two hours after cardiac catheterization
Answer: D
Rationale: Following cardiac catheterization of the femoral artery, the client remains on
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bedrest for 2 to 6 hours with the affected leg straight and the head of the bed elevated to
30 degrees . Blood-tinged sputum is an expected finding after bronchoscopy; removal of
fluid from the peritoneal cavity (paracentesis) will result in decreased abdominal girth; a
post-lumbar puncture headache ranging from mild to severe may appear a few hours to
days following the procedure .
3. The nurse is caring for a client being treated for Vancomycin Resistant
Enterococcus (VRE). The nurse should place the client on:
A) Contact precautions
B) Droplet precautions
C) Protective precautions
D) Airborne precautions
Answer: A
Rationale: Vancomycin resistant enterococcus (VRE) is spread by direct contact .
Diseases transmitted by droplets (sneezing, coughing) include influenza, pneumonia,
and streptococcal pharyngitis. Airborne precautions are required for tuberculosis,
measles, and varicella.
4. The nurse has provided health teaching for a group of clients who were recently
diagnosed with HIV. Which statement made by the clients will require further
teaching?
A) "I will miss not being able to work in my garden."
B) "I need to avoid crowds and people with infections."
C) "I should take my medications exactly as prescribed."
D) "I need to practice safe sex to prevent transmission."
Answer: A
Rationale: Clients with HIV should avoid gardening due to the risk of exposure to soil-
borne organisms (e.g., Aspergillus, Toxoplasma) that can cause opportunistic infections
in immunocompromised individuals . The other statements indicate appropriate
understanding of HIV management.
5. The nurse has become aware of the following client situations. The nurse should
first assess the client who:
A) Had an abdominal hysterectomy yesterday and is reporting calf pain
B) Is two hours post-operative and requesting pain medication
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C) Is scheduled for discharge and needs final teaching
D) Has a new colostomy and is asking questions about pouching
Answer: A
Rationale: Calf pain in a post-operative client may indicate a deep vein thrombosis
(DVT), which can lead to a pulmonary embolism . This is the priority assessment using
the ABCs and risk reduction framework. Pain medication, discharge teaching, and
colostomy questions can wait.
6. The nurse at a health promotion fair has taught a group of parents about car seat
and seat belt safety. Which statement by a parent indicates correct understanding?
A) "I will place my newborn infant in a rear-facing car seat in the middle of the rear seat."
B) "I will wear a lap seat belt high on my belly since I am 8 months pregnant."
C) "I can use a front-facing car seat once my baby weighs 15 pounds."
D) "I can allow my six-year-old to use a seat belt in the front passenger seat."
Answer: A
Rationale: The newborn should be placed in a rear-facing car seat with appropriate
restraints until about one year of age and at least 20 pounds . The lap belt should be
positioned snugly around the hips, never the abdomen; all children under age 12 should
be placed in the rear seat .
7. The charge nurse is making assignments for a float RN who is unfamiliar with the
unit. Which patient should be assigned to the float RN?
A) Post-op day 1 after CABG on a dobutamine drip
B) New admission with chest pain awaiting cardiac cath
C) Stable chronic heart failure patient scheduled for discharge teaching
D) Patient with acute asthma on continuous BiPAP
Answer: C
Rationale: A float RN receives the lowest-acuity, most stable patient within their scope
of practice . Discharge teaching for a stable CHF patient is predictable and safe for a
float nurse. Patients on titratable drips, new admissions with acute conditions, and
patients on continuous BiPAP require the expertise of a unit-specialized RN.
8. The nurse should intervene if a new hire nurse is observed:
A) Cleansing a wound from the inner surface to the outer surface
B) Cleansing a wound from the outer surface to the inner surface for a client with MRSA
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C) Applying sterile gloves before a sterile procedure
D) Using sterile technique for a central line dressing change
Answer: B
Rationale: For a client with an infected wound (MRSA), the wound should be cleansed
from the inner (clean) surface to the outer (contaminated) surface to prevent
introducing bacteria into the wound . Cleansing from outer to inner would spread
contamination into the wound.
9. A patient on contact precautions for VRE needs a stat CT. Which action is
appropriate for the transporting UAP?
A) Remove gown inside patient room
B) Wear gown only outside scanner
C) Don gown and gloves, transport patient wearing gloves, and dispose inside room on
return
D) No special attire needed
Answer: C
Rationale: Contact precautions must be maintained during transport . The UAP should
don gown and gloves in the patient's room, transport the patient wearing gloves, and
dispose of PPE inside the patient's room upon return. Gowns should be removed and
disposed inside the patient's room, not in hallways or the scanner room.
10. A nurse receives a verbal order for morphine 10 mg IV push. Which action is
required?
A) Transcribe directly to MAR
B) Repeat back only if unclear
C) Repeat back, document order with date/time/provider, and follow agency policy for
co-signature
D) Ask another nurse to listen
Answer: C
Rationale: TJC standards require verbal orders to be repeated back and documented
per policy . A co-signature within 24 hours is common practice. Verbal orders should
always be read back to confirm accuracy, not just when unclear. Morphine is a high-
alert medication requiring additional safety measures.
11. The nurse is caring for a client with a white blood cell count of 2,500/mm³.
Which precaution should the nurse implement?
NURS 280 FINAL EXAM QUESTIONS UPDATED ACTUAL EXAM
LATEST 2026 – 2027 VERSION SOLVED QUESTIONS &
ANSWERS
NURS 280 Final Exam - 250 Questions with Rationales
QUESTIONS 1-50: Safe & Effective Care Environment & Clinical Judgment
1. The charge nurse is observing a Licensed Practical Nurse (LPN) performing care
for assigned clients. Follow up will be required if the LPN:
A) Assesses a client's apical pulse before administering Digoxin (Lanoxin)
B) Elevates the client's stump on a pillow eight hours after amputation
C) Dons a clean glove on the dominant hand before tracheal suctioning
D) Positions a client on the operative side following a pneumonectomy
Answer: C
Rationale: A sterile glove, not a clean glove, should be used on the dominant hand
during tracheal suctioning to prevent infection . The apical pulse should be assessed for
one full minute prior to Digoxin administration; elevation of the stump following
amputation is performed for the first 24 hours only to prevent hip or knee flexion
contracture; clients should be positioned on the operative side to promote lung
expansion of the unaffected lung .
2. Four clients recently returned to the unit following invasive diagnostic testing.
The nurse should immediately intervene if one of the clients:
A) Reports blood-tinged sputum following a bronchoscopy
B) Has decreased abdominal girth following paracentesis
C) Reports a headache following a lumbar puncture
D) Is observed flexing and extending the legs two hours after cardiac catheterization
Answer: D
Rationale: Following cardiac catheterization of the femoral artery, the client remains on
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bedrest for 2 to 6 hours with the affected leg straight and the head of the bed elevated to
30 degrees . Blood-tinged sputum is an expected finding after bronchoscopy; removal of
fluid from the peritoneal cavity (paracentesis) will result in decreased abdominal girth; a
post-lumbar puncture headache ranging from mild to severe may appear a few hours to
days following the procedure .
3. The nurse is caring for a client being treated for Vancomycin Resistant
Enterococcus (VRE). The nurse should place the client on:
A) Contact precautions
B) Droplet precautions
C) Protective precautions
D) Airborne precautions
Answer: A
Rationale: Vancomycin resistant enterococcus (VRE) is spread by direct contact .
Diseases transmitted by droplets (sneezing, coughing) include influenza, pneumonia,
and streptococcal pharyngitis. Airborne precautions are required for tuberculosis,
measles, and varicella.
4. The nurse has provided health teaching for a group of clients who were recently
diagnosed with HIV. Which statement made by the clients will require further
teaching?
A) "I will miss not being able to work in my garden."
B) "I need to avoid crowds and people with infections."
C) "I should take my medications exactly as prescribed."
D) "I need to practice safe sex to prevent transmission."
Answer: A
Rationale: Clients with HIV should avoid gardening due to the risk of exposure to soil-
borne organisms (e.g., Aspergillus, Toxoplasma) that can cause opportunistic infections
in immunocompromised individuals . The other statements indicate appropriate
understanding of HIV management.
5. The nurse has become aware of the following client situations. The nurse should
first assess the client who:
A) Had an abdominal hysterectomy yesterday and is reporting calf pain
B) Is two hours post-operative and requesting pain medication
, Page 3 of 81
C) Is scheduled for discharge and needs final teaching
D) Has a new colostomy and is asking questions about pouching
Answer: A
Rationale: Calf pain in a post-operative client may indicate a deep vein thrombosis
(DVT), which can lead to a pulmonary embolism . This is the priority assessment using
the ABCs and risk reduction framework. Pain medication, discharge teaching, and
colostomy questions can wait.
6. The nurse at a health promotion fair has taught a group of parents about car seat
and seat belt safety. Which statement by a parent indicates correct understanding?
A) "I will place my newborn infant in a rear-facing car seat in the middle of the rear seat."
B) "I will wear a lap seat belt high on my belly since I am 8 months pregnant."
C) "I can use a front-facing car seat once my baby weighs 15 pounds."
D) "I can allow my six-year-old to use a seat belt in the front passenger seat."
Answer: A
Rationale: The newborn should be placed in a rear-facing car seat with appropriate
restraints until about one year of age and at least 20 pounds . The lap belt should be
positioned snugly around the hips, never the abdomen; all children under age 12 should
be placed in the rear seat .
7. The charge nurse is making assignments for a float RN who is unfamiliar with the
unit. Which patient should be assigned to the float RN?
A) Post-op day 1 after CABG on a dobutamine drip
B) New admission with chest pain awaiting cardiac cath
C) Stable chronic heart failure patient scheduled for discharge teaching
D) Patient with acute asthma on continuous BiPAP
Answer: C
Rationale: A float RN receives the lowest-acuity, most stable patient within their scope
of practice . Discharge teaching for a stable CHF patient is predictable and safe for a
float nurse. Patients on titratable drips, new admissions with acute conditions, and
patients on continuous BiPAP require the expertise of a unit-specialized RN.
8. The nurse should intervene if a new hire nurse is observed:
A) Cleansing a wound from the inner surface to the outer surface
B) Cleansing a wound from the outer surface to the inner surface for a client with MRSA
, Page 4 of 81
C) Applying sterile gloves before a sterile procedure
D) Using sterile technique for a central line dressing change
Answer: B
Rationale: For a client with an infected wound (MRSA), the wound should be cleansed
from the inner (clean) surface to the outer (contaminated) surface to prevent
introducing bacteria into the wound . Cleansing from outer to inner would spread
contamination into the wound.
9. A patient on contact precautions for VRE needs a stat CT. Which action is
appropriate for the transporting UAP?
A) Remove gown inside patient room
B) Wear gown only outside scanner
C) Don gown and gloves, transport patient wearing gloves, and dispose inside room on
return
D) No special attire needed
Answer: C
Rationale: Contact precautions must be maintained during transport . The UAP should
don gown and gloves in the patient's room, transport the patient wearing gloves, and
dispose of PPE inside the patient's room upon return. Gowns should be removed and
disposed inside the patient's room, not in hallways or the scanner room.
10. A nurse receives a verbal order for morphine 10 mg IV push. Which action is
required?
A) Transcribe directly to MAR
B) Repeat back only if unclear
C) Repeat back, document order with date/time/provider, and follow agency policy for
co-signature
D) Ask another nurse to listen
Answer: C
Rationale: TJC standards require verbal orders to be repeated back and documented
per policy . A co-signature within 24 hours is common practice. Verbal orders should
always be read back to confirm accuracy, not just when unclear. Morphine is a high-
alert medication requiring additional safety measures.
11. The nurse is caring for a client with a white blood cell count of 2,500/mm³.
Which precaution should the nurse implement?
