NUR280 Transition to RN Practice - 160+ Q&A
Exam Review & Practice Test (2026/2027
Latest) | 100% Verified Answers | Galen College
Ultimate NCLEX-RN Question Bank | Complete Practice Set | 2026/2027 Standards
Galen College of Nursing | NUR 280 Transition to RN Practice | Master Question Bank
This master question bank contains 165 practice questions covering the full scope of
nursing knowledge for the 2026/2027 NCLEX-RN.
Cluster 1: Safe & Effective Care Environment (Questions 1-33)
1. An RN is managing a team that includes an LPN and a UAP on a 2026 telemetry
unit equipped with AI-assisted fall-risk alerts. Which task can be safely delegated
to the LPN?
A. Adjust the dosage of a heparin drip per protocol
B. *Administer a PO metoprolol tablet to a stable post-MI patient
C. Interpret AI-generated fall-risk scores for newly admitted patients
D. Perform the initial assessment on a patient just returned from PCI
Rationale: Per 2026 NCSBN delegation rules, LPNs may administer PO
medications to stable patients; IV push, initial assessments, and interpretation of
data requiring clinical judgment remain RN responsibilities.
2. A nurse on a 2026 telehealth shift receives a remote alert: a home heart-failure
patient’s wearable CardioMEMS™ PA pressure is 35 mmHg (baseline 20 mmHg).
The patient reports no dyspnea. Which action is most appropriate?
A. Instruct the patient to increase carvedilol dose
B. *Coach the patient to double diuretic dose for 3 days and recheck remote
pressure
C. Schedule an in-person visit in 2 weeks
, D. Tell the patient the device is malfunctioning
Rationale: 2026 HFSA guidelines list a >25 % increase in PA pressure as an early
trigger for diuretic self-titration under protocol; RN coaching prevents
decompensation.
3. (Select all that apply) The charge nurse is making assignments for the shift.
Which patients should be assigned to the RN rather than the LPN?
A. *A 2-hour post-PCI patient on a heparin drip
B. *A new admission with chest pain and ST depression on telemonitor
C. A stable COPD patient needing PO meds and incentive spirometry coaching
D. *A patient with a new order for morphine IV push q4h PRN
Rationale: Options A, B, and D require RN-level assessment, IV push, or care of an
unstable patient; C is within LPN scope for stable patients (2026 NCSBN).
4. A nurse receives an AI-generated alert that a patient’s 24-hour fluid balance
shows +3.5 L and weight gain of 2.5 kg. The patient has bilateral crackles and
JVD. Which action should the nurse take first?
A. Document findings and wait for the next scheduled assessment
B. *Notify the provider and prepare to increase diuretic dose per protocol
C. Restrict all fluids to 500 mL/day
D. Request a STAT echocardiogram
Rationale: Recognize acute fluid overload; 2026 heart-failure protocols support
early diuretic escalation to prevent intubation.
5. A nurse manager is evaluating AI-generated staffing recommendations. The
system suggests reducing RN staffing because “patients’ fall-risk scores are low.”
Which action is appropriate?
A. Accept the AI suggestion and reassign RNs to another unit
B. *Review each patient’s acuity manually and maintain appropriate RN ratios
regardless of fall scores
C. Ask the AI to recalculate including fall scores only
D. Use the suggestion as the sole determinant for the shift
Rationale: 2026 ANA staffing principles state that AI tools are advisory;
professional RN judgment must prevail over single-parameter algorithms.
6. A patient on hospital-at-home (HaH) protocol develops sudden confusion and a
Glascow Coma Scale of 12. The vital signs obtained by the home telemetry
technician are HR 118, BP 90/50, RR 28, SpO₂ 90 % on 2 L NC. Which is the
priority nursing action via telepresence?
A. Instruct the technician to obtain a 12-lead ECG
B. *Direct the technician to call 911 for immediate transport; patient needs
acute-level care
C. Coach the technician to increase oxygen to 4 L
, D. Schedule an in-person nurse visit within 2 hours
Rationale: Acute altered mental status + hypotension + hypoxemia exceeds HaH
capabilities; 2026 HaH exclusion criteria mandate immediate escalation.
7. (Ordered Response) Place the following steps in the correct order when using an
AI-assisted medication-administration system that alerts a potential wrong-drug
selection:
8. Verify the 5 rights manually
9. Scan the patient’s wristband
10. *1 → 2 → 4 → 5 → 6
11. Read the AI alert message
12. Recheck the order and prescriber
13. Proceed only after alert is resolved or overridden
Rationale: 2026 ISMP guidelines: always perform manual verification first, then
interact with technology; never bypass alert without resolution.
14. A nurse is supervising a UAP who is using a robotic patient-lift device. Which
observation requires immediate intervention?
A. UAP lowers bed rail before activating lift
B. *UAP positions sling hooks facing outward rather than inward toward patient
C. UAP secures 4 side rails during transfer
D. UAP asks patient to hold remote control
Rationale: Hooks facing outward can disconnect; 2026 robotic lift manufacturer
and ISMP list this as critical safety step.
15. A patient’s family member is live-streaming the patient’s recovery on social
media without the patient’s explicit consent. Which action should the nurse take
first?
A. Ignore the streaming to avoid conflict
B. *Ask the family member to stop and explain privacy policy; escalate to charge
nurse if needed
C. Join the live stream to correct misinformation
D. Confiscate the device
Rationale: 2026 HIPAA and facility policy prohibit unauthorized recording; nurse
must protect patient privacy and escalate appropriately.
16. A nurse is informed that the hospital’s AI documentation assistant has
auto-populated a nursing note stating “patient ambulated 200 ft” when the
patient actually ambulated 50 ft. Which action is required?
A. Leave the note as is because AI is accurate
B. *Edit the note to reflect actual distance and document the correction per
facility policy
C. Delete the entire note
, D. Add a comment that AI makes errors
Rationale: 2026 TJC sentinel alert: nurses remain responsible for accuracy of all
documentation, including AI-generated content; must correct errors promptly.
17. A patient with a new tracheostomy on a speaking valve accidentally dislodges
the entire tracheostomy tube while turning. The stoma is patent, patient is alert,
RR 30, SpO₂ 88 %. Which action first?
A. Replace the tube immediately using the obturator
B. *Cover stoma with sterile gauze and provide bag-mask ventilation over mouth
and nose
C. Apply high-flow oxygen via nasal cannula
D. Call respiratory therapy to reinsert
Rationale: 2026 AACN procedure: total dislodgement within 7 days = stoma not
mature; ventilate oro-nasally while preparing for emergent reinsertion.
18. A nurse is managing a patient on continuous renal replacement therapy (CRRT)
via tele-ICU. The machine alarms “Air Detector Positive.” Which action should the
remote nurse take first?
A. Silence alarm and continue
B. *Pause blood pump and clamp lines; follow air-emergency protocol per policy
C. Increase ultrafiltration rate
D. Document the alarm and wait for bedside staff
Rationale: Air embolus is life-threatening; 2026 CRRT manufacturer and ANCC
tele-ICU standards require immediate pump stop and line clamping.
19. (Select all that apply) Which actions demonstrate appropriate use of AI-powered
fall-prevention bed alarms?
A. *Responding immediately to every alarm
B. *Using alarm data in conjunction with clinical assessment
C. *Educating patients that the bed will alert staff if they try to stand
D. *Documenting response to each alarm
E. Disregarding alarms during shift change
Rationale: Options A-D reflect 2026 evidence-based integration of bed sensor
technology; E is unsafe.
20. A nurse is informed that an AI chatbot has been answering patient call-light
requests overnight. A patient now refuses morning meds because “the computer
said I don’t need them.” Which action?
A. Reassure patient that AI is accurate
B. *Clarify with patient, administer meds as ordered, and report the incident to
prevent further AI misinformation
C. Cancel the morning doses
D. Tell the patient the chatbot is just for fun
Exam Review & Practice Test (2026/2027
Latest) | 100% Verified Answers | Galen College
Ultimate NCLEX-RN Question Bank | Complete Practice Set | 2026/2027 Standards
Galen College of Nursing | NUR 280 Transition to RN Practice | Master Question Bank
This master question bank contains 165 practice questions covering the full scope of
nursing knowledge for the 2026/2027 NCLEX-RN.
Cluster 1: Safe & Effective Care Environment (Questions 1-33)
1. An RN is managing a team that includes an LPN and a UAP on a 2026 telemetry
unit equipped with AI-assisted fall-risk alerts. Which task can be safely delegated
to the LPN?
A. Adjust the dosage of a heparin drip per protocol
B. *Administer a PO metoprolol tablet to a stable post-MI patient
C. Interpret AI-generated fall-risk scores for newly admitted patients
D. Perform the initial assessment on a patient just returned from PCI
Rationale: Per 2026 NCSBN delegation rules, LPNs may administer PO
medications to stable patients; IV push, initial assessments, and interpretation of
data requiring clinical judgment remain RN responsibilities.
2. A nurse on a 2026 telehealth shift receives a remote alert: a home heart-failure
patient’s wearable CardioMEMS™ PA pressure is 35 mmHg (baseline 20 mmHg).
The patient reports no dyspnea. Which action is most appropriate?
A. Instruct the patient to increase carvedilol dose
B. *Coach the patient to double diuretic dose for 3 days and recheck remote
pressure
C. Schedule an in-person visit in 2 weeks
, D. Tell the patient the device is malfunctioning
Rationale: 2026 HFSA guidelines list a >25 % increase in PA pressure as an early
trigger for diuretic self-titration under protocol; RN coaching prevents
decompensation.
3. (Select all that apply) The charge nurse is making assignments for the shift.
Which patients should be assigned to the RN rather than the LPN?
A. *A 2-hour post-PCI patient on a heparin drip
B. *A new admission with chest pain and ST depression on telemonitor
C. A stable COPD patient needing PO meds and incentive spirometry coaching
D. *A patient with a new order for morphine IV push q4h PRN
Rationale: Options A, B, and D require RN-level assessment, IV push, or care of an
unstable patient; C is within LPN scope for stable patients (2026 NCSBN).
4. A nurse receives an AI-generated alert that a patient’s 24-hour fluid balance
shows +3.5 L and weight gain of 2.5 kg. The patient has bilateral crackles and
JVD. Which action should the nurse take first?
A. Document findings and wait for the next scheduled assessment
B. *Notify the provider and prepare to increase diuretic dose per protocol
C. Restrict all fluids to 500 mL/day
D. Request a STAT echocardiogram
Rationale: Recognize acute fluid overload; 2026 heart-failure protocols support
early diuretic escalation to prevent intubation.
5. A nurse manager is evaluating AI-generated staffing recommendations. The
system suggests reducing RN staffing because “patients’ fall-risk scores are low.”
Which action is appropriate?
A. Accept the AI suggestion and reassign RNs to another unit
B. *Review each patient’s acuity manually and maintain appropriate RN ratios
regardless of fall scores
C. Ask the AI to recalculate including fall scores only
D. Use the suggestion as the sole determinant for the shift
Rationale: 2026 ANA staffing principles state that AI tools are advisory;
professional RN judgment must prevail over single-parameter algorithms.
6. A patient on hospital-at-home (HaH) protocol develops sudden confusion and a
Glascow Coma Scale of 12. The vital signs obtained by the home telemetry
technician are HR 118, BP 90/50, RR 28, SpO₂ 90 % on 2 L NC. Which is the
priority nursing action via telepresence?
A. Instruct the technician to obtain a 12-lead ECG
B. *Direct the technician to call 911 for immediate transport; patient needs
acute-level care
C. Coach the technician to increase oxygen to 4 L
, D. Schedule an in-person nurse visit within 2 hours
Rationale: Acute altered mental status + hypotension + hypoxemia exceeds HaH
capabilities; 2026 HaH exclusion criteria mandate immediate escalation.
7. (Ordered Response) Place the following steps in the correct order when using an
AI-assisted medication-administration system that alerts a potential wrong-drug
selection:
8. Verify the 5 rights manually
9. Scan the patient’s wristband
10. *1 → 2 → 4 → 5 → 6
11. Read the AI alert message
12. Recheck the order and prescriber
13. Proceed only after alert is resolved or overridden
Rationale: 2026 ISMP guidelines: always perform manual verification first, then
interact with technology; never bypass alert without resolution.
14. A nurse is supervising a UAP who is using a robotic patient-lift device. Which
observation requires immediate intervention?
A. UAP lowers bed rail before activating lift
B. *UAP positions sling hooks facing outward rather than inward toward patient
C. UAP secures 4 side rails during transfer
D. UAP asks patient to hold remote control
Rationale: Hooks facing outward can disconnect; 2026 robotic lift manufacturer
and ISMP list this as critical safety step.
15. A patient’s family member is live-streaming the patient’s recovery on social
media without the patient’s explicit consent. Which action should the nurse take
first?
A. Ignore the streaming to avoid conflict
B. *Ask the family member to stop and explain privacy policy; escalate to charge
nurse if needed
C. Join the live stream to correct misinformation
D. Confiscate the device
Rationale: 2026 HIPAA and facility policy prohibit unauthorized recording; nurse
must protect patient privacy and escalate appropriately.
16. A nurse is informed that the hospital’s AI documentation assistant has
auto-populated a nursing note stating “patient ambulated 200 ft” when the
patient actually ambulated 50 ft. Which action is required?
A. Leave the note as is because AI is accurate
B. *Edit the note to reflect actual distance and document the correction per
facility policy
C. Delete the entire note
, D. Add a comment that AI makes errors
Rationale: 2026 TJC sentinel alert: nurses remain responsible for accuracy of all
documentation, including AI-generated content; must correct errors promptly.
17. A patient with a new tracheostomy on a speaking valve accidentally dislodges
the entire tracheostomy tube while turning. The stoma is patent, patient is alert,
RR 30, SpO₂ 88 %. Which action first?
A. Replace the tube immediately using the obturator
B. *Cover stoma with sterile gauze and provide bag-mask ventilation over mouth
and nose
C. Apply high-flow oxygen via nasal cannula
D. Call respiratory therapy to reinsert
Rationale: 2026 AACN procedure: total dislodgement within 7 days = stoma not
mature; ventilate oro-nasally while preparing for emergent reinsertion.
18. A nurse is managing a patient on continuous renal replacement therapy (CRRT)
via tele-ICU. The machine alarms “Air Detector Positive.” Which action should the
remote nurse take first?
A. Silence alarm and continue
B. *Pause blood pump and clamp lines; follow air-emergency protocol per policy
C. Increase ultrafiltration rate
D. Document the alarm and wait for bedside staff
Rationale: Air embolus is life-threatening; 2026 CRRT manufacturer and ANCC
tele-ICU standards require immediate pump stop and line clamping.
19. (Select all that apply) Which actions demonstrate appropriate use of AI-powered
fall-prevention bed alarms?
A. *Responding immediately to every alarm
B. *Using alarm data in conjunction with clinical assessment
C. *Educating patients that the bed will alert staff if they try to stand
D. *Documenting response to each alarm
E. Disregarding alarms during shift change
Rationale: Options A-D reflect 2026 evidence-based integration of bed sensor
technology; E is unsafe.
20. A nurse is informed that an AI chatbot has been answering patient call-light
requests overnight. A patient now refuses morning meds because “the computer
said I don’t need them.” Which action?
A. Reassure patient that AI is accurate
B. *Clarify with patient, administer meds as ordered, and report the incident to
prevent further AI misinformation
C. Cancel the morning doses
D. Tell the patient the chatbot is just for fun
