Comp 1 Exam Recording
1. Medications should be given through a central line
2. The nurse working on a medical surgical unit is delegating tasks to
unlicensed personnel which of the following delegated task would
REQUIRE FOLLOW UP by the charge nurse?
A - Assisting a client who had a paracentesis 2 hours ago to get out of bed for the
first time
Rationale – anytime a client is doing something for the first time the RN needs to do it
3. The nurse is prioritizing patient care after a change of shift report the
nurse should first plan to see the patient who:
B – Had an endoscopic retrograde cholangiopancreatography 30 minutes ago
and is reporting difficulty swallowing
Rationale – Difficulty swallowing – ABC’s!
4. The nurse working on the mom/baby unit has become aware of the
following client situations, which of the following clients should the
nurse INITIALLY assess?
C – a neonate who is 4 hours old, whose resting HR is 95 BPM.
Rationale – Normal HR for a newborn is 120-140 BPM – 95 is a LOW BPM
5. A nurse working on a medical surgical unit has just received a hand-
off report on the following clients, the nurse should FIRST plan to
assess the client who has:
D –Acute pancreatitis and is reporting the development of pain on deep
inspiration
Rationale – “acute” if not caught early, will possible burst and patient will become septic
6. The nurse working on a pediatric unit is caring for the following
children who have been admitted in the past 12 hours - it would be a
, priority goal for the nurse to initiate an interdisciplinary conference
for the child who:
A – 5 yr old with diagnosed cystic fibrosis at birth and has been hospitalized 4
times in the past 2 months
Rationale – This is conferencing everyone!!! PT, dietary, spiritual guidance, everyone
should be conferenced for this patient. This question is asking – WHO / WHICH child is
requiring the MOST help and resources???
7. The nurse working in the ED has received the following prescriptions
for a newly admitted client, which prescriptions should the nurse
implement FIRST?
D – Initiate IV sodium and potassium for a client admitted with diarrhea and
dehydration who has a serum potassium level of 2.9.
Rationale – serum potassium of 2.9 is CRITICAL - this is a critical lab value and should
be addressed first!
8. A nurse is working in a community health clinic is assessing clients
who are waiting to be seen, which client should the nurse have the
primary health care provider see FIRST?
A – a 57 year old with graves disease with a temperature of 100.5
Rationale – Thyroid issue
9. A nurse is working on a pediatric cardiac unit is reviewing the
telemetry monitors for assigned clients, which client should the nurse
INITIALLY plan to assess?
A – 2 year old toddler who is walking in the hallway and has a HR of 160 BPM
Rationale – Abnormal HR – all the other choices were normal for the child
10. A nurse is caring for a male client who has a deep partial
thickness and a full thickness burn to 45 % of the lower body, it would
be a PRIORITY for the nurse to notify the primary health care
physician if the client has:
D – A urinary output of 45 ml over the past two hours
1. Medications should be given through a central line
2. The nurse working on a medical surgical unit is delegating tasks to
unlicensed personnel which of the following delegated task would
REQUIRE FOLLOW UP by the charge nurse?
A - Assisting a client who had a paracentesis 2 hours ago to get out of bed for the
first time
Rationale – anytime a client is doing something for the first time the RN needs to do it
3. The nurse is prioritizing patient care after a change of shift report the
nurse should first plan to see the patient who:
B – Had an endoscopic retrograde cholangiopancreatography 30 minutes ago
and is reporting difficulty swallowing
Rationale – Difficulty swallowing – ABC’s!
4. The nurse working on the mom/baby unit has become aware of the
following client situations, which of the following clients should the
nurse INITIALLY assess?
C – a neonate who is 4 hours old, whose resting HR is 95 BPM.
Rationale – Normal HR for a newborn is 120-140 BPM – 95 is a LOW BPM
5. A nurse working on a medical surgical unit has just received a hand-
off report on the following clients, the nurse should FIRST plan to
assess the client who has:
D –Acute pancreatitis and is reporting the development of pain on deep
inspiration
Rationale – “acute” if not caught early, will possible burst and patient will become septic
6. The nurse working on a pediatric unit is caring for the following
children who have been admitted in the past 12 hours - it would be a
, priority goal for the nurse to initiate an interdisciplinary conference
for the child who:
A – 5 yr old with diagnosed cystic fibrosis at birth and has been hospitalized 4
times in the past 2 months
Rationale – This is conferencing everyone!!! PT, dietary, spiritual guidance, everyone
should be conferenced for this patient. This question is asking – WHO / WHICH child is
requiring the MOST help and resources???
7. The nurse working in the ED has received the following prescriptions
for a newly admitted client, which prescriptions should the nurse
implement FIRST?
D – Initiate IV sodium and potassium for a client admitted with diarrhea and
dehydration who has a serum potassium level of 2.9.
Rationale – serum potassium of 2.9 is CRITICAL - this is a critical lab value and should
be addressed first!
8. A nurse is working in a community health clinic is assessing clients
who are waiting to be seen, which client should the nurse have the
primary health care provider see FIRST?
A – a 57 year old with graves disease with a temperature of 100.5
Rationale – Thyroid issue
9. A nurse is working on a pediatric cardiac unit is reviewing the
telemetry monitors for assigned clients, which client should the nurse
INITIALLY plan to assess?
A – 2 year old toddler who is walking in the hallway and has a HR of 160 BPM
Rationale – Abnormal HR – all the other choices were normal for the child
10. A nurse is caring for a male client who has a deep partial
thickness and a full thickness burn to 45 % of the lower body, it would
be a PRIORITY for the nurse to notify the primary health care
physician if the client has:
D – A urinary output of 45 ml over the past two hours
