NSG 4800 COMPREHENSIVE EXAM:
ACTUAL QUESTIONS AND ANSWERS
LATEST UPDATED 2026/2027 (GRADED A+)
AT GALEN COLLEGE OF NURSING.
Question 1: Initial Assessment Prioritization
The nurse has been made aware of the following client situations. It is necess
ary for the nurse to initially assess the client who has:
a. Diabetes mellitus
(type 1), is difficult to arouse, and has a blood glucose of 38 mg/dL
b. Pneumonia and an elevated white blood cell count
c. A urinary tract infection reporting urinary frequency
d. Suspected appendicitis reporting abdominal pain rated 4/10
Answer: a. Diabetes mellitus
(type 1), is difficult to arouse, and has a blood glucose of 38 mg/dL.
Rationale: A blood glucose of 38 mg/dL indicates severe hypoglycemia, whic
h is a life-threatening condition. Altered level of consciousness suggests neur
ological compromise and places the client at risk for seizures or coma. Imme
diate intervention such as administration of glucagon or IV dextrose is requir
ed. The other options represent expected findings for those conditions and ar
e not immediately life-threatening.
Question 2: Delegation to Unlicensed Assistive Personnel
(UAP)
,The nurse has received the hand-off report and is assigning tasks to unlicens
ed assistive personnel
(UAP). Which task should the nurse instruct the UAP to perform first?
a. Collect a sputum specimen from a client suspected of having tuberculosis
b. Turn and reposition a client who was last turned 2 hours ago
c. Deliver meal trays to clients on the unit
d. Check the response of a client who received IV dextrose for hypoglycemia
Answer: b. Turn and reposition a client who was last turned 2 hours ago.
Rationale: Turning and repositioning every two hours is a routine, time-
sensitive intervention used to prevent pressure injuries and maintain skin int
egrity. This task is appropriate to delegate to UAP because it does not requir
e nursing judgment. Collecting TB specimens requires infection control knowl
edge, and evaluating medication response requires assessment by the nurse
. Delivering trays is appropriate but less urgent than maintaining scheduled r
epositioning.
Question 3: Pediatric Unit Prioritization
The nurse working on a pediatric unit has four clients assigned. Which client
should the nurse assess first?
a. A school-age child with asthma requesting a snack
b. A child with type 1 diabetes scheduled for routine glucose monitoring
c. An infant diagnosed with pertussis receiving oxygen via nasal cannula
d. A toddler recovering from a tonsillectomy asking for water
Answer: c. An infant diagnosed with pertussis receiving oxygen via nasal can
nula.
Rationale: The infant with pertussis is the priority because respiratory compr
omise threatens airway and breathing. Infants are especially vulnerable to ap
nea and airway obstruction with this infection. Oxygen use indicates the infa
nt already has respiratory distress. The other clients are stable and their nee
ds can safely wait.
Question 4: Floating Nurse Assignment
,A nurse who normally works on the maternity unit has been floated to an adu
lt medical-surgical unit. Which client assignment is most appropriate for the
float nurse?
a. A client learning sterile dressing changes for a surgical wound
b. A client who is 24 hours postoperative after an appendectomy
c. A client with chronic obstructive pulmonary disease experiencing dyspnea
d. A client preparing for a below-the-knee amputation
Answer: b. A client who is 24 hours postoperative after an appendectomy.
Rationale: Float nurses should be assigned stable clients with predictable out
comes. A client recovering from a routine appendectomy typically requires b
asic postoperative care such as monitoring vital signs and managing pain. M
ore complex cases requiring specialized knowledge or advanced assessment
s should remain with experienced unit staff.
Question 5: Interpreter Use in Patient Education
A nurse preceptor observes a newly hired nurse teaching a client with pelvic
inflammatory disease about self-care. The client does not speak English. Whi
ch action requires intervention?
a. Providing written instructions translated into the client's primary language
b. Requesting assistance from the hospital’s professional interpreter
c. Asking a family member to translate the instructions
d. Using an approved telephone interpreter service
Answer: c. Asking a family member to translate the instructions.
Rationale: Using family members as interpreters can lead to inaccuracies, o
missions, or discomfort discussing sensitive medical information. It also risks
violating patient confidentiality. Professional interpreters ensure accurate tra
nslation and maintain privacy. Healthcare facilities typically require approved
interpreter services for all medical communication.
Question 6: Labor and Delivery Monitoring
A nurse caring for a laboring client whose membranes have just ruptured ide
ntifies several findings. Which finding should be reported immediately to the
primary health care provider?
, a. Maternal temperature of 99.5°F (37.5°C)
b. New onset of late decelerations on the fetal monitor
c. Four contractions occurring in ten minutes
d. Contractions lasting approximately 60 seconds
Answer: b. New onset of late decelerations on the fetal monitor.
Rationale: Late decelerations are associated with uteroplacental insufficiency
and indicate that the fetus may not be receiving adequate oxygen during con
tractions. This finding requires immediate evaluation and possible interventio
n to prevent fetal distress. The other findings are expected in active labor an
d do not represent an immediate threat.
Question 7: Safe Injection Practice
A nurse preceptor observes a newly hired nurse performing several tasks. W
hich action demonstrates correct nursing care?
a. Using a 23-gauge, 1-inch needle to administer a medication into the deltoi
d muscle
b. Placing an N95 mask on a client with active tuberculosis during transport
c. Giving oral pain medication 20 minutes before discharge
d. Emptying an ileostomy bag 30 minutes after meals
Answer: a. Using a 23-gauge, 1-inch needle to administer a medication into t
he deltoid muscle.
Rationale: Recommended needle size for intramuscular injections in the delto
id of an adult is typically 22–25 gauge and 1–1.5 inches long. This size allows
medication to reach the muscle tissue effectively. The other options demonst
rate incorrect care practices related to infection control, medication timing, a
nd ostomy management.
Question 8: Infection Control Precautions
Which intervention is appropriate when caring for a client diagnosed with Clo
stridioides difficile infection?
a. Using alcohol-based hand sanitizer after patient contact
b. Implementing contact precautions and washing hands with soap and wate
r
ACTUAL QUESTIONS AND ANSWERS
LATEST UPDATED 2026/2027 (GRADED A+)
AT GALEN COLLEGE OF NURSING.
Question 1: Initial Assessment Prioritization
The nurse has been made aware of the following client situations. It is necess
ary for the nurse to initially assess the client who has:
a. Diabetes mellitus
(type 1), is difficult to arouse, and has a blood glucose of 38 mg/dL
b. Pneumonia and an elevated white blood cell count
c. A urinary tract infection reporting urinary frequency
d. Suspected appendicitis reporting abdominal pain rated 4/10
Answer: a. Diabetes mellitus
(type 1), is difficult to arouse, and has a blood glucose of 38 mg/dL.
Rationale: A blood glucose of 38 mg/dL indicates severe hypoglycemia, whic
h is a life-threatening condition. Altered level of consciousness suggests neur
ological compromise and places the client at risk for seizures or coma. Imme
diate intervention such as administration of glucagon or IV dextrose is requir
ed. The other options represent expected findings for those conditions and ar
e not immediately life-threatening.
Question 2: Delegation to Unlicensed Assistive Personnel
(UAP)
,The nurse has received the hand-off report and is assigning tasks to unlicens
ed assistive personnel
(UAP). Which task should the nurse instruct the UAP to perform first?
a. Collect a sputum specimen from a client suspected of having tuberculosis
b. Turn and reposition a client who was last turned 2 hours ago
c. Deliver meal trays to clients on the unit
d. Check the response of a client who received IV dextrose for hypoglycemia
Answer: b. Turn and reposition a client who was last turned 2 hours ago.
Rationale: Turning and repositioning every two hours is a routine, time-
sensitive intervention used to prevent pressure injuries and maintain skin int
egrity. This task is appropriate to delegate to UAP because it does not requir
e nursing judgment. Collecting TB specimens requires infection control knowl
edge, and evaluating medication response requires assessment by the nurse
. Delivering trays is appropriate but less urgent than maintaining scheduled r
epositioning.
Question 3: Pediatric Unit Prioritization
The nurse working on a pediatric unit has four clients assigned. Which client
should the nurse assess first?
a. A school-age child with asthma requesting a snack
b. A child with type 1 diabetes scheduled for routine glucose monitoring
c. An infant diagnosed with pertussis receiving oxygen via nasal cannula
d. A toddler recovering from a tonsillectomy asking for water
Answer: c. An infant diagnosed with pertussis receiving oxygen via nasal can
nula.
Rationale: The infant with pertussis is the priority because respiratory compr
omise threatens airway and breathing. Infants are especially vulnerable to ap
nea and airway obstruction with this infection. Oxygen use indicates the infa
nt already has respiratory distress. The other clients are stable and their nee
ds can safely wait.
Question 4: Floating Nurse Assignment
,A nurse who normally works on the maternity unit has been floated to an adu
lt medical-surgical unit. Which client assignment is most appropriate for the
float nurse?
a. A client learning sterile dressing changes for a surgical wound
b. A client who is 24 hours postoperative after an appendectomy
c. A client with chronic obstructive pulmonary disease experiencing dyspnea
d. A client preparing for a below-the-knee amputation
Answer: b. A client who is 24 hours postoperative after an appendectomy.
Rationale: Float nurses should be assigned stable clients with predictable out
comes. A client recovering from a routine appendectomy typically requires b
asic postoperative care such as monitoring vital signs and managing pain. M
ore complex cases requiring specialized knowledge or advanced assessment
s should remain with experienced unit staff.
Question 5: Interpreter Use in Patient Education
A nurse preceptor observes a newly hired nurse teaching a client with pelvic
inflammatory disease about self-care. The client does not speak English. Whi
ch action requires intervention?
a. Providing written instructions translated into the client's primary language
b. Requesting assistance from the hospital’s professional interpreter
c. Asking a family member to translate the instructions
d. Using an approved telephone interpreter service
Answer: c. Asking a family member to translate the instructions.
Rationale: Using family members as interpreters can lead to inaccuracies, o
missions, or discomfort discussing sensitive medical information. It also risks
violating patient confidentiality. Professional interpreters ensure accurate tra
nslation and maintain privacy. Healthcare facilities typically require approved
interpreter services for all medical communication.
Question 6: Labor and Delivery Monitoring
A nurse caring for a laboring client whose membranes have just ruptured ide
ntifies several findings. Which finding should be reported immediately to the
primary health care provider?
, a. Maternal temperature of 99.5°F (37.5°C)
b. New onset of late decelerations on the fetal monitor
c. Four contractions occurring in ten minutes
d. Contractions lasting approximately 60 seconds
Answer: b. New onset of late decelerations on the fetal monitor.
Rationale: Late decelerations are associated with uteroplacental insufficiency
and indicate that the fetus may not be receiving adequate oxygen during con
tractions. This finding requires immediate evaluation and possible interventio
n to prevent fetal distress. The other findings are expected in active labor an
d do not represent an immediate threat.
Question 7: Safe Injection Practice
A nurse preceptor observes a newly hired nurse performing several tasks. W
hich action demonstrates correct nursing care?
a. Using a 23-gauge, 1-inch needle to administer a medication into the deltoi
d muscle
b. Placing an N95 mask on a client with active tuberculosis during transport
c. Giving oral pain medication 20 minutes before discharge
d. Emptying an ileostomy bag 30 minutes after meals
Answer: a. Using a 23-gauge, 1-inch needle to administer a medication into t
he deltoid muscle.
Rationale: Recommended needle size for intramuscular injections in the delto
id of an adult is typically 22–25 gauge and 1–1.5 inches long. This size allows
medication to reach the muscle tissue effectively. The other options demonst
rate incorrect care practices related to infection control, medication timing, a
nd ostomy management.
Question 8: Infection Control Precautions
Which intervention is appropriate when caring for a client diagnosed with Clo
stridioides difficile infection?
a. Using alcohol-based hand sanitizer after patient contact
b. Implementing contact precautions and washing hands with soap and wate
r
