NUR 282 Advanced Clinical and Transition Nursing Comprehensive
Exam 2026 |Galen College
1. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which
task is appropriate for the nurse to delegate?
A. Assisting a stable patient with a bed bath
B. Evaluating a patient’s response to pain medication
C. Educating a patient on a low-sodium diet
D. Assessing the breath sounds of a post-operative patient
Answer: A
Rationale: UAPs can perform tasks that do not require clinical judgment or assessment,
such as hygiene, feeding, and basic mobility. Assessment, education, and evaluation are the
responsibility of the RN.
2. A patient in the ICU has a Central Venous Pressure (CVP) of 2 mmHg. Which
intervention should the nurse anticipate?
A. Administering a bolus of intravenous fluids
B. Administering a loop diuretic
C. Restricting oral fluid intake
D. Placing the patient in High-Fowler’s position
Answer: A
Rationale: A normal CVP is 2-8 mmHg. A value of 2 is at the low end, indicating potential
hypovolemia. IV fluids are typically used to increase preload and CVP.
,3. During a mass casualty incident, which patient should be assigned a ‘red tag’?
A. A patient with an obstructed airway and gasping respirations
B. A patient with a closed fracture of the right arm
C. A patient with a minor abrasion and high anxiety
D. A patient with no pulse or respirations for 10 minutes
Answer: A
Rationale: Red tags signify immediate priority for patients with life-threatening but
treatable injuries, such as airway obstruction. Black tags are for the deceased or expectant.
4. A patient is experiencing Autonomic Dysreflexia. What is the priority nursing
action?
A. Administer an antihypertensive medication
B. Assess the patient’s pupils for reactivity
C. Lower the head of the bed to a flat position
D. Check for bladder distention or fecal impaction
Answer: D
Rationale: The first step in treating autonomic dysreflexia is to remove the stimulus
(usually a full bladder or bowel) while keeping the head of the bed elevated.
5. The high-pressure alarm on a mechanical ventilator is sounding. What is a
possible cause?
A. A leak in the ventilator circuit
B. The endotracheal tube cuff is deflated
C. The patient is biting the endotracheal tube
D. Disconnection of the ventilator tubing
Answer: C
Rationale: High-pressure alarms are triggered by increased resistance, such as secretions,
kinking of the tube, or the patient biting the tube. Leaks cause low-pressure alarms.
, 6. A nurse is caring for a patient with Diabetic Ketoacidosis (DKA). Which
laboratory finding is expected?
A. Blood glucose 150 mg/dL
B. pH 7.45
C. Negative urine ketones
D. Serum bicarbonate 12 mEq/L
Answer: D
Rationale: DKA is characterized by metabolic acidosis, which involves a low pH and low
bicarbonate level (less than 18 mEq/L).
7. In a patient with SIADH, which electrolyte imbalance is the primary concern?
A. Hyponatremia
B. Hypocalcemia
C. Hyperkalemia
D. Hypernatremia
Answer: A
Rationale: SIADH leads to excessive water retention, which dilutes the serum sodium level,
resulting in dilutional hyponatremia.
8. A patient with a chest tube has continuous bubbling in the water-seal
chamber. This indicates:
A. Normal functioning of the system
B. An air leak in the system
C. The lung has fully re-expanded
D. Excessive suction is being applied
Answer: B
Rationale: Intermittent bubbling is normal in a patient with a pneumothorax, but
continuous bubbling indicates a leak in the drainage system or at the insertion site.
Exam 2026 |Galen College
1. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which
task is appropriate for the nurse to delegate?
A. Assisting a stable patient with a bed bath
B. Evaluating a patient’s response to pain medication
C. Educating a patient on a low-sodium diet
D. Assessing the breath sounds of a post-operative patient
Answer: A
Rationale: UAPs can perform tasks that do not require clinical judgment or assessment,
such as hygiene, feeding, and basic mobility. Assessment, education, and evaluation are the
responsibility of the RN.
2. A patient in the ICU has a Central Venous Pressure (CVP) of 2 mmHg. Which
intervention should the nurse anticipate?
A. Administering a bolus of intravenous fluids
B. Administering a loop diuretic
C. Restricting oral fluid intake
D. Placing the patient in High-Fowler’s position
Answer: A
Rationale: A normal CVP is 2-8 mmHg. A value of 2 is at the low end, indicating potential
hypovolemia. IV fluids are typically used to increase preload and CVP.
,3. During a mass casualty incident, which patient should be assigned a ‘red tag’?
A. A patient with an obstructed airway and gasping respirations
B. A patient with a closed fracture of the right arm
C. A patient with a minor abrasion and high anxiety
D. A patient with no pulse or respirations for 10 minutes
Answer: A
Rationale: Red tags signify immediate priority for patients with life-threatening but
treatable injuries, such as airway obstruction. Black tags are for the deceased or expectant.
4. A patient is experiencing Autonomic Dysreflexia. What is the priority nursing
action?
A. Administer an antihypertensive medication
B. Assess the patient’s pupils for reactivity
C. Lower the head of the bed to a flat position
D. Check for bladder distention or fecal impaction
Answer: D
Rationale: The first step in treating autonomic dysreflexia is to remove the stimulus
(usually a full bladder or bowel) while keeping the head of the bed elevated.
5. The high-pressure alarm on a mechanical ventilator is sounding. What is a
possible cause?
A. A leak in the ventilator circuit
B. The endotracheal tube cuff is deflated
C. The patient is biting the endotracheal tube
D. Disconnection of the ventilator tubing
Answer: C
Rationale: High-pressure alarms are triggered by increased resistance, such as secretions,
kinking of the tube, or the patient biting the tube. Leaks cause low-pressure alarms.
, 6. A nurse is caring for a patient with Diabetic Ketoacidosis (DKA). Which
laboratory finding is expected?
A. Blood glucose 150 mg/dL
B. pH 7.45
C. Negative urine ketones
D. Serum bicarbonate 12 mEq/L
Answer: D
Rationale: DKA is characterized by metabolic acidosis, which involves a low pH and low
bicarbonate level (less than 18 mEq/L).
7. In a patient with SIADH, which electrolyte imbalance is the primary concern?
A. Hyponatremia
B. Hypocalcemia
C. Hyperkalemia
D. Hypernatremia
Answer: A
Rationale: SIADH leads to excessive water retention, which dilutes the serum sodium level,
resulting in dilutional hyponatremia.
8. A patient with a chest tube has continuous bubbling in the water-seal
chamber. This indicates:
A. Normal functioning of the system
B. An air leak in the system
C. The lung has fully re-expanded
D. Excessive suction is being applied
Answer: B
Rationale: Intermittent bubbling is normal in a patient with a pneumothorax, but
continuous bubbling indicates a leak in the drainage system or at the insertion site.
