NUR 283 COMP 2 Transition to RN
Exam – Questions & answers with
Rationales 2026\2027
EXAM
Questions 1–10: Prioritization & Delegation
1. A nurse receives report on 4 patients. Which patient should be
assessed first?
A) Patient with a broken hip requesting pain medication
B) Patient with a tracheostomy and oxygen saturation of 88%
C) Patient who needs discharge teaching about warfarin
D) Patient scheduled for an abdominal CT scan in 2 hours
Answer: B
Rationale: Airway and breathing are priority. An SpO₂ of 88%
indicates hypoxemia; the tracheostomy patient is at high risk for
airway obstruction or mucus plugging. Pain, teaching, and
diagnostic tests can wait.
2. An RN on a medical-surgical unit delegates a task to an
LPN/LVN. Which task is appropriate?
A) Initial assessment of a new admission with chest pain
B) Administration of IV push morphine to a post-op patient
C) Administering oral metoprolol to a stable hypertensive patient
D) Creating a care plan for a patient with diabetes
,Answer: C
Rationale: LPNs can give oral medications to stable patients.
Initial assessment, IV push opioids, and care plan creation require
RN scope.
3. A charge nurse is assigning staff. Which patient should be
assigned to an experienced RN rather than a new graduate?
A) Patient with pneumonia on room air
B) Patient with appendicitis scheduled for surgery in 4 hours
C) Patient with unstable atrial fibrillation and a new heparin drip
D) Patient with a urinary tract infection receiving oral antibiotics
Answer: C
Rationale: Unstable dysrhythmia and a titratable IV anticoagulant
drip require critical thinking and experience. Stable patients can
be managed by new graduates under supervision.
4. A patient with a chest tube has continuous bubbling in the
water seal chamber. What action should the nurse take first?
A) Clamp the chest tube near the insertion site
B) Assess for an air leak and notify the provider
C) Increase suction pressure
D) Document the finding as normal
Answer: B
Rationale: Continuous bubbling indicates an air leak. Clamping
could cause tension pneumothorax. Assess the system, then notify
provider.
5. Which task can the nurse delegate to a nursing assistive
personnel (NAP)?
A) Measuring a patient’s blood pressure every 15 minutes after a
,seizure
B) Teaching a patient how to use an incentive spirometer
C) Assessing a surgical incision for redness
D) Administering a tap water enema
Answer: A
Rationale: Vital signs measurement is within NAP scope after
stable training. Teaching, assessment, and enema administration
(requires more judgment) are not delegated to NAP.
6. A patient is found on the floor. After calling for help, what is the
nurse’s priority action?
A) Move the patient back to bed immediately
B) Assess the patient’s ABCs and level of consciousness
C) Complete an incident report
D) Ask the patient what happened
Answer: B
Rationale: First assess airway, breathing, circulation, and
neurological status to identify life threats. Moving the patient
could worsen injury; the incident report is completed later.
7. A nurse manager is reviewing fall prevention. Which action
demonstrates a safe culture?
A) Placing bed exit alarms only on patients over age 80
B) Keeping side rails fully raised on all beds
C) Conducting a fall risk assessment on every admission
D) Using physical restraints as the first intervention for confusion
Answer: C
Rationale: Universal fall risk assessment identifies at-risk patients.
Side rails fully up can increase injury risk; restraints are last resort.
, 8. The nurse receives a telephone order from a provider. Which is
the most important step?
A) Repeat the order back to the provider verbatim
B) Write the order on a sticky note for later entry
C) Implement the order before writing it down
D) Ask another nurse to listen on the extension
Answer: A
Rationale: Read-back (repeat back) verifies accuracy and prevents
errors. Orders must be written immediately, not on sticky notes,
and implemented only after verification.
9. A patient with a new colostomy asks, “When can I start
irrigating it?” The nurse should base the answer on which
principle?
A) Irrigation is usually started 24 hours after surgery
B) Irrigation is never performed on a colostomy
C) Irrigation is started once bowel sounds return and ostomy is
functioning (usually day 3–7)
D) The patient must wait until after hospital discharge
Answer: C
Rationale: Colostomy irrigation is initiated after bowel function
returns, typically 3–7 days post-op, per provider order. Not all
colostomies are irrigated.
10. Which patient statement indicates correct understanding of
digoxin teaching?
A) “I will take my digoxin with antacids if I get heartburn.”
B) “I will check my pulse daily and call if it is below 60.”
C) “I can stop taking digoxin when I feel better.”
D) “I will double my dose if I miss one.”
Exam – Questions & answers with
Rationales 2026\2027
EXAM
Questions 1–10: Prioritization & Delegation
1. A nurse receives report on 4 patients. Which patient should be
assessed first?
A) Patient with a broken hip requesting pain medication
B) Patient with a tracheostomy and oxygen saturation of 88%
C) Patient who needs discharge teaching about warfarin
D) Patient scheduled for an abdominal CT scan in 2 hours
Answer: B
Rationale: Airway and breathing are priority. An SpO₂ of 88%
indicates hypoxemia; the tracheostomy patient is at high risk for
airway obstruction or mucus plugging. Pain, teaching, and
diagnostic tests can wait.
2. An RN on a medical-surgical unit delegates a task to an
LPN/LVN. Which task is appropriate?
A) Initial assessment of a new admission with chest pain
B) Administration of IV push morphine to a post-op patient
C) Administering oral metoprolol to a stable hypertensive patient
D) Creating a care plan for a patient with diabetes
,Answer: C
Rationale: LPNs can give oral medications to stable patients.
Initial assessment, IV push opioids, and care plan creation require
RN scope.
3. A charge nurse is assigning staff. Which patient should be
assigned to an experienced RN rather than a new graduate?
A) Patient with pneumonia on room air
B) Patient with appendicitis scheduled for surgery in 4 hours
C) Patient with unstable atrial fibrillation and a new heparin drip
D) Patient with a urinary tract infection receiving oral antibiotics
Answer: C
Rationale: Unstable dysrhythmia and a titratable IV anticoagulant
drip require critical thinking and experience. Stable patients can
be managed by new graduates under supervision.
4. A patient with a chest tube has continuous bubbling in the
water seal chamber. What action should the nurse take first?
A) Clamp the chest tube near the insertion site
B) Assess for an air leak and notify the provider
C) Increase suction pressure
D) Document the finding as normal
Answer: B
Rationale: Continuous bubbling indicates an air leak. Clamping
could cause tension pneumothorax. Assess the system, then notify
provider.
5. Which task can the nurse delegate to a nursing assistive
personnel (NAP)?
A) Measuring a patient’s blood pressure every 15 minutes after a
,seizure
B) Teaching a patient how to use an incentive spirometer
C) Assessing a surgical incision for redness
D) Administering a tap water enema
Answer: A
Rationale: Vital signs measurement is within NAP scope after
stable training. Teaching, assessment, and enema administration
(requires more judgment) are not delegated to NAP.
6. A patient is found on the floor. After calling for help, what is the
nurse’s priority action?
A) Move the patient back to bed immediately
B) Assess the patient’s ABCs and level of consciousness
C) Complete an incident report
D) Ask the patient what happened
Answer: B
Rationale: First assess airway, breathing, circulation, and
neurological status to identify life threats. Moving the patient
could worsen injury; the incident report is completed later.
7. A nurse manager is reviewing fall prevention. Which action
demonstrates a safe culture?
A) Placing bed exit alarms only on patients over age 80
B) Keeping side rails fully raised on all beds
C) Conducting a fall risk assessment on every admission
D) Using physical restraints as the first intervention for confusion
Answer: C
Rationale: Universal fall risk assessment identifies at-risk patients.
Side rails fully up can increase injury risk; restraints are last resort.
, 8. The nurse receives a telephone order from a provider. Which is
the most important step?
A) Repeat the order back to the provider verbatim
B) Write the order on a sticky note for later entry
C) Implement the order before writing it down
D) Ask another nurse to listen on the extension
Answer: A
Rationale: Read-back (repeat back) verifies accuracy and prevents
errors. Orders must be written immediately, not on sticky notes,
and implemented only after verification.
9. A patient with a new colostomy asks, “When can I start
irrigating it?” The nurse should base the answer on which
principle?
A) Irrigation is usually started 24 hours after surgery
B) Irrigation is never performed on a colostomy
C) Irrigation is started once bowel sounds return and ostomy is
functioning (usually day 3–7)
D) The patient must wait until after hospital discharge
Answer: C
Rationale: Colostomy irrigation is initiated after bowel function
returns, typically 3–7 days post-op, per provider order. Not all
colostomies are irrigated.
10. Which patient statement indicates correct understanding of
digoxin teaching?
A) “I will take my digoxin with antacids if I get heartburn.”
B) “I will check my pulse daily and call if it is below 60.”
C) “I can stop taking digoxin when I feel better.”
D) “I will double my dose if I miss one.”
