,NUR 283 Comp 3 Exam | Transition to RN Practice
(2026) Q&A | Galen College
1. A nurse in the emergency department receives report on four clients. Which
client should be assessed first?
A) A 55-year-old with a history of asthma reporting mild wheezing after using an
inhaler
B) A 60-year-old with crushing substernal chest pain radiating to the left arm
C) A 45-year-old with a sprained ankle and moderate swelling
D) A 70-year-old with a urinary tract infection and a temperature of 100.4°F
(38°C)
Correct Answer: A 60-year-old with crushing substernal chest pain radiating to
the left arm
Rationale: Chest pain suggestive of myocardial infarction is an immediate threat
to life. Using the ABCs and urgency of cardiac ischemia, this client takes priority
over a stable asthmatic, a musculoskeletal injury, or a stable UTI with low-grade
fever.
2. The charge nurse is making assignments for the oncoming shift. Which client
should be assigned to the registered nurse (RN) rather than the licensed
practical/vocational nurse (LPN/VN)?
A) A client with pneumonia who is hemodynamically stable and receiving oral
antibiotics
B) A client with a newly diagnosed diabetic ketoacidosis on an insulin infusion
C) A client with chronic kidney disease who needs a routine dressing change
,D) A client who had a cerebrovascular accident 5 days ago and is awaiting
transfer to rehabilitation
Correct Answer: A client with a newly diagnosed diabetic ketoacidosis on an
insulin infusion
Rationale: DKA with an insulin infusion is an unstable, complex condition
requiring frequent assessment and titration of therapy, which is within the RN’s
scope. LPNs care for stable clients with predictable outcomes; the other clients
are stable.
3. A client with heart failure has bilateral crackles and 3+ pitting edema. The
nurse anticipates which medication will be prescribed?
A) Metoprolol
B) Furosemide
C) Digoxin
D) Lisinopril
Correct Answer: Furosemide
Rationale: Furosemide, a loop diuretic, rapidly reduces preload by promoting
fluid excretion, relieving pulmonary congestion and peripheral edema.
Metoprolol reduces heart rate, digoxin improves contractility, and lisinopril
reduces afterload; diuresis is the immediate need for volume overload.
4. The nurse is caring for a client who is 24 hours postoperative abdominal
surgery. Which change in condition should the nurse identify as a priority?
, A) The client who reports a pain level of 8 on a 0–10 scale after receiving an
opioid analgesic
B) The client who reports nausea after receiving IV antibiotics
C) The client whose dressing has a small amount of serosanguineous drainage
D) The client who has voided 200 mL in the last 4 hours
Correct Answer: The client who reports a pain level of 8 on a 0–10 scale after
receiving an opioid analgesic
Rationale: Unrelieved or increasing pain after opioids may signal complications
such as hemorrhage, compartment syndrome, or anastomotic leak. This change
from baseline is the most concerning and needs prompt evaluation. The other
findings are expected or less urgent.
5. A newly licensed nurse is discussing informed consent with a preceptor.
Which statement indicates understanding?
A) "I can obtain informed consent if the provider is unavailable."
B) "The nurse is responsible for ensuring the client understands the procedure
before signing."
C) "I am responsible for obtaining informed consent for all procedures."
D) "The client's family member can sign the consent form if the client is
confused."
Correct Answer: "The nurse is responsible for ensuring the client understands
the procedure before signing."
(2026) Q&A | Galen College
1. A nurse in the emergency department receives report on four clients. Which
client should be assessed first?
A) A 55-year-old with a history of asthma reporting mild wheezing after using an
inhaler
B) A 60-year-old with crushing substernal chest pain radiating to the left arm
C) A 45-year-old with a sprained ankle and moderate swelling
D) A 70-year-old with a urinary tract infection and a temperature of 100.4°F
(38°C)
Correct Answer: A 60-year-old with crushing substernal chest pain radiating to
the left arm
Rationale: Chest pain suggestive of myocardial infarction is an immediate threat
to life. Using the ABCs and urgency of cardiac ischemia, this client takes priority
over a stable asthmatic, a musculoskeletal injury, or a stable UTI with low-grade
fever.
2. The charge nurse is making assignments for the oncoming shift. Which client
should be assigned to the registered nurse (RN) rather than the licensed
practical/vocational nurse (LPN/VN)?
A) A client with pneumonia who is hemodynamically stable and receiving oral
antibiotics
B) A client with a newly diagnosed diabetic ketoacidosis on an insulin infusion
C) A client with chronic kidney disease who needs a routine dressing change
,D) A client who had a cerebrovascular accident 5 days ago and is awaiting
transfer to rehabilitation
Correct Answer: A client with a newly diagnosed diabetic ketoacidosis on an
insulin infusion
Rationale: DKA with an insulin infusion is an unstable, complex condition
requiring frequent assessment and titration of therapy, which is within the RN’s
scope. LPNs care for stable clients with predictable outcomes; the other clients
are stable.
3. A client with heart failure has bilateral crackles and 3+ pitting edema. The
nurse anticipates which medication will be prescribed?
A) Metoprolol
B) Furosemide
C) Digoxin
D) Lisinopril
Correct Answer: Furosemide
Rationale: Furosemide, a loop diuretic, rapidly reduces preload by promoting
fluid excretion, relieving pulmonary congestion and peripheral edema.
Metoprolol reduces heart rate, digoxin improves contractility, and lisinopril
reduces afterload; diuresis is the immediate need for volume overload.
4. The nurse is caring for a client who is 24 hours postoperative abdominal
surgery. Which change in condition should the nurse identify as a priority?
, A) The client who reports a pain level of 8 on a 0–10 scale after receiving an
opioid analgesic
B) The client who reports nausea after receiving IV antibiotics
C) The client whose dressing has a small amount of serosanguineous drainage
D) The client who has voided 200 mL in the last 4 hours
Correct Answer: The client who reports a pain level of 8 on a 0–10 scale after
receiving an opioid analgesic
Rationale: Unrelieved or increasing pain after opioids may signal complications
such as hemorrhage, compartment syndrome, or anastomotic leak. This change
from baseline is the most concerning and needs prompt evaluation. The other
findings are expected or less urgent.
5. A newly licensed nurse is discussing informed consent with a preceptor.
Which statement indicates understanding?
A) "I can obtain informed consent if the provider is unavailable."
B) "The nurse is responsible for ensuring the client understands the procedure
before signing."
C) "I am responsible for obtaining informed consent for all procedures."
D) "The client's family member can sign the consent form if the client is
confused."
Correct Answer: "The nurse is responsible for ensuring the client understands
the procedure before signing."
