NUR 283 COMP 1, 2 & 3 EXAMS (GALEN) 200
UNIQUE PRACTICE QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES
COMP 1: FOUNDATIONAL CONCEPTS & PRIORITIZATION (Questions 167)
Question 1
A nurse is caring for four clients. Which client should the nurse assess FIRST?
A) A client with COPD reporting increased shortness of breath
B) A client with diabetes requesting pain medication
C) A client with a hip fracture requesting assistance with bedpan
D) A client with a urinary tract infection requesting water
Answer: A) A client with COPD reporting increased shortness of breath
Rationale: Prioritization follows the ABCs (Airway, Breathing, Circulation). A
client with COPD experiencing increased shortness of breath has a potential
airway/breathing compromise that requires immediate assessment. The
other clients have stable needs that can be addressed after stabilizing the
breathing issue. This reflects the nursing priority framework where
lifethreatening conditions are addressed first.
,Question 2
A client is prescribed warfarin (Coumadin). Which laboratory value should the
nurse monitor most closely?
A) Serum potassium
B) Serum sodium
C) International Normalized Ratio (INR)
D) Blood urea nitrogen (BUN)
Answer: C) International Normalized Ratio (INR)
Rationale: Warfarin is an anticoagulant that requires close monitoring of INR
to maintain therapeutic levels between 2.0 and 3.0 for most indications. This
prevents bleeding complications or clot formation. Serum potassium, sodium,
and BUN are not directly affected by warfarin therapy.
Question 3
A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which
task is appropriate to delegate?
A) Administering oral medications
B) Assessing a client's surgical wound
C) Providing a bed bath to a stable client
D) Performing a sterile dressing change
Answer: C) Providing a bed bath to a stable client
,Rationale: UAP can perform basic hygiene and activities of daily living for
stable clients. Medication administration, assessment, and sterile procedures
require licensed nursing judgment and are outside the scope of UAP practice.
Delegation must follow the five rights: right task, right circumstance, right
person, right communication, and right supervision.
Question 4
A client with heart failure is receiving furosemide (Lasix). Which assessment
finding indicates the medication is effective?
A) Decreased blood pressure
B) Increased urine output
C) Decreased heart rate
D) Increased respiratory rate
Answer: B) Increased urine output
Rationale: Furosemide is a loop diuretic that promotes diuresis by inhibiting
sodium and chloride reabsorption in the ascending loop of Henle. Increased
urine output indicates effective removal of excess fluid, which should reduce
edema and improve cardiac function. While decreased blood pressure may
occur, it is not the primary indicator of effectiveness.
Question 5
, A nurse is preparing to administer a blood transfusion. Which action should
the nurse take FIRST?
A) Obtain informed consent from the client
B) Verify the client's identity using two identifiers
C) Prime the IV tubing with normal saline
D) Assess vital signs
Answer: B) Verify the client's identity using two identifiers
Rationale: Client safety is paramount in blood administration. Verifying
identity using two unique identifiers (name and date of birth) against the
blood product and the client's armband is the first and most critical step to
prevent transfusion errors. While all options are important, identity
verification must occur before proceeding with other steps.
Question 6
Which client is at highest risk for developing a pressure injury?
A) A 25yearold with a fractured leg
B) A 45yearold with hypertension
C) An 80yearold who is bedridden and incontinent
D) A 60yearold with diabetes
Answer: C) An 80yearold who is bedridden and incontinent
UNIQUE PRACTICE QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES
COMP 1: FOUNDATIONAL CONCEPTS & PRIORITIZATION (Questions 167)
Question 1
A nurse is caring for four clients. Which client should the nurse assess FIRST?
A) A client with COPD reporting increased shortness of breath
B) A client with diabetes requesting pain medication
C) A client with a hip fracture requesting assistance with bedpan
D) A client with a urinary tract infection requesting water
Answer: A) A client with COPD reporting increased shortness of breath
Rationale: Prioritization follows the ABCs (Airway, Breathing, Circulation). A
client with COPD experiencing increased shortness of breath has a potential
airway/breathing compromise that requires immediate assessment. The
other clients have stable needs that can be addressed after stabilizing the
breathing issue. This reflects the nursing priority framework where
lifethreatening conditions are addressed first.
,Question 2
A client is prescribed warfarin (Coumadin). Which laboratory value should the
nurse monitor most closely?
A) Serum potassium
B) Serum sodium
C) International Normalized Ratio (INR)
D) Blood urea nitrogen (BUN)
Answer: C) International Normalized Ratio (INR)
Rationale: Warfarin is an anticoagulant that requires close monitoring of INR
to maintain therapeutic levels between 2.0 and 3.0 for most indications. This
prevents bleeding complications or clot formation. Serum potassium, sodium,
and BUN are not directly affected by warfarin therapy.
Question 3
A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which
task is appropriate to delegate?
A) Administering oral medications
B) Assessing a client's surgical wound
C) Providing a bed bath to a stable client
D) Performing a sterile dressing change
Answer: C) Providing a bed bath to a stable client
,Rationale: UAP can perform basic hygiene and activities of daily living for
stable clients. Medication administration, assessment, and sterile procedures
require licensed nursing judgment and are outside the scope of UAP practice.
Delegation must follow the five rights: right task, right circumstance, right
person, right communication, and right supervision.
Question 4
A client with heart failure is receiving furosemide (Lasix). Which assessment
finding indicates the medication is effective?
A) Decreased blood pressure
B) Increased urine output
C) Decreased heart rate
D) Increased respiratory rate
Answer: B) Increased urine output
Rationale: Furosemide is a loop diuretic that promotes diuresis by inhibiting
sodium and chloride reabsorption in the ascending loop of Henle. Increased
urine output indicates effective removal of excess fluid, which should reduce
edema and improve cardiac function. While decreased blood pressure may
occur, it is not the primary indicator of effectiveness.
Question 5
, A nurse is preparing to administer a blood transfusion. Which action should
the nurse take FIRST?
A) Obtain informed consent from the client
B) Verify the client's identity using two identifiers
C) Prime the IV tubing with normal saline
D) Assess vital signs
Answer: B) Verify the client's identity using two identifiers
Rationale: Client safety is paramount in blood administration. Verifying
identity using two unique identifiers (name and date of birth) against the
blood product and the client's armband is the first and most critical step to
prevent transfusion errors. While all options are important, identity
verification must occur before proceeding with other steps.
Question 6
Which client is at highest risk for developing a pressure injury?
A) A 25yearold with a fractured leg
B) A 45yearold with hypertension
C) An 80yearold who is bedridden and incontinent
D) A 60yearold with diabetes
Answer: C) An 80yearold who is bedridden and incontinent
