Galen NUR 283 Exam 1 – Transition to RN Practice –
(2026/2027) Actual Questions & Answers, 100%
Guarantee Pass
BLOCK 1: Prioritization & ABCs
1. The nurse has just received shift report. Which client should the nurse assess
FIRST?
A. Client with pneumonia requesting pain medication for a headache.
B. Client with heart failure who has 2+ pitting edema in the lower extremities.
C. Client with diabetes mellitus who has a blood glucose of 180 mg/dL.
D. Client with a tracheostomy who has thick, yellow secretions and a SpO2 of
88%.
Rationale: Airway is the priority (ABCs). An SpO2 of 88% with thick secretions
indicates an obstructed airway and hypoxemia. The others are stable.
2. A client is experiencing an anaphylactic reaction to IV antibiotics. What is the
nurse's priority action?
A. Administer epinephrine.
B. Start an IV line.
C. Apply a non-rebreather mask.
D. Call the provider.
Rationale: Epinephrine is the first-line treatment for anaphylaxis to reverse
bronchospasm and hypotension. Airway support (oxygen) comes next, but
epinephrine is the priority.
3. A client fell and hit their head 4 hours ago. Which finding requires immediate
intervention?
A. Blood pressure 132/80 mmHg.
B. Pupils equal and reactive to light.
C. Glasgow Coma Scale (GCS) dropping from 15 to 12.
D. Heart rate 88 bpm.
,Rationale: A decreasing GCS indicates neurological deterioration and increased
intracranial pressure. This is the priority over stable vital signs.
4. A client receiving a blood transfusion reports chills and low back pain. What is
the nurse's FIRST action?
A. Stop the transfusion.
B. Slow the infusion rate.
C. Administer acetaminophen.
D. Notify the blood bank.
Rationale: Chills and low back pain are signs of an acute hemolytic transfusion
reaction. The priority is to stop the transfusion immediately to prevent further
hemolysis.
5. A client with a seizure history is actively seizing. What should the nurse do
FIRST?
A. Restrain the client's limbs.
B. Insert a padded tongue blade.
C. Place the client on their side.
D. Suction the airway.
Rationale: Turning the client to the side prevents aspiration by allowing
secretions to drain. Never restrain or put anything in the mouth during a seizure.
6. The cardiac monitor shows ventricular fibrillation. What is the priority action?
A. Defibrillate immediately.
B. Administer IV Amiodarone.
C. Start CPR.
D. Check the client's pulse.
Rationale: V-fib is a shockable rhythm. Immediate defibrillation is the priority.
CPR should be started if a defibrillator isn't immediately available.
, 7. A client is on a continuous IV heparin infusion. Which lab value requires the
MOST immediate action?
A. aPTT of 80 seconds (normal ~30-40).
B. Hemoglobin of 12 g/dL.
C. Platelet count of 100,000/mm³.
D. Potassium of 3.8 mEq/L.
Rationale: An aPTT of 80 seconds is significantly elevated (>2x control), placing
the client at high risk for bleeding. The nurse must notify the provider to adjust
the heparin drip.
8. The nurse is giving shift report. Which client should the oncoming nurse
assess FIRST?
A. Client 2 days post-op with a temp of 100.2°F.
B. Client with chest tubes who has continuous bubbling in the water seal
chamber.
C. Client with a colostomy bag that needs changing.
D. Client requesting a sleeping pill.
Rationale: Continuous bubbling in the water seal chamber indicates an air leak,
which could lead to pneumothorax or lung collapse. This is a breathing priority.
9. A client with a new tracheostomy has stridor and copious secretions. What
should the nurse do FIRST?
A. Deflate the tracheostomy cuff.
B. Suction the tracheostomy.
C. Call respiratory therapy.
D. Increase oxygen flow.
Rationale: Stridor indicates an obstructed airway. The priority is to clear the
airway by suctioning the tracheostomy immediately.
10. A post-cardiac arrest client is intubated. The EtCO2 monitor reads 20 mmHg.
What does this indicate?
A. Adequate ventilation.
(2026/2027) Actual Questions & Answers, 100%
Guarantee Pass
BLOCK 1: Prioritization & ABCs
1. The nurse has just received shift report. Which client should the nurse assess
FIRST?
A. Client with pneumonia requesting pain medication for a headache.
B. Client with heart failure who has 2+ pitting edema in the lower extremities.
C. Client with diabetes mellitus who has a blood glucose of 180 mg/dL.
D. Client with a tracheostomy who has thick, yellow secretions and a SpO2 of
88%.
Rationale: Airway is the priority (ABCs). An SpO2 of 88% with thick secretions
indicates an obstructed airway and hypoxemia. The others are stable.
2. A client is experiencing an anaphylactic reaction to IV antibiotics. What is the
nurse's priority action?
A. Administer epinephrine.
B. Start an IV line.
C. Apply a non-rebreather mask.
D. Call the provider.
Rationale: Epinephrine is the first-line treatment for anaphylaxis to reverse
bronchospasm and hypotension. Airway support (oxygen) comes next, but
epinephrine is the priority.
3. A client fell and hit their head 4 hours ago. Which finding requires immediate
intervention?
A. Blood pressure 132/80 mmHg.
B. Pupils equal and reactive to light.
C. Glasgow Coma Scale (GCS) dropping from 15 to 12.
D. Heart rate 88 bpm.
,Rationale: A decreasing GCS indicates neurological deterioration and increased
intracranial pressure. This is the priority over stable vital signs.
4. A client receiving a blood transfusion reports chills and low back pain. What is
the nurse's FIRST action?
A. Stop the transfusion.
B. Slow the infusion rate.
C. Administer acetaminophen.
D. Notify the blood bank.
Rationale: Chills and low back pain are signs of an acute hemolytic transfusion
reaction. The priority is to stop the transfusion immediately to prevent further
hemolysis.
5. A client with a seizure history is actively seizing. What should the nurse do
FIRST?
A. Restrain the client's limbs.
B. Insert a padded tongue blade.
C. Place the client on their side.
D. Suction the airway.
Rationale: Turning the client to the side prevents aspiration by allowing
secretions to drain. Never restrain or put anything in the mouth during a seizure.
6. The cardiac monitor shows ventricular fibrillation. What is the priority action?
A. Defibrillate immediately.
B. Administer IV Amiodarone.
C. Start CPR.
D. Check the client's pulse.
Rationale: V-fib is a shockable rhythm. Immediate defibrillation is the priority.
CPR should be started if a defibrillator isn't immediately available.
, 7. A client is on a continuous IV heparin infusion. Which lab value requires the
MOST immediate action?
A. aPTT of 80 seconds (normal ~30-40).
B. Hemoglobin of 12 g/dL.
C. Platelet count of 100,000/mm³.
D. Potassium of 3.8 mEq/L.
Rationale: An aPTT of 80 seconds is significantly elevated (>2x control), placing
the client at high risk for bleeding. The nurse must notify the provider to adjust
the heparin drip.
8. The nurse is giving shift report. Which client should the oncoming nurse
assess FIRST?
A. Client 2 days post-op with a temp of 100.2°F.
B. Client with chest tubes who has continuous bubbling in the water seal
chamber.
C. Client with a colostomy bag that needs changing.
D. Client requesting a sleeping pill.
Rationale: Continuous bubbling in the water seal chamber indicates an air leak,
which could lead to pneumothorax or lung collapse. This is a breathing priority.
9. A client with a new tracheostomy has stridor and copious secretions. What
should the nurse do FIRST?
A. Deflate the tracheostomy cuff.
B. Suction the tracheostomy.
C. Call respiratory therapy.
D. Increase oxygen flow.
Rationale: Stridor indicates an obstructed airway. The priority is to clear the
airway by suctioning the tracheostomy immediately.
10. A post-cardiac arrest client is intubated. The EtCO2 monitor reads 20 mmHg.
What does this indicate?
A. Adequate ventilation.
