NUR 283 COMP 3 Exam – RN Transition Practice –
(2026) Actual Questions & Answers (Galen) 100%
Guarantee Pass
SECTION 1: PRIORITIZATION & CLINICAL JUDGMENT
1. The nurse is caring for multiple patients. Which client should the nurse attend
to FIRST?
• A) A client who requests assistance with bathing
• B) A client who reports new onset shortness of breath
• C) A client who needs discharge teaching
• D) A client who requests a snack
Answer: B) A client who reports new onset shortness of breath
Rationale: Airway and breathing concerns receive the highest priority. New onset
shortness of breath may indicate a life-threatening respiratory or cardiac event.
Bathing, discharge teaching, and snack requests are lower priority tasks that can
be delegated or completed later. The ABCs (Airway, Breathing, Circulation) should
always guide prioritization .
2. The nurse working in the emergency department (ED) is caring for a newly
admitted client who has a history of peptic ulcer disease (PUD). Initial
assessment findings include: BP 110/72 mm Hg, P 90, yellow colored emesis,
frequent belching, Hgb 9.2 g/dL. It is a priority for the nurse to:
• A) Administer an antiemetic
• B) Type and cross for a packed red blood cell (PRBC) transfusion
• C) Place the client on NPO status
, • D) Obtain a stool sample for occult blood
Answer: B) Type and cross for a packed red blood cell (PRBC) transfusion
Rationale: Yellow-colored emesis (bile) with a hemoglobin of 9.2 g/dL in a patient
with peptic ulcer disease suggests upper GI bleeding. The priority is to prepare for
blood transfusion to correct anemia and prevent further hemodynamic
compromise. Type and cross should be obtained immediately .
3. The nurse is caring for a client who is 4-hours postoperative after receiving
general anesthesia. Assessment findings: T 98.4°F, P 58 with thready peripheral
pulses, BP 98/64 mm Hg, shallow respirations at 26, pale dry skin, indwelling
catheter with 400 mL clear yellow urine, receiving IV 0.9% NS at 125 mL/hr. ABG
results: pH 7.20, PaCO₂ 54 mm Hg, HCO₃ 26 mEq/L. Which assessment findings
are related to the ABG findings? (Select all that apply)
• A) Blood pressure 98/64 mm Hg
• B) Pulse 58
• C) Shallow respirations at 26
• D) Pale, dry skin
• E) Urine output 400 mL
Answer: A, B, and C
Rationale: The ABG shows respiratory acidosis (pH 7.20, PaCO₂ 54). Shallow
respirations indicate hypoventilation causing CO₂ retention. The low BP (98/64)
and bradycardia (P 58) may reflect the effects of acidosis on the cardiovascular
system. Pale, dry skin and urine output are not directly related to the ABG
findings .
4. A patient receiving a blood transfusion 30 minutes ago reports low back pain
and chills. What is the nurse's PRIORITY action?
, • A) Stop the transfusion
• B) Slow the infusion rate
• C) Notify the healthcare provider
• D) Administer acetaminophen
Answer: A) Stop the transfusion
Rationale: Low back pain and chills are classic signs of an acute hemolytic
transfusion reaction. The priority is to stop the transfusion immediately to prevent
further reaction. The provider should be notified after stopping the transfusion,
and the blood product and tubing should be returned to the blood bank .
5. The nurse is caring for a client who is in labor and receiving fetal heart
monitoring. The fetal heart rate (FHR) is 180. Which action should the nurse take
first?
• A) Turn the client to the left side
• B) Increase the IV fluid rate
• C) Administer oxygen
• D) Notify the provider
Answer: A) Turn the client to the left side
Rationale: Fetal tachycardia (FHR >160 bpm) can indicate fetal distress or
maternal dehydration. Turning the client to the left side improves uterine blood
flow and fetal oxygenation. This is a first-line intervention before more invasive
measures .
6. The nurse is caring for assigned clients when a fire with smoke is noted in the
nurses' station. Which action should the nurse take first?
• A) Use a bag valve mask to move a client on a mechanical ventilator
, • B) Chart all assessments quickly before leaving the nurses' station
• C) Extinguish the fire before moving any clients
• D) Close all doors and wait for security to arrive
Answer: A) Use a bag valve mask to move a client on a mechanical ventilator
Rationale: Using the RACE sequence, after sounding the alarm, the nurse must
rescue clients in immediate danger—especially those dependent on equipment
(ventilator). Manually ventilating while evacuating prioritizes life safety over
documentation or property .
7. The nurse is working in an ambulatory health center and has assessed the
following clients who are waiting. The nurse should immediately remove from
the waiting room and place in an examining room the client who has:
• A) A sprained ankle and 4/10 pain
• B) A fever of 101.8°F and is reporting a headache, vomiting, and sensitivity
to light
• C) Myasthenia gravis, ptosis of the left eye, and a nasal-sounding voice
• D) Mild seasonal allergies with clear nasal drainage
Answer: B) A fever of 101.8°F and is reporting a headache, vomiting, and
sensitivity to light
Rationale: Fever, headache, vomiting, and photophobia are classic signs of
meningitis, which is both emergent and highly infectious. This client needs
immediate isolation and evaluation. The others are stable or chronic issues .
8. The nurse is caring for a pediatric client who is postoperative following
ventriculoperitoneal (VP) shunt placement. The nurse notes that the client has
become difficult to arouse. Which action should the nurse take immediately?
(2026) Actual Questions & Answers (Galen) 100%
Guarantee Pass
SECTION 1: PRIORITIZATION & CLINICAL JUDGMENT
1. The nurse is caring for multiple patients. Which client should the nurse attend
to FIRST?
• A) A client who requests assistance with bathing
• B) A client who reports new onset shortness of breath
• C) A client who needs discharge teaching
• D) A client who requests a snack
Answer: B) A client who reports new onset shortness of breath
Rationale: Airway and breathing concerns receive the highest priority. New onset
shortness of breath may indicate a life-threatening respiratory or cardiac event.
Bathing, discharge teaching, and snack requests are lower priority tasks that can
be delegated or completed later. The ABCs (Airway, Breathing, Circulation) should
always guide prioritization .
2. The nurse working in the emergency department (ED) is caring for a newly
admitted client who has a history of peptic ulcer disease (PUD). Initial
assessment findings include: BP 110/72 mm Hg, P 90, yellow colored emesis,
frequent belching, Hgb 9.2 g/dL. It is a priority for the nurse to:
• A) Administer an antiemetic
• B) Type and cross for a packed red blood cell (PRBC) transfusion
• C) Place the client on NPO status
, • D) Obtain a stool sample for occult blood
Answer: B) Type and cross for a packed red blood cell (PRBC) transfusion
Rationale: Yellow-colored emesis (bile) with a hemoglobin of 9.2 g/dL in a patient
with peptic ulcer disease suggests upper GI bleeding. The priority is to prepare for
blood transfusion to correct anemia and prevent further hemodynamic
compromise. Type and cross should be obtained immediately .
3. The nurse is caring for a client who is 4-hours postoperative after receiving
general anesthesia. Assessment findings: T 98.4°F, P 58 with thready peripheral
pulses, BP 98/64 mm Hg, shallow respirations at 26, pale dry skin, indwelling
catheter with 400 mL clear yellow urine, receiving IV 0.9% NS at 125 mL/hr. ABG
results: pH 7.20, PaCO₂ 54 mm Hg, HCO₃ 26 mEq/L. Which assessment findings
are related to the ABG findings? (Select all that apply)
• A) Blood pressure 98/64 mm Hg
• B) Pulse 58
• C) Shallow respirations at 26
• D) Pale, dry skin
• E) Urine output 400 mL
Answer: A, B, and C
Rationale: The ABG shows respiratory acidosis (pH 7.20, PaCO₂ 54). Shallow
respirations indicate hypoventilation causing CO₂ retention. The low BP (98/64)
and bradycardia (P 58) may reflect the effects of acidosis on the cardiovascular
system. Pale, dry skin and urine output are not directly related to the ABG
findings .
4. A patient receiving a blood transfusion 30 minutes ago reports low back pain
and chills. What is the nurse's PRIORITY action?
, • A) Stop the transfusion
• B) Slow the infusion rate
• C) Notify the healthcare provider
• D) Administer acetaminophen
Answer: A) Stop the transfusion
Rationale: Low back pain and chills are classic signs of an acute hemolytic
transfusion reaction. The priority is to stop the transfusion immediately to prevent
further reaction. The provider should be notified after stopping the transfusion,
and the blood product and tubing should be returned to the blood bank .
5. The nurse is caring for a client who is in labor and receiving fetal heart
monitoring. The fetal heart rate (FHR) is 180. Which action should the nurse take
first?
• A) Turn the client to the left side
• B) Increase the IV fluid rate
• C) Administer oxygen
• D) Notify the provider
Answer: A) Turn the client to the left side
Rationale: Fetal tachycardia (FHR >160 bpm) can indicate fetal distress or
maternal dehydration. Turning the client to the left side improves uterine blood
flow and fetal oxygenation. This is a first-line intervention before more invasive
measures .
6. The nurse is caring for assigned clients when a fire with smoke is noted in the
nurses' station. Which action should the nurse take first?
• A) Use a bag valve mask to move a client on a mechanical ventilator
, • B) Chart all assessments quickly before leaving the nurses' station
• C) Extinguish the fire before moving any clients
• D) Close all doors and wait for security to arrive
Answer: A) Use a bag valve mask to move a client on a mechanical ventilator
Rationale: Using the RACE sequence, after sounding the alarm, the nurse must
rescue clients in immediate danger—especially those dependent on equipment
(ventilator). Manually ventilating while evacuating prioritizes life safety over
documentation or property .
7. The nurse is working in an ambulatory health center and has assessed the
following clients who are waiting. The nurse should immediately remove from
the waiting room and place in an examining room the client who has:
• A) A sprained ankle and 4/10 pain
• B) A fever of 101.8°F and is reporting a headache, vomiting, and sensitivity
to light
• C) Myasthenia gravis, ptosis of the left eye, and a nasal-sounding voice
• D) Mild seasonal allergies with clear nasal drainage
Answer: B) A fever of 101.8°F and is reporting a headache, vomiting, and
sensitivity to light
Rationale: Fever, headache, vomiting, and photophobia are classic signs of
meningitis, which is both emergent and highly infectious. This client needs
immediate isolation and evaluation. The others are stable or chronic issues .
8. The nurse is caring for a pediatric client who is postoperative following
ventriculoperitoneal (VP) shunt placement. The nurse notes that the client has
become difficult to arouse. Which action should the nurse take immediately?
