NUR 283 Comprehensive Exam 1 | Complete
Practice Exam Questions with Verified Correct
Answers & Detailed Rationales | Latest Update
2026/2027 | Galen College of Nursing
SECTION 1: PRIORITIZATION & CLINICAL JUDGMENT
The ABC Framework & Life-Threatening Conditions
Q1. The nurse receives a hand-off report on a pediatric unit. Which client should
the nurse assess FIRST?
A) A toddler with bronchiolitis on room air with mild wheezing
B) An infant diagnosed with pertussis who is receiving oxygen via nasal cannula
C) A preschooler with otitis media awaiting discharge
D) A school-age child with a simple fracture in a cast
Correct Answer: B
Rationale: Infants with pertussis are at high risk for apnea and severe respiratory
compromise. Any child on supplemental oxygen with a respiratory diagnosis takes
priority over stable conditions. The ABC framework always places airway and
breathing as the top priority .
Q2. The nurse is triaging clients in the emergency department. Which client
should be seen FIRST?
A) Client with multiple compound fractures reporting chest pain
B) Client with pancreatitis experiencing pain upon inspiration
C) Client with asthma who suddenly stops wheezing
D) Client with polycystic fibrosis bleeding with black tarry stool
,Correct Answer: A
Rationale: The combination of multiple fractures and chest pain raises concern for
fat embolism syndrome or pulmonary embolism—life-threatening conditions
requiring immediate intervention. The "who will die first" principle guides this
decision .
Q3. A nurse receives report on four patients. Which patient should the nurse
assess 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
Correct Answer: B
Rationale: Airway and breathing are always the priority. An SpO₂ of 88% indicates
hypoxemia, and the tracheostomy patient is at high risk for airway obstruction or
mucus plugging .
Q4. A nurse is reviewing clients on a telemetry unit. Which patient should be
assessed FIRST?
A) Patient with chest pain that resolved after nitroglycerin
B) Patient with new atrial fibrillation and heart rate of 110
C) Patient with potassium level of 6.2 mEq/L and peaked T waves
D) Patient with blood glucose of 350 mg/dL and no symptoms
Correct Answer: C
Rationale: Hyperkalemia with ECG changes (peaked T waves) is life-threatening
and can lead to cardiac arrest. Potassium levels above 5.0 mEq/L with ECG
changes represent a critical risk for lethal arrhythmias .
,Q5. The nurse is assessing a pediatric client in the emergency department.
Which finding is most concerning and requires immediate intervention?
A) 6-year-old child sitting at a table eating with pulse of 130
B) 4-month-old infant who can roll from abdomen to back
C) 9-month-old infant who pulls to stand
D) 12-month-old child who walks with assistance
Correct Answer: A
Rationale: A pulse of 130 in a 6-year-old is significantly elevated (normal 60-110
bpm). Combined with being in an ED setting, this requires immediate assessment
for pain, fever, dehydration, or cardiac issues .
Q6. The nurse is assessing several clients in an outpatient clinic. Which client
should the provider see FIRST?
A) A 28-year-old with a sprained ankle and mild swelling
B) A 45-year-old with stable chronic back pain
C) A 55-year-old with blood pressure 164/96 mm Hg who recently stopped
smoking
D) A 70-year-old with asymptomatic pulse of 62
Correct Answer: C
Rationale: Stage 2 hypertension plus recent smoking history significantly increases
cardiovascular risk and requires prompt follow-up .
Q7. The nurse is working in a pediatric cardiac unit reviewing vital signs. Which
child should be assessed FIRST?
A) 6-year-old with pulse of 130 while eating
B) 2-year-old with respiratory rate of 28 and mild wheezing
C) 10-year-old with blood pressure of 110/70
D) Adolescent with heart rate of 80 and normal rhythm
, Correct Answer: A
Rationale: A pulse of 130 in a 6-year-old is significantly elevated and requires
immediate assessment. Normal heart rate for a 6-year-old is 60-110 bpm .
Q8. The nurse is caring for a client who is 4-hours post-operative after general
anesthesia. Assessment findings include: T 98.4°F, P 58 with thready pulses, BP
98/64 mm Hg, RR 26 shallow, pale dry skin. ABG: pH 7.20, PaCO₂ 54, HCO₃ 26.
Which findings are related to the ABG results?
A) IV fluids and temperature
B) Blood pressure, pulse, and general anesthesia
C) Urine output and pale dry skin
D) Shallow respirations and blood pressure
Correct Answer: B
Rationale: The ABG shows respiratory acidosis (pH 7.20, PaCO₂ 54). Respiratory
acidosis is caused by hypoventilation, which is reflected in shallow respirations.
Hypotension (BP 98/64) and thready pulses are compensatory responses to
acidosis. General anesthesia is the underlying cause .
Q9. The nurse is caring for a client who has severe hypocalcemia. Which
intervention should the nurse include in the plan of care?
A) Place the client on seizure precautions
B) Limit the client's fluid intake
C) Encourage high-phosphorus foods
D) Place the client in high Fowler's position at all times
Correct Answer: A
Rationale: Severe hypocalcemia increases neuromuscular excitability, leading to
tetany and seizures. Safety measures such as seizure precautions are a priority.
Fluid restriction and phosphorus loading are not indicated .
Practice Exam Questions with Verified Correct
Answers & Detailed Rationales | Latest Update
2026/2027 | Galen College of Nursing
SECTION 1: PRIORITIZATION & CLINICAL JUDGMENT
The ABC Framework & Life-Threatening Conditions
Q1. The nurse receives a hand-off report on a pediatric unit. Which client should
the nurse assess FIRST?
A) A toddler with bronchiolitis on room air with mild wheezing
B) An infant diagnosed with pertussis who is receiving oxygen via nasal cannula
C) A preschooler with otitis media awaiting discharge
D) A school-age child with a simple fracture in a cast
Correct Answer: B
Rationale: Infants with pertussis are at high risk for apnea and severe respiratory
compromise. Any child on supplemental oxygen with a respiratory diagnosis takes
priority over stable conditions. The ABC framework always places airway and
breathing as the top priority .
Q2. The nurse is triaging clients in the emergency department. Which client
should be seen FIRST?
A) Client with multiple compound fractures reporting chest pain
B) Client with pancreatitis experiencing pain upon inspiration
C) Client with asthma who suddenly stops wheezing
D) Client with polycystic fibrosis bleeding with black tarry stool
,Correct Answer: A
Rationale: The combination of multiple fractures and chest pain raises concern for
fat embolism syndrome or pulmonary embolism—life-threatening conditions
requiring immediate intervention. The "who will die first" principle guides this
decision .
Q3. A nurse receives report on four patients. Which patient should the nurse
assess 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
Correct Answer: B
Rationale: Airway and breathing are always the priority. An SpO₂ of 88% indicates
hypoxemia, and the tracheostomy patient is at high risk for airway obstruction or
mucus plugging .
Q4. A nurse is reviewing clients on a telemetry unit. Which patient should be
assessed FIRST?
A) Patient with chest pain that resolved after nitroglycerin
B) Patient with new atrial fibrillation and heart rate of 110
C) Patient with potassium level of 6.2 mEq/L and peaked T waves
D) Patient with blood glucose of 350 mg/dL and no symptoms
Correct Answer: C
Rationale: Hyperkalemia with ECG changes (peaked T waves) is life-threatening
and can lead to cardiac arrest. Potassium levels above 5.0 mEq/L with ECG
changes represent a critical risk for lethal arrhythmias .
,Q5. The nurse is assessing a pediatric client in the emergency department.
Which finding is most concerning and requires immediate intervention?
A) 6-year-old child sitting at a table eating with pulse of 130
B) 4-month-old infant who can roll from abdomen to back
C) 9-month-old infant who pulls to stand
D) 12-month-old child who walks with assistance
Correct Answer: A
Rationale: A pulse of 130 in a 6-year-old is significantly elevated (normal 60-110
bpm). Combined with being in an ED setting, this requires immediate assessment
for pain, fever, dehydration, or cardiac issues .
Q6. The nurse is assessing several clients in an outpatient clinic. Which client
should the provider see FIRST?
A) A 28-year-old with a sprained ankle and mild swelling
B) A 45-year-old with stable chronic back pain
C) A 55-year-old with blood pressure 164/96 mm Hg who recently stopped
smoking
D) A 70-year-old with asymptomatic pulse of 62
Correct Answer: C
Rationale: Stage 2 hypertension plus recent smoking history significantly increases
cardiovascular risk and requires prompt follow-up .
Q7. The nurse is working in a pediatric cardiac unit reviewing vital signs. Which
child should be assessed FIRST?
A) 6-year-old with pulse of 130 while eating
B) 2-year-old with respiratory rate of 28 and mild wheezing
C) 10-year-old with blood pressure of 110/70
D) Adolescent with heart rate of 80 and normal rhythm
, Correct Answer: A
Rationale: A pulse of 130 in a 6-year-old is significantly elevated and requires
immediate assessment. Normal heart rate for a 6-year-old is 60-110 bpm .
Q8. The nurse is caring for a client who is 4-hours post-operative after general
anesthesia. Assessment findings include: T 98.4°F, P 58 with thready pulses, BP
98/64 mm Hg, RR 26 shallow, pale dry skin. ABG: pH 7.20, PaCO₂ 54, HCO₃ 26.
Which findings are related to the ABG results?
A) IV fluids and temperature
B) Blood pressure, pulse, and general anesthesia
C) Urine output and pale dry skin
D) Shallow respirations and blood pressure
Correct Answer: B
Rationale: The ABG shows respiratory acidosis (pH 7.20, PaCO₂ 54). Respiratory
acidosis is caused by hypoventilation, which is reflected in shallow respirations.
Hypotension (BP 98/64) and thready pulses are compensatory responses to
acidosis. General anesthesia is the underlying cause .
Q9. The nurse is caring for a client who has severe hypocalcemia. Which
intervention should the nurse include in the plan of care?
A) Place the client on seizure precautions
B) Limit the client's fluid intake
C) Encourage high-phosphorus foods
D) Place the client in high Fowler's position at all times
Correct Answer: A
Rationale: Severe hypocalcemia increases neuromuscular excitability, leading to
tetany and seizures. Safety measures such as seizure precautions are a priority.
Fluid restriction and phosphorus loading are not indicated .
