NUR 283 COMPREHENSIVE EXAM AND PRACTICE
EXAM (GALEN) QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026/2027 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Management of Care, Prioritization, and Delegation
Safety and Infection Control
Pharmacological and Parenteral Therapies
Reduction of Risk Potential
Physiological Adaptation
Psychosocial Integrity
Basic Care and Comfort
Health Promotion and Maintenance
Clinical Judgment and Critical Thinking
Professional Identity and Transition to Practice
Introduction
The NUR 283 Comprehensive Exam and Practice Exam assesses the clinical judgment and nursing
knowledge required for safe transition to registered nursing practice. This examination evaluates
management of care, prioritization, delegation, infection control, pharmacological therapies,
physiological adaptation, and psychosocial integrity. Questions are structured in multiple-choice and
scenario-based formats emphasizing real-world application, critical thinking, and clinical decision-
making. Candidates must demonstrate competency in recognizing life-threatening conditions,
implementing evidence-based interventions, and applying the nursing process across diverse patient
populations in preparation for entry-level registered nursing practice.
SECTION ONE: QUESTIONS 1–100
Question 1
A client who had an ERCP 30 minutes ago reports difficulty swallowing. Which action should the nurse
take first?
A. Offer oral fluids to assess swallowing ability
B. Assess airway and swallowing function immediately
C. Document the finding and continue monitoring
D. Notify the family of the client's condition
B. Assess airway and swallowing function immediately
, RATIONALE: Airway compromise is the priority after ERCP because the gag reflex may be absent,
increasing aspiration risk. Immediate assessment of airway and swallowing is essential. Offering fluids or
documenting delays safety .
Question 2
The nurse receives a hand-off report on a pediatric unit. Which client should be seen first?
A. A toddler with bronchiolitis on room air and mild wheezing
B. An infant with pertussis 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
B. An infant with pertussis receiving oxygen via nasal cannula
RATIONALE: Infants with pertussis are at high risk for apnea and severe respiratory compromise. Any
client on supplemental oxygen with a respiratory diagnosis is a priority over stable conditions. The other
clients have predictable, stable conditions .
Question 3
The charge nurse is making assignments on a medical-surgical unit. Which client should be assigned to
the most experienced RN?
A. A client with a urinary tract infection on oral antibiotics
B. A client who is 2 days post-op and ambulating independently
C. A client with a newly placed tracheostomy
D. A client requiring discharge teaching
C. A client with a newly placed tracheostomy
RATIONALE: A newly placed tracheostomy requires complex airway management and assessment
skills. The most experienced nurse should care for this client. The other clients have stable, predictable
conditions .
Question 4
A client has a do-not-resuscitate order. Which action is most appropriate?
A. Perform CPR if the client's heart stops
B. Ask the family for permission to perform CPR
C. Call a code blue if the client stops breathing
D. Respect the do-not-resuscitate order and not initiate CPR
D. Respect the do-not-resuscitate order and not initiate CPR
RATIONALE: A do-not-resuscitate order means CPR should not be initiated. The nurse must honor
this order and focus on comfort measures. Performing CPR, asking family, or calling a code violates the
legal order .
Question 5
,A graduate RN asks about the difference between NCLEX and nursing residency. Which response by the
preceptor is most accurate?
A. NCLEX tests minimum competency; residency builds clinical reasoning and leadership skills for safe,
autonomous RN practice.
B. NCLEX tests everything needed; residency is optional.
C. NCLEX is for practical nurses; residency is for registered nurses.
D. NCLEX is a written test; residency is a clinical test.
A. NCLEX tests minimum competency; residency builds clinical reasoning and leadership skills for
safe, autonomous RN practice.
RATIONALE: The NCLEX tests minimum entry-level competency. Residency programs develop the
clinical reasoning, leadership, and autonomous skills required for safe independent RN practice .
Question 6
A nurse is delegating a task to unlicensed assistive personnel. Which task can the RN safely delegate?
A. Performing an initial assessment on a new admission
B. Ambulating a stable client
C. Developing a plan of care
D. Evaluating the effectiveness of pain medication
B. Ambulating a stable client
RATIONALE: Ambulating a stable client is a routine, non-invasive task that can be safely delegated to
UAP. Initial assessment, care planning, and evaluation of medication effectiveness require RN-level
clinical judgment and cannot be delegated .
Question 7
A client with end-stage renal disease is exhibiting confusion and twitching. Which client should the
charge nurse assign to the most experienced RN?
A. A client with pneumonia requiring IV antibiotics every 6 hours
B. A client with a fractured hip who is 1 day post-operative
C. A client with end-stage renal disease who is exhibiting confusion and twitching
D. A client with a new diagnosis of hypertension requiring dietary teaching
C. A client with end-stage renal disease who is exhibiting confusion and twitching
RATIONALE: The client with ESRD exhibiting confusion and twitching is displaying signs of severe
uremia or electrolyte imbalances, which can rapidly progress to seizures or cardiac arrest. This client
requires the most experienced RN for complex assessment .
Question 8
A nurse is caring for four clients. Which client should the nurse assess FIRST?
, A. A client with an NG tube who has vomited 50 mL of greenish fluid
B. A client with a new colostomy who is reporting abdominal cramping
C. A client with a hip replacement who is reporting incisional pain of 6/10
D. A client with a chest tube who has continuous bubbling in the water seal chamber
D. A client with a chest tube who has continuous bubbling in the water seal chamber
RATIONALE: Continuous bubbling in the water seal chamber indicates an air leak, which can lead to
a tension pneumothorax or complete lung collapse. This is a life-threatening airway/breathing issue
requiring immediate assessment .
Question 9
The nurse receives a telephone order for "Morphine sulfate 4 mg IV push every 2 hours PRN for severe
pain." Which action should the nurse take FIRST?
A. Administer the medication as ordered
B. Ask the provider to clarify the administration rate
C. Repeat the order back to the provider
D. Document the order in the electronic medical record
B. Ask the provider to clarify the administration rate
RATIONALE: An IV push order must include the rate of administration to prevent severe respiratory
depression and hypotension. While repeating back is part of telephone orders, the FIRST action is to
recognize the missing component and obtain clarification before administration .
Question 10
An RN is delegating tasks to an unlicensed assistive personnel (UAP). Which task is appropriate to
delegate?
A. Performing a sterile dressing change on a surgical wound
B. Assessing a client's lung sounds for crackles
C. Measuring a client's intake and output
D. Teaching a client how to use an incentive spirometer
C. Measuring a client's intake and output
RATIONALE: UAPs can perform routine, non-invasive tasks such as measuring intake and output on
stable clients. Assessment, sterile procedures, and teaching are within the RN's scope of practice and
cannot be delegated .
Question 11
A client with Clostridioides difficile requires which hand hygiene method?
A. Alcohol-based hand rub only
B. Soap and water handwashing
EXAM (GALEN) QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026/2027 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Management of Care, Prioritization, and Delegation
Safety and Infection Control
Pharmacological and Parenteral Therapies
Reduction of Risk Potential
Physiological Adaptation
Psychosocial Integrity
Basic Care and Comfort
Health Promotion and Maintenance
Clinical Judgment and Critical Thinking
Professional Identity and Transition to Practice
Introduction
The NUR 283 Comprehensive Exam and Practice Exam assesses the clinical judgment and nursing
knowledge required for safe transition to registered nursing practice. This examination evaluates
management of care, prioritization, delegation, infection control, pharmacological therapies,
physiological adaptation, and psychosocial integrity. Questions are structured in multiple-choice and
scenario-based formats emphasizing real-world application, critical thinking, and clinical decision-
making. Candidates must demonstrate competency in recognizing life-threatening conditions,
implementing evidence-based interventions, and applying the nursing process across diverse patient
populations in preparation for entry-level registered nursing practice.
SECTION ONE: QUESTIONS 1–100
Question 1
A client who had an ERCP 30 minutes ago reports difficulty swallowing. Which action should the nurse
take first?
A. Offer oral fluids to assess swallowing ability
B. Assess airway and swallowing function immediately
C. Document the finding and continue monitoring
D. Notify the family of the client's condition
B. Assess airway and swallowing function immediately
, RATIONALE: Airway compromise is the priority after ERCP because the gag reflex may be absent,
increasing aspiration risk. Immediate assessment of airway and swallowing is essential. Offering fluids or
documenting delays safety .
Question 2
The nurse receives a hand-off report on a pediatric unit. Which client should be seen first?
A. A toddler with bronchiolitis on room air and mild wheezing
B. An infant with pertussis 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
B. An infant with pertussis receiving oxygen via nasal cannula
RATIONALE: Infants with pertussis are at high risk for apnea and severe respiratory compromise. Any
client on supplemental oxygen with a respiratory diagnosis is a priority over stable conditions. The other
clients have predictable, stable conditions .
Question 3
The charge nurse is making assignments on a medical-surgical unit. Which client should be assigned to
the most experienced RN?
A. A client with a urinary tract infection on oral antibiotics
B. A client who is 2 days post-op and ambulating independently
C. A client with a newly placed tracheostomy
D. A client requiring discharge teaching
C. A client with a newly placed tracheostomy
RATIONALE: A newly placed tracheostomy requires complex airway management and assessment
skills. The most experienced nurse should care for this client. The other clients have stable, predictable
conditions .
Question 4
A client has a do-not-resuscitate order. Which action is most appropriate?
A. Perform CPR if the client's heart stops
B. Ask the family for permission to perform CPR
C. Call a code blue if the client stops breathing
D. Respect the do-not-resuscitate order and not initiate CPR
D. Respect the do-not-resuscitate order and not initiate CPR
RATIONALE: A do-not-resuscitate order means CPR should not be initiated. The nurse must honor
this order and focus on comfort measures. Performing CPR, asking family, or calling a code violates the
legal order .
Question 5
,A graduate RN asks about the difference between NCLEX and nursing residency. Which response by the
preceptor is most accurate?
A. NCLEX tests minimum competency; residency builds clinical reasoning and leadership skills for safe,
autonomous RN practice.
B. NCLEX tests everything needed; residency is optional.
C. NCLEX is for practical nurses; residency is for registered nurses.
D. NCLEX is a written test; residency is a clinical test.
A. NCLEX tests minimum competency; residency builds clinical reasoning and leadership skills for
safe, autonomous RN practice.
RATIONALE: The NCLEX tests minimum entry-level competency. Residency programs develop the
clinical reasoning, leadership, and autonomous skills required for safe independent RN practice .
Question 6
A nurse is delegating a task to unlicensed assistive personnel. Which task can the RN safely delegate?
A. Performing an initial assessment on a new admission
B. Ambulating a stable client
C. Developing a plan of care
D. Evaluating the effectiveness of pain medication
B. Ambulating a stable client
RATIONALE: Ambulating a stable client is a routine, non-invasive task that can be safely delegated to
UAP. Initial assessment, care planning, and evaluation of medication effectiveness require RN-level
clinical judgment and cannot be delegated .
Question 7
A client with end-stage renal disease is exhibiting confusion and twitching. Which client should the
charge nurse assign to the most experienced RN?
A. A client with pneumonia requiring IV antibiotics every 6 hours
B. A client with a fractured hip who is 1 day post-operative
C. A client with end-stage renal disease who is exhibiting confusion and twitching
D. A client with a new diagnosis of hypertension requiring dietary teaching
C. A client with end-stage renal disease who is exhibiting confusion and twitching
RATIONALE: The client with ESRD exhibiting confusion and twitching is displaying signs of severe
uremia or electrolyte imbalances, which can rapidly progress to seizures or cardiac arrest. This client
requires the most experienced RN for complex assessment .
Question 8
A nurse is caring for four clients. Which client should the nurse assess FIRST?
, A. A client with an NG tube who has vomited 50 mL of greenish fluid
B. A client with a new colostomy who is reporting abdominal cramping
C. A client with a hip replacement who is reporting incisional pain of 6/10
D. A client with a chest tube who has continuous bubbling in the water seal chamber
D. A client with a chest tube who has continuous bubbling in the water seal chamber
RATIONALE: Continuous bubbling in the water seal chamber indicates an air leak, which can lead to
a tension pneumothorax or complete lung collapse. This is a life-threatening airway/breathing issue
requiring immediate assessment .
Question 9
The nurse receives a telephone order for "Morphine sulfate 4 mg IV push every 2 hours PRN for severe
pain." Which action should the nurse take FIRST?
A. Administer the medication as ordered
B. Ask the provider to clarify the administration rate
C. Repeat the order back to the provider
D. Document the order in the electronic medical record
B. Ask the provider to clarify the administration rate
RATIONALE: An IV push order must include the rate of administration to prevent severe respiratory
depression and hypotension. While repeating back is part of telephone orders, the FIRST action is to
recognize the missing component and obtain clarification before administration .
Question 10
An RN is delegating tasks to an unlicensed assistive personnel (UAP). Which task is appropriate to
delegate?
A. Performing a sterile dressing change on a surgical wound
B. Assessing a client's lung sounds for crackles
C. Measuring a client's intake and output
D. Teaching a client how to use an incentive spirometer
C. Measuring a client's intake and output
RATIONALE: UAPs can perform routine, non-invasive tasks such as measuring intake and output on
stable clients. Assessment, sterile procedures, and teaching are within the RN's scope of practice and
cannot be delegated .
Question 11
A client with Clostridioides difficile requires which hand hygiene method?
A. Alcohol-based hand rub only
B. Soap and water handwashing
