NUR 265 Exam 4 – ATI-Style Review Guide (V1 & V2) |
Complete Questions and Correct Answers plus Rationale
| New Update 2026-2027 | Galen
V2
Question 1
A charge nurse reviews the Hospital Incident Command System (HICS) with staff.
Which statement by a staff nurse shows understanding?
• A. HICS is used only after a federal disaster declaration.
• B. HICS replaces local emergency services at the scene.
• C. HICS assigns facility responsibilities and reporting channels.
• D. HICS permits each unit to establish an unrelated response plan.
Correct Answer: C. HICS assigns facility responsibilities and reporting channels.
Rationale: HICS is an organizational framework that establishes clear roles,
responsibilities, and reporting structures within a healthcare facility during
emergencies. It does not replace local emergency services, is not limited to federal
declarations, and requires coordinated (not unrelated) response plans across
units.
Question 2
A nurse plans end-of-life care for a client with AIDS. Which goal is realistic?
• A. The client will avoid all opioid medication.
• B. The client will receive medication that limits breakthrough pain.
• C. The client will remain free of all disease manifestations.
• D. The client will increase strenuous activity each day.
,Correct Answer: B. The client will receive medication that limits breakthrough
pain.
Rationale: End-of-life care focuses on comfort and symptom management.
Limiting breakthrough pain is a realistic and appropriate goal. Avoiding opioids is
not necessary, freedom from all disease manifestations is unrealistic, and
increasing strenuous activity is inappropriate at end of life.
Question 3
Before surgery for benign prostatic hypertrophy, a client says, "I am afraid they
will find cancer." Which response is therapeutic?
• A. It sounds as though you are worried that cancer may be found.
• B. You should not worry until the pathology report returns.
• C. Tell me why you think the result will be cancer.
• D. Most enlarged prostates are not cancerous.
Correct Answer: A. It sounds as though you are worried that cancer may be
found.
Rationale: This response uses therapeutic communication by reflecting the
client's feelings and acknowledging their concern. It encourages further
expression without dismissing or challenging the client's fears.
Question 4
A middle-aged client reports a pathogenic BRCA1 mutation. The nurse should
identify an increased risk for which condition?
• A. Laryngeal cancer
• B. Renal cancer
• C. Thyroid cancer
• D. Breast cancer
,Correct Answer: D. Breast cancer
Rationale: BRCA1 mutations significantly increase the risk of breast and ovarian
cancers. They are not associated with laryngeal, renal, or thyroid cancers.
Question 5
A client reports sudden severe chest pain. Which test should the nurse obtain
promptly to evaluate for myocardial infarction?
• A. Pulmonary function testing
• B. 12-lead electrocardiogram
• C. Mantoux test
• D. Bronchoscopy
Correct Answer: B. 12-lead electrocardiogram
Rationale: A 12-lead ECG is the priority diagnostic test for suspected MI, as it can
quickly identify ST-elevation MI and guide immediate treatment. Pulmonary
function tests, Mantoux tests, and bronchoscopy are not used to diagnose MI.
Question 6
At a motor-vehicle crash, a client is apneic and a cervical injury is suspected.
Which action is the priority?
• A. Open the airway with a jaw-thrust maneuver.
• B. Apply a rigid cervical collar.
• C. Complete a neurologic assessment.
• D. Inspect the client for additional injuries.
Correct Answer: A. Open the airway with a jaw-thrust maneuver.
Rationale: Airway is the priority in any emergency. The jaw-thrust maneuver
opens the airway without extending the neck, which is critical when cervical injury
, is suspected. Cervical collar application and assessments follow after the airway is
secured.
Question 7
During disaster triage after a toxic release, which task is the lowest priority for a
registered nurse and can be delegated to nonmedical personnel?
• A. Performing a concise assessment
• B. Preventing cross-contamination
• C. Maintaining client tracking
• D. Transporting a stable client to the discharge area
Correct Answer: D. Transporting a stable client to the discharge area
Rationale: Transporting a stable client is a non-skilled task that can be safely
delegated to nonmedical personnel. Assessment, infection control, and client
tracking require nursing judgment and cannot be delegated.
Question 8
A nurse hesitates to give prescribed morphine to a dying client because of
concern about causing harm. Which ethical principle is the nurse considering?
• A. Veracity
• B. Fidelity
• C. Nonmaleficence
• D. Utilitarianism
Correct Answer: C. Nonmaleficence
Rationale: Nonmaleficence is the ethical principle of "do no harm." The nurse's
concern about causing harm reflects this principle. Veracity relates to truthfulness,
fidelity to keeping promises, and utilitarianism to the greatest good for the
greatest number.
Complete Questions and Correct Answers plus Rationale
| New Update 2026-2027 | Galen
V2
Question 1
A charge nurse reviews the Hospital Incident Command System (HICS) with staff.
Which statement by a staff nurse shows understanding?
• A. HICS is used only after a federal disaster declaration.
• B. HICS replaces local emergency services at the scene.
• C. HICS assigns facility responsibilities and reporting channels.
• D. HICS permits each unit to establish an unrelated response plan.
Correct Answer: C. HICS assigns facility responsibilities and reporting channels.
Rationale: HICS is an organizational framework that establishes clear roles,
responsibilities, and reporting structures within a healthcare facility during
emergencies. It does not replace local emergency services, is not limited to federal
declarations, and requires coordinated (not unrelated) response plans across
units.
Question 2
A nurse plans end-of-life care for a client with AIDS. Which goal is realistic?
• A. The client will avoid all opioid medication.
• B. The client will receive medication that limits breakthrough pain.
• C. The client will remain free of all disease manifestations.
• D. The client will increase strenuous activity each day.
,Correct Answer: B. The client will receive medication that limits breakthrough
pain.
Rationale: End-of-life care focuses on comfort and symptom management.
Limiting breakthrough pain is a realistic and appropriate goal. Avoiding opioids is
not necessary, freedom from all disease manifestations is unrealistic, and
increasing strenuous activity is inappropriate at end of life.
Question 3
Before surgery for benign prostatic hypertrophy, a client says, "I am afraid they
will find cancer." Which response is therapeutic?
• A. It sounds as though you are worried that cancer may be found.
• B. You should not worry until the pathology report returns.
• C. Tell me why you think the result will be cancer.
• D. Most enlarged prostates are not cancerous.
Correct Answer: A. It sounds as though you are worried that cancer may be
found.
Rationale: This response uses therapeutic communication by reflecting the
client's feelings and acknowledging their concern. It encourages further
expression without dismissing or challenging the client's fears.
Question 4
A middle-aged client reports a pathogenic BRCA1 mutation. The nurse should
identify an increased risk for which condition?
• A. Laryngeal cancer
• B. Renal cancer
• C. Thyroid cancer
• D. Breast cancer
,Correct Answer: D. Breast cancer
Rationale: BRCA1 mutations significantly increase the risk of breast and ovarian
cancers. They are not associated with laryngeal, renal, or thyroid cancers.
Question 5
A client reports sudden severe chest pain. Which test should the nurse obtain
promptly to evaluate for myocardial infarction?
• A. Pulmonary function testing
• B. 12-lead electrocardiogram
• C. Mantoux test
• D. Bronchoscopy
Correct Answer: B. 12-lead electrocardiogram
Rationale: A 12-lead ECG is the priority diagnostic test for suspected MI, as it can
quickly identify ST-elevation MI and guide immediate treatment. Pulmonary
function tests, Mantoux tests, and bronchoscopy are not used to diagnose MI.
Question 6
At a motor-vehicle crash, a client is apneic and a cervical injury is suspected.
Which action is the priority?
• A. Open the airway with a jaw-thrust maneuver.
• B. Apply a rigid cervical collar.
• C. Complete a neurologic assessment.
• D. Inspect the client for additional injuries.
Correct Answer: A. Open the airway with a jaw-thrust maneuver.
Rationale: Airway is the priority in any emergency. The jaw-thrust maneuver
opens the airway without extending the neck, which is critical when cervical injury
, is suspected. Cervical collar application and assessments follow after the airway is
secured.
Question 7
During disaster triage after a toxic release, which task is the lowest priority for a
registered nurse and can be delegated to nonmedical personnel?
• A. Performing a concise assessment
• B. Preventing cross-contamination
• C. Maintaining client tracking
• D. Transporting a stable client to the discharge area
Correct Answer: D. Transporting a stable client to the discharge area
Rationale: Transporting a stable client is a non-skilled task that can be safely
delegated to nonmedical personnel. Assessment, infection control, and client
tracking require nursing judgment and cannot be delegated.
Question 8
A nurse hesitates to give prescribed morphine to a dying client because of
concern about causing harm. Which ethical principle is the nurse considering?
• A. Veracity
• B. Fidelity
• C. Nonmaleficence
• D. Utilitarianism
Correct Answer: C. Nonmaleficence
Rationale: Nonmaleficence is the ethical principle of "do no harm." The nurse's
concern about causing harm reflects this principle. Veracity relates to truthfulness,
fidelity to keeping promises, and utilitarianism to the greatest good for the
greatest number.
