,NUR210 Transition to Practice Capstone Exam
2 Study Guide & 150 Practice Questions Fortis
College 2026/2027
1. A 72-year-old female with heart failure (EF 30%), COPD (FEV₁ 45%), type 2 diabetes, and
depression is admitted with acute dyspnea. Vital signs: BP 92/58, HR 112, RR 28, SpO₂ 84% on 2
L NC, audible wheezes, JVP 10 cm. Which action should the nurse take first?
A. Administer the scheduled morning dose of metformin.
B. Place the client in high Fowler's position and apply oxygen to titrate SpO₂ to 90–92%.
C. Obtain a 12-lead ECG before initiating any intervention.
D. Request a psychiatry consult for depression screening.
Correct Answer: B. Place the client in high Fowler's position and apply oxygen to titrate SpO₂ to
90–92%.
Rationale: Airway and breathing take absolute priority. Positioning and oxygen address the
immediate life threat; other interventions can follow after stabilization.
2. A nurse receives report on four clients. Which client should the nurse assess first?
A. A client requesting pain medication for chronic back pain rated 5/10
,B. A client who is scheduled for discharge in 1 hour
C. A client with new onset of confusion and a respiratory rate of 8 breaths/min
D. A client who needs assistance with ambulation to the bathroom
Correct Answer: C. A client with new onset of confusion and a respiratory rate of 8 breaths/min
Rationale: A respiratory rate of 8 breaths/min indicates respiratory depression and requires
immediate intervention. New confusion may indicate hypoxia. This takes priority over routine
requests.
3. A nurse is caring for a client with sepsis. Which assessment finding requires immediate
intervention?
A. Temperature of 100.8°F
B. White blood cell count of 14,000/mm³
C. Blood pressure of 88/54 mmHg and heart rate of 128 beats/min
D. Respiratory rate of 22 breaths/min
Correct Answer: C. Blood pressure of 88/54 mmHg and heart rate of 128 beats/min
, Rationale: Hypotension and tachycardia in a client with sepsis indicate inadequate perfusion
and possible septic shock, requiring immediate intervention.
4. A client with COPD has an SpO₂ of 86% on room air. Which nursing action is the priority?
A. Administer a prescribed bronchodilator nebulizer treatment
B. Obtain a sputum specimen for culture
C. Apply oxygen and titrate to maintain SpO₂ at 88–92%
D. Encourage the client to increase fluid intake
Correct Answer: C. Apply oxygen and titrate to maintain SpO₂ at 88–92%
Rationale: For a client with COPD, the priority is to correct hypoxemia while avoiding excessive
oxygen that could suppress respiratory drive. Target SpO₂ for COPD clients is typically 88–92%.
5. A nurse is using the Clinical Judgment Measurement Model (NCJMM) to evaluate a client.
Which step involves comparing assessment findings to normal values and ranking their urgency?
A. Recognize Cues
2 Study Guide & 150 Practice Questions Fortis
College 2026/2027
1. A 72-year-old female with heart failure (EF 30%), COPD (FEV₁ 45%), type 2 diabetes, and
depression is admitted with acute dyspnea. Vital signs: BP 92/58, HR 112, RR 28, SpO₂ 84% on 2
L NC, audible wheezes, JVP 10 cm. Which action should the nurse take first?
A. Administer the scheduled morning dose of metformin.
B. Place the client in high Fowler's position and apply oxygen to titrate SpO₂ to 90–92%.
C. Obtain a 12-lead ECG before initiating any intervention.
D. Request a psychiatry consult for depression screening.
Correct Answer: B. Place the client in high Fowler's position and apply oxygen to titrate SpO₂ to
90–92%.
Rationale: Airway and breathing take absolute priority. Positioning and oxygen address the
immediate life threat; other interventions can follow after stabilization.
2. A nurse receives report on four clients. Which client should the nurse assess first?
A. A client requesting pain medication for chronic back pain rated 5/10
,B. A client who is scheduled for discharge in 1 hour
C. A client with new onset of confusion and a respiratory rate of 8 breaths/min
D. A client who needs assistance with ambulation to the bathroom
Correct Answer: C. A client with new onset of confusion and a respiratory rate of 8 breaths/min
Rationale: A respiratory rate of 8 breaths/min indicates respiratory depression and requires
immediate intervention. New confusion may indicate hypoxia. This takes priority over routine
requests.
3. A nurse is caring for a client with sepsis. Which assessment finding requires immediate
intervention?
A. Temperature of 100.8°F
B. White blood cell count of 14,000/mm³
C. Blood pressure of 88/54 mmHg and heart rate of 128 beats/min
D. Respiratory rate of 22 breaths/min
Correct Answer: C. Blood pressure of 88/54 mmHg and heart rate of 128 beats/min
, Rationale: Hypotension and tachycardia in a client with sepsis indicate inadequate perfusion
and possible septic shock, requiring immediate intervention.
4. A client with COPD has an SpO₂ of 86% on room air. Which nursing action is the priority?
A. Administer a prescribed bronchodilator nebulizer treatment
B. Obtain a sputum specimen for culture
C. Apply oxygen and titrate to maintain SpO₂ at 88–92%
D. Encourage the client to increase fluid intake
Correct Answer: C. Apply oxygen and titrate to maintain SpO₂ at 88–92%
Rationale: For a client with COPD, the priority is to correct hypoxemia while avoiding excessive
oxygen that could suppress respiratory drive. Target SpO₂ for COPD clients is typically 88–92%.
5. A nurse is using the Clinical Judgment Measurement Model (NCJMM) to evaluate a client.
Which step involves comparing assessment findings to normal values and ranking their urgency?
A. Recognize Cues
