NUR283 / NUR 283 ALL Comprehensive Exams
(NEW 2025/ 2026 Updates BUNDLED TOGETHER
PACKAGE WITH SOLUTIONS) | Questions &
Answers | Grade A | 100% Correct (Verified
Solutions) - Galen
SECTION 1: Prioritization (ABCs & Maslow) – Q1–40
Q1. The nurse is prioritizing client care after shift report. Which client should be
seen first?
A) Client scheduled for discharge needing medication teaching
B) Client who had ERCP 30 minutes ago and reports difficulty swallowing
C) Client with knee arthroscopy yesterday reporting pain 4/10
D) Client NPO for abdominal ultrasound this morning
Answer: B
Rationale: ABCs – Airway first. After ERCP, the gag reflex may be absent;
difficulty swallowing indicates a risk for aspiration, which is a life-threatening
airway emergency.
Q2. Pediatric unit – which child first?
A) Toddler with bronchiolitis on room air, mild wheezing
B) Infant with pertussis on oxygen via nasal cannula
C) Preschooler with otitis media awaiting discharge
D) School-age child with simple fracture in cast
Answer: B
Rationale: Pertussis infants are at high risk for apnea and respiratory failure.
Requiring oxygen indicates instability and a higher priority over stable conditions.
Q3. Four clients – which first?
A) Acute pancreatitis with pain on deep inspiration
B) COPD on 2L O2, SpO2 93%
C) Type 2 diabetes, glucose 220 mg/dL
,D) Stage II pressure injury needing dressing change
Answer: A
Rationale: Pain on inspiration in pancreatitis may indicate pleural effusion,
atelectasis, or ARDS – signaling respiratory compromise. Airway/Breathing is the
priority.
Q4. ED triage – which first?
A) 57 y/o with Graves’ disease and temp 100.5°F
B) 28 y/o sprained ankle
C) 32 y/o seasonal allergies
D) 55 y/o chronic back pain
Answer: A
Rationale: Fever in Graves’ disease is a red flag for possible thyroid storm (life-
threatening hypermetabolism). Needs immediate evaluation.
Q5. 24 hours post-op – which change is priority?
A) Increased pain 8/10 after opioid administration
B) Nausea after antibiotics
C) Small serosanguineous drainage on dressing
D) Voided 200 mL in 4 hours
Answer: A
Rationale: Increasing pain post-op unrelieved by opioids is a classic sign of
hemorrhage, compartment syndrome, or an anastomotic leak – all urgent
complications.
Q6. Tracheostomy – which finding requires immediate intervention?
A) Small bloody secretions
B) Requesting suction q4h
C) RR 28/min
D) Thick, yellow secretions extending from stoma
Answer: D
Rationale: Thick yellow secretions indicate possible infection and impending
airway obstruction – an imminent ABC priority.
Q7. Client with chest pain – which action first?
A) Give sublingual nitroglycerin
,B) Obtain 12-lead ECG
C) Apply oxygen at 2-4 L/min
D) Ask about pain location
Answer: C
Rationale: Chest pain = possible MI. ABC priority: oxygenate the patient first,
then obtain an ECG, then administer nitroglycerin if prescribed.
Q8. Postpartum client with perineal heaviness – first action?
A) Give pain medication
B) Assess fundus
C) Assess for hematoma
D) Encourage ambulation
Answer: C
Rationale: Heaviness is a sign of a vaginal hematoma (which can cause rapid
hidden blood loss and hypovolemic shock). Immediate assessment and intervention
are needed.
Q9. Client on heparin drip – which lab requires immediate action?
A) aPTT 65 seconds
B) Platelets 150,000
C) aPTT 120 seconds
D) Hemoglobin 12 g/dL
Answer: C
Rationale: An aPTT of 120 seconds (therapeutic is usually 1.5-2.5x normal,
approx 45-75 sec) indicates a critically high risk for hemorrhage. The drip must be
stopped and the provider notified.
Q10. Which client should the nurse assess first?
A) Client with a new onset of stridor
B) Client requesting pain meds for a headache
C) Client with a BP of 150/90
D) Client with a fasting blood glucose of 150
Answer: A
Rationale: Stridor indicates upper airway obstruction, which is an immediate life-
threatening emergency.
, Q11. A client with a spinal cord injury at T6 reports a severe pounding headache
and has a BP of 220/110. What is the first action?
A) Administer a prescribed antihypertensive
B) Sit the client upright immediately
C) Place the client supine
D) Check the client's blood glucose
Answer: B
Rationale: This is autonomic dysreflexia. Sitting the client upright (high Fowler's)
helps lower the blood pressure by pooling blood in the extremities. Next, identify
and remove the stimulus (e.g., full bladder).
Q12. A nurse is triaging clients after a mass casualty event. Which client should be
tagged Red (Immediate)?
A) Client with a minor laceration to the arm
B) Client with a tension pneumothorax
C) Client with a fractured femur and a distal pulse
D) Client who is deceased
Answer: B
Rationale: Red tags are for life-threatening injuries that are treatable (e.g., tension
pneumothorax, airway obstruction). Fractures with pulses are Yellow (delayed).
Q13. A client with a history of alcohol abuse is admitted with severe vomiting.
Which finding requires immediate intervention?
A) Hematemesis and tachycardia
B) Nausea and anorexia
C) Mild epigastric pain
D) Dry mucous membranes
Answer: A
Rationale: Hematemesis (vomiting blood) and tachycardia indicate active upper
GI bleeding and hypovolemia, which takes priority.
Q14. A client receiving a blood transfusion develops fever, chills, and flank pain
after 15 minutes. What is the priority action?
A) Slow the transfusion
B) Administer an antihistamine
C) Stop the transfusion immediately
(NEW 2025/ 2026 Updates BUNDLED TOGETHER
PACKAGE WITH SOLUTIONS) | Questions &
Answers | Grade A | 100% Correct (Verified
Solutions) - Galen
SECTION 1: Prioritization (ABCs & Maslow) – Q1–40
Q1. The nurse is prioritizing client care after shift report. Which client should be
seen first?
A) Client scheduled for discharge needing medication teaching
B) Client who had ERCP 30 minutes ago and reports difficulty swallowing
C) Client with knee arthroscopy yesterday reporting pain 4/10
D) Client NPO for abdominal ultrasound this morning
Answer: B
Rationale: ABCs – Airway first. After ERCP, the gag reflex may be absent;
difficulty swallowing indicates a risk for aspiration, which is a life-threatening
airway emergency.
Q2. Pediatric unit – which child first?
A) Toddler with bronchiolitis on room air, mild wheezing
B) Infant with pertussis on oxygen via nasal cannula
C) Preschooler with otitis media awaiting discharge
D) School-age child with simple fracture in cast
Answer: B
Rationale: Pertussis infants are at high risk for apnea and respiratory failure.
Requiring oxygen indicates instability and a higher priority over stable conditions.
Q3. Four clients – which first?
A) Acute pancreatitis with pain on deep inspiration
B) COPD on 2L O2, SpO2 93%
C) Type 2 diabetes, glucose 220 mg/dL
,D) Stage II pressure injury needing dressing change
Answer: A
Rationale: Pain on inspiration in pancreatitis may indicate pleural effusion,
atelectasis, or ARDS – signaling respiratory compromise. Airway/Breathing is the
priority.
Q4. ED triage – which first?
A) 57 y/o with Graves’ disease and temp 100.5°F
B) 28 y/o sprained ankle
C) 32 y/o seasonal allergies
D) 55 y/o chronic back pain
Answer: A
Rationale: Fever in Graves’ disease is a red flag for possible thyroid storm (life-
threatening hypermetabolism). Needs immediate evaluation.
Q5. 24 hours post-op – which change is priority?
A) Increased pain 8/10 after opioid administration
B) Nausea after antibiotics
C) Small serosanguineous drainage on dressing
D) Voided 200 mL in 4 hours
Answer: A
Rationale: Increasing pain post-op unrelieved by opioids is a classic sign of
hemorrhage, compartment syndrome, or an anastomotic leak – all urgent
complications.
Q6. Tracheostomy – which finding requires immediate intervention?
A) Small bloody secretions
B) Requesting suction q4h
C) RR 28/min
D) Thick, yellow secretions extending from stoma
Answer: D
Rationale: Thick yellow secretions indicate possible infection and impending
airway obstruction – an imminent ABC priority.
Q7. Client with chest pain – which action first?
A) Give sublingual nitroglycerin
,B) Obtain 12-lead ECG
C) Apply oxygen at 2-4 L/min
D) Ask about pain location
Answer: C
Rationale: Chest pain = possible MI. ABC priority: oxygenate the patient first,
then obtain an ECG, then administer nitroglycerin if prescribed.
Q8. Postpartum client with perineal heaviness – first action?
A) Give pain medication
B) Assess fundus
C) Assess for hematoma
D) Encourage ambulation
Answer: C
Rationale: Heaviness is a sign of a vaginal hematoma (which can cause rapid
hidden blood loss and hypovolemic shock). Immediate assessment and intervention
are needed.
Q9. Client on heparin drip – which lab requires immediate action?
A) aPTT 65 seconds
B) Platelets 150,000
C) aPTT 120 seconds
D) Hemoglobin 12 g/dL
Answer: C
Rationale: An aPTT of 120 seconds (therapeutic is usually 1.5-2.5x normal,
approx 45-75 sec) indicates a critically high risk for hemorrhage. The drip must be
stopped and the provider notified.
Q10. Which client should the nurse assess first?
A) Client with a new onset of stridor
B) Client requesting pain meds for a headache
C) Client with a BP of 150/90
D) Client with a fasting blood glucose of 150
Answer: A
Rationale: Stridor indicates upper airway obstruction, which is an immediate life-
threatening emergency.
, Q11. A client with a spinal cord injury at T6 reports a severe pounding headache
and has a BP of 220/110. What is the first action?
A) Administer a prescribed antihypertensive
B) Sit the client upright immediately
C) Place the client supine
D) Check the client's blood glucose
Answer: B
Rationale: This is autonomic dysreflexia. Sitting the client upright (high Fowler's)
helps lower the blood pressure by pooling blood in the extremities. Next, identify
and remove the stimulus (e.g., full bladder).
Q12. A nurse is triaging clients after a mass casualty event. Which client should be
tagged Red (Immediate)?
A) Client with a minor laceration to the arm
B) Client with a tension pneumothorax
C) Client with a fractured femur and a distal pulse
D) Client who is deceased
Answer: B
Rationale: Red tags are for life-threatening injuries that are treatable (e.g., tension
pneumothorax, airway obstruction). Fractures with pulses are Yellow (delayed).
Q13. A client with a history of alcohol abuse is admitted with severe vomiting.
Which finding requires immediate intervention?
A) Hematemesis and tachycardia
B) Nausea and anorexia
C) Mild epigastric pain
D) Dry mucous membranes
Answer: A
Rationale: Hematemesis (vomiting blood) and tachycardia indicate active upper
GI bleeding and hypovolemia, which takes priority.
Q14. A client receiving a blood transfusion develops fever, chills, and flank pain
after 15 minutes. What is the priority action?
A) Slow the transfusion
B) Administer an antihistamine
C) Stop the transfusion immediately
