NUR283 / NUR 283 ALL Comprehensive Exams Review (Latest 2025/
2026 Update) Transition to Registered Nursing| Questions & Answers|
Grade A| 100% Correct (Verified Solutions)- Galen
Question 1
A nurse is assessing a client who had a transverse colostomy placed 2 days ago. Which finding
requires immediate intervention?
A) The stoma is pink and moist.
B) The client is passing flatus from the stoma.
C) The skin around the stoma is intact and free of redness.
D) The stoma is a deep, dusky purple color.
E) The colostomy bag is one-third full of soft, brown stool.
Correct Answer: D) The stoma is a deep, dusky purple color.
Rationale: A healthy, viable stoma should be reddish-pink and moist. A dusky, purple, or
black color indicates impaired blood supply (ischemia or necrosis) to the stoma, which is a
medical emergency requiring immediate surgical intervention to prevent further
complications.
Question 2
A client with a history of heart failure is prescribed digoxin. The nurse should instruct the client
to withhold the medication and notify the healthcare provider for which of the following
findings?
A) Apical pulse rate of 62 beats per minute.
B) Experiencing nausea and seeing yellow-green halos around objects.
C) A blood pressure reading of 118/78 mmHg.
D) A serum potassium level of 4.5 mEq/L.
E) Mild fatigue in the afternoon.
Correct Answer: B) Experiencing nausea and seeing yellow-green halos around objects.
Rationale: Nausea, vomiting, and visual disturbances (such as blurred vision or seeing
yellow-green halos) are classic signs of digoxin toxicity.[1] An apical pulse below 60 bpm is
also a reason to hold the medication, but the presence of visual disturbances and GI upset
are strong indicators that the client is experiencing toxic effects.
,[Type here]
Question 3
The nurse is caring for a client on mechanical ventilation when the low-pressure alarm sounds.
What is the nurse's initial action?
A) Manually ventilate the client with a bag-valve mask.
B) Auscultate the client's bilateral lung sounds.
C) Assess the ventilator circuit for disconnections or leaks.
D) Notify the respiratory therapist immediately.
E) Administer a prescribed sedative to the client.
Correct Answer: C) Assess the ventilator circuit for disconnections or leaks.
Rationale: A low-pressure alarm indicates a loss of pressure in the ventilator circuit. The
most common cause is a disconnection or leak in the tubing between the ventilator and the
client.[2] The nurse's initial action should be to quickly assess for and correct any obvious
leaks or disconnections.
Question 4
A registered nurse (RN) is delegating tasks on a medical-surgical unit. Which task is appropriate
to delegate to a Unlicensed Assistive Personnel (UAP)?
A) Reinforcing teaching about a low-sodium diet to a client with hypertension.
B) Administering a tap water enema to a client scheduled for a colonoscopy.
C) Assessing the gag reflex of a client who had a stroke.
D) Changing the dressing on a 24-hour post-operative incision.
E) Monitoring a client receiving a blood transfusion.
Correct Answer: B) Administering a tap water enema to a client scheduled for a
colonoscopy.
Rationale: The scope of practice for a UAP includes tasks that are non-invasive and have a
predictable outcome.[3] Administering a simple, non-medicated enema like tap water falls
within this scope. Reinforcing teaching, performing assessments, sterile procedures, and
monitoring transfusions are complex tasks that require the clinical judgment of a licensed
nurse (RN or LPN).
Question 5
A client is admitted to the emergency department with acute shortness of breath and pink, frothy
,[Type here]
sputum. The client has a history of hypertension and myocardial infarction. The nurse should
anticipate interventions for which condition?
A) Pneumonia
B) Spontaneous pneumothorax
C) Acute pulmonary edema
D) Plural effusion
E) Status asthmaticus
Correct Answer: C) Acute pulmonary edema
Rationale: The classic signs of acute pulmonary edema, a life-threatening condition often
caused by left-sided heart failure, include acute dyspnea, crackles on auscultation, and the
production of pink, frothy sputum.[2] This presentation requires immediate intervention to
improve gas exchange and reduce fluid overload.
Question 6
When providing care for a client with a sealed radiation implant for cervical cancer, which
precaution must the nurse implement?
A) Wear a lead apron when providing direct client care.
B) Place the client in a room with a positive-pressure airflow.
C) Allow visitors to stay for up to 2 hours at a time.
D) Dispose of the client's linens in a biohazard bag.
E) Encourage the client to ambulate in the hallway twice daily.
Correct Answer: A) Wear a lead apron when providing direct client care.
Rationale: A sealed radiation implant emits radiation. To adhere to the principles of
radiation safety (time, distance, shielding), the nurse must wear a lead shield and a
dosimeter badge when in the client's room.[4] Care should be clustered to minimize
exposure time, and visitors are typically limited.
Question 7
The nurse is planning care for a client in the manic phase of bipolar disorder. Which activity
would be most appropriate for this client?
A) Participating in a competitive group board game.
B) Assembling a complex jigsaw puzzle.
, [Type here]
C) Engaging in a session of deep breathing and meditation.
D) Walking with the nurse in the hospital garden.
E) Leading a unit-wide discussion group.
Correct Answer: D) Walking with the nurse in the hospital garden.
Rationale: A client in a manic phase has high energy levels, a short attention span, and poor
concentration. An appropriate activity is one that allows for the release of excess energy
without requiring intense focus or competition, which could escalate agitation. A non-
competitive physical activity like walking is ideal.
Question 8
A nurse is caring for a client who has vomited for 24 hours. The arterial blood gas (ABG) results
are: pH 7.52, PaCO2 48 mmHg, HCO3 34 mEq/L. How should the nurse interpret these results?
A) Respiratory Acidosis
B) Metabolic Alkalosis, partially compensated
C) Respiratory Alkalosis
D) Metabolic Acidosis, uncompensated
E) Normal ABG values
Correct Answer: B) Metabolic Alkalosis, partially compensated
Rationale: The pH is elevated (>7.45), indicating alkalosis. The HCO3 is elevated (>26
mEq/L), indicating a metabolic cause. Prolonged vomiting leads to the loss of stomach acid
(hydrochloric acid), resulting in metabolic alkalosis. The PaCO2 is also elevated (>45
mmHg), which is the respiratory system's attempt to compensate by retaining CO2 (an
acid). Since the pH is not yet back to normal, it is partially compensated.
Question 9
A client who is 24 hours post-operative is on bed rest. Which nursing action is most effective for
preventing a pulmonary embolism (PE)?
A) Encouraging the use of an incentive spirometer every hour.
B) Instructing the client to perform leg exercises regularly.
C) Maintaining the client in a high-Fowler's position.
D) Administering oxygen via nasal cannula.
E) Limiting the client's fluid intake.
2026 Update) Transition to Registered Nursing| Questions & Answers|
Grade A| 100% Correct (Verified Solutions)- Galen
Question 1
A nurse is assessing a client who had a transverse colostomy placed 2 days ago. Which finding
requires immediate intervention?
A) The stoma is pink and moist.
B) The client is passing flatus from the stoma.
C) The skin around the stoma is intact and free of redness.
D) The stoma is a deep, dusky purple color.
E) The colostomy bag is one-third full of soft, brown stool.
Correct Answer: D) The stoma is a deep, dusky purple color.
Rationale: A healthy, viable stoma should be reddish-pink and moist. A dusky, purple, or
black color indicates impaired blood supply (ischemia or necrosis) to the stoma, which is a
medical emergency requiring immediate surgical intervention to prevent further
complications.
Question 2
A client with a history of heart failure is prescribed digoxin. The nurse should instruct the client
to withhold the medication and notify the healthcare provider for which of the following
findings?
A) Apical pulse rate of 62 beats per minute.
B) Experiencing nausea and seeing yellow-green halos around objects.
C) A blood pressure reading of 118/78 mmHg.
D) A serum potassium level of 4.5 mEq/L.
E) Mild fatigue in the afternoon.
Correct Answer: B) Experiencing nausea and seeing yellow-green halos around objects.
Rationale: Nausea, vomiting, and visual disturbances (such as blurred vision or seeing
yellow-green halos) are classic signs of digoxin toxicity.[1] An apical pulse below 60 bpm is
also a reason to hold the medication, but the presence of visual disturbances and GI upset
are strong indicators that the client is experiencing toxic effects.
,[Type here]
Question 3
The nurse is caring for a client on mechanical ventilation when the low-pressure alarm sounds.
What is the nurse's initial action?
A) Manually ventilate the client with a bag-valve mask.
B) Auscultate the client's bilateral lung sounds.
C) Assess the ventilator circuit for disconnections or leaks.
D) Notify the respiratory therapist immediately.
E) Administer a prescribed sedative to the client.
Correct Answer: C) Assess the ventilator circuit for disconnections or leaks.
Rationale: A low-pressure alarm indicates a loss of pressure in the ventilator circuit. The
most common cause is a disconnection or leak in the tubing between the ventilator and the
client.[2] The nurse's initial action should be to quickly assess for and correct any obvious
leaks or disconnections.
Question 4
A registered nurse (RN) is delegating tasks on a medical-surgical unit. Which task is appropriate
to delegate to a Unlicensed Assistive Personnel (UAP)?
A) Reinforcing teaching about a low-sodium diet to a client with hypertension.
B) Administering a tap water enema to a client scheduled for a colonoscopy.
C) Assessing the gag reflex of a client who had a stroke.
D) Changing the dressing on a 24-hour post-operative incision.
E) Monitoring a client receiving a blood transfusion.
Correct Answer: B) Administering a tap water enema to a client scheduled for a
colonoscopy.
Rationale: The scope of practice for a UAP includes tasks that are non-invasive and have a
predictable outcome.[3] Administering a simple, non-medicated enema like tap water falls
within this scope. Reinforcing teaching, performing assessments, sterile procedures, and
monitoring transfusions are complex tasks that require the clinical judgment of a licensed
nurse (RN or LPN).
Question 5
A client is admitted to the emergency department with acute shortness of breath and pink, frothy
,[Type here]
sputum. The client has a history of hypertension and myocardial infarction. The nurse should
anticipate interventions for which condition?
A) Pneumonia
B) Spontaneous pneumothorax
C) Acute pulmonary edema
D) Plural effusion
E) Status asthmaticus
Correct Answer: C) Acute pulmonary edema
Rationale: The classic signs of acute pulmonary edema, a life-threatening condition often
caused by left-sided heart failure, include acute dyspnea, crackles on auscultation, and the
production of pink, frothy sputum.[2] This presentation requires immediate intervention to
improve gas exchange and reduce fluid overload.
Question 6
When providing care for a client with a sealed radiation implant for cervical cancer, which
precaution must the nurse implement?
A) Wear a lead apron when providing direct client care.
B) Place the client in a room with a positive-pressure airflow.
C) Allow visitors to stay for up to 2 hours at a time.
D) Dispose of the client's linens in a biohazard bag.
E) Encourage the client to ambulate in the hallway twice daily.
Correct Answer: A) Wear a lead apron when providing direct client care.
Rationale: A sealed radiation implant emits radiation. To adhere to the principles of
radiation safety (time, distance, shielding), the nurse must wear a lead shield and a
dosimeter badge when in the client's room.[4] Care should be clustered to minimize
exposure time, and visitors are typically limited.
Question 7
The nurse is planning care for a client in the manic phase of bipolar disorder. Which activity
would be most appropriate for this client?
A) Participating in a competitive group board game.
B) Assembling a complex jigsaw puzzle.
, [Type here]
C) Engaging in a session of deep breathing and meditation.
D) Walking with the nurse in the hospital garden.
E) Leading a unit-wide discussion group.
Correct Answer: D) Walking with the nurse in the hospital garden.
Rationale: A client in a manic phase has high energy levels, a short attention span, and poor
concentration. An appropriate activity is one that allows for the release of excess energy
without requiring intense focus or competition, which could escalate agitation. A non-
competitive physical activity like walking is ideal.
Question 8
A nurse is caring for a client who has vomited for 24 hours. The arterial blood gas (ABG) results
are: pH 7.52, PaCO2 48 mmHg, HCO3 34 mEq/L. How should the nurse interpret these results?
A) Respiratory Acidosis
B) Metabolic Alkalosis, partially compensated
C) Respiratory Alkalosis
D) Metabolic Acidosis, uncompensated
E) Normal ABG values
Correct Answer: B) Metabolic Alkalosis, partially compensated
Rationale: The pH is elevated (>7.45), indicating alkalosis. The HCO3 is elevated (>26
mEq/L), indicating a metabolic cause. Prolonged vomiting leads to the loss of stomach acid
(hydrochloric acid), resulting in metabolic alkalosis. The PaCO2 is also elevated (>45
mmHg), which is the respiratory system's attempt to compensate by retaining CO2 (an
acid). Since the pH is not yet back to normal, it is partially compensated.
Question 9
A client who is 24 hours post-operative is on bed rest. Which nursing action is most effective for
preventing a pulmonary embolism (PE)?
A) Encouraging the use of an incentive spirometer every hour.
B) Instructing the client to perform leg exercises regularly.
C) Maintaining the client in a high-Fowler's position.
D) Administering oxygen via nasal cannula.
E) Limiting the client's fluid intake.
