NUR 282 | Advanced Clinical / Transition Nursing | Final Exam Prep
2026 |Galen College
1. A nurse is using the SBAR tool to communicate with a physician about a
patient’s declining status. Which statement belongs in the ‘Assessment’ portion
of the report?
A. ‘The patient’s breath sounds are now diminished in the bases with increased work of breathing.’
B. ‘I suggest we order a stat chest X-ray and arterial blood gases.’
C. ‘The patient was admitted two days ago with a diagnosis of heart failure.’
D. ‘The patient is becoming increasingly restless and tachypneic.’
Answer: A
Rationale: The Assessment portion of SBAR focuses on the nurse’s clinical findings and
what they think is going on, such as changed breath sounds.
2. In a mass casualty incident, which color tag would be assigned to a patient
with a sucking chest wound and stable vital signs?
A. Red (Emergent)
B. Yellow (Urgent)
C. Green (Non-urgent)
D. Black (Expectant)
Answer: A
Rationale: Red tags are for immediate, life-threatening injuries that are treatable, such as a
sucking chest wound or airway obstruction.
,3. Which ethical principle is the nurse practicing when they respect a patient’s
right to refuse a life-saving blood transfusion due to religious beliefs?
A. Beneficence
B. Autonomy
C. Justice
D. Non-maleficence
Answer: B
Rationale: Autonomy is the right of the patient to make their own decisions regarding
their health care, even if the nurse disagrees.
4. A charge nurse is delegating tasks to an Unlicensed Assistive Personnel (UAP).
Which task is appropriate to delegate?
A. Evaluating a patient’s response to pain medication.
B. Assisting a stable patient with ambulation to the bathroom.
C. Performing an admission assessment on a new patient.
D. Teaching a patient how to use an incentive spirometer.
Answer: B
Rationale: UAPs can perform routine tasks for stable patients, such as ADLs and
ambulation. Assessment, teaching, and evaluation require the judgment of an RN.
5. A nurse is caring for a patient in the early stage of septic shock. Which clinical
finding is most expected?
A. Hypotension and cool, clammy skin.
B. Tachycardia and warm, flushed skin.
C. Bradycardia and decreased cardiac output.
D. Anuria and peripheral edema.
Answer: B
Rationale: Early (hyperdynamic) septic shock is characterized by high cardiac output, low
systemic vascular resistance, and warm, flushed skin.
, 6. Which laboratory value is the most sensitive indicator of acute kidney injury
(AKI) development in a critically ill patient?
A. Glomerular Filtration Rate (GFR)
B. Blood Urea Nitrogen (BUN)
C. Serum Creatinine
D. Urine Specific Gravity
Answer: C
Rationale: While GFR is important for chronic disease, an increase in Serum Creatinine is
the standard marker for identifying acute changes in kidney function.
7. A nurse is caring for a patient with increased intracranial pressure (ICP).
Which position is most therapeutic for this patient?
A. Trendelenburg position
B. Supine with legs elevated
C. Side-lying with knees flexed
D. Semi-Fowler’s with head midline
Answer: D
Rationale: Elevating the head of the bed to 30-45 degrees (Semi-Fowler’s) and keeping the
head midline promotes venous drainage and helps lower ICP.
8. According to Lewin’s Change Theory, what occurs during the ‘Unfreezing’
stage?
A. Recognizing the need for change and building awareness.
B. Implementing the new policy across the unit.
C. Standardizing the change into the daily routine.
D. Evaluating the outcomes of the change process.
Answer: A
Rationale: Unfreezing involves creating readiness for change by identifying the problem
and reducing resistance.
2026 |Galen College
1. A nurse is using the SBAR tool to communicate with a physician about a
patient’s declining status. Which statement belongs in the ‘Assessment’ portion
of the report?
A. ‘The patient’s breath sounds are now diminished in the bases with increased work of breathing.’
B. ‘I suggest we order a stat chest X-ray and arterial blood gases.’
C. ‘The patient was admitted two days ago with a diagnosis of heart failure.’
D. ‘The patient is becoming increasingly restless and tachypneic.’
Answer: A
Rationale: The Assessment portion of SBAR focuses on the nurse’s clinical findings and
what they think is going on, such as changed breath sounds.
2. In a mass casualty incident, which color tag would be assigned to a patient
with a sucking chest wound and stable vital signs?
A. Red (Emergent)
B. Yellow (Urgent)
C. Green (Non-urgent)
D. Black (Expectant)
Answer: A
Rationale: Red tags are for immediate, life-threatening injuries that are treatable, such as a
sucking chest wound or airway obstruction.
,3. Which ethical principle is the nurse practicing when they respect a patient’s
right to refuse a life-saving blood transfusion due to religious beliefs?
A. Beneficence
B. Autonomy
C. Justice
D. Non-maleficence
Answer: B
Rationale: Autonomy is the right of the patient to make their own decisions regarding
their health care, even if the nurse disagrees.
4. A charge nurse is delegating tasks to an Unlicensed Assistive Personnel (UAP).
Which task is appropriate to delegate?
A. Evaluating a patient’s response to pain medication.
B. Assisting a stable patient with ambulation to the bathroom.
C. Performing an admission assessment on a new patient.
D. Teaching a patient how to use an incentive spirometer.
Answer: B
Rationale: UAPs can perform routine tasks for stable patients, such as ADLs and
ambulation. Assessment, teaching, and evaluation require the judgment of an RN.
5. A nurse is caring for a patient in the early stage of septic shock. Which clinical
finding is most expected?
A. Hypotension and cool, clammy skin.
B. Tachycardia and warm, flushed skin.
C. Bradycardia and decreased cardiac output.
D. Anuria and peripheral edema.
Answer: B
Rationale: Early (hyperdynamic) septic shock is characterized by high cardiac output, low
systemic vascular resistance, and warm, flushed skin.
, 6. Which laboratory value is the most sensitive indicator of acute kidney injury
(AKI) development in a critically ill patient?
A. Glomerular Filtration Rate (GFR)
B. Blood Urea Nitrogen (BUN)
C. Serum Creatinine
D. Urine Specific Gravity
Answer: C
Rationale: While GFR is important for chronic disease, an increase in Serum Creatinine is
the standard marker for identifying acute changes in kidney function.
7. A nurse is caring for a patient with increased intracranial pressure (ICP).
Which position is most therapeutic for this patient?
A. Trendelenburg position
B. Supine with legs elevated
C. Side-lying with knees flexed
D. Semi-Fowler’s with head midline
Answer: D
Rationale: Elevating the head of the bed to 30-45 degrees (Semi-Fowler’s) and keeping the
head midline promotes venous drainage and helps lower ICP.
8. According to Lewin’s Change Theory, what occurs during the ‘Unfreezing’
stage?
A. Recognizing the need for change and building awareness.
B. Implementing the new policy across the unit.
C. Standardizing the change into the daily routine.
D. Evaluating the outcomes of the change process.
Answer: A
Rationale: Unfreezing involves creating readiness for change by identifying the problem
and reducing resistance.
