NUR 282 | Advanced Clinical / Transition Nursing | Final Exam Version
2 2026 |Galen College
1. A nurse is caring for four clients on a medical-surgical unit. Which client
should the nurse assess first?
A. A client with a deep vein thrombosis reporting sudden onset shortness of breath and chest pain.
B. A client who is 2 days postoperative from a total hip replacement with a hemoglobin of 10.2 g/dL.
C. A client with a history of heart failure reporting a 2-pound weight gain in 24 hours.
D. A client with diabetes mellitus who has a pre-meal blood glucose level of 160 mg/dL.
Answer: A
Rationale: Sudden onset shortness of breath and chest pain in a client with DVT are
hallmark signs of a pulmonary embolism, which is a life-threatening emergency
(Circulation/Oxygenation priority).
2. The charge nurse is making assignments for the day shift. Which task is most
appropriate to delegate to an Unlicensed Assistive Personnel (UAP)?
A. Performing a sterile dressing change on a post-surgical wound.
B. Titrating an intravenous infusion of dopamine based on blood pressure.
C. Providing discharge instructions to a client going home after a mastectomy.
D. Assisting a stable client with ambulation to the bathroom.
Answer: D
Rationale: UAPs can perform routine, non-invasive tasks such as ambulating stable clients.
Assessment, teaching, and medication titration require the specialized knowledge of a
nurse.
,3. A client is admitted with respiratory acidosis. Which of the following arterial
blood gas (ABG) results is consistent with this diagnosis?
A. pH 7.50, PaCO2 40 mm Hg, HCO3 32 mEq/L
B. pH 7.48, PaCO2 30 mm Hg, HCO3 22 mEq/L
C. pH 7.25, PaCO2 35 mm Hg, HCO3 18 mEq/L
D. pH 7.30, PaCO2 55 mm Hg, HCO3 24 mEq/L
Answer: D
Rationale: Respiratory acidosis is characterized by a low pH (less than 7.35) and a high
PaCO2 (greater than 45 mm Hg).
4. A nurse is caring for a client in the early stage of hypovolemic shock. Which
clinical manifestation should the nurse expect to observe?
A. Bradycardia
B. Increased urine output
C. Lethargy
D. Tachycardia
Answer: D
Rationale: Tachycardia is one of the earliest compensatory mechanisms for hypovolemic
shock as the body attempts to maintain cardiac output.
5. Which leadership style is characterized by a leader who makes decisions
independently without consulting others and exercises strong control over the
group?
A. Democratic
B. Laissez-faire
C. Autocratic
D. Transformational
Answer: C
, Rationale: Autocratic leadership involves centralized decision-making with little input
from staff, often used in emergency situations.
6. A nurse is evaluating the effectiveness of teaching for a client with Chronic
Kidney Disease (CKD) regarding diet. Which statement by the client indicates
understanding?
A. ‘I should use a salt substitute for all my meals.’
B. ‘I should eat plenty of bananas and spinach to stay healthy.’
C. ‘I will limit my intake of protein to reduce the workload on my kidneys.’
D. ‘I will increase my fluid intake to at least 3 liters a day.’
Answer: C
Rationale: CKD patients typically need to limit protein, potassium, and sodium. Salt
substitutes often contain potassium, which can be dangerous for CKD patients.
7. A client presents to the emergency department with a Glasgow Coma Scale
(GCS) score of 7. How should the nurse interpret this finding?
A. The client is fully awake and oriented.
B. The client is in a coma and requires immediate airway protection.
C. The client has a mild head injury.
D. The client shows normal neurological function.
Answer: B
Rationale: A GCS score of 8 or less is generally accepted as the threshold for a coma and
typically requires intubation to protect the airway.
2 2026 |Galen College
1. A nurse is caring for four clients on a medical-surgical unit. Which client
should the nurse assess first?
A. A client with a deep vein thrombosis reporting sudden onset shortness of breath and chest pain.
B. A client who is 2 days postoperative from a total hip replacement with a hemoglobin of 10.2 g/dL.
C. A client with a history of heart failure reporting a 2-pound weight gain in 24 hours.
D. A client with diabetes mellitus who has a pre-meal blood glucose level of 160 mg/dL.
Answer: A
Rationale: Sudden onset shortness of breath and chest pain in a client with DVT are
hallmark signs of a pulmonary embolism, which is a life-threatening emergency
(Circulation/Oxygenation priority).
2. The charge nurse is making assignments for the day shift. Which task is most
appropriate to delegate to an Unlicensed Assistive Personnel (UAP)?
A. Performing a sterile dressing change on a post-surgical wound.
B. Titrating an intravenous infusion of dopamine based on blood pressure.
C. Providing discharge instructions to a client going home after a mastectomy.
D. Assisting a stable client with ambulation to the bathroom.
Answer: D
Rationale: UAPs can perform routine, non-invasive tasks such as ambulating stable clients.
Assessment, teaching, and medication titration require the specialized knowledge of a
nurse.
,3. A client is admitted with respiratory acidosis. Which of the following arterial
blood gas (ABG) results is consistent with this diagnosis?
A. pH 7.50, PaCO2 40 mm Hg, HCO3 32 mEq/L
B. pH 7.48, PaCO2 30 mm Hg, HCO3 22 mEq/L
C. pH 7.25, PaCO2 35 mm Hg, HCO3 18 mEq/L
D. pH 7.30, PaCO2 55 mm Hg, HCO3 24 mEq/L
Answer: D
Rationale: Respiratory acidosis is characterized by a low pH (less than 7.35) and a high
PaCO2 (greater than 45 mm Hg).
4. A nurse is caring for a client in the early stage of hypovolemic shock. Which
clinical manifestation should the nurse expect to observe?
A. Bradycardia
B. Increased urine output
C. Lethargy
D. Tachycardia
Answer: D
Rationale: Tachycardia is one of the earliest compensatory mechanisms for hypovolemic
shock as the body attempts to maintain cardiac output.
5. Which leadership style is characterized by a leader who makes decisions
independently without consulting others and exercises strong control over the
group?
A. Democratic
B. Laissez-faire
C. Autocratic
D. Transformational
Answer: C
, Rationale: Autocratic leadership involves centralized decision-making with little input
from staff, often used in emergency situations.
6. A nurse is evaluating the effectiveness of teaching for a client with Chronic
Kidney Disease (CKD) regarding diet. Which statement by the client indicates
understanding?
A. ‘I should use a salt substitute for all my meals.’
B. ‘I should eat plenty of bananas and spinach to stay healthy.’
C. ‘I will limit my intake of protein to reduce the workload on my kidneys.’
D. ‘I will increase my fluid intake to at least 3 liters a day.’
Answer: C
Rationale: CKD patients typically need to limit protein, potassium, and sodium. Salt
substitutes often contain potassium, which can be dangerous for CKD patients.
7. A client presents to the emergency department with a Glasgow Coma Scale
(GCS) score of 7. How should the nurse interpret this finding?
A. The client is fully awake and oriented.
B. The client is in a coma and requires immediate airway protection.
C. The client has a mild head injury.
D. The client shows normal neurological function.
Answer: B
Rationale: A GCS score of 8 or less is generally accepted as the threshold for a coma and
typically requires intubation to protect the airway.
