NUR 282 Advanced Clinical Nursing Exam Bundle 2026 |Galen College
1. A patient with a T4 spinal cord injury reports a sudden, severe headache and
is found to be hypertensive and bradycardic. What is the nurse’s priority action?
A. Administer prescribed antihypertensive medication
B. Place the patient in a supine position to lower blood pressure
C. Check the patient’s bladder for distension or a kinked catheter
D. Call the physician immediately to report the findings
Answer: C
Rationale: These are signs of autonomic dysreflexia. The priority is to identify and remove
the noxious stimulus, most commonly a full bladder or impacted bowel.
2. Which clinical finding is part of Cushing’s Triad, indicating increased
intracranial pressure (ICP)?
A. Tachycardia, hypotension, and tachypnea
B. Bradycardia, hypotension, and Cheyne-Stokes respirations
C. Bradycardia, hypertension with widening pulse pressure, and irregular respirations
D. Tachycardia, hypertension, and shallow respirations
Answer: C
Rationale: Cushing’s Triad consists of bradycardia, hypertension (with a widening pulse
pressure), and irregular/altered respirations, signifying late-stage increased ICP.
,3. A nurse is caring for a patient in Septic Shock. Which laboratory value is the
most sensitive indicator of tissue hypoperfusion?
A. White Blood Cell (WBC) count
B. Blood Urea Nitrogen (BUN)
C. Serum Potassium
D. Serum Lactate level
Answer: D
Rationale: Elevated serum lactate levels indicate anaerobic metabolism due to inadequate
tissue oxygenation, a hallmark of shock.
4. The nurse notes a high-pressure alarm on the mechanical ventilator. Which of
the following should the nurse check first?
A. Check for a disconnected oxygen sensor
B. Assess the patient for a need to suction or biting the tube
C. Look for a leak in the ventilator circuit
D. Check if the patient has been extubated
Answer: B
Rationale: High-pressure alarms are triggered by increased resistance, such as secretions,
coughing, biting the ETT, or kinking of the tube.
5. Which task is most appropriate for the RN to delegate to a Licensed Practical
Nurse (LPN)?
A. Developing the initial plan of care for a new admission
B. Administering IV push medications to a patient in the ICU
C. Performing a sterile dressing change on a stable post-operative wound
D. Providing discharge teaching to a patient after a CABG
Answer: C
Rationale: LPNs can perform sterile procedures and care for stable patients. EAT
(Evaluate, Assess, Teach) and IV push meds are typically reserved for the RN.
, 6. In the Emergency Department triage, which patient should be assigned the
‘Red’ tag (Immediate)?
A. A patient with a tension pneumothorax and severe respiratory distress
B. A patient with an open femur fracture but stable vital signs
C. A patient with a minor forearm laceration and controlled bleeding
D. A patient who is pulseless and non-breathing with a massive head injury
Answer: A
Rationale: Red tags are for life-threatening injuries that are treatable with immediate
intervention, such as airway or breathing emergencies.
7. A patient with Diabetic Ketoacidosis (DKA) has a blood glucose of 450 mg/dL
and is receiving IV insulin. What is the priority nursing assessment?
A. Assessing for hypoglycemia and hypokalemia
B. Monitoring for signs of fluid volume overload
C. Checking for peripheral edema
D. Measuring hourly urine output
Answer: A
Rationale: Insulin therapy drives glucose and potassium into the cells, risking rapid drops
in both blood sugar and serum potassium.
8. A patient has a Glasgow Coma Scale (GCS) score of 7. What is the priority
nursing intervention?
A. Preparing for immediate endotracheal intubation
B. Performing a neurological assessment every 4 hours
C. Encouraging the patient to cough and deep breathe
D. Administering oral fluids to maintain hydration
Answer: A
Rationale: A GCS of 8 or less generally indicates a need for intubation (‘GCS less than 8,
intubate’) to protect the airway.
1. A patient with a T4 spinal cord injury reports a sudden, severe headache and
is found to be hypertensive and bradycardic. What is the nurse’s priority action?
A. Administer prescribed antihypertensive medication
B. Place the patient in a supine position to lower blood pressure
C. Check the patient’s bladder for distension or a kinked catheter
D. Call the physician immediately to report the findings
Answer: C
Rationale: These are signs of autonomic dysreflexia. The priority is to identify and remove
the noxious stimulus, most commonly a full bladder or impacted bowel.
2. Which clinical finding is part of Cushing’s Triad, indicating increased
intracranial pressure (ICP)?
A. Tachycardia, hypotension, and tachypnea
B. Bradycardia, hypotension, and Cheyne-Stokes respirations
C. Bradycardia, hypertension with widening pulse pressure, and irregular respirations
D. Tachycardia, hypertension, and shallow respirations
Answer: C
Rationale: Cushing’s Triad consists of bradycardia, hypertension (with a widening pulse
pressure), and irregular/altered respirations, signifying late-stage increased ICP.
,3. A nurse is caring for a patient in Septic Shock. Which laboratory value is the
most sensitive indicator of tissue hypoperfusion?
A. White Blood Cell (WBC) count
B. Blood Urea Nitrogen (BUN)
C. Serum Potassium
D. Serum Lactate level
Answer: D
Rationale: Elevated serum lactate levels indicate anaerobic metabolism due to inadequate
tissue oxygenation, a hallmark of shock.
4. The nurse notes a high-pressure alarm on the mechanical ventilator. Which of
the following should the nurse check first?
A. Check for a disconnected oxygen sensor
B. Assess the patient for a need to suction or biting the tube
C. Look for a leak in the ventilator circuit
D. Check if the patient has been extubated
Answer: B
Rationale: High-pressure alarms are triggered by increased resistance, such as secretions,
coughing, biting the ETT, or kinking of the tube.
5. Which task is most appropriate for the RN to delegate to a Licensed Practical
Nurse (LPN)?
A. Developing the initial plan of care for a new admission
B. Administering IV push medications to a patient in the ICU
C. Performing a sterile dressing change on a stable post-operative wound
D. Providing discharge teaching to a patient after a CABG
Answer: C
Rationale: LPNs can perform sterile procedures and care for stable patients. EAT
(Evaluate, Assess, Teach) and IV push meds are typically reserved for the RN.
, 6. In the Emergency Department triage, which patient should be assigned the
‘Red’ tag (Immediate)?
A. A patient with a tension pneumothorax and severe respiratory distress
B. A patient with an open femur fracture but stable vital signs
C. A patient with a minor forearm laceration and controlled bleeding
D. A patient who is pulseless and non-breathing with a massive head injury
Answer: A
Rationale: Red tags are for life-threatening injuries that are treatable with immediate
intervention, such as airway or breathing emergencies.
7. A patient with Diabetic Ketoacidosis (DKA) has a blood glucose of 450 mg/dL
and is receiving IV insulin. What is the priority nursing assessment?
A. Assessing for hypoglycemia and hypokalemia
B. Monitoring for signs of fluid volume overload
C. Checking for peripheral edema
D. Measuring hourly urine output
Answer: A
Rationale: Insulin therapy drives glucose and potassium into the cells, risking rapid drops
in both blood sugar and serum potassium.
8. A patient has a Glasgow Coma Scale (GCS) score of 7. What is the priority
nursing intervention?
A. Preparing for immediate endotracheal intubation
B. Performing a neurological assessment every 4 hours
C. Encouraging the patient to cough and deep breathe
D. Administering oral fluids to maintain hydration
Answer: A
Rationale: A GCS of 8 or less generally indicates a need for intubation (‘GCS less than 8,
intubate’) to protect the airway.
