,Galen NSG 4800 Comp 4 Exam | Transition to
Professional Nursing Practice (2026) Q&A
1. A client with acute pancreatitis is admitted. Which analgesic does the nurse
anticipate administering?
A) Morphine
B) Hydromorphone
C) Meperidine
D) Acetaminophen
Correct Answer: Hydromorphone
Rationale: Hydromorphone (Dilaudid) is the preferred opioid for pancreatitis
pain. Morphine may cause spasm of the sphincter of Oddi, potentially
worsening the condition. Meperidine is avoided due to neurotoxic metabolites.
Acetaminophen alone is insufficient for severe pain.
2. A nurse manager wants to implement shared governance on the unit. Which
statement best describes this model?
A) All decisions are made by the nurse manager
B) Staff nurses can give input but have no authority
C) Staff nurses are empowered to make decisions about clinical practice and
quality improvement
D) The hospital board controls nursing policies
Correct Answer: Staff nurses are empowered to make decisions about clinical
practice and quality improvement
,Rationale: Shared governance gives frontline nurses authority over their
practice, including policies and quality initiatives. It fosters autonomy and
professional accountability. The other options describe autocratic or advisory
models without true empowerment.
3. A charge nurse is using a just culture approach after a medication error. What
is the first step?
A) Review systems and processes that contributed to the error
B) Terminate the nurse involved
C) Report the nurse to the board
D) Ignore the error if no harm occurred
Correct Answer: Review systems and processes that contributed to the error
Rationale: A just culture focuses on system analysis rather than immediate
blame. The first step is to examine processes that may have led to the error.
This promotes safety improvements and distinguishes human error from
reckless behavior.
4. The nurse is reviewing a client's medication orders. Which order should the
nurse follow up with the provider?
A) Potassium 4.0 mEq/L and no Kayexalate ordered
B) INR 2.0 on warfarin
C) Blood glucose 110 mg/dL
D) Potassium 4.0 mEq/L and Kayexalate prescribed
, Correct Answer: Potassium 4.0 mEq/L and Kayexalate prescribed
Rationale: Kayexalate is indicated for hyperkalemia (K⁺ >5.0 mEq/L). A
potassium of 4.0 is normal, so administering Kayexalate could cause
hypokalemia. The nurse should clarify this order with the provider before giving
the medication.
5. A client with heart failure develops sudden severe dyspnea and pink frothy
sputum. What is the priority action?
A) Administer digoxin
B) Place the client in high Fowler's position
C) Prepare for intubation
D) Obtain an ECG
Correct Answer: Place the client in high Fowler's position
Rationale: High Fowler's position decreases venous return and improves lung
expansion, rapidly alleviating pulmonary edema. It is a noninvasive intervention
that can be implemented immediately. Medications and intubation may follow,
but positioning is the first step.
6. A nurse is teaching a client about warfarin therapy. Which statement
indicates understanding?
A) "I will have my INR checked regularly."
B) "I can take aspirin for headaches."
C) "I will stop the medication if I notice bruising."
D) "I will increase my intake of green leafy vegetables."
Professional Nursing Practice (2026) Q&A
1. A client with acute pancreatitis is admitted. Which analgesic does the nurse
anticipate administering?
A) Morphine
B) Hydromorphone
C) Meperidine
D) Acetaminophen
Correct Answer: Hydromorphone
Rationale: Hydromorphone (Dilaudid) is the preferred opioid for pancreatitis
pain. Morphine may cause spasm of the sphincter of Oddi, potentially
worsening the condition. Meperidine is avoided due to neurotoxic metabolites.
Acetaminophen alone is insufficient for severe pain.
2. A nurse manager wants to implement shared governance on the unit. Which
statement best describes this model?
A) All decisions are made by the nurse manager
B) Staff nurses can give input but have no authority
C) Staff nurses are empowered to make decisions about clinical practice and
quality improvement
D) The hospital board controls nursing policies
Correct Answer: Staff nurses are empowered to make decisions about clinical
practice and quality improvement
,Rationale: Shared governance gives frontline nurses authority over their
practice, including policies and quality initiatives. It fosters autonomy and
professional accountability. The other options describe autocratic or advisory
models without true empowerment.
3. A charge nurse is using a just culture approach after a medication error. What
is the first step?
A) Review systems and processes that contributed to the error
B) Terminate the nurse involved
C) Report the nurse to the board
D) Ignore the error if no harm occurred
Correct Answer: Review systems and processes that contributed to the error
Rationale: A just culture focuses on system analysis rather than immediate
blame. The first step is to examine processes that may have led to the error.
This promotes safety improvements and distinguishes human error from
reckless behavior.
4. The nurse is reviewing a client's medication orders. Which order should the
nurse follow up with the provider?
A) Potassium 4.0 mEq/L and no Kayexalate ordered
B) INR 2.0 on warfarin
C) Blood glucose 110 mg/dL
D) Potassium 4.0 mEq/L and Kayexalate prescribed
, Correct Answer: Potassium 4.0 mEq/L and Kayexalate prescribed
Rationale: Kayexalate is indicated for hyperkalemia (K⁺ >5.0 mEq/L). A
potassium of 4.0 is normal, so administering Kayexalate could cause
hypokalemia. The nurse should clarify this order with the provider before giving
the medication.
5. A client with heart failure develops sudden severe dyspnea and pink frothy
sputum. What is the priority action?
A) Administer digoxin
B) Place the client in high Fowler's position
C) Prepare for intubation
D) Obtain an ECG
Correct Answer: Place the client in high Fowler's position
Rationale: High Fowler's position decreases venous return and improves lung
expansion, rapidly alleviating pulmonary edema. It is a noninvasive intervention
that can be implemented immediately. Medications and intubation may follow,
but positioning is the first step.
6. A nurse is teaching a client about warfarin therapy. Which statement
indicates understanding?
A) "I will have my INR checked regularly."
B) "I can take aspirin for headaches."
C) "I will stop the medication if I notice bruising."
D) "I will increase my intake of green leafy vegetables."
