1|Page
NUR 283 COMP 3 EXAM (GALEN) – Complete Test
Bank with 300 Q&A and Rationales for
Transition to RN Practice | Critical Care,
Emergency Response, Leadership, Management,
Quality Improvement, Patient Safety, Evidence-
Based Practice, Interprofessional Collaboration,
Healthcare Policy, Legal & Ethical Dilemmas,
Comprehensive Final Exam Prep
Complete NUR 283 Comprehensive Exam 3 test bank for Galen
College Transition to Registered Nursing Practice. 300 verified
multiple-choice questions with correct answers and detailed
rationales covering critical care, emergency response,
leadership, management, quality improvement, patient safety,
evidence-based practice, interprofessional collaboration,
healthcare policy, and legal/ethical dilemmas. Perfect for
nursing students preparing for COMP 3 finals. Questions reflect
real exam content with NCLEX-style application. Pass your
Galen NUR 283 COMP 3 exam on the first attempt with this
comprehensive Q&A study resource covering all leadership and
advanced practice concepts for RN transition success. Updated
for current curriculum.
, 2|Page
1. A nurse is caring for a patient who is in septic shock. Which finding is most
concerning and requires immediate intervention?
A. Blood pressure of 90/60 mmHg.
B. Heart rate of 110 beats per minute.
C. Respiratory rate of 22 breaths per minute.
D. Temperature of 101.2°F (38.4°C).
*A. Blood pressure of 90/60 mmHg.
Rationale: Septic shock is characterized by hypotension that does not respond to fluid
resuscitation. A blood pressure of 90/60 mmHg indicates inadequate tissue perfusion
and requires immediate intervention with vasopressors and fluids to maintain organ
perfusion. Tachycardia, tachypnea, and fever are also concerning but hypotension is
the most immediate threat to life.
2. A nurse is caring for a patient who has a chest tube connected to a water seal
drainage system. Which finding indicates that the chest tube system is functioning
properly?
A. Continuous bubbling in the water seal chamber.
B. Fluctuation (tidaling) of fluid in the water seal chamber with respirations.
C. Absence of drainage in the collection chamber.
D. Constant vigorous bubbling in the suction control chamber.
*B. Fluctuation (tidaling) of fluid in the water seal chamber with respirations.
Rationale: Tidaling (fluid movement in the water seal chamber with inspiration and
expiration) indicates that the chest tube is patent and functioning properly. Continuous
bubbling in the water seal chamber indicates an air leak. Constant bubbling in the
suction control chamber is normal if suction is applied but should be gentle, not
vigorous. Absence of drainage does not indicate malfunction.
3. A nurse is assessing a patient who has just returned from the post-anesthesia care
unit (PACU) after abdominal surgery. Which finding requires immediate notification
of the provider?
A. Pain of 5/10 on the numeric pain scale.
B. Blood pressure of 100/60 mmHg.
C. Heart rate of 90 beats per minute.
D. Oxygen saturation of 88% on room air.
*D. Oxygen saturation of 88% on room air.
Rationale: An oxygen saturation of 88% indicates hypoxemia and requires immediate
intervention to prevent respiratory failure. Pain, mild hypotension, and tachycardia are
common post-operative findings but are not immediately life-threatening. The nurse
should administer oxygen and notify the provider.
4. A nurse is caring for a patient in the intensive care unit who is on a mechanical
ventilator. Which intervention is most important to prevent ventilator-associated
pneumonia (VAP)?
A. Change the ventilator circuit daily.
B. Elevate the head of the bed to 30-45 degrees.
C. Suction the patient every 2 hours.
, 3|Page
D. Administer prophylactic antibiotics.
*B. Elevate the head of the bed to 30-45 degrees.
Rationale: Elevating the head of the bed to 30-45 degrees is the most effective
intervention to prevent VAP by reducing the risk of aspiration of gastric contents.
Ventilator circuits should not be changed routinely. Suctioning should be done as
needed, not on a fixed schedule. Prophylactic antibiotics are not recommended for VAP
prevention.
5. A nurse is assessing a patient with a traumatic brain injury. Which finding indicates
increased intracranial pressure (ICP)?
A. Hypotension.
B. Tachycardia.
C. Widening pulse pressure.
D. Constricted pupils.
*C. Widening pulse pressure.
Rationale: Cushing's triad is a classic sign of increased ICP and includes: (1)
hypertension, (2) bradycardia, and (3) irregular respirations. Widening pulse pressure
(increasing systolic blood pressure with a stable or decreasing diastolic pressure) is an
early sign. Hypotension, tachycardia, and constricted pupils are not consistent with
increased ICP.
6. A nurse is caring for a patient who is receiving continuous renal replacement therapy
(CRRT). Which finding indicates a complication of this therapy?
A. Blood pressure of 110/70 mmHg.
B. Heart rate of 80 beats per minute.
C. Temperature of 99.0°F (37.2°C).
D. Potassium level of 6.5 mEq/L.
*D. Potassium level of 6.5 mEq/L.
Rationale: CRRT is used to remove waste products and excess electrolytes in patients
with renal failure. A potassium level of 6.5 mEq/L indicates hyperkalemia and suggests
that the CRRT is not effectively removing potassium. This requires immediate
intervention to prevent cardiac dysrhythmias. The other findings are within normal
limits.
7. A nurse is preparing to administer a blood transfusion to a patient. Which action is
most important to prevent a transfusion reaction?
A. Pre-medicate the patient with diphenhydramine (Benadryl).
B. Verify the patient's identity and blood product with another licensed nurse.
C. Infuse the blood over 4 hours.
D. Check the patient's vital signs before the transfusion.
*B. Verify the patient's identity and blood product with another licensed nurse.
Rationale: The most critical safety step before a blood transfusion is verifying the
patient's identity, blood type, and the blood product with another licensed nurse (two-
nurse verification) to prevent fatal ABO incompatibility reactions. Vital signs, pre-
medication, and infusion rate are also important but come after the identity
verification.
, 4|Page
8. A nurse is assessing a patient who is experiencing an acute asthma exacerbation.
Which finding is most concerning?
A. Wheezing audible without a stethoscope.
B. Respiratory rate of 28 breaths per minute.
C. Oxygen saturation of 92% on room air.
D. Absence of wheezing and decreased breath sounds.
*D. Absence of wheezing and decreased breath sounds.
Rationale: Absence of wheezing with decreased breath sounds in an asthma patient
indicates severe airway obstruction and impending respiratory failure. This is a "silent
chest" and is a medical emergency requiring immediate intubation. Wheezing,
tachypnea, and mild hypoxemia are concerning but not as critical as the silent chest.
9. A nurse is caring for a patient who has a pulmonary artery catheter (Swan-Ganz
catheter). Which hemodynamic parameter indicates that the patient is in cardiogenic
shock?
A. Cardiac output (CO) of 6 L/min.
B. Pulmonary artery wedge pressure (PAWP) of 25 mmHg.
C. Central venous pressure (CVP) of 5 mmHg.
D. Mixed venous oxygen saturation (SvO2) of 75%.
*B. Pulmonary artery wedge pressure (PAWP) of 25 mmHg.
Rationale: Cardiogenic shock is characterized by decreased cardiac output and
increased PAWP due to left ventricular failure. A PAWP of 25 mmHg (normal 4-12
mmHg) indicates elevated left ventricular end-diastolic pressure and fluid overload in
the lungs. Low CO, low CVP, and low SvO2 are also seen in cardiogenic shock but
elevated PAWP is the hallmark.
10. A nurse is providing education to a patient who is being discharged with a new
diagnosis of heart failure. Which statement by the patient indicates a need for further
teaching?
A. "I will weigh myself every morning before breakfast."
B. "I will call my doctor if I gain 2 pounds in one day."
C. "I can eat as much salt as I want as long as I take my diuretics."
D. "I will rest when I am tired and avoid strenuous activity."
*C. "I can eat as much salt as I want as long as I take my diuretics."
Rationale: Patients with heart failure must adhere to a strict low-sodium diet to prevent
fluid overload. Diuretics do not negate the effects of high sodium intake. Daily weights
and monitoring for sudden weight gain (2-3 lbs in 24 hours) are key indicators of
worsening fluid status.
11. A nurse is caring for a patient who has just been diagnosed with acute myocardial
infarction (MI). Which medication should the nurse administer FIRST?
A. Morphine.
B. Aspirin.
C. Nitroglycerin.
D. Oxygen.
*B. Aspirin.
NUR 283 COMP 3 EXAM (GALEN) – Complete Test
Bank with 300 Q&A and Rationales for
Transition to RN Practice | Critical Care,
Emergency Response, Leadership, Management,
Quality Improvement, Patient Safety, Evidence-
Based Practice, Interprofessional Collaboration,
Healthcare Policy, Legal & Ethical Dilemmas,
Comprehensive Final Exam Prep
Complete NUR 283 Comprehensive Exam 3 test bank for Galen
College Transition to Registered Nursing Practice. 300 verified
multiple-choice questions with correct answers and detailed
rationales covering critical care, emergency response,
leadership, management, quality improvement, patient safety,
evidence-based practice, interprofessional collaboration,
healthcare policy, and legal/ethical dilemmas. Perfect for
nursing students preparing for COMP 3 finals. Questions reflect
real exam content with NCLEX-style application. Pass your
Galen NUR 283 COMP 3 exam on the first attempt with this
comprehensive Q&A study resource covering all leadership and
advanced practice concepts for RN transition success. Updated
for current curriculum.
, 2|Page
1. A nurse is caring for a patient who is in septic shock. Which finding is most
concerning and requires immediate intervention?
A. Blood pressure of 90/60 mmHg.
B. Heart rate of 110 beats per minute.
C. Respiratory rate of 22 breaths per minute.
D. Temperature of 101.2°F (38.4°C).
*A. Blood pressure of 90/60 mmHg.
Rationale: Septic shock is characterized by hypotension that does not respond to fluid
resuscitation. A blood pressure of 90/60 mmHg indicates inadequate tissue perfusion
and requires immediate intervention with vasopressors and fluids to maintain organ
perfusion. Tachycardia, tachypnea, and fever are also concerning but hypotension is
the most immediate threat to life.
2. A nurse is caring for a patient who has a chest tube connected to a water seal
drainage system. Which finding indicates that the chest tube system is functioning
properly?
A. Continuous bubbling in the water seal chamber.
B. Fluctuation (tidaling) of fluid in the water seal chamber with respirations.
C. Absence of drainage in the collection chamber.
D. Constant vigorous bubbling in the suction control chamber.
*B. Fluctuation (tidaling) of fluid in the water seal chamber with respirations.
Rationale: Tidaling (fluid movement in the water seal chamber with inspiration and
expiration) indicates that the chest tube is patent and functioning properly. Continuous
bubbling in the water seal chamber indicates an air leak. Constant bubbling in the
suction control chamber is normal if suction is applied but should be gentle, not
vigorous. Absence of drainage does not indicate malfunction.
3. A nurse is assessing a patient who has just returned from the post-anesthesia care
unit (PACU) after abdominal surgery. Which finding requires immediate notification
of the provider?
A. Pain of 5/10 on the numeric pain scale.
B. Blood pressure of 100/60 mmHg.
C. Heart rate of 90 beats per minute.
D. Oxygen saturation of 88% on room air.
*D. Oxygen saturation of 88% on room air.
Rationale: An oxygen saturation of 88% indicates hypoxemia and requires immediate
intervention to prevent respiratory failure. Pain, mild hypotension, and tachycardia are
common post-operative findings but are not immediately life-threatening. The nurse
should administer oxygen and notify the provider.
4. A nurse is caring for a patient in the intensive care unit who is on a mechanical
ventilator. Which intervention is most important to prevent ventilator-associated
pneumonia (VAP)?
A. Change the ventilator circuit daily.
B. Elevate the head of the bed to 30-45 degrees.
C. Suction the patient every 2 hours.
, 3|Page
D. Administer prophylactic antibiotics.
*B. Elevate the head of the bed to 30-45 degrees.
Rationale: Elevating the head of the bed to 30-45 degrees is the most effective
intervention to prevent VAP by reducing the risk of aspiration of gastric contents.
Ventilator circuits should not be changed routinely. Suctioning should be done as
needed, not on a fixed schedule. Prophylactic antibiotics are not recommended for VAP
prevention.
5. A nurse is assessing a patient with a traumatic brain injury. Which finding indicates
increased intracranial pressure (ICP)?
A. Hypotension.
B. Tachycardia.
C. Widening pulse pressure.
D. Constricted pupils.
*C. Widening pulse pressure.
Rationale: Cushing's triad is a classic sign of increased ICP and includes: (1)
hypertension, (2) bradycardia, and (3) irregular respirations. Widening pulse pressure
(increasing systolic blood pressure with a stable or decreasing diastolic pressure) is an
early sign. Hypotension, tachycardia, and constricted pupils are not consistent with
increased ICP.
6. A nurse is caring for a patient who is receiving continuous renal replacement therapy
(CRRT). Which finding indicates a complication of this therapy?
A. Blood pressure of 110/70 mmHg.
B. Heart rate of 80 beats per minute.
C. Temperature of 99.0°F (37.2°C).
D. Potassium level of 6.5 mEq/L.
*D. Potassium level of 6.5 mEq/L.
Rationale: CRRT is used to remove waste products and excess electrolytes in patients
with renal failure. A potassium level of 6.5 mEq/L indicates hyperkalemia and suggests
that the CRRT is not effectively removing potassium. This requires immediate
intervention to prevent cardiac dysrhythmias. The other findings are within normal
limits.
7. A nurse is preparing to administer a blood transfusion to a patient. Which action is
most important to prevent a transfusion reaction?
A. Pre-medicate the patient with diphenhydramine (Benadryl).
B. Verify the patient's identity and blood product with another licensed nurse.
C. Infuse the blood over 4 hours.
D. Check the patient's vital signs before the transfusion.
*B. Verify the patient's identity and blood product with another licensed nurse.
Rationale: The most critical safety step before a blood transfusion is verifying the
patient's identity, blood type, and the blood product with another licensed nurse (two-
nurse verification) to prevent fatal ABO incompatibility reactions. Vital signs, pre-
medication, and infusion rate are also important but come after the identity
verification.
, 4|Page
8. A nurse is assessing a patient who is experiencing an acute asthma exacerbation.
Which finding is most concerning?
A. Wheezing audible without a stethoscope.
B. Respiratory rate of 28 breaths per minute.
C. Oxygen saturation of 92% on room air.
D. Absence of wheezing and decreased breath sounds.
*D. Absence of wheezing and decreased breath sounds.
Rationale: Absence of wheezing with decreased breath sounds in an asthma patient
indicates severe airway obstruction and impending respiratory failure. This is a "silent
chest" and is a medical emergency requiring immediate intubation. Wheezing,
tachypnea, and mild hypoxemia are concerning but not as critical as the silent chest.
9. A nurse is caring for a patient who has a pulmonary artery catheter (Swan-Ganz
catheter). Which hemodynamic parameter indicates that the patient is in cardiogenic
shock?
A. Cardiac output (CO) of 6 L/min.
B. Pulmonary artery wedge pressure (PAWP) of 25 mmHg.
C. Central venous pressure (CVP) of 5 mmHg.
D. Mixed venous oxygen saturation (SvO2) of 75%.
*B. Pulmonary artery wedge pressure (PAWP) of 25 mmHg.
Rationale: Cardiogenic shock is characterized by decreased cardiac output and
increased PAWP due to left ventricular failure. A PAWP of 25 mmHg (normal 4-12
mmHg) indicates elevated left ventricular end-diastolic pressure and fluid overload in
the lungs. Low CO, low CVP, and low SvO2 are also seen in cardiogenic shock but
elevated PAWP is the hallmark.
10. A nurse is providing education to a patient who is being discharged with a new
diagnosis of heart failure. Which statement by the patient indicates a need for further
teaching?
A. "I will weigh myself every morning before breakfast."
B. "I will call my doctor if I gain 2 pounds in one day."
C. "I can eat as much salt as I want as long as I take my diuretics."
D. "I will rest when I am tired and avoid strenuous activity."
*C. "I can eat as much salt as I want as long as I take my diuretics."
Rationale: Patients with heart failure must adhere to a strict low-sodium diet to prevent
fluid overload. Diuretics do not negate the effects of high sodium intake. Daily weights
and monitoring for sudden weight gain (2-3 lbs in 24 hours) are key indicators of
worsening fluid status.
11. A nurse is caring for a patient who has just been diagnosed with acute myocardial
infarction (MI). Which medication should the nurse administer FIRST?
A. Morphine.
B. Aspirin.
C. Nitroglycerin.
D. Oxygen.
*B. Aspirin.
