Galen NSG 4800 Transition to Professional Nursing Practice:
Exam 3 - Questions with Correct Answers
100 questions
1. Social media use by nurses should:
A. Never include patient information or images, even without names
B. Include patient photos if faces are hidden
C. Include complaints about specific patients
D. Include colleagues' private information
Correct Answer: A. Never include patient information or images, even without names
Rationale: NCSBN guidelines warn that even de-identified details can identify patients and violate HIPAA
and professional standards. Hiding faces is not enough, because details such as room numbers,
diagnoses or dates can still identify a patient.
2. Malpractice differs from negligence in that malpractice:
A. Is professional negligence by a licensed professional failing to meet the standard of care
B. Requires intent to harm
C. Is a criminal act always
D. Applies only to physicians
Correct Answer: A. Is professional negligence by a licensed professional failing to meet the
standard of care
Rationale: Both involve failure to meet a standard; malpractice applies the professional standard.
Malpractice does not require intent and is usually a civil matter; it applies to licensed professionals,
including nurses.
3. Nurse residency programs for new graduates have been shown to:
A. Replace licensure exams
B. Increase turnover
C. Reduce patient safety
D. Improve retention, confidence and competence during the first year
Correct Answer: D. Improve retention, confidence and competence during the first year
Rationale: Structured residencies (e.g., the Vizient/AACN model) reduce first-year turnover, which can
otherwise exceed 20%. They supplement, not replace, orientation and licensure.
,4. The Nurse Licensure Compact (NLC) allows a nurse to:
A. Practice in any country
B. Hold one multistate license to practice in other compact states
C. Skip the NCLEX
D. Practice as an advanced practice nurse without certification
Correct Answer: B. Hold one multistate license to practice in other compact states
Rationale: The NLC lets RNs and LPNs with a multistate license, issued by their primary state of
residence, practice in other participating states. It does not cover APRN practice or remove licensure
exams.
5. A new nurse is asked to float to an unfamiliar specialty unit. The most appropriate action is to:
A. Refuse to go
B. Accept every task without telling anyone
C. Accept assignments within competence and inform the charge nurse of skills not yet mastered
D. Leave the hospital
Correct Answer: C. Accept assignments within competence and inform the charge nurse of
skills not yet mastered
Rationale: Nurses can float but should accept only care they are competent to provide and communicate
limits so safe assignments are made. Refusing outright may be treated as insubordination, while silently
accepting care beyond competence risks patient harm.
6. The NGN NCLEX-RN has a minimum and maximum number of items of:
A. 75 and 265
B. 85 and 150
C. 60 and 145
D. 100 and 200
Correct Answer: B. 85 and 150
Rationale: Since April 2023, the RN exam ranges from 85 to 150 items, including 15 unscored pretest
items, with a 5-hour time limit. The old 75-265 range no longer applies.
,7. Patient abandonment occurs when a nurse:
A. Leaves an assignment after accepting it without ensuring a qualified nurse takes over
B. Refuses an assignment before accepting it, with explanation
C. Takes a scheduled break with coverage
D. Completes a shift and gives report
Correct Answer: A. Leaves an assignment after accepting it without ensuring a qualified
nurse takes over
Rationale: Abandonment requires accepting the patient care assignment and then leaving without proper
handoff. Declining before acceptance, with notice, is not abandonment.
8. The six cognitive steps of the NCSBN Clinical Judgment Measurement Model begin with:
A. Recognize cues
B. Take action
C. Evaluate outcomes
D. Generate solutions
Correct Answer: A. Recognize cues
Rationale: The sequence is recognize cues, analyze cues, prioritize hypotheses, generate solutions, take
action and evaluate outcomes. Starting with action skips the assessment needed to choose the right
action.
9. A client with type 1 diabetes has a glucose of 450 mg/dL, Kussmaul respirations and fruity
breath. The priority intervention is:
A. Oral glucose
B. IV fluid replacement with 0.9% normal saline
C. Subcutaneous long-acting insulin only
D. Restricting fluids
Correct Answer: B. IV fluid replacement with 0.9% normal saline
Rationale: DKA treatment starts with fluid resuscitation, then IV regular insulin with potassium monitoring
and replacement. Oral glucose would worsen hyperglycemia, long-acting insulin alone is too slow, and
restricting fluids worsens the severe dehydration of DKA.
, 10. A client receiving IV potassium reports burning at the IV site. The nurse should first:
A. Increase the rate to finish faster
B. Stop or slow the infusion and assess the site for infiltration or phlebitis
C. Apply heat and continue
D. Ignore it as expected
Correct Answer: B. Stop or slow the infusion and assess the site for infiltration or phlebitis
Rationale: Potassium is irritating to veins; burning may indicate phlebitis or infiltration. Never give
potassium IV push. Increasing the rate or applying heat and continuing could worsen tissue damage;
potassium can cause severe vein irritation and necrosis if it infiltrates.
11. The 'Recognize cues' step of clinical judgment involves:
A. Identifying relevant and important information from the client data
B. Implementing interventions
C. Evaluating outcomes
D. Ranking hypotheses
Correct Answer: A. Identifying relevant and important information from the client data
Rationale: Recognizing which data matter, such as abnormal vitals or changes from baseline, is the first
step in the NCSBN model. Implementing interventions and evaluating outcomes come later; without
recognizing the relevant cues, the nurse cannot identify the right problem.
12. A client is prescribed a new antibiotic and develops hives, wheezing and throat tightness.
The first action is to:
A. Give oral diphenhydramine only
B. Stop the infusion and administer epinephrine IM per protocol
C. Continue the infusion slowly
D. Document and observe
Correct Answer: B. Stop the infusion and administer epinephrine IM per protocol
Rationale: This is anaphylaxis. IM epinephrine in the anterolateral thigh is first-line; antihistamines are
adjuncts. Oral antihistamines alone are too slow and do not reverse airway swelling or shock; continuing
the infusion worsens the reaction.
Exam 3 - Questions with Correct Answers
100 questions
1. Social media use by nurses should:
A. Never include patient information or images, even without names
B. Include patient photos if faces are hidden
C. Include complaints about specific patients
D. Include colleagues' private information
Correct Answer: A. Never include patient information or images, even without names
Rationale: NCSBN guidelines warn that even de-identified details can identify patients and violate HIPAA
and professional standards. Hiding faces is not enough, because details such as room numbers,
diagnoses or dates can still identify a patient.
2. Malpractice differs from negligence in that malpractice:
A. Is professional negligence by a licensed professional failing to meet the standard of care
B. Requires intent to harm
C. Is a criminal act always
D. Applies only to physicians
Correct Answer: A. Is professional negligence by a licensed professional failing to meet the
standard of care
Rationale: Both involve failure to meet a standard; malpractice applies the professional standard.
Malpractice does not require intent and is usually a civil matter; it applies to licensed professionals,
including nurses.
3. Nurse residency programs for new graduates have been shown to:
A. Replace licensure exams
B. Increase turnover
C. Reduce patient safety
D. Improve retention, confidence and competence during the first year
Correct Answer: D. Improve retention, confidence and competence during the first year
Rationale: Structured residencies (e.g., the Vizient/AACN model) reduce first-year turnover, which can
otherwise exceed 20%. They supplement, not replace, orientation and licensure.
,4. The Nurse Licensure Compact (NLC) allows a nurse to:
A. Practice in any country
B. Hold one multistate license to practice in other compact states
C. Skip the NCLEX
D. Practice as an advanced practice nurse without certification
Correct Answer: B. Hold one multistate license to practice in other compact states
Rationale: The NLC lets RNs and LPNs with a multistate license, issued by their primary state of
residence, practice in other participating states. It does not cover APRN practice or remove licensure
exams.
5. A new nurse is asked to float to an unfamiliar specialty unit. The most appropriate action is to:
A. Refuse to go
B. Accept every task without telling anyone
C. Accept assignments within competence and inform the charge nurse of skills not yet mastered
D. Leave the hospital
Correct Answer: C. Accept assignments within competence and inform the charge nurse of
skills not yet mastered
Rationale: Nurses can float but should accept only care they are competent to provide and communicate
limits so safe assignments are made. Refusing outright may be treated as insubordination, while silently
accepting care beyond competence risks patient harm.
6. The NGN NCLEX-RN has a minimum and maximum number of items of:
A. 75 and 265
B. 85 and 150
C. 60 and 145
D. 100 and 200
Correct Answer: B. 85 and 150
Rationale: Since April 2023, the RN exam ranges from 85 to 150 items, including 15 unscored pretest
items, with a 5-hour time limit. The old 75-265 range no longer applies.
,7. Patient abandonment occurs when a nurse:
A. Leaves an assignment after accepting it without ensuring a qualified nurse takes over
B. Refuses an assignment before accepting it, with explanation
C. Takes a scheduled break with coverage
D. Completes a shift and gives report
Correct Answer: A. Leaves an assignment after accepting it without ensuring a qualified
nurse takes over
Rationale: Abandonment requires accepting the patient care assignment and then leaving without proper
handoff. Declining before acceptance, with notice, is not abandonment.
8. The six cognitive steps of the NCSBN Clinical Judgment Measurement Model begin with:
A. Recognize cues
B. Take action
C. Evaluate outcomes
D. Generate solutions
Correct Answer: A. Recognize cues
Rationale: The sequence is recognize cues, analyze cues, prioritize hypotheses, generate solutions, take
action and evaluate outcomes. Starting with action skips the assessment needed to choose the right
action.
9. A client with type 1 diabetes has a glucose of 450 mg/dL, Kussmaul respirations and fruity
breath. The priority intervention is:
A. Oral glucose
B. IV fluid replacement with 0.9% normal saline
C. Subcutaneous long-acting insulin only
D. Restricting fluids
Correct Answer: B. IV fluid replacement with 0.9% normal saline
Rationale: DKA treatment starts with fluid resuscitation, then IV regular insulin with potassium monitoring
and replacement. Oral glucose would worsen hyperglycemia, long-acting insulin alone is too slow, and
restricting fluids worsens the severe dehydration of DKA.
, 10. A client receiving IV potassium reports burning at the IV site. The nurse should first:
A. Increase the rate to finish faster
B. Stop or slow the infusion and assess the site for infiltration or phlebitis
C. Apply heat and continue
D. Ignore it as expected
Correct Answer: B. Stop or slow the infusion and assess the site for infiltration or phlebitis
Rationale: Potassium is irritating to veins; burning may indicate phlebitis or infiltration. Never give
potassium IV push. Increasing the rate or applying heat and continuing could worsen tissue damage;
potassium can cause severe vein irritation and necrosis if it infiltrates.
11. The 'Recognize cues' step of clinical judgment involves:
A. Identifying relevant and important information from the client data
B. Implementing interventions
C. Evaluating outcomes
D. Ranking hypotheses
Correct Answer: A. Identifying relevant and important information from the client data
Rationale: Recognizing which data matter, such as abnormal vitals or changes from baseline, is the first
step in the NCSBN model. Implementing interventions and evaluating outcomes come later; without
recognizing the relevant cues, the nurse cannot identify the right problem.
12. A client is prescribed a new antibiotic and develops hives, wheezing and throat tightness.
The first action is to:
A. Give oral diphenhydramine only
B. Stop the infusion and administer epinephrine IM per protocol
C. Continue the infusion slowly
D. Document and observe
Correct Answer: B. Stop the infusion and administer epinephrine IM per protocol
Rationale: This is anaphylaxis. IM epinephrine in the anterolateral thigh is first-line; antihistamines are
adjuncts. Oral antihistamines alone are too slow and do not reverse airway swelling or shock; continuing
the infusion worsens the reaction.
