Galen NSG 4800 Transition to Professional Nursing Practice:
Final Exam (Comprehensive) - Questions with Correct Answers
100 questions
1. Which client should the charge nurse assign to the float nurse from the obstetrics unit?
A. A client on a ventilator
B. A client with a new tracheostomy and unstable vitals
C. A client requiring titration of vasoactive drips
D. A stable postoperative client receiving routine care
Correct Answer: D. A stable postoperative client receiving routine care
Rationale: Float nurses should receive stable clients with predictable needs that match general nursing
skills. Ventilated clients, unstable tracheostomies and vasoactive drips require specialized skills a float
nurse may lack.
2. A UAP tells the RN they are too busy to complete a delegated task. The RN should:
A. Force the UAP to complete it
B. Ignore the concern
C. Reassess workload, reprioritize or reassign tasks
D. Leave the task
Correct Answer: C. Reassess workload, reprioritize or reassign tasks
Rationale: Effective delegation adapts to changing workload. Forcing completion or ignoring the concern
risks missed or rushed care.
3. A client asks the nurse to witness their will. The nurse should:
A. Always witness it
B. Write the will
C. Follow facility policy, which often prohibits nurses from witnessing legal documents unrelated to
care
D. Refuse rudely
Correct Answer: C. Follow facility policy, which often prohibits nurses from witnessing legal
documents unrelated to care
Rationale: Policies vary; involving legal/social work services may be appropriate. Witnessing legal
documents unrelated to care can create conflicts, so policy often directs these requests elsewhere.
,4. When tying wrist restraints, the nurse should:
A. Tie to the side rail
B. Use a square knot
C. Use a quick-release knot and secure to the bed frame, not the side rail
D. Tie as tightly as possible
Correct Answer: C. Use a quick-release knot and secure to the bed frame, not the side rail
Rationale: Side rails move and can injure; quick-release knots allow rapid removal. Side rails move when
raised or lowered and can injure the client, and tight square knots prevent quick release in an emergency.
5. When transferring a client with left-sided weakness from bed to chair, the nurse should place
the chair:
A. On the client's right (strong) side
B. On the left (weak) side
C. Behind the client
D. Far from the bed
Correct Answer: A. On the client's right (strong) side
Rationale: The client leads with the strong side to bear weight safely. Placing the chair on the weak side
forces the client to pivot on the weaker leg, increasing fall risk.
6. An alert from a smart infusion pump that a dose exceeds limits means the nurse should:
A. Override immediately
B. Turn off the pump
C. Stop and verify the order and programming before proceeding
D. Ignore the alert
Correct Answer: C. Stop and verify the order and programming before proceeding
Rationale: Dose-error reduction software catches programming errors. Overriding without checking or
turning off the pump defeats the safety system.
,7. Clozapine requires monitoring of:
A. Blood glucose only
B. Liver enzymes only
C. Absolute neutrophil count for agranulocytosis
D. Potassium only
Correct Answer: C. Absolute neutrophil count for agranulocytosis
Rationale: Clozapine carries a risk of severe neutropenia; report fever or sore throat. Glucose and lipids
are also monitored, but neutrophil count monitoring is required because agranulocytosis can be fatal.
8. Levothyroxine should be taken:
A. With calcium supplements
B. At bedtime with food
C. Only as needed
D. On an empty stomach in the morning, 30-60 minutes before breakfast
Correct Answer: D. On an empty stomach in the morning, 30-60 minutes before breakfast
Rationale: Absorption is reduced by food, calcium and iron. Calcium and food reduce absorption, and it is
a daily replacement, not an as-needed drug.
9. After a thoracentesis, the nurse should monitor for:
A. Hypertension
B. Pneumothorax, such as sudden dyspnea or decreased breath sounds
C. Hyperglycemia
D. Diarrhea
Correct Answer: B. Pneumothorax, such as sudden dyspnea or decreased breath sounds
Rationale: A chest X-ray is often obtained afterward. The needle can puncture the lung, so watch for
sudden breathing difficulty.
, 10. Ventricular fibrillation is treated first with:
A. Synchronized cardioversion
B. Atropine
C. Adenosine
D. Immediate defibrillation and CPR
Correct Answer: D. Immediate defibrillation and CPR
Rationale: VF is a shockable, pulseless rhythm. Synchronized cardioversion is used for unstable rhythms
with a pulse. Synchronized cardioversion requires an organized rhythm, and atropine and adenosine do
not treat VF.
11. Hyperglycemia signs include:
A. Sweating and tremor
B. Polyuria, polydipsia, polyphagia and blurred vision
C. Bradycardia
D. Hypothermia
Correct Answer: B. Polyuria, polydipsia, polyphagia and blurred vision
Rationale: High glucose pulls water into the urine, causing polyuria, thirst and hunger, and can blur
vision. Sweating, tremor and shakiness are adrenergic signs of hypoglycemia, not hyperglycemia.
12. SIADH causes:
A. Polyuria and dilute urine
B. Hypernatremia
C. Water retention, dilutional hyponatremia and concentrated urine
D. Dehydration
Correct Answer: C. Water retention, dilutional hyponatremia and concentrated urine
Rationale: Treat with fluid restriction; monitor for seizures from low sodium. Polyuria, dilute urine and
hypernatremia describe diabetes insipidus.
Final Exam (Comprehensive) - Questions with Correct Answers
100 questions
1. Which client should the charge nurse assign to the float nurse from the obstetrics unit?
A. A client on a ventilator
B. A client with a new tracheostomy and unstable vitals
C. A client requiring titration of vasoactive drips
D. A stable postoperative client receiving routine care
Correct Answer: D. A stable postoperative client receiving routine care
Rationale: Float nurses should receive stable clients with predictable needs that match general nursing
skills. Ventilated clients, unstable tracheostomies and vasoactive drips require specialized skills a float
nurse may lack.
2. A UAP tells the RN they are too busy to complete a delegated task. The RN should:
A. Force the UAP to complete it
B. Ignore the concern
C. Reassess workload, reprioritize or reassign tasks
D. Leave the task
Correct Answer: C. Reassess workload, reprioritize or reassign tasks
Rationale: Effective delegation adapts to changing workload. Forcing completion or ignoring the concern
risks missed or rushed care.
3. A client asks the nurse to witness their will. The nurse should:
A. Always witness it
B. Write the will
C. Follow facility policy, which often prohibits nurses from witnessing legal documents unrelated to
care
D. Refuse rudely
Correct Answer: C. Follow facility policy, which often prohibits nurses from witnessing legal
documents unrelated to care
Rationale: Policies vary; involving legal/social work services may be appropriate. Witnessing legal
documents unrelated to care can create conflicts, so policy often directs these requests elsewhere.
,4. When tying wrist restraints, the nurse should:
A. Tie to the side rail
B. Use a square knot
C. Use a quick-release knot and secure to the bed frame, not the side rail
D. Tie as tightly as possible
Correct Answer: C. Use a quick-release knot and secure to the bed frame, not the side rail
Rationale: Side rails move and can injure; quick-release knots allow rapid removal. Side rails move when
raised or lowered and can injure the client, and tight square knots prevent quick release in an emergency.
5. When transferring a client with left-sided weakness from bed to chair, the nurse should place
the chair:
A. On the client's right (strong) side
B. On the left (weak) side
C. Behind the client
D. Far from the bed
Correct Answer: A. On the client's right (strong) side
Rationale: The client leads with the strong side to bear weight safely. Placing the chair on the weak side
forces the client to pivot on the weaker leg, increasing fall risk.
6. An alert from a smart infusion pump that a dose exceeds limits means the nurse should:
A. Override immediately
B. Turn off the pump
C. Stop and verify the order and programming before proceeding
D. Ignore the alert
Correct Answer: C. Stop and verify the order and programming before proceeding
Rationale: Dose-error reduction software catches programming errors. Overriding without checking or
turning off the pump defeats the safety system.
,7. Clozapine requires monitoring of:
A. Blood glucose only
B. Liver enzymes only
C. Absolute neutrophil count for agranulocytosis
D. Potassium only
Correct Answer: C. Absolute neutrophil count for agranulocytosis
Rationale: Clozapine carries a risk of severe neutropenia; report fever or sore throat. Glucose and lipids
are also monitored, but neutrophil count monitoring is required because agranulocytosis can be fatal.
8. Levothyroxine should be taken:
A. With calcium supplements
B. At bedtime with food
C. Only as needed
D. On an empty stomach in the morning, 30-60 minutes before breakfast
Correct Answer: D. On an empty stomach in the morning, 30-60 minutes before breakfast
Rationale: Absorption is reduced by food, calcium and iron. Calcium and food reduce absorption, and it is
a daily replacement, not an as-needed drug.
9. After a thoracentesis, the nurse should monitor for:
A. Hypertension
B. Pneumothorax, such as sudden dyspnea or decreased breath sounds
C. Hyperglycemia
D. Diarrhea
Correct Answer: B. Pneumothorax, such as sudden dyspnea or decreased breath sounds
Rationale: A chest X-ray is often obtained afterward. The needle can puncture the lung, so watch for
sudden breathing difficulty.
, 10. Ventricular fibrillation is treated first with:
A. Synchronized cardioversion
B. Atropine
C. Adenosine
D. Immediate defibrillation and CPR
Correct Answer: D. Immediate defibrillation and CPR
Rationale: VF is a shockable, pulseless rhythm. Synchronized cardioversion is used for unstable rhythms
with a pulse. Synchronized cardioversion requires an organized rhythm, and atropine and adenosine do
not treat VF.
11. Hyperglycemia signs include:
A. Sweating and tremor
B. Polyuria, polydipsia, polyphagia and blurred vision
C. Bradycardia
D. Hypothermia
Correct Answer: B. Polyuria, polydipsia, polyphagia and blurred vision
Rationale: High glucose pulls water into the urine, causing polyuria, thirst and hunger, and can blur
vision. Sweating, tremor and shakiness are adrenergic signs of hypoglycemia, not hyperglycemia.
12. SIADH causes:
A. Polyuria and dilute urine
B. Hypernatremia
C. Water retention, dilutional hyponatremia and concentrated urine
D. Dehydration
Correct Answer: C. Water retention, dilutional hyponatremia and concentrated urine
Rationale: Treat with fluid restriction; monitor for seizures from low sodium. Polyuria, dilute urine and
hypernatremia describe diabetes insipidus.
