Galen NSG 4800 Transition to Professional Nursing Practice:
Exam 1 - Questions with Correct Answers
100 questions
1. A nurse suspects a colleague is diverting opioids. The nurse should:
A. Confront the colleague publicly
B. Ignore it to avoid conflict
C. Report the concern through the chain of command per policy
D. Post about it online
Correct Answer: C. Report the concern through the chain of command per policy
Rationale: Diversion endangers patients and the impaired nurse. Following policy ensures a proper
investigation and access to help. Public confrontation can escalate and compromise an investigation,
while ignoring it leaves patients without their medications and the colleague without help.
2. Duchscher's transition shock model identifies the first 4 months of practice as a period of:
A. Knowing: full confidence
B. Being: stable integration
C. Doing: intense adjustment, with fear of failing and feelings of inadequacy
D. Retirement planning
Correct Answer: C. Doing: intense adjustment, with fear of failing and feelings of inadequacy
Rationale: Duchscher's stages are doing, being and knowing. The 'doing' stage is the hardest, so
residency programs and preceptors focus support on these months.
3. Accepting a large gift from a patient's family is generally:
A. Inappropriate; follow facility policy, which often allows only token items shared with staff
B. Encouraged
C. Required
D. Always legal and ethical
Correct Answer: A. Inappropriate; follow facility policy, which often allows only token items
shared with staff
Rationale: Gifts can create obligations and blur boundaries. Even well-meant gifts can create a sense of
obligation or favoritism, which is why policies limit them.
,4. Magnet Recognition is awarded by:
A. The Joint Commission
B. CMS
C. The state board of nursing
D. The American Nurses Credentialing Center (ANCC)
Correct Answer: D. The American Nurses Credentialing Center (ANCC)
Rationale: Magnet recognizes nursing excellence based on transformational leadership, structural
empowerment, exemplary practice, new knowledge and outcomes.
5. Cultural competence in professional practice includes:
A. Treating all patients identically
B. Assuming beliefs based on ethnicity
C. Avoiding discussion of culture
D. Self-awareness of biases and respect for patients' beliefs while providing individualized care
Correct Answer: D. Self-awareness of biases and respect for patients' beliefs while providing
individualized care
Rationale: Individualized, respectful care improves outcomes; stereotyping does not. Treating every
patient identically or assuming beliefs from ethnicity ignores individual preferences.
6. When answering behavioral interview questions, the STAR method stands for:
A. Skills, Training, Attitude, Responsibility
B. Situation, Task, Action, Result
C. Start, Talk, Ask, Reply
D. Strengths, Talents, Abilities, Résumé
Correct Answer: B. Situation, Task, Action, Result
Rationale: STAR responses give concrete examples of past performance. Behavioral questions ask how
you handled past situations; STAR gives a clear structure for a concise, specific answer.
,7. A nurse with a multistate license moves permanently to another compact state. The nurse
must:
A. Keep the old license indefinitely
B. Apply for licensure in the new primary state of residence within the allowed time
C. Retake the NCLEX
D. Stop practicing
Correct Answer: B. Apply for licensure in the new primary state of residence within the
allowed time
Rationale: The multistate license is tied to the primary state of residence. The license follows the nurse's
primary state of residence, so a permanent move requires applying in the new home state.
8. A state board of nursing may take disciplinary action against a nurse for:
A. Joining a professional organization
B. Refusing overtime when not mandated
C. Practicing while impaired, fraud, or practicing outside the scope of practice
D. Earning a graduate degree
Correct Answer: C. Practicing while impaired, fraud, or practicing outside the scope of
practice
Rationale: Boards investigate conduct that endangers the public, such as impairment, diversion, falsifying
records or practice violations. Professional growth and lawful refusal of voluntary overtime are not
grounds for discipline.
9. A newborn has a respiratory rate of 72/min, grunting and nasal flaring. The nurse should:
A. Document as normal newborn breathing
B. Feed the infant
C. Notify the provider and support respiration
D. Wrap the infant tightly
Correct Answer: C. Notify the provider and support respiration
Rationale: Newborn respiratory rate is normally 30-60/min. Grunting and flaring signal respiratory
distress. Feeding a newborn in respiratory distress risks aspiration, and tight wrapping does not address
the breathing problem.
, 10. An acute problem generally takes priority over a chronic problem because:
A. Chronic problems never matter
B. Chronic problems are always stable
C. Acute problems are always minor
D. Acute changes signal new instability requiring intervention
Correct Answer: D. Acute changes signal new instability requiring intervention
Rationale: A sudden change from baseline is often the earliest sign of deterioration. Expected findings for
a chronic condition are usually lower priority.
11. A client admitted with community-acquired pneumonia becomes newly confused, with RR
28, BP 92/58 and temperature 39 C. The nurse recognizes these findings as:
A. Expected findings with pneumonia
B. Possible sepsis requiring rapid escalation (positive qSOFA)
C. Dehydration only
D. Anxiety
Correct Answer: B. Possible sepsis requiring rapid escalation (positive qSOFA)
Rationale: Altered mentation, respiratory rate of 22 or higher and systolic BP of 100 or lower meet
qSOFA criteria suggesting sepsis with higher mortality risk. Treating these as expected pneumonia
findings delays the sepsis bundle.
12. A client with a history of seizures begins having a tonic-clonic seizure. The nurse's first
action is to:
A. Protect the client from injury and turn to the side if possible
B. Insert an oral airway by force
C. Restrain the client's limbs
D. Give oral medication
Correct Answer: A. Protect the client from injury and turn to the side if possible
Rationale: Never force objects into the mouth or restrain. Side-lying maintains the airway; time the
seizure and give rescue medication per order. Forcing an airway in or restraining limbs can cause injury,
and nothing should be given by mouth during a seizure.
Exam 1 - Questions with Correct Answers
100 questions
1. A nurse suspects a colleague is diverting opioids. The nurse should:
A. Confront the colleague publicly
B. Ignore it to avoid conflict
C. Report the concern through the chain of command per policy
D. Post about it online
Correct Answer: C. Report the concern through the chain of command per policy
Rationale: Diversion endangers patients and the impaired nurse. Following policy ensures a proper
investigation and access to help. Public confrontation can escalate and compromise an investigation,
while ignoring it leaves patients without their medications and the colleague without help.
2. Duchscher's transition shock model identifies the first 4 months of practice as a period of:
A. Knowing: full confidence
B. Being: stable integration
C. Doing: intense adjustment, with fear of failing and feelings of inadequacy
D. Retirement planning
Correct Answer: C. Doing: intense adjustment, with fear of failing and feelings of inadequacy
Rationale: Duchscher's stages are doing, being and knowing. The 'doing' stage is the hardest, so
residency programs and preceptors focus support on these months.
3. Accepting a large gift from a patient's family is generally:
A. Inappropriate; follow facility policy, which often allows only token items shared with staff
B. Encouraged
C. Required
D. Always legal and ethical
Correct Answer: A. Inappropriate; follow facility policy, which often allows only token items
shared with staff
Rationale: Gifts can create obligations and blur boundaries. Even well-meant gifts can create a sense of
obligation or favoritism, which is why policies limit them.
,4. Magnet Recognition is awarded by:
A. The Joint Commission
B. CMS
C. The state board of nursing
D. The American Nurses Credentialing Center (ANCC)
Correct Answer: D. The American Nurses Credentialing Center (ANCC)
Rationale: Magnet recognizes nursing excellence based on transformational leadership, structural
empowerment, exemplary practice, new knowledge and outcomes.
5. Cultural competence in professional practice includes:
A. Treating all patients identically
B. Assuming beliefs based on ethnicity
C. Avoiding discussion of culture
D. Self-awareness of biases and respect for patients' beliefs while providing individualized care
Correct Answer: D. Self-awareness of biases and respect for patients' beliefs while providing
individualized care
Rationale: Individualized, respectful care improves outcomes; stereotyping does not. Treating every
patient identically or assuming beliefs from ethnicity ignores individual preferences.
6. When answering behavioral interview questions, the STAR method stands for:
A. Skills, Training, Attitude, Responsibility
B. Situation, Task, Action, Result
C. Start, Talk, Ask, Reply
D. Strengths, Talents, Abilities, Résumé
Correct Answer: B. Situation, Task, Action, Result
Rationale: STAR responses give concrete examples of past performance. Behavioral questions ask how
you handled past situations; STAR gives a clear structure for a concise, specific answer.
,7. A nurse with a multistate license moves permanently to another compact state. The nurse
must:
A. Keep the old license indefinitely
B. Apply for licensure in the new primary state of residence within the allowed time
C. Retake the NCLEX
D. Stop practicing
Correct Answer: B. Apply for licensure in the new primary state of residence within the
allowed time
Rationale: The multistate license is tied to the primary state of residence. The license follows the nurse's
primary state of residence, so a permanent move requires applying in the new home state.
8. A state board of nursing may take disciplinary action against a nurse for:
A. Joining a professional organization
B. Refusing overtime when not mandated
C. Practicing while impaired, fraud, or practicing outside the scope of practice
D. Earning a graduate degree
Correct Answer: C. Practicing while impaired, fraud, or practicing outside the scope of
practice
Rationale: Boards investigate conduct that endangers the public, such as impairment, diversion, falsifying
records or practice violations. Professional growth and lawful refusal of voluntary overtime are not
grounds for discipline.
9. A newborn has a respiratory rate of 72/min, grunting and nasal flaring. The nurse should:
A. Document as normal newborn breathing
B. Feed the infant
C. Notify the provider and support respiration
D. Wrap the infant tightly
Correct Answer: C. Notify the provider and support respiration
Rationale: Newborn respiratory rate is normally 30-60/min. Grunting and flaring signal respiratory
distress. Feeding a newborn in respiratory distress risks aspiration, and tight wrapping does not address
the breathing problem.
, 10. An acute problem generally takes priority over a chronic problem because:
A. Chronic problems never matter
B. Chronic problems are always stable
C. Acute problems are always minor
D. Acute changes signal new instability requiring intervention
Correct Answer: D. Acute changes signal new instability requiring intervention
Rationale: A sudden change from baseline is often the earliest sign of deterioration. Expected findings for
a chronic condition are usually lower priority.
11. A client admitted with community-acquired pneumonia becomes newly confused, with RR
28, BP 92/58 and temperature 39 C. The nurse recognizes these findings as:
A. Expected findings with pneumonia
B. Possible sepsis requiring rapid escalation (positive qSOFA)
C. Dehydration only
D. Anxiety
Correct Answer: B. Possible sepsis requiring rapid escalation (positive qSOFA)
Rationale: Altered mentation, respiratory rate of 22 or higher and systolic BP of 100 or lower meet
qSOFA criteria suggesting sepsis with higher mortality risk. Treating these as expected pneumonia
findings delays the sepsis bundle.
12. A client with a history of seizures begins having a tonic-clonic seizure. The nurse's first
action is to:
A. Protect the client from injury and turn to the side if possible
B. Insert an oral airway by force
C. Restrain the client's limbs
D. Give oral medication
Correct Answer: A. Protect the client from injury and turn to the side if possible
Rationale: Never force objects into the mouth or restrain. Side-lying maintains the airway; time the
seizure and give rescue medication per order. Forcing an airway in or restraining limbs can cause injury,
and nothing should be given by mouth during a seizure.
