Galen NSG 4800 Transition to Professional Nursing Practice:
Exam 2 - Questions with Correct Answers
100 questions
1. Time management for a new nurse is improved by:
A. Completing all charting at the end of shift
B. Doing tasks in room-number order
C. Using a shift 'brain sheet,' clustering care and prioritizing by patient acuity
D. Skipping assessments
Correct Answer: C. Using a shift 'brain sheet,' clustering care and prioritizing by patient
acuity
Rationale: Organization tools and prioritization based on patient needs prevent missed care. Delaying
charting increases errors and late entries. Charting everything at the end of shift leads to omissions and
late entries, and room-number order ignores which patients need attention first.
2. Specialty certification (e.g., CCRN, CMSRN) demonstrates:
A. Basic licensure
B. Validated expertise in a specialty beyond basic licensure
C. A graduate degree
D. Board discipline
Correct Answer: B. Validated expertise in a specialty beyond basic licensure
Rationale: Certification requires experience and an exam and is linked to improved outcomes.
Certification goes beyond basic licensure and is not a degree; it validates specialty knowledge through
experience and examination.
3. Collective bargaining for nurses is:
A. Required in all states
B. Illegal for nurses
C. Done by the board of nursing
D. Negotiation between a union and an employer over wages, benefits and working conditions
Correct Answer: D. Negotiation between a union and an employer over wages, benefits and
working conditions
Rationale: Union representation varies; the board of nursing does not negotiate employment terms. It is
legal for nurses in many settings and is separate from the board of nursing, which regulates practice
rather than employment terms.
,4. Evidence-based practice integrates:
A. Tradition only
B. Best research evidence, clinical expertise and patient preferences and values
C. Physician preference only
D. Cost only
Correct Answer: B. Best research evidence, clinical expertise and patient preferences and
values
Rationale: Sackett's model includes all three; ignoring patient values or relying on tradition can lead to
inappropriate care. Practice based only on tradition, physician preference or cost can ignore better
evidence or what matters to the patient.
5. The nurse's responsibility regarding personal health and impairment includes:
A. Not practicing when impaired and seeking help through peer assistance or alternative-to-discipline
programs
B. Hiding impairment
C. Self-medicating at work
D. Ignoring colleagues' impairment
Correct Answer: A. Not practicing when impaired and seeking help through peer assistance
or alternative-to-discipline programs
Rationale: Most boards offer confidential alternative-to-discipline programs. Reporting an impaired
colleague protects patients and the colleague. Hiding impairment or self-medicating at work endangers
patients, while early help through alternative programs often preserves the nurse's license.
6. The Joint Commission's primary role is to:
A. License nurses
B. Pay Medicare claims
C. Accredit and certify health care organizations based on quality and safety standards
D. Write the NCLEX
Correct Answer: C. Accredit and certify health care organizations based on quality and safety
standards
Rationale: TJC also publishes National Patient Safety Goals. Licensure is a state board function. TJC
does not license nurses or pay claims; its accreditation standards and National Patient Safety Goals drive
many hospital safety practices.
,7. Lateral (horizontal) violence among nurses includes:
A. Eye-rolling, sabotage, gossip and withholding information
B. Providing constructive feedback
C. Precepting new staff
D. Reporting unsafe practice
Correct Answer: A. Eye-rolling, sabotage, gossip and withholding information
Rationale: Incivility harms retention and patient safety. Feedback and reporting unsafe practice are
professional responsibilities, not bullying. Constructive feedback, precepting and reporting unsafe practice
support safety; incivility undermines teamwork and drives new nurses out of the profession.
8. The Institute of Medicine (now National Academy of Medicine) report 'The Future of Nursing'
(2010) recommended:
A. Eliminating nursing degrees
B. Increasing the proportion of BSN-prepared nurses to 80% by 2020
C. Reducing nurse education
D. Ending nurse residencies
Correct Answer: B. Increasing the proportion of BSN-prepared nurses to 80% by 2020
Rationale: It also recommended residency programs and doubling nurses with doctorates. The report
called for more education and support for nurses, not less, including residency programs and more
doctorally prepared nurses.
9. A client who had a total thyroidectomy has stridor. The priority equipment is:
A. A tracheostomy tray at the bedside
B. A urinary catheter
C. A feeding tube
D. A heating pad
Correct Answer: A. A tracheostomy tray at the bedside
Rationale: Laryngeal edema, hemorrhage or nerve injury can obstruct the airway. Emergency airway
equipment should be readily available. A urinary catheter, feeding tube and heating pad do not address
airway obstruction.
, 10. Which client is most at risk for airway compromise?
A. A client with partial-thickness burns to the face and singed nasal hairs
B. A client with a full-thickness burn to the leg
C. A client with a sunburn on the back
D. A client with a burn on the hand
Correct Answer: A. A client with partial-thickness burns to the face and singed nasal hairs
Rationale: Facial burns and singed nasal hair suggest inhalation injury, which can cause rapid airway
edema; early intubation may be needed. Burns to the leg, back or hand are serious but do not threaten
the airway; facial burns with singed nasal hair can cause rapid swelling.
11. Which client requires the nurse's immediate attention?
A. A client with a potassium of 3.8 mEq/L
B. A client with a sodium of 138 mEq/L
C. A client with a potassium of 6.8 mEq/L and peaked T waves
D. A client with a glucose of 110 mg/dL
Correct Answer: C. A client with a potassium of 6.8 mEq/L and peaked T waves
Rationale: Severe hyperkalemia with ECG changes can cause life-threatening dysrhythmias. The other
values are within normal ranges. A potassium of 3.8, sodium of 138 and glucose of 110 are normal; a
potassium of 6.8 with ECG changes can cause cardiac arrest.
12. A client admitted with alcohol use disorder, last drink 48 hours ago, has tremors, diaphoresis
and a heart rate of 120. The nurse anticipates:
A. Discharge home
B. Encouraging more fluids only
C. Placing in a dark room only
D. Benzodiazepine administration per CIWA-Ar protocol and seizure precautions
Correct Answer: D. Benzodiazepine administration per CIWA-Ar protocol and seizure
precautions
Rationale: These are signs of moderate to severe withdrawal; benzodiazepines prevent progression to
seizures and delirium tremens, which peaks around 48-72 hours.
Exam 2 - Questions with Correct Answers
100 questions
1. Time management for a new nurse is improved by:
A. Completing all charting at the end of shift
B. Doing tasks in room-number order
C. Using a shift 'brain sheet,' clustering care and prioritizing by patient acuity
D. Skipping assessments
Correct Answer: C. Using a shift 'brain sheet,' clustering care and prioritizing by patient
acuity
Rationale: Organization tools and prioritization based on patient needs prevent missed care. Delaying
charting increases errors and late entries. Charting everything at the end of shift leads to omissions and
late entries, and room-number order ignores which patients need attention first.
2. Specialty certification (e.g., CCRN, CMSRN) demonstrates:
A. Basic licensure
B. Validated expertise in a specialty beyond basic licensure
C. A graduate degree
D. Board discipline
Correct Answer: B. Validated expertise in a specialty beyond basic licensure
Rationale: Certification requires experience and an exam and is linked to improved outcomes.
Certification goes beyond basic licensure and is not a degree; it validates specialty knowledge through
experience and examination.
3. Collective bargaining for nurses is:
A. Required in all states
B. Illegal for nurses
C. Done by the board of nursing
D. Negotiation between a union and an employer over wages, benefits and working conditions
Correct Answer: D. Negotiation between a union and an employer over wages, benefits and
working conditions
Rationale: Union representation varies; the board of nursing does not negotiate employment terms. It is
legal for nurses in many settings and is separate from the board of nursing, which regulates practice
rather than employment terms.
,4. Evidence-based practice integrates:
A. Tradition only
B. Best research evidence, clinical expertise and patient preferences and values
C. Physician preference only
D. Cost only
Correct Answer: B. Best research evidence, clinical expertise and patient preferences and
values
Rationale: Sackett's model includes all three; ignoring patient values or relying on tradition can lead to
inappropriate care. Practice based only on tradition, physician preference or cost can ignore better
evidence or what matters to the patient.
5. The nurse's responsibility regarding personal health and impairment includes:
A. Not practicing when impaired and seeking help through peer assistance or alternative-to-discipline
programs
B. Hiding impairment
C. Self-medicating at work
D. Ignoring colleagues' impairment
Correct Answer: A. Not practicing when impaired and seeking help through peer assistance
or alternative-to-discipline programs
Rationale: Most boards offer confidential alternative-to-discipline programs. Reporting an impaired
colleague protects patients and the colleague. Hiding impairment or self-medicating at work endangers
patients, while early help through alternative programs often preserves the nurse's license.
6. The Joint Commission's primary role is to:
A. License nurses
B. Pay Medicare claims
C. Accredit and certify health care organizations based on quality and safety standards
D. Write the NCLEX
Correct Answer: C. Accredit and certify health care organizations based on quality and safety
standards
Rationale: TJC also publishes National Patient Safety Goals. Licensure is a state board function. TJC
does not license nurses or pay claims; its accreditation standards and National Patient Safety Goals drive
many hospital safety practices.
,7. Lateral (horizontal) violence among nurses includes:
A. Eye-rolling, sabotage, gossip and withholding information
B. Providing constructive feedback
C. Precepting new staff
D. Reporting unsafe practice
Correct Answer: A. Eye-rolling, sabotage, gossip and withholding information
Rationale: Incivility harms retention and patient safety. Feedback and reporting unsafe practice are
professional responsibilities, not bullying. Constructive feedback, precepting and reporting unsafe practice
support safety; incivility undermines teamwork and drives new nurses out of the profession.
8. The Institute of Medicine (now National Academy of Medicine) report 'The Future of Nursing'
(2010) recommended:
A. Eliminating nursing degrees
B. Increasing the proportion of BSN-prepared nurses to 80% by 2020
C. Reducing nurse education
D. Ending nurse residencies
Correct Answer: B. Increasing the proportion of BSN-prepared nurses to 80% by 2020
Rationale: It also recommended residency programs and doubling nurses with doctorates. The report
called for more education and support for nurses, not less, including residency programs and more
doctorally prepared nurses.
9. A client who had a total thyroidectomy has stridor. The priority equipment is:
A. A tracheostomy tray at the bedside
B. A urinary catheter
C. A feeding tube
D. A heating pad
Correct Answer: A. A tracheostomy tray at the bedside
Rationale: Laryngeal edema, hemorrhage or nerve injury can obstruct the airway. Emergency airway
equipment should be readily available. A urinary catheter, feeding tube and heating pad do not address
airway obstruction.
, 10. Which client is most at risk for airway compromise?
A. A client with partial-thickness burns to the face and singed nasal hairs
B. A client with a full-thickness burn to the leg
C. A client with a sunburn on the back
D. A client with a burn on the hand
Correct Answer: A. A client with partial-thickness burns to the face and singed nasal hairs
Rationale: Facial burns and singed nasal hair suggest inhalation injury, which can cause rapid airway
edema; early intubation may be needed. Burns to the leg, back or hand are serious but do not threaten
the airway; facial burns with singed nasal hair can cause rapid swelling.
11. Which client requires the nurse's immediate attention?
A. A client with a potassium of 3.8 mEq/L
B. A client with a sodium of 138 mEq/L
C. A client with a potassium of 6.8 mEq/L and peaked T waves
D. A client with a glucose of 110 mg/dL
Correct Answer: C. A client with a potassium of 6.8 mEq/L and peaked T waves
Rationale: Severe hyperkalemia with ECG changes can cause life-threatening dysrhythmias. The other
values are within normal ranges. A potassium of 3.8, sodium of 138 and glucose of 110 are normal; a
potassium of 6.8 with ECG changes can cause cardiac arrest.
12. A client admitted with alcohol use disorder, last drink 48 hours ago, has tremors, diaphoresis
and a heart rate of 120. The nurse anticipates:
A. Discharge home
B. Encouraging more fluids only
C. Placing in a dark room only
D. Benzodiazepine administration per CIWA-Ar protocol and seizure precautions
Correct Answer: D. Benzodiazepine administration per CIWA-Ar protocol and seizure
precautions
Rationale: These are signs of moderate to severe withdrawal; benzodiazepines prevent progression to
seizures and delirium tremens, which peaks around 48-72 hours.
