1|Page
NUR 283 COMP 1 EXAM ULTIMATE
STUDY GUIDE | 200 PRACTICE
QUESTIONS & ANSWERS WITH
RATIONALES FOR GALEN
COLLEGE OF NURSING
This comprehensive NUR 283 Comp 1 Exam Study Guide contains
200+ multiple-choice questions with correct answers and detailed
rationales in Galen format. Covers all key content areas: Medical-
Surgical Nursing (Cardiovascular, Respiratory, GI, Renal, Endocrine),
Pediatrics (growth & development, bronchiolitis, pertussis, VP shunt,
immunizations), Obstetrics (stages of labor, postpartum hemorrhage,
fundal assessment, fetal monitoring), Pharmacology (digoxin,
heparin, warfarin, insulin, gentamicin, vancomycin, psych meds),
Prioritization & Delegation (ABCs, Maslow, RN vs LPN vs UAP
scope), Acid-Base Balance, Mental Health, Oncology, and
Neurological Disorders. Includes high-yield NCLEX-style questions
with priority nursing interventions, delegation scenarios, and clinical
judgment. Perfect for Galen College of Nursing students preparing for
Comp 1. Pass with confidence!
,2|Page
1. Which of the following clients should the nurse assess first after receiving a
hand-off report on a pediatric unit?
A) A toddler with bronchiolitis on room air with mild wheezing
B) An infant diagnosed with pertussis who is receiving oxygen via nasal cannula
C) A preschooler with otitis media awaiting discharge
D) A school-age child with a simple fracture in a cast
*B) An infant diagnosed with pertussis who is receiving oxygen via nasal
cannula
Rationale: Infants with pertussis are at high risk for apnea and severe respiratory
compromise. Any child on supplemental oxygen with a respiratory diagnosis takes
priority over stable conditions, as early recognition is essential for pediatric safety .
2. A charge nurse is making client assignments on a medical-surgical unit.
Which client should the nurse assign to an LPN (Licensed Practical Nurse)?
A) A client who is 24 hours post-operative following a total knee replacement with
stable vital signs
B) A client with a new tracheostomy requiring initial tracheostomy care teaching
C) A client with a chest tube who requires assessment of breath sounds every 2 hours
D) A client with a new diagnosis of diabetes requiring initial insulin pump education
*A) A client who is 24 hours post-operative following a total knee replacement
with stable vital signs
Rationale: LPNs can provide care for clients with stable, predictable conditions,
reinforce teaching, administer PO/SQ/IM medications, and perform wound care. Initial
assessments, unstable clients, and complex teaching are the responsibility of the RN .
3. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which
task is within the scope of practice for a UAP?
A) Administering a tap water enema
B) Assessing a client's lung sounds
C) Administering oral medications
D) Reinforcing dietary teaching
*A) Administering a tap water enema
Rationale: UAPs can perform tasks such as changing linens, obtaining vital signs (but
,3|Page
not new ones), reminding clients of care, and administering a tap water enema (not a
Fleet enema). Assessment, medication administration, and teaching are outside their
scope .
4. A nurse is caring for a postpartum client who is 1 hour post-delivery. The
nurse notes that the client's perineal pad is saturated with lochia rubra in 15
minutes. Which action should the nurse take first?
A) Document the finding as normal
B) Notify the healthcare provider
C) Assess the fundus and perform fundal massage
D) Administer prescribed oxytocin
*C) Assess the fundus and perform fundal massage
Rationale: Saturation of a pad in 15 minutes indicates excessive bleeding. The priority
is to assess the fundus for atony and perform fundal massage to stimulate uterine
contraction. Further interventions like oxytocin or provider notification follow the initial
assessment .
5. A nurse is caring for a client with a boggy uterus that is deviated to the right.
The nurse should first:
A) Notify the healthcare provider immediately
B) Perform fundal massage
C) Assist the client to void
D) Administer methergine
*C) Assist the client to void
Rationale: A boggy uterus deviated to the side (usually right) is a classic sign of a full
bladder displacing the uterus. The first intervention is to assist the client to void, which
allows the uterus to contract and become firm .
6. A nurse is planning care for a client in the active phase of the first stage of
labor. Which intervention is appropriate for this phase?
A) Providing emotional support and breathing techniques
B) Encouraging the client to push with each contraction
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C) Preparing for the delivery of the placenta
D) Monitoring the client for signs of infection
*A) Providing emotional support and breathing techniques
Rationale: The active phase (4–7 cm dilation) involves pain management, oxytocin,
epidural, and breathing techniques. Pushing occurs at 10 cm in the transition phase,
and placental delivery is stage 3 .
7. A nurse is assessing a client in the transition phase of labor (8–10 cm). Which
finding is expected?
A) The client reports decreased anxiety
B) The client has an urge to have a bowel movement
C) Contractions are less frequent and intense
D) The client is not yet fully effaced
*B) The client has an urge to have a bowel movement
Rationale: The transition phase (8–10 cm, 100% effacement) is characterized by
increased anxiety, nausea, vomiting, and an urge to have a bowel movement due to
fetal descent .
8. A nurse is caring for a client who is in labor and receiving fetal heart
monitoring. The fetal heart rate (FHR) is 180. Which of the following actions
should the nurse take?
A) Turn the client to the left side
B) Administer oxygen at 2 L/min
C) Notify the healthcare provider immediately
D) Document the finding as normal
*A) Turn the client to the left side
Rationale: A fetal heart rate of 180 is tachycardic, indicating possible fetal distress.
Turning the client to the left side improves placental perfusion by relieving aortocaval
compression. This is the first-line intervention before further actions .
9. The nurse is caring for a pediatric client who is postoperative following
ventriculoperitoneal (VP) shunt placement. The nurse notes that the client has
NUR 283 COMP 1 EXAM ULTIMATE
STUDY GUIDE | 200 PRACTICE
QUESTIONS & ANSWERS WITH
RATIONALES FOR GALEN
COLLEGE OF NURSING
This comprehensive NUR 283 Comp 1 Exam Study Guide contains
200+ multiple-choice questions with correct answers and detailed
rationales in Galen format. Covers all key content areas: Medical-
Surgical Nursing (Cardiovascular, Respiratory, GI, Renal, Endocrine),
Pediatrics (growth & development, bronchiolitis, pertussis, VP shunt,
immunizations), Obstetrics (stages of labor, postpartum hemorrhage,
fundal assessment, fetal monitoring), Pharmacology (digoxin,
heparin, warfarin, insulin, gentamicin, vancomycin, psych meds),
Prioritization & Delegation (ABCs, Maslow, RN vs LPN vs UAP
scope), Acid-Base Balance, Mental Health, Oncology, and
Neurological Disorders. Includes high-yield NCLEX-style questions
with priority nursing interventions, delegation scenarios, and clinical
judgment. Perfect for Galen College of Nursing students preparing for
Comp 1. Pass with confidence!
,2|Page
1. Which of the following clients should the nurse assess first after receiving a
hand-off report on a pediatric unit?
A) A toddler with bronchiolitis on room air with mild wheezing
B) An infant diagnosed with pertussis who is receiving oxygen via nasal cannula
C) A preschooler with otitis media awaiting discharge
D) A school-age child with a simple fracture in a cast
*B) An infant diagnosed with pertussis who is receiving oxygen via nasal
cannula
Rationale: Infants with pertussis are at high risk for apnea and severe respiratory
compromise. Any child on supplemental oxygen with a respiratory diagnosis takes
priority over stable conditions, as early recognition is essential for pediatric safety .
2. A charge nurse is making client assignments on a medical-surgical unit.
Which client should the nurse assign to an LPN (Licensed Practical Nurse)?
A) A client who is 24 hours post-operative following a total knee replacement with
stable vital signs
B) A client with a new tracheostomy requiring initial tracheostomy care teaching
C) A client with a chest tube who requires assessment of breath sounds every 2 hours
D) A client with a new diagnosis of diabetes requiring initial insulin pump education
*A) A client who is 24 hours post-operative following a total knee replacement
with stable vital signs
Rationale: LPNs can provide care for clients with stable, predictable conditions,
reinforce teaching, administer PO/SQ/IM medications, and perform wound care. Initial
assessments, unstable clients, and complex teaching are the responsibility of the RN .
3. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which
task is within the scope of practice for a UAP?
A) Administering a tap water enema
B) Assessing a client's lung sounds
C) Administering oral medications
D) Reinforcing dietary teaching
*A) Administering a tap water enema
Rationale: UAPs can perform tasks such as changing linens, obtaining vital signs (but
,3|Page
not new ones), reminding clients of care, and administering a tap water enema (not a
Fleet enema). Assessment, medication administration, and teaching are outside their
scope .
4. A nurse is caring for a postpartum client who is 1 hour post-delivery. The
nurse notes that the client's perineal pad is saturated with lochia rubra in 15
minutes. Which action should the nurse take first?
A) Document the finding as normal
B) Notify the healthcare provider
C) Assess the fundus and perform fundal massage
D) Administer prescribed oxytocin
*C) Assess the fundus and perform fundal massage
Rationale: Saturation of a pad in 15 minutes indicates excessive bleeding. The priority
is to assess the fundus for atony and perform fundal massage to stimulate uterine
contraction. Further interventions like oxytocin or provider notification follow the initial
assessment .
5. A nurse is caring for a client with a boggy uterus that is deviated to the right.
The nurse should first:
A) Notify the healthcare provider immediately
B) Perform fundal massage
C) Assist the client to void
D) Administer methergine
*C) Assist the client to void
Rationale: A boggy uterus deviated to the side (usually right) is a classic sign of a full
bladder displacing the uterus. The first intervention is to assist the client to void, which
allows the uterus to contract and become firm .
6. A nurse is planning care for a client in the active phase of the first stage of
labor. Which intervention is appropriate for this phase?
A) Providing emotional support and breathing techniques
B) Encouraging the client to push with each contraction
, 4|Page
C) Preparing for the delivery of the placenta
D) Monitoring the client for signs of infection
*A) Providing emotional support and breathing techniques
Rationale: The active phase (4–7 cm dilation) involves pain management, oxytocin,
epidural, and breathing techniques. Pushing occurs at 10 cm in the transition phase,
and placental delivery is stage 3 .
7. A nurse is assessing a client in the transition phase of labor (8–10 cm). Which
finding is expected?
A) The client reports decreased anxiety
B) The client has an urge to have a bowel movement
C) Contractions are less frequent and intense
D) The client is not yet fully effaced
*B) The client has an urge to have a bowel movement
Rationale: The transition phase (8–10 cm, 100% effacement) is characterized by
increased anxiety, nausea, vomiting, and an urge to have a bowel movement due to
fetal descent .
8. A nurse is caring for a client who is in labor and receiving fetal heart
monitoring. The fetal heart rate (FHR) is 180. Which of the following actions
should the nurse take?
A) Turn the client to the left side
B) Administer oxygen at 2 L/min
C) Notify the healthcare provider immediately
D) Document the finding as normal
*A) Turn the client to the left side
Rationale: A fetal heart rate of 180 is tachycardic, indicating possible fetal distress.
Turning the client to the left side improves placental perfusion by relieving aortocaval
compression. This is the first-line intervention before further actions .
9. The nurse is caring for a pediatric client who is postoperative following
ventriculoperitoneal (VP) shunt placement. The nurse notes that the client has
