Galen College of Nursing — NUR 283 Comp 3 Review, Updated Fall 2025/2027.

Galen College of Nursing — NUR 283 Comp 3 Review, Updated Fall 2026 ### 1. The nurse is serving as a member on the continuous quality improvement (CQI) committee. The committee has been assigned to develop a program to reduce the number of medication administration errors following a recent sentinel event at the facility. Which of the following strategies should the committee plan to initiate first? A. Identify the key performance indicators (KPIs) of the medication administration error. B. Review the events that led to the medication administration error by creating a flow diagram. C. Provide an inservice to staff nurses on safe medication administration practices. D. Develop a quality improvement program for nurses involved in medication administration errors. ### 2. The nurse has attended a conference on informed consent. It indicates a correct understanding of the conference if the nurse states that informed consent: A. Can be waived, per facility policy, for urgent medical or surgical treatment if the client is unconscious. B. May not be withdrawn by the client once they have confirmed understanding and signed the consent. C. Can be signed by a client who has dementia if they are oriented at the time of signing the form. D. Is signed by the nurse to indicate that the client understands the procedure. ### 3. The nurse is prioritizing client care after receiving the hand-off report. The nurse should first plan to see the client who: A. Has pancreatitis and is reporting mid-epigastric discomfort. B. Had a transesophageal echocardiogram (TEE) 2 hours ago, has a BP of 106/64 mm Hg, and reports a sore throat. C. Has cirrhosis, reports several new areas of ecchymosis, and has a partial thromboplastin time (PTT) of 76 seconds. D. Had a laparoscopic cholecystectomy 18 hours ago and is reporting bilateral shoulder pain. ### 4. The nurse is caring for the following assigned clients who are 24 hours postoperative. The nurse performed a change-of-shift assessment 4 hours ago. Which change in client condition should the nurse identify as a priority? A. The client who received NPH insulin and has a current capillary blood glucose of 110 mg/dL. B. The client whose wound drainage was sanguineous and is now serosanguineous. C. The client whose BP was 138/86 and is now 136/84 mm Hg. D. The client who reports an increased pain level of 8 on a scale of 0 to 10 after receiving an opioid analgesic. ### 5. The nurse preceptor is teaching a newly hired nurse about legal principles when providing client care. Which situation should the nurse preceptor use as an example of malpractice? A. An alert and oriented client makes an informed decision to leave against medical advice, and the nurse applies restraints to prevent the client from leaving. B. A competent client refuses an antidepressant medication. The nurse dissolves the medication in food and administers it without the client’s knowledge. C. A nurse plugs an IV pump into an outlet even though the outlet cover is loose. D. A nurse finds a client on a low-sodium diet eating salted potato chips and threatens to apply wrist restraints if the client does not stop. ### 6. The nurse is caring for assigned clients. It is a priority for the nurse to follow up with a client who: A. Is receiving hydrocortisone and has a blood glucose level of 135 mg/dL. B. Has multiple sclerosis (MS), reports feeling tired, and is experiencing diplopia. C. Has active pulmonary tuberculosis (TB), hemoptysis, and weight loss. D. Is receiving pyridostigmine and reports nausea and congested cough. ### 7. The nurse working on a pediatric cardiac unit is reviewing the telemetry monitors for assigned clients. Which client should the nurse initially plan to assess? A. A 5-year-old child who is watching television and has a pulse of 78. B. A [age obscured in PDF]-old toddler who is playing with toys and has a pulse of 100. C. A 1-month-old infant who is sleeping and has a pulse of 180. D. A 15-year-old adolescent who is reading and has a pulse of 60. ### 8. The nurse working on a pediatric unit is caring for children admitted within the past 12 hours. It is a priority for the nurse to initiate an interdisciplinary conference for the child who: A. Is 3 years old, was admitted with epiglottitis, and is currently having difficulty breathing. B. Is 4 years old, was recently diagnosed with Kawasaki disease, and recently started immunoglobulin therapy. C. Is 8 years old, was admitted with multiple compound fractures, and was recently placed in Buck’s traction. D. Is 5 years old, was diagnosed with cystic fibrosis at birth, and has been hospitalized 4 times in the past 2 months. ### 9. The nurse is reviewing the plan of care for a client diagnosed with pericarditis who has been hospitalized for 24 hours. The client’s WBC count is 13,000/mm³ and oral temperature is 100.8°F. Which action is most appropriate? A. Update the nursing interventions as needed. B. Notify the charge nurse that the plan of care is outdated. C. Change the client’s goal to reflect their current status. D. Obtain an order for an infectious disease referral. ### 10. The charge nurse is reviewing clients’ electronic medical records. Which note indicates correct documentation? A. “Dressing change performed to coccyx wound with no adverse effects noted by the client. Client transferred to chair.” B. “IV catheter site in left antecubital space is red and warm to touch. IV catheter removed intact. 20-gauge catheter placed in right forearm.” C. “Found client sitting on floor. All 4 side rails were in upright position. Client reports no pain. No abrasions or bleeding noted. PHCP notified. Incident report completed.” D. “Reports of pain in abdomen with vomiting noted. Medications administered.” ### 11. A client brings their own continuous positive airway pressure (CPAP) machine for use while hospitalized. Which action is most important? A. Explain that the hospital has to supply the CPAP machine. B. Review the instruction booklet on operating the machine. C. Ask when the client last cleaned the CPAP machine. D. Have the machine inspected by the facility’s engineering department. ### 12. The nurse working on a medical-surgical unit is caring for assigned clients when the facility’s emergency response plan is activated. Which client should the nurse recommend for discharge? A. A client who has DVT, is receiving warfarin, and has a PT of 28 seconds. B. A client who is HIV-positive, has a nonproductive cough, and has a 24-hour Mantoux test reading of 6 mm induration. C. A client with suspected appendicitis, intense pain at McBurney’s point, who now reports cessation of pain. D. A client with COPD receiving IV steroid therapy and an oxygen saturation of 86% on room air. ### 13. The nurse is observing newly hired unlicensed assistive personnel (UAP) care for assigned clients. Correct client care is demonstrated when the UAP is observed: A. Wearing a gown when entering the room of a client with influenza. B. Removing protective eyewear before removing gloves. C. Placing dedicated equipment in the room of a client who has herpes zoster. D. Donning sterile gloves to empty a urinary drainage device. ### 14. The nurse is teaching a class on child car-passenger safety. Which statement by a parent indicates a need for further teaching? A. “Car seats should be rear-facing in the back seat until approximately ages 2 to 4 years.” B. “When using a booster seat, the lap belt should be across the child’s upper thighs.” C. “The car seat harness chest clip should be at the level of the infant’s armpits.” D. “One hand should fit between the infant and the car seat harness.” ### 15. The nurse working on a pediatric unit is reviewing newly written orders. Which order requires follow-up? A. A fluid bolus of 500 mL over 1 hour for a 12-year-old child with sickle cell crisis. B. A high-potassium diet for a 5-year-old child with acute glomerulonephritis. C. Chelation therapy for an 8-year-old child with lead poisoning. D. Hydrocortisone IV for a 10-year-old with adrenocortical insufficiency. ### 16. The nurse is reviewing orders for assigned clients. The nurse should clarify the order for the client who: A. Presented with manifestations of an ischemic stroke that started 2 hours ago and is to receive IV alteplase. B. Has acute kidney injury and is to receive a low-sodium, low-potassium diet. C. Had a permanent pacemaker inserted 6 months ago and is scheduled for a chest radiograph. D. Has polycythemia vera and is to receive 1 unit of packed red blood cells. ### 17. The nurse is assessing a female client whose labor is being supplemented with oxytocin IV. The nurse should discontinue oxytocin if the client develops: A. Uterine relaxation between contractions. B. Fetal heart rate of 68 for 90 seconds. C. Dark red streaks in her bloody show. D. Intermittent back pain with each contraction. ### 18. The nurse is caring for a newborn immediately after birth and has ensured the newborn has a patent airway. Which action should the nurse take next? A. Weigh the newborn and document the weight. B. Dry the newborn’s skin and cover with a warm blanket. C. Administer vitamin K. D. Administer eye prophylaxis. ### 19. The nurse is auscultating a client’s heart sounds. At which location on the diagram should the nurse place the stethoscope to auscultate the aortic valve? A. Location 4 B. Location 1 C. Location 2 D. Location 3 ### 20. A client has a blood type of AB negative and delivered a baby 4 hours ago. Which action should the nurse be prepared to take? A. Assess the newborn for abnormal clotting. B. Administer Rh(D) immune globulin to the infant. C. Review the newborn’s blood type. D. Administer Rh(D) immune globulin to the mother within 24 hours regardless of newborn type. ### 21. A pregnant client’s last menstrual period began November 19. Using Naegele’s rule, what is the estimated date of delivery? A. July 12 B. August 12 C. July 26 D. August 26 ### 22. A client had a left below-the-knee amputation caused by poor circulation secondary to type 1 diabetes and is demonstrating ineffective coping with use of defense mechanisms. Which action should the nurse take? A. Determine what is causing the client to respond in such a way. B. Obtain an order for a psychiatric consultation. C. Tell the client the behavior is not acceptable. D. Explain that the reactions are unproductive to getting better. ### 23. A client presents to the ED after an overdose of amitriptyline. Which action should the nurse take first? A. Administer oxygen via nasal cannula. B. Initiate gastric lavage with activated charcoal. C. Determine the events leading to the overdose. D. Document the number of pills ingested. ### 24. The nurse working on a mental health unit should first assess the client who has: A. Paranoid schizophrenia and has not bathed or brushed their teeth in 3 days. B. Major depressive disorder and states, “I wish I could stop crying all the time.” C. Bulimia nervosa and has gone to the restroom 15 minutes after eating a meal. D. Suicidal ideations and is reluctantly discussing a suicide contract with a staff member. ### 25. Which client should the nurse recognize as being at highest risk for suicide? A. A 70-year-old male whose wife recently died and who has been going to weekly bingo with friends. B. A 52-year-old male who lost his job 3 months ago and feels he will never find another job. C. A 39-year-old female recently diagnosed with breast cancer who is seeking a second opinion. D. A 15-year-old female who recently broke up with her boyfriend and is spending more time with friends. ### 26. A newly hired nurse is caring for a client receiving continuous tube feeding through a gastrostomy tube. Which action requires immediate intervention by the preceptor? A. Adding no more than 4 hours’ worth of feeding to the bag. B. Maintaining the head of bed at a 30- to 45-degree angle. C. Using an irrigation set that was opened 48 hours ago. D. Returning the residual obtained from the g-tube. ### 27. A client has urinary incontinence and is at risk for skin breakdown. Which preventive action should the nurse implement? A. Check the skin every 8 hours for breakdown. B. Request an indwelling urinary catheter. C. Clean the perineum with hot water after each incontinent episode. D. Apply a moisture barrier ointment to the skin. ### 28. A client is in skin traction (Buck’s traction). Which action should the nurse take? A. Turn the client to a 30-degree angle every 2 hours. B. Provide pin-site care. C. Assess pedal push strength every 4 hours. D. Keep the foot of the bed elevated. ### 29. The nurse is assessing an older adult for urinary incontinence. Which question is important to ask? A. “Do you take the herbal preparation ginkgo biloba?” B. “Do you ever use pads or tissues in your underwear to catch urine?” C. “Do you have a history of kidney stones?” D. “Do you have a family history of polycystic kidney disease?” ### 30. A client with a urinary tract infection is prescribed ciprofloxacin. Which instruction should the nurse give? A. “This medication provides an analgesic effect and decreases painful urination.” B. “Antacids should be taken 30 minutes after this medication.” C. “You should not operate heavy machinery or drive an automobile while taking this medication.” D. “You could experience dizziness and should change positions slowly.” ### 31. An older adult takes furosemide daily for heart failure. Which finding is a priority for follow-up? A. Reports ringing in the ears. B. Orientation to person and place only. C. Potassium level of 3.5 mEq/L. D. Weight loss of 1 lb in 3 days. ### 32. A 22-year-old client recently prescribed lithium makes which statement indicating a need for further teaching? A. “I should be sure to eat food that contains sodium.” B. “I should take this medication with food.” C. “I should anticipate that this medication will make my urine turn reddish-orange.” D. “I should avoid becoming dehydrated while taking this medication.” ### 33. A client has a serum potassium level of 2.4 mEq/L. Which order should the nurse question? A. Administer 20 mEq KCl IV over 15 minutes. B. Withhold the client’s regularly scheduled furosemide. C. Place the client on a telemetry monitor. D. Allow the client out of bed with assistance only. ### 34. The nurse should follow up with the PHCP regarding the client who has: A. A sensitivity to acetylsalicylic acid and is prescribed acetaminophen. B. A potassium level of 3.8 mEq/L and is prescribed sodium polystyrene. C. A decreased phenytoin level and is prescribed seizure precautions. D. A history of rash with penicillin and is prescribed a monoamine oxidase inhibitor. ### 35. The nurse is teaching a client with anemia who has a new prescription for liquid ferrous sulfate. Which instruction should be included? A. “Avoid eating excessive amounts of beans and green leafy vegetables.” B. “You will notice a change in your bowel habits and stool color.” C. “The medication can be taken with milk to prevent gastrointestinal irritation.” D. “Do not mix the medication with any other medications, foods, or liquids.” ### 36. The nurse has a prescription to administer subcutaneous enoxaparin. Which action should the nurse take? A. Check the most current D-dimer. B. Gently massage the area after administration. C. Aspirate for blood before injection. D. Insert the needle into the skin at a 90-degree angle. ### 37. Ampicillin 150 mg PO three times daily is prescribed to a toddler weighing 22 lb. Available: ampicillin suspension 250 mg/5 mL. Which action should the nurse take? A. Check for an allergy to sulfa medications. B. Contact the PHCP for clarification. C. Administer 3 mL by mouth 3 times per day. D. Determine the toddler’s weight in kilograms. ### 38. The nurse is monitoring a client following a paracentesis. It is a priority to notify the PHCP if the client develops: A. Pink-tinged urine. B. Vesicular breath sounds. C. Flatulence. D. Pruritus. ### 39. ABG results: pH 7.52, PaCO₂ 26 mm Hg, HCO₃⁻ 24 mEq/L. Which acid-base imbalance is present? A. Respiratory acidosis. B. Metabolic acidosis. C. Respiratory alkalosis. D. Metabolic alkalosis. ### 40. A client was admitted for alcohol withdrawal. At 1500 the client has T 102°F, P 120, R 20, BP 164/100, profuse diaphoresis, hallucinations, nausea, and vomiting. Which action is appropriate? A. Administer flumazenil. B. Notify the primary health care provider. C. Attempt to orient the client. D. Increase the IV infusion rate. ### 41. During administration of a large-volume enema, the client’s abdomen becomes distended and rigid. Which action should the nurse take? A. Reposition the client for better instillation. B. Lower the enema fluid bag. C. Ask the client to rate their pain. D. Discontinue the enema treatment. ### 42. Which statement by a female client collecting a midstream urine specimen requires additional teaching? A. “After collecting the specimen, I will remove the container before stopping the flow of my urine.” B. “Since I am right-handed, I will use my left hand to spread the labia apart.” C. “I will use the provided towelette to cleanse the area using a back-and-forth motion.” D. “I will start to urinate in the toilet before I urinate in the container.” ### 43. The nurse is caring for a client with Addison disease who is at risk for Addisonian crisis. Which action should the nurse take? A. Restrict fluid intake. B. Administer hydrocortisone. C. Provide a low-carbohydrate diet. D. Monitor the client’s antidiuretic hormone levels. ### 44. The nurse is providing discharge instructions to parents of a child who had a tonsillectomy. Which finding should the parents report to the surgeon? A. Odor to the breath. B. Persistent earache. C. Mouth breathing. D. Temperature of 99.4°F. ### 45. The nurse working on the telemetry unit is caring for a client who continues to develop the cardiac rhythm shown in the PDF. Which action should the nurse plan to take? A. Prepare to administer digoxin. B. Initiate transcutaneous pacing. C. Defibrillate the client. D. Administer IV atropine. ### 46. The nurse is discussing how to recognize peritonitis in a client receiving peritoneal dialysis. Which findings should be included? 47. Hypoactive bowel sounds. 48. Rebound abdominal tenderness. 49. Amber-colored urine. 50. Nausea and vomiting. 51. Cloudy or opaque outflow. 52. Diarrhea. 53. Bradycardia. A. 2, 5, 6, 7 B. 1, 4, 7 C. 4 only D. 1, 2, 4, 5 *The source itself displays the findings as 47–53 while the answer combinations refer to 1–7, so I preserved the PDF's wording rather than silently changing it.* ### 47. A client is suspected of having a retinal detachment of the left eye. Which statement is consistent with this diagnosis? A. “I feel as if a curtain has been pulled down over my right eye.” B. “I have lost the central part of my vision.” C. “I am experiencing a sharp pain in my eye.” D. “I see floating dark spots in my left eye.” ### 48. The nurse has an order to remove intermittent sutures from a client’s abdominal wound. Which action should the nurse take? A. Remove each suture in order from the top to bottom of the suture line. B. Lift the suture with forceps and cut as close as possible to the skin. C. Place removed sutures in a sterile cup for culture and sensitivity. D. Apply adhesive strips to each suture area after each suture is removed. ### 49. The nurse is reviewing laboratory values for a client with pulmonary embolism who is receiving heparin. Which value requires immediate attention? A. PT of 12 seconds. B. aPTT of 60 seconds. C. Hemoglobin of 10.8 g/dL. D. Platelet count of 100,000/mm³. ### 50. The ED nurse is caring for a client who sustained deep partial-thickness burns to the lower torso, both forearms, and thighs from a hot grease spill. Which action is a priority? A. Maintain a warm environment. B. Insert an indwelling urethral catheter. C. Prepare to intubate the client. D. Inspect for signs of inhalation injuries.