Transition to Register Nursing NUR205

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Sample questions from Transition to Register Nursing NUR205

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a medical-surgical unit, a newly licensed RN receives report on four clients. Which client should the RN assess first?

   • A.A 68-year-old 1 day after knee replacement who reports pain of 7/10 and has a dry dressing
   • B.A 54-year-old who received an opioid 30 minutes ago and is difficult to arouse, with RR 8/min and SpO2 89%
   • C.A 72-year-old with heart failure who has gained 1 kg in 24 hours and has bilateral ankle edema
   • D.A 43-year-old with diabetes whose premeal glucose is 246 mg/dL and who requests correction insulin

   Rationale: The client who is difficult to arouse with a respiratory rate of 8/min and low oxygen saturation may have opioid-induced respiratory depression and needs immediate assessment and intervention. The weight gain and edema require timely follow-up but do not indicate the same immediate airway risk. The elevated glucose and postoperative pain also need care, but neither takes priority over compromised ventilation. Use airway and breathing findings to prioritize acute changes.

2. 2.On a pediatric unit, an RN is planning assignments for a stable 7-year-old admitted with asthma who is awaiting discharge; the child has clear breath sounds, RR 20/min, and SpO2 97% on room air. Which tasks may the RN delegate to an experienced unlicensed assistive personnel (UAP)? Select all that apply.

   • A.Teach the caregiver how to use a metered-dose inhaler with a spacer
   • B.Report to the RN if the child develops increased work of breathing
   • C.Determine whether the caregiver understands the written discharge instructions
   • D.Assist the child with bathing and dressing
   • E.Assess the child's response after a prescribed bronchodilator treatment
   • F.Obtain and document the child's routine vital signs

   Rationale: Obtaining routine vital signs and assisting with bathing and dressing are predictable tasks for a trained UAP when the child is stable. The UAP should promptly report increased work of breathing, while the RN remains responsible for interpreting the finding and acting on it. Assessing treatment response, teaching inhaler technique, and evaluating caregiver understanding require RN assessment, teaching, or evaluation skills and should not be delegated.

3. 3.During a home visit, a 76-year-old client with limited mobility says, "I fell last night, but I do not want my daughter to know." The client has a new forearm bruise, denies head injury, and has BP 138/76 mm Hg and HR 82/min. What should the RN do first?

   • A.Call the client's daughter before continuing the assessment
   • B.Document the client's statement and complete the planned medication review
   • C.Ask focused questions about the fall, assess for injury, and determine whether immediate medical evaluation is needed
   • D.Tell the client that the fall must be reported to the primary care provider before discussing it further

   Rationale: The RN should first assess the circumstances of the fall and the client for injury, including potential injuries that may not be immediately apparent, to determine urgent needs. Calling the daughter without the client's permission may breach confidentiality unless a safety or legal exception applies. Continuing with routine medication review before assessing the fall could delay needed care. The RN should explain the plan and seek the client's consent when arranging follow-up, while meeting applicable reporting obligations.

4. 4.A provider prescribes a medication dose that is 10 times the usual dose for a 39-year-old client; the client is stable, and the pharmacy has not yet dispensed the medication. What is the RN's best action?

   • A.Hold the medication and clarify the order with the prescribing provider
   • B.Administer the prescribed dose because the provider is accountable for prescribing
   • C.Reduce the dose to the usual amount and document the change
   • D.Ask another RN to administer the dose so the decision is shared

   Answer and rationale are in the full material.

5. 5.Refer to the client's chart. Which actions should the RN take now for this 64-year-old client on a medical unit? Select all that apply.

   • A.Apply oxygen according to emergency protocol and reassess oxygen saturation
   • B.Stay with the client and activate the rapid response process
   • C.Notify the provider while another team member obtains emergency equipment
   • D.Document that the client is stable because the temperature is normal
   • E.Ask the UAP to repeat the blood pressure in 30 minutes before taking further action

   Answer and rationale are in the full material.