Relias Medical-Surgical RN A - Complete
Questions with Answers and Rationales -
Latest Updated 2026/2027) | Graded A+
Question 1
Which adaptive equipment would be most appropriate to use for a severely contracted
patient who is unable to bear weight when transferring from bed to chair?
Answer: Mechanical lift (Hoyer lift) ✔✔
Rationale: A severely contracted patient who cannot bear weight requires a
mechanical lift for safe transfer. This equipment supports the patient's full weight and
reduces the risk of injury to both the patient and healthcare provider.
Question 2
What lab values are expected to be in a patient with end stage renal disease on
hemodialysis?
Answer: Elevated BUN and creatinine, elevated potassium (hyperkalemia), elevated
phosphorus, low calcium, low hemoglobin (anemia), and metabolic acidosis ✔✔
Rationale: End-stage renal disease (ESRD) results in the kidneys' inability to filter
waste products. Common lab findings include elevated BUN and creatinine,
hyperkalemia, hyperphosphatemia, hypocalcemia, anemia, and metabolic acidosis.
Question 3
Your 85-year-old patient with atrial fibrillation fell at home 3 days ago. You notice she
has been having several episodes of acute confusion since being admitted to your unit.
What is the most important order you should anticipate from the provider?
Answer: A stat head CT (or MRI) to rule out intracranial bleeding ✔✔
Rationale: An elderly patient on anticoagulation for atrial fibrillation who fell and is
now experiencing acute confusion is at high risk for intracranial bleeding. A head CT is
the priority diagnostic test to rule out subdural hematoma or other intracranial
hemorrhage.
pg. 1
,Question 4
Your new admission presents with a cough, unintentional weight loss, frequent night
sweats, and bloody sputum. What type of isolation precautions should you initiate, if
any?
Answer: Airborne precautions ✔✔
Rationale: The patient's symptoms (cough, weight loss, night sweats, hemoptysis) are
classic signs of tuberculosis (TB). TB requires airborne precautions, including a negative
pressure room, N95 respirator, and strict infection control protocols.
Question 5
Upon entering your patient's room you note that they are having a seizure. What is your
1st action?
Answer: Position the patient on their side to maintain the airway ✔✔
Rationale: The priority during a seizure is maintaining a patent airway and preventing
aspiration. Positioning the patient on their side (recovery position) allows secretions to
drain and keeps the airway open.
Question 6
You find your coworker looking through your patient's medical record. She states "How
is Mr. Smith doing? He is my best friend's dad. We are so worried about him." What is
the best course of action?
Answer: Advise the coworker that accessing a patient's record without a legitimate
need-to-know violates HIPAA, and report the incident to your supervisor or compliance
officer ✔✔
Rationale: Under HIPAA, healthcare workers may only access patient information
when there is a legitimate treatment, payment, or operations need. Accessing a record
out of personal curiosity violates patient privacy.
Question 7
Your male patient complains of discomfort while inflating the balloon during insertion
of an indwelling urinary catheter. What would be the most appropriate action?
Answer: Stop inflating the balloon, deflate it, and advance the catheter further into the
bladder before reinflating ✔✔
pg. 2
, Rationale: Discomfort during balloon inflation typically indicates the catheter is not
fully inserted into the bladder. The balloon may be inflating in the urethra, which can
cause trauma.
Question 8
A patient with diabetes who is receiving peritoneal dialysis is at risk for which of the
following?
Answer: Peritonitis (infection) and hyperglycemia ✔✔
Rationale: Peritoneal dialysis patients with diabetes are at risk for peritonitis from
contamination of the catheter site or dialysis fluid. They are also at risk for
hyperglycemia due to the dextrose in dialysis solutions.
Question 9
What is a proton pump inhibitor, such as pantoprazole (Protonix), used for?
Answer: Reduce gastric acid secretion ✔✔
Rationale: Proton pump inhibitors (PPIs) like pantoprazole reduce gastric acid
production by inhibiting the proton pump in the gastric parietal cells. They are used to
treat GERD, peptic ulcer disease, and to prevent stress ulcers.
Question 10
Your patient has a nonproductive cough and presence of secretions in his tracheostomy.
Prior to suctioning the patient, what should you do first?
Answer: Hyperoxygenate the patient ✔✔
Rationale: Before suctioning a patient with a tracheostomy, you should
hyperoxygenate the patient with 100% oxygen for 1-2 minutes to prevent hypoxia during
suctioning.
Question 11
Dietary teaching for a patient with chronic renal failure should include choices that are:
Answer: Low potassium, low protein, moderate fat ✔✔
pg. 3
Questions with Answers and Rationales -
Latest Updated 2026/2027) | Graded A+
Question 1
Which adaptive equipment would be most appropriate to use for a severely contracted
patient who is unable to bear weight when transferring from bed to chair?
Answer: Mechanical lift (Hoyer lift) ✔✔
Rationale: A severely contracted patient who cannot bear weight requires a
mechanical lift for safe transfer. This equipment supports the patient's full weight and
reduces the risk of injury to both the patient and healthcare provider.
Question 2
What lab values are expected to be in a patient with end stage renal disease on
hemodialysis?
Answer: Elevated BUN and creatinine, elevated potassium (hyperkalemia), elevated
phosphorus, low calcium, low hemoglobin (anemia), and metabolic acidosis ✔✔
Rationale: End-stage renal disease (ESRD) results in the kidneys' inability to filter
waste products. Common lab findings include elevated BUN and creatinine,
hyperkalemia, hyperphosphatemia, hypocalcemia, anemia, and metabolic acidosis.
Question 3
Your 85-year-old patient with atrial fibrillation fell at home 3 days ago. You notice she
has been having several episodes of acute confusion since being admitted to your unit.
What is the most important order you should anticipate from the provider?
Answer: A stat head CT (or MRI) to rule out intracranial bleeding ✔✔
Rationale: An elderly patient on anticoagulation for atrial fibrillation who fell and is
now experiencing acute confusion is at high risk for intracranial bleeding. A head CT is
the priority diagnostic test to rule out subdural hematoma or other intracranial
hemorrhage.
pg. 1
,Question 4
Your new admission presents with a cough, unintentional weight loss, frequent night
sweats, and bloody sputum. What type of isolation precautions should you initiate, if
any?
Answer: Airborne precautions ✔✔
Rationale: The patient's symptoms (cough, weight loss, night sweats, hemoptysis) are
classic signs of tuberculosis (TB). TB requires airborne precautions, including a negative
pressure room, N95 respirator, and strict infection control protocols.
Question 5
Upon entering your patient's room you note that they are having a seizure. What is your
1st action?
Answer: Position the patient on their side to maintain the airway ✔✔
Rationale: The priority during a seizure is maintaining a patent airway and preventing
aspiration. Positioning the patient on their side (recovery position) allows secretions to
drain and keeps the airway open.
Question 6
You find your coworker looking through your patient's medical record. She states "How
is Mr. Smith doing? He is my best friend's dad. We are so worried about him." What is
the best course of action?
Answer: Advise the coworker that accessing a patient's record without a legitimate
need-to-know violates HIPAA, and report the incident to your supervisor or compliance
officer ✔✔
Rationale: Under HIPAA, healthcare workers may only access patient information
when there is a legitimate treatment, payment, or operations need. Accessing a record
out of personal curiosity violates patient privacy.
Question 7
Your male patient complains of discomfort while inflating the balloon during insertion
of an indwelling urinary catheter. What would be the most appropriate action?
Answer: Stop inflating the balloon, deflate it, and advance the catheter further into the
bladder before reinflating ✔✔
pg. 2
, Rationale: Discomfort during balloon inflation typically indicates the catheter is not
fully inserted into the bladder. The balloon may be inflating in the urethra, which can
cause trauma.
Question 8
A patient with diabetes who is receiving peritoneal dialysis is at risk for which of the
following?
Answer: Peritonitis (infection) and hyperglycemia ✔✔
Rationale: Peritoneal dialysis patients with diabetes are at risk for peritonitis from
contamination of the catheter site or dialysis fluid. They are also at risk for
hyperglycemia due to the dextrose in dialysis solutions.
Question 9
What is a proton pump inhibitor, such as pantoprazole (Protonix), used for?
Answer: Reduce gastric acid secretion ✔✔
Rationale: Proton pump inhibitors (PPIs) like pantoprazole reduce gastric acid
production by inhibiting the proton pump in the gastric parietal cells. They are used to
treat GERD, peptic ulcer disease, and to prevent stress ulcers.
Question 10
Your patient has a nonproductive cough and presence of secretions in his tracheostomy.
Prior to suctioning the patient, what should you do first?
Answer: Hyperoxygenate the patient ✔✔
Rationale: Before suctioning a patient with a tracheostomy, you should
hyperoxygenate the patient with 100% oxygen for 1-2 minutes to prevent hypoxia during
suctioning.
Question 11
Dietary teaching for a patient with chronic renal failure should include choices that are:
Answer: Low potassium, low protein, moderate fat ✔✔
pg. 3
