Medical-Surgical RN A Prophecy Relias - Complete
Questions with Answers and Detailed Rationales -
Latest Test (Updated 2026-2027) | Graded A+
Question 1
1.2 milligrams is equal to how many micrograms?
Answer: 1200 mcg ✔✔
Rationale: 1 mg = 1000 mcg. Therefore, 1.2 mg = 1.2 × 1000 = 1200 mcg. Always
double-check decimal placement when converting medication dosages to prevent
medication errors.
Question 2
Your post-op patient has a Jackson-Pratt (JP) drain in place. How do you ensure
effective drain function?
Answer: Compress the drain, then plug the bulb to establish suction ✔✔
Rationale: A Jackson-Pratt (JP) drain uses bulb suction. After compressing the bulb, it
is plugged to create negative pressure. This negative pressure pulls fluid from the wound
into the collection bulb, promoting healing and preventing fluid accumulation.
Question 3
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: Deflate the balloon, advance the catheter further, then reinflate the balloon
✔✔
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. The catheter should be advanced further until urine flows freely before
inflating the balloon.
Question 4
pg. 1
,Your patient has symptomatic anemia but is refusing a blood transfusion for religious
reasons. What is an appropriate response?
Answer: Respect his wishes and notify the provider ✔✔
Rationale: The patient has the right to refuse treatment based on religious beliefs or
personal preferences. The nurse should respect the patient's autonomy, notify the
provider, and discuss alternative treatments (e.g., iron supplements, erythropoietin)
while thoroughly documenting the refusal.
Question 5
Your patient is admitted with diverticulitis. What type of diet do you expect to be
ordered for the patient?
Answer: Clear liquids (broth, jello, clear juices) ✔✔
Rationale: During the acute phase of diverticulitis, the bowel needs rest. A clear liquid
diet is typically ordered initially to decrease bowel activity and inflammation. As
symptoms improve, the diet is advanced gradually to low-fiber, then high-fiber foods.
Question 6
You were hired to work the medical unit and when you arrive at work the charge nurse
has assigned you to the post-surgical unit since they are understaffed. Which is the
MOST appropriate action?
Answer: Report to the post-surgical unit but inform the charge nurse and supervisor
that you are not competent to work on that unit ✔✔
Rationale: You should advocate for patient safety by being honest about your
competency level. Working on a unit where you lack the necessary training and skills
could lead to errors. Notify the supervisor of your concerns and request orientation or
reassignment.
Question 7
What is a proton pump inhibitor, such as pantoprazole (Protonix), used for?
Answer: Acid reduction ✔✔
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.
pg. 2
, Question 8
Which adaptive equipment would be MOST appropriate to use for a severely contracted
patient who is unable to bear weight when transferring from the bed to the 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 9
Which tool should you use to assess pain in your 80-year-old patient with severe
dementia?
Answer: PAINAD scale ✔✔
Rationale: For patients with severe dementia who cannot self-report pain,
observational pain assessment tools such as the PAINAD scale or Abbey Pain Scale
should be used. These tools assess behavioral indicators such as breathing, vocalization,
facial expression, body language, and consolability.
Question 10
Your patient is admitted from the ED with failure to thrive and advanced dementia. You
note he is extremely underweight, appears unbathed for some time, and has a stage 4
pressure injury to his coccyx. You were told in report that he lives at home with family
members. What should you do?
Answer: Notify the charge nurse and social worker of your concerns ✔✔
Rationale: This is a reportable safeguarding concern suggesting potential neglect or
abuse. You should report your concerns to the charge nurse and social worker, who will
follow mandatory reporting procedures to Adult Protective Services.
Question 11
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 ✔✔
pg. 3
Questions with Answers and Detailed Rationales -
Latest Test (Updated 2026-2027) | Graded A+
Question 1
1.2 milligrams is equal to how many micrograms?
Answer: 1200 mcg ✔✔
Rationale: 1 mg = 1000 mcg. Therefore, 1.2 mg = 1.2 × 1000 = 1200 mcg. Always
double-check decimal placement when converting medication dosages to prevent
medication errors.
Question 2
Your post-op patient has a Jackson-Pratt (JP) drain in place. How do you ensure
effective drain function?
Answer: Compress the drain, then plug the bulb to establish suction ✔✔
Rationale: A Jackson-Pratt (JP) drain uses bulb suction. After compressing the bulb, it
is plugged to create negative pressure. This negative pressure pulls fluid from the wound
into the collection bulb, promoting healing and preventing fluid accumulation.
Question 3
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: Deflate the balloon, advance the catheter further, then reinflate the balloon
✔✔
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. The catheter should be advanced further until urine flows freely before
inflating the balloon.
Question 4
pg. 1
,Your patient has symptomatic anemia but is refusing a blood transfusion for religious
reasons. What is an appropriate response?
Answer: Respect his wishes and notify the provider ✔✔
Rationale: The patient has the right to refuse treatment based on religious beliefs or
personal preferences. The nurse should respect the patient's autonomy, notify the
provider, and discuss alternative treatments (e.g., iron supplements, erythropoietin)
while thoroughly documenting the refusal.
Question 5
Your patient is admitted with diverticulitis. What type of diet do you expect to be
ordered for the patient?
Answer: Clear liquids (broth, jello, clear juices) ✔✔
Rationale: During the acute phase of diverticulitis, the bowel needs rest. A clear liquid
diet is typically ordered initially to decrease bowel activity and inflammation. As
symptoms improve, the diet is advanced gradually to low-fiber, then high-fiber foods.
Question 6
You were hired to work the medical unit and when you arrive at work the charge nurse
has assigned you to the post-surgical unit since they are understaffed. Which is the
MOST appropriate action?
Answer: Report to the post-surgical unit but inform the charge nurse and supervisor
that you are not competent to work on that unit ✔✔
Rationale: You should advocate for patient safety by being honest about your
competency level. Working on a unit where you lack the necessary training and skills
could lead to errors. Notify the supervisor of your concerns and request orientation or
reassignment.
Question 7
What is a proton pump inhibitor, such as pantoprazole (Protonix), used for?
Answer: Acid reduction ✔✔
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.
pg. 2
, Question 8
Which adaptive equipment would be MOST appropriate to use for a severely contracted
patient who is unable to bear weight when transferring from the bed to the 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 9
Which tool should you use to assess pain in your 80-year-old patient with severe
dementia?
Answer: PAINAD scale ✔✔
Rationale: For patients with severe dementia who cannot self-report pain,
observational pain assessment tools such as the PAINAD scale or Abbey Pain Scale
should be used. These tools assess behavioral indicators such as breathing, vocalization,
facial expression, body language, and consolability.
Question 10
Your patient is admitted from the ED with failure to thrive and advanced dementia. You
note he is extremely underweight, appears unbathed for some time, and has a stage 4
pressure injury to his coccyx. You were told in report that he lives at home with family
members. What should you do?
Answer: Notify the charge nurse and social worker of your concerns ✔✔
Rationale: This is a reportable safeguarding concern suggesting potential neglect or
abuse. You should report your concerns to the charge nurse and social worker, who will
follow mandatory reporting procedures to Adult Protective Services.
Question 11
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 ✔✔
pg. 3
