PROPHECY RELIAS RN MEDICAL-SURGICAL FORM A
PRACTICE EXAM: 200 QUESTIONS WITH 100%
CORRECT ANSWERS & DETAILED EXPLANATIONS
1. A patient is ordered to receive digoxin (Lanoxin). Vital signs are: BP
130/70, Temp 97.9°F, HR 52, RR 16, O2 Sat 100% on room air. What
should the nurse do NEXT?
A. Administer the digoxin as ordered
B. Hold the digoxin and reassess heart rate in 30 minutes
C. Hold digoxin and call the provider
D. Give the digoxin with a full glass of water
Correct Answer: C
Explanation: The patient's heart rate is 52 bpm, which is below the
typical threshold for holding digoxin (usually <60 bpm). The nurse
should hold the medication and notify the provider to prevent digoxin
toxicity.
2. Your patient continues to pull at their IV site in the left forearm
despite verbal reminders. The nursing assistant recommends using
soft mitt restraints. What is your recommendation?
A. Apply soft mitt restraints immediately
B. Request an order for soft mitts as they are the least restrictive
C. Use wrist restraints instead for better security
D. Sedate the patient to prevent IV removal
Correct Answer: B
Explanation: Soft mitts are the least restrictive intervention and require
,a provider's order. They should be used only after less restrictive
measures have failed.
3. You have a patient going for dialysis. Their medications include
lisinopril (Prinivil), ondansetron (Zofran), famotidine (Pepcid), and
atorvastatin (Lipitor). Which medication would you possibly hold and
seek clarification?
A. Lisinopril
B. Ondansetron
C. Famotidine
D. Atorvastatin
Correct Answer: C
Explanation: Famotidine is a histamine-2 blocker that may need dose
adjustment or holding in renal failure/dialysis due to accumulation and
risk of CNS effects.
4. Your patient was admitted for a hypertensive crisis and has a history
of HTN, Parkinson's disease, depression, and alcohol use. On his
second hospitalized day, you notice he is more anxious and restless
than his baseline. What would be your FIRST nursing intervention?
A. Administer PRN anxiolytic medication
B. Place the patient in restraints for safety
C. Ask the patient when his last drink of alcohol was
D. Notify the provider immediately
Correct Answer: C
Explanation: The patient's history of alcohol use and acute
anxiety/restlessness suggests possible alcohol withdrawal. The first step
is to assess when the patient last consumed alcohol.
,5. Your 68-year-old patient is a Type 1 diabetic with a history of
schizophrenia and exhibits signs and symptoms of tardive dyskinesia.
What long-term medication is associated with signs and symptoms of
tardive dyskinesia?
A. Metformin
B. Insulin glargine
C. Risperidone
D. Lisinopril
Correct Answer: C
Explanation: Risperidone is an atypical antipsychotic known to cause
tardive dyskinesia with long-term use. Other antipsychotics like
haloperidol and olanzapine are also associated.
6. What is the BEST indication of an acute neurological problem?
A. Pupillary changes
B. Change in level of consciousness
C. Motor weakness
D. Seizure activity
Correct Answer: B
Explanation: A change in level of consciousness is the earliest and most
sensitive indicator of acute neurological deterioration.
7. Central Telemetry calls and tells you your patient is experiencing
bradycardia. What is the first thing you should do after entering the
room?
A. Prepare for transcutaneous pacing
B. Assess the patient and take vital signs
C. Administer atropine IV push
D. Call a code blue
Correct Answer: B
, Explanation: The nurse must first assess the patient's clinical status and
obtain vital signs to determine if the bradycardia is symptomatic or
hemodynamically significant.
8. While in a supine position your patient states, "I'm tired and cannot
catch my breath." Physical assessment reveals jugular vein distention
and a third heart sound (S3). These symptoms are indicative of what
condition?
A. Pneumonia
B. Pulmonary embolism
C. Heart failure
D. Cardiac tamponade
Correct Answer: C
Explanation: JVD, S3 heart sound, and dyspnea in a supine position are
classic signs of heart failure and fluid volume overload.
9. 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?
A. Standard precautions only
B. Droplet precautions
C. Airborne precautions
D. Contact precautions
Correct Answer: C
Explanation: These symptoms are suggestive of tuberculosis, which
requires airborne precautions (negative pressure room, N95 respirator).
10. Patients with diabetes are at high risk for complications from
damage to what body areas?
A. Heart and lungs
PRACTICE EXAM: 200 QUESTIONS WITH 100%
CORRECT ANSWERS & DETAILED EXPLANATIONS
1. A patient is ordered to receive digoxin (Lanoxin). Vital signs are: BP
130/70, Temp 97.9°F, HR 52, RR 16, O2 Sat 100% on room air. What
should the nurse do NEXT?
A. Administer the digoxin as ordered
B. Hold the digoxin and reassess heart rate in 30 minutes
C. Hold digoxin and call the provider
D. Give the digoxin with a full glass of water
Correct Answer: C
Explanation: The patient's heart rate is 52 bpm, which is below the
typical threshold for holding digoxin (usually <60 bpm). The nurse
should hold the medication and notify the provider to prevent digoxin
toxicity.
2. Your patient continues to pull at their IV site in the left forearm
despite verbal reminders. The nursing assistant recommends using
soft mitt restraints. What is your recommendation?
A. Apply soft mitt restraints immediately
B. Request an order for soft mitts as they are the least restrictive
C. Use wrist restraints instead for better security
D. Sedate the patient to prevent IV removal
Correct Answer: B
Explanation: Soft mitts are the least restrictive intervention and require
,a provider's order. They should be used only after less restrictive
measures have failed.
3. You have a patient going for dialysis. Their medications include
lisinopril (Prinivil), ondansetron (Zofran), famotidine (Pepcid), and
atorvastatin (Lipitor). Which medication would you possibly hold and
seek clarification?
A. Lisinopril
B. Ondansetron
C. Famotidine
D. Atorvastatin
Correct Answer: C
Explanation: Famotidine is a histamine-2 blocker that may need dose
adjustment or holding in renal failure/dialysis due to accumulation and
risk of CNS effects.
4. Your patient was admitted for a hypertensive crisis and has a history
of HTN, Parkinson's disease, depression, and alcohol use. On his
second hospitalized day, you notice he is more anxious and restless
than his baseline. What would be your FIRST nursing intervention?
A. Administer PRN anxiolytic medication
B. Place the patient in restraints for safety
C. Ask the patient when his last drink of alcohol was
D. Notify the provider immediately
Correct Answer: C
Explanation: The patient's history of alcohol use and acute
anxiety/restlessness suggests possible alcohol withdrawal. The first step
is to assess when the patient last consumed alcohol.
,5. Your 68-year-old patient is a Type 1 diabetic with a history of
schizophrenia and exhibits signs and symptoms of tardive dyskinesia.
What long-term medication is associated with signs and symptoms of
tardive dyskinesia?
A. Metformin
B. Insulin glargine
C. Risperidone
D. Lisinopril
Correct Answer: C
Explanation: Risperidone is an atypical antipsychotic known to cause
tardive dyskinesia with long-term use. Other antipsychotics like
haloperidol and olanzapine are also associated.
6. What is the BEST indication of an acute neurological problem?
A. Pupillary changes
B. Change in level of consciousness
C. Motor weakness
D. Seizure activity
Correct Answer: B
Explanation: A change in level of consciousness is the earliest and most
sensitive indicator of acute neurological deterioration.
7. Central Telemetry calls and tells you your patient is experiencing
bradycardia. What is the first thing you should do after entering the
room?
A. Prepare for transcutaneous pacing
B. Assess the patient and take vital signs
C. Administer atropine IV push
D. Call a code blue
Correct Answer: B
, Explanation: The nurse must first assess the patient's clinical status and
obtain vital signs to determine if the bradycardia is symptomatic or
hemodynamically significant.
8. While in a supine position your patient states, "I'm tired and cannot
catch my breath." Physical assessment reveals jugular vein distention
and a third heart sound (S3). These symptoms are indicative of what
condition?
A. Pneumonia
B. Pulmonary embolism
C. Heart failure
D. Cardiac tamponade
Correct Answer: C
Explanation: JVD, S3 heart sound, and dyspnea in a supine position are
classic signs of heart failure and fluid volume overload.
9. 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?
A. Standard precautions only
B. Droplet precautions
C. Airborne precautions
D. Contact precautions
Correct Answer: C
Explanation: These symptoms are suggestive of tuberculosis, which
requires airborne precautions (negative pressure room, N95 respirator).
10. Patients with diabetes are at high risk for complications from
damage to what body areas?
A. Heart and lungs
