MEDICAL-SURGICAL RN – A PROPHECY
RELIAS STUDY GUIDE EXAM QUESTIONS AND
100% VERIFIED ANSWERS WITH RATIONALES
GRADED A+
GUARANTEED PASS ON THE FIRST ATTEMPT
1.
A nurse is caring for a patient with heart failure who suddenly develops dyspnea,
crackles in both lungs, and frothy sputum. Which action should the nurse take
first?
A. Administer IV furosemide
B. Place the patient in high-Fowler position
C. Obtain a stat chest x-ray
D. Restrict oral fluids
Correct Answer: B
Rationale: Positioning the patient upright improves ventilation and decreases
venous return, providing immediate relief of respiratory distress before
pharmacologic or diagnostic interventions.
,2.
A patient with chronic kidney disease has a potassium level of 6.2 mEq/L. Which
assessment finding is most concerning?
A. Muscle weakness
B. Fatigue
C. Peaked T waves on ECG
D. Nausea
Correct Answer: C
Rationale: Hyperkalemia can cause life-threatening cardiac dysrhythmias. Peaked
T waves indicate significant cardiac involvement requiring immediate intervention.
3.
A nurse is reviewing lab values for a patient with sepsis. Which result indicates
worsening tissue perfusion?
A. White blood cell count 14,000/mm³
B. Lactate 4.5 mmol/L
C. Platelets 160,000/mm³
D. Hemoglobin 13 g/dL
Correct Answer: B
Rationale: Elevated lactate reflects anaerobic metabolism due to inadequate tissue
perfusion and is a key marker of sepsis severity.
,4.
A postoperative patient reports increasing pain unrelieved by prescribed
analgesics. The surgical site is swollen and tense. What complication should the
nurse suspect?
A. Infection
B. Hematoma
C. Compartment syndrome
D. Seroma
Correct Answer: C
Rationale: Severe pain unrelieved by medication and increasing swelling are
hallmark signs of compartment syndrome, a surgical emergency.
5.
A patient with COPD is receiving oxygen at 6 L/min via nasal cannula. Which
finding requires immediate nursing action?
A. Oxygen saturation 92%
B. Respiratory rate 10/min
C. Barrel-shaped chest
D. Use of accessory muscles
Correct Answer: B
Rationale: A low respiratory rate suggests hypoventilation and possible CO₂
retention, which can be worsened by excessive oxygen delivery in COPD patients.
6.
Which medication should be questioned for a patient with a history of asthma?
A. Metoprolol
B. Lisinopril
C. Furosemide
D. Atorvastatin
, Correct Answer: A
Rationale: Beta-blockers can precipitate bronchospasm in patients with asthma,
especially if non-selective or used without caution.
7.
A patient with diabetes reports shakiness, diaphoresis, and confusion. Blood
glucose is 54 mg/dL. What is the priority intervention?
A. Administer long-acting insulin
B. Give oral glucose or juice
C. Start IV normal saline
D. Notify the provider
Correct Answer: B
Rationale: The patient is experiencing hypoglycemia. Rapid administration of
glucose is the priority to prevent neurologic injury.
8.
A nurse is caring for a patient with acute pancreatitis. Which intervention is most
appropriate?
A. Encourage oral fluids
B. Administer morphine as prescribed
C. Maintain NPO status
D. Place the patient in Trendelenburg position
Correct Answer: C
Rationale: Keeping the patient NPO decreases pancreatic stimulation and helps
reduce inflammation during the acute phase.
RELIAS STUDY GUIDE EXAM QUESTIONS AND
100% VERIFIED ANSWERS WITH RATIONALES
GRADED A+
GUARANTEED PASS ON THE FIRST ATTEMPT
1.
A nurse is caring for a patient with heart failure who suddenly develops dyspnea,
crackles in both lungs, and frothy sputum. Which action should the nurse take
first?
A. Administer IV furosemide
B. Place the patient in high-Fowler position
C. Obtain a stat chest x-ray
D. Restrict oral fluids
Correct Answer: B
Rationale: Positioning the patient upright improves ventilation and decreases
venous return, providing immediate relief of respiratory distress before
pharmacologic or diagnostic interventions.
,2.
A patient with chronic kidney disease has a potassium level of 6.2 mEq/L. Which
assessment finding is most concerning?
A. Muscle weakness
B. Fatigue
C. Peaked T waves on ECG
D. Nausea
Correct Answer: C
Rationale: Hyperkalemia can cause life-threatening cardiac dysrhythmias. Peaked
T waves indicate significant cardiac involvement requiring immediate intervention.
3.
A nurse is reviewing lab values for a patient with sepsis. Which result indicates
worsening tissue perfusion?
A. White blood cell count 14,000/mm³
B. Lactate 4.5 mmol/L
C. Platelets 160,000/mm³
D. Hemoglobin 13 g/dL
Correct Answer: B
Rationale: Elevated lactate reflects anaerobic metabolism due to inadequate tissue
perfusion and is a key marker of sepsis severity.
,4.
A postoperative patient reports increasing pain unrelieved by prescribed
analgesics. The surgical site is swollen and tense. What complication should the
nurse suspect?
A. Infection
B. Hematoma
C. Compartment syndrome
D. Seroma
Correct Answer: C
Rationale: Severe pain unrelieved by medication and increasing swelling are
hallmark signs of compartment syndrome, a surgical emergency.
5.
A patient with COPD is receiving oxygen at 6 L/min via nasal cannula. Which
finding requires immediate nursing action?
A. Oxygen saturation 92%
B. Respiratory rate 10/min
C. Barrel-shaped chest
D. Use of accessory muscles
Correct Answer: B
Rationale: A low respiratory rate suggests hypoventilation and possible CO₂
retention, which can be worsened by excessive oxygen delivery in COPD patients.
6.
Which medication should be questioned for a patient with a history of asthma?
A. Metoprolol
B. Lisinopril
C. Furosemide
D. Atorvastatin
, Correct Answer: A
Rationale: Beta-blockers can precipitate bronchospasm in patients with asthma,
especially if non-selective or used without caution.
7.
A patient with diabetes reports shakiness, diaphoresis, and confusion. Blood
glucose is 54 mg/dL. What is the priority intervention?
A. Administer long-acting insulin
B. Give oral glucose or juice
C. Start IV normal saline
D. Notify the provider
Correct Answer: B
Rationale: The patient is experiencing hypoglycemia. Rapid administration of
glucose is the priority to prevent neurologic injury.
8.
A nurse is caring for a patient with acute pancreatitis. Which intervention is most
appropriate?
A. Encourage oral fluids
B. Administer morphine as prescribed
C. Maintain NPO status
D. Place the patient in Trendelenburg position
Correct Answer: C
Rationale: Keeping the patient NPO decreases pancreatic stimulation and helps
reduce inflammation during the acute phase.
