RELIAS Emergency Department RN Competency
Exam - Practice Questions with Correct Answers
and Detailed Explanations
This comprehensive RELIAS ED RN exam study guide contains verified
multiple-choice questions with correct answers in bold italic and detailed
rationales in bold italic, covering all essential emergency nursing topics
including triage, cardiac emergencies, trauma, stroke, respiratory
distress, obstetrical emergencies, toxicology, and legal/ethical
considerations. Each question is formatted with the answer and
explanation provided before moving to the next question, making it ideal
for self-study, exam preparation, and clinical practice review. This
resource is perfect for nursing students, new graduate nurses, and
experienced ED nurses preparing for the RELIAS competency exam, with
content aligned to current AHA, ENA, and evidence-based practice
guidelines.
Question 1
A patient arrives with suspected appendicitis. What action, if observed,
would require additional training for the unlicensed assistive personnel
(UAP)?
,A) The UAP offers the patient a ginger ale
B) The UAP allows the patient to move to a position of comfort
C) The UAP helps the patient with a bedpan
D) The UAP reminds the patient to stay in bed
Answer: A) The UAP offers the patient a ginger ale
Explanation: Patients with suspected appendicitis should be kept NPO
(nothing by mouth) in case they require emergency surgery.
Offering oral intake, including ginger ale, is contraindicated and
would require additional training for the UAP .
Question 2
What laboratory value would you monitor closely if your patient is
vomiting coffee-ground emesis?
A) White blood cells
B) Serum potassium
C) Arterial Blood Gas
D) Hemoglobin
Answer: D) Hemoglobin
Explanation: Coffee-ground emesis indicates upper gastrointestinal
bleeding. Hemoglobin levels should be monitored closely to assess
the degree of blood loss and guide transfusion needs .
,Question 3
A patient who is 32 weeks pregnant presents with a three-day history of
headache and significant swelling of the lower extremities and face. The
patient's vital signs are BP: 160/90, HR: 105/min, RR: 19/min, SpO2: 94%
on RA, Temp: 97.3°F. What medication do you anticipate the provider to
order FIRST?
A) Furosemide (Lasix)
B) Magnesium Sulfate
C) Labetalol (Trandate)
D) Acetaminophen (Tylenol)
Answer: B) Magnesium Sulfate
Explanation: This patient is showing signs of preeclampsia with
severe features (headache, hypertension, edema). Magnesium
sulfate is the first-line treatment to prevent seizures (eclampsia) in
patients with severe preeclampsia .
Question 4
You are caring for a patient who has a history of alcohol use and seizures.
You suddenly notice the patient becoming diaphoretic, anxious,
tachycardic, and has clammy skin. What would you do NEXT?
, A) Check their blood glucose
B) Turn them on their side
C) Auscultate their lungs
D) Administer propranolol
Answer: A) Check their blood glucose
Explanation: These symptoms (diaphoresis, anxiety, tachycardia,
clammy skin) are classic signs of hypoglycemia. In patients with
alcohol use disorder, hypoglycemia is a common concern. Point-of-
care blood glucose testing should be performed immediately .
Question 5
A patient who is 24 weeks pregnant presents with fever and right upper
quadrant pain. The patient states that the pain is radiating to the right
shoulder blade, and started an hour after having a pizza for lunch. She is
tachycardic, tachypneic, and diaphoretic on the initial triage assessment.
What is the MOST likely diagnosis for this patient?
A) Pericarditis
B) Cholecystitis
C) Diverticulitis
D) Pancreatitis
Answer: B) Cholecystitis
Exam - Practice Questions with Correct Answers
and Detailed Explanations
This comprehensive RELIAS ED RN exam study guide contains verified
multiple-choice questions with correct answers in bold italic and detailed
rationales in bold italic, covering all essential emergency nursing topics
including triage, cardiac emergencies, trauma, stroke, respiratory
distress, obstetrical emergencies, toxicology, and legal/ethical
considerations. Each question is formatted with the answer and
explanation provided before moving to the next question, making it ideal
for self-study, exam preparation, and clinical practice review. This
resource is perfect for nursing students, new graduate nurses, and
experienced ED nurses preparing for the RELIAS competency exam, with
content aligned to current AHA, ENA, and evidence-based practice
guidelines.
Question 1
A patient arrives with suspected appendicitis. What action, if observed,
would require additional training for the unlicensed assistive personnel
(UAP)?
,A) The UAP offers the patient a ginger ale
B) The UAP allows the patient to move to a position of comfort
C) The UAP helps the patient with a bedpan
D) The UAP reminds the patient to stay in bed
Answer: A) The UAP offers the patient a ginger ale
Explanation: Patients with suspected appendicitis should be kept NPO
(nothing by mouth) in case they require emergency surgery.
Offering oral intake, including ginger ale, is contraindicated and
would require additional training for the UAP .
Question 2
What laboratory value would you monitor closely if your patient is
vomiting coffee-ground emesis?
A) White blood cells
B) Serum potassium
C) Arterial Blood Gas
D) Hemoglobin
Answer: D) Hemoglobin
Explanation: Coffee-ground emesis indicates upper gastrointestinal
bleeding. Hemoglobin levels should be monitored closely to assess
the degree of blood loss and guide transfusion needs .
,Question 3
A patient who is 32 weeks pregnant presents with a three-day history of
headache and significant swelling of the lower extremities and face. The
patient's vital signs are BP: 160/90, HR: 105/min, RR: 19/min, SpO2: 94%
on RA, Temp: 97.3°F. What medication do you anticipate the provider to
order FIRST?
A) Furosemide (Lasix)
B) Magnesium Sulfate
C) Labetalol (Trandate)
D) Acetaminophen (Tylenol)
Answer: B) Magnesium Sulfate
Explanation: This patient is showing signs of preeclampsia with
severe features (headache, hypertension, edema). Magnesium
sulfate is the first-line treatment to prevent seizures (eclampsia) in
patients with severe preeclampsia .
Question 4
You are caring for a patient who has a history of alcohol use and seizures.
You suddenly notice the patient becoming diaphoretic, anxious,
tachycardic, and has clammy skin. What would you do NEXT?
, A) Check their blood glucose
B) Turn them on their side
C) Auscultate their lungs
D) Administer propranolol
Answer: A) Check their blood glucose
Explanation: These symptoms (diaphoresis, anxiety, tachycardia,
clammy skin) are classic signs of hypoglycemia. In patients with
alcohol use disorder, hypoglycemia is a common concern. Point-of-
care blood glucose testing should be performed immediately .
Question 5
A patient who is 24 weeks pregnant presents with fever and right upper
quadrant pain. The patient states that the pain is radiating to the right
shoulder blade, and started an hour after having a pizza for lunch. She is
tachycardic, tachypneic, and diaphoretic on the initial triage assessment.
What is the MOST likely diagnosis for this patient?
A) Pericarditis
B) Cholecystitis
C) Diverticulitis
D) Pancreatitis
Answer: B) Cholecystitis
