Relias RN Medical-Surgical Midterm
Exam With Actual Questions &
Verified Answers,Plus
Rationales/Expert Verified For
Guaranteed Pass 2025/2026 /Latest
Update/Instant Download Pdf
1. A patient with chronic obstructive pulmonary disease (COPD) is experiencing
increased dyspnea and sputum production. What is the priority nursing intervention?
A. Administer a PRN analgesic
B. Encourage deep breathing and coughing
C. Increase oral fluid intake
D. Assess oxygen saturation
B. Encourage deep breathing and coughing
Rationale: Encouraging deep breathing and coughing helps mobilize secretions and
improves ventilation, which is crucial for patients experiencing exacerbation of COPD.
2. Which electrolyte imbalance is most commonly associated with chronic kidney
disease?
A. Hypercalcemia
B. Hypernatremia
C. Hyperkalemia
D. Hypophosphatemia
C. Hyperkalemia
Rationale: Impaired kidney function decreases potassium excretion, leading to
hyperkalemia, which can cause life-threatening cardiac arrhythmias.
3. A patient with heart failure is prescribed furosemide. Which assessment finding
requires immediate intervention?
A. Blood pressure 110/70 mmHg
B. Potassium level 2.9 mEq/L
, C. Weight loss of 1 kg in 24 hours
D. Urine output 60 mL/hr
B. Potassium level 2.9 mEq/L
Rationale: Furosemide is a loop diuretic that can cause hypokalemia. A potassium level of
2.9 mEq/L is critically low and increases the risk of cardiac arrhythmias.
4. A patient presents with acute pancreatitis. Which lab value is most indicative of this
condition?
A. Elevated amylase and lipase
B. Decreased white blood cell count
C. Decreased liver enzymes
D. Elevated hemoglobin
A. Elevated amylase and lipase
Rationale: Amylase and lipase are pancreatic enzymes, and elevations indicate pancreatic
inflammation or injury, which is typical in acute pancreatitis.
5. Which of the following is a common side effect of opioid analgesics?
A. Diarrhea
B. Bradycardia
C. Respiratory depression
D. Hypotension
C. Respiratory depression
Rationale: Opioids depress the central nervous system, including the respiratory center,
leading to respiratory depression, especially with higher doses.
6. A patient with a history of liver cirrhosis develops ascites. Which intervention should
the nurse anticipate?
A. Administer a high-protein diet
B. Encourage bed rest and mobility
C. Administer diuretics as prescribed
D. Restrict water intake
C. Administer diuretics as prescribed
Rationale: Diuretics like spironolactone or furosemide help reduce fluid accumulation in
ascites. Sodium restriction is also typically part of management.
7. A patient is receiving a blood transfusion and develops chills, fever, and hypotension.
What is the nurse’s priority action?
A. Slow the transfusion
B. Stop the transfusion and notify the provider
C. Administer antipyretics
D. Monitor vital signs every 15 minutes
, B. Stop the transfusion and notify the provider
Rationale: These are signs of a hemolytic transfusion reaction. The transfusion must be
stopped immediately to prevent life-threatening complications.
8. Which dietary modification is recommended for a patient with chronic kidney
disease?
A. High-potassium foods
B. High-phosphate foods
C. Protein restriction
D. Low-carbohydrate diet
C. Protein restriction
Rationale: Limiting protein intake reduces the accumulation of nitrogenous waste, which
can slow the progression of kidney disease.
9. A patient with diabetes mellitus has a blood glucose level of 320 mg/dL and fruity-
smelling breath. What is the nurse’s priority action?
A. Encourage oral fluids
B. Administer insulin as prescribed
C. Monitor urine output
D. Recheck blood glucose in 2 hours
B. Administer insulin as prescribed
Rationale: The patient is exhibiting signs of hyperglycemia and possible diabetic
ketoacidosis (DKA). Prompt insulin administration is essential to lower blood glucose and
prevent complications.
10. A patient with deep vein thrombosis (DVT) is prescribed enoxaparin. Which lab test
should the nurse monitor?
A. INR
B. aPTT
C. Platelet count
D. Hemoglobin
C. Platelet count
Rationale: Low molecular weight heparins like enoxaparin can cause heparin-induced
thrombocytopenia, so monitoring platelet counts is necessary.
11. Which sign indicates a possible myocardial infarction in a female patient?
A. Sudden, severe chest pain radiating to the left arm
B. Jaw pain, fatigue, and nausea
C. Sharp stabbing chest pain relieved by movement
D. Intermittent palpitations
Exam With Actual Questions &
Verified Answers,Plus
Rationales/Expert Verified For
Guaranteed Pass 2025/2026 /Latest
Update/Instant Download Pdf
1. A patient with chronic obstructive pulmonary disease (COPD) is experiencing
increased dyspnea and sputum production. What is the priority nursing intervention?
A. Administer a PRN analgesic
B. Encourage deep breathing and coughing
C. Increase oral fluid intake
D. Assess oxygen saturation
B. Encourage deep breathing and coughing
Rationale: Encouraging deep breathing and coughing helps mobilize secretions and
improves ventilation, which is crucial for patients experiencing exacerbation of COPD.
2. Which electrolyte imbalance is most commonly associated with chronic kidney
disease?
A. Hypercalcemia
B. Hypernatremia
C. Hyperkalemia
D. Hypophosphatemia
C. Hyperkalemia
Rationale: Impaired kidney function decreases potassium excretion, leading to
hyperkalemia, which can cause life-threatening cardiac arrhythmias.
3. A patient with heart failure is prescribed furosemide. Which assessment finding
requires immediate intervention?
A. Blood pressure 110/70 mmHg
B. Potassium level 2.9 mEq/L
, C. Weight loss of 1 kg in 24 hours
D. Urine output 60 mL/hr
B. Potassium level 2.9 mEq/L
Rationale: Furosemide is a loop diuretic that can cause hypokalemia. A potassium level of
2.9 mEq/L is critically low and increases the risk of cardiac arrhythmias.
4. A patient presents with acute pancreatitis. Which lab value is most indicative of this
condition?
A. Elevated amylase and lipase
B. Decreased white blood cell count
C. Decreased liver enzymes
D. Elevated hemoglobin
A. Elevated amylase and lipase
Rationale: Amylase and lipase are pancreatic enzymes, and elevations indicate pancreatic
inflammation or injury, which is typical in acute pancreatitis.
5. Which of the following is a common side effect of opioid analgesics?
A. Diarrhea
B. Bradycardia
C. Respiratory depression
D. Hypotension
C. Respiratory depression
Rationale: Opioids depress the central nervous system, including the respiratory center,
leading to respiratory depression, especially with higher doses.
6. A patient with a history of liver cirrhosis develops ascites. Which intervention should
the nurse anticipate?
A. Administer a high-protein diet
B. Encourage bed rest and mobility
C. Administer diuretics as prescribed
D. Restrict water intake
C. Administer diuretics as prescribed
Rationale: Diuretics like spironolactone or furosemide help reduce fluid accumulation in
ascites. Sodium restriction is also typically part of management.
7. A patient is receiving a blood transfusion and develops chills, fever, and hypotension.
What is the nurse’s priority action?
A. Slow the transfusion
B. Stop the transfusion and notify the provider
C. Administer antipyretics
D. Monitor vital signs every 15 minutes
, B. Stop the transfusion and notify the provider
Rationale: These are signs of a hemolytic transfusion reaction. The transfusion must be
stopped immediately to prevent life-threatening complications.
8. Which dietary modification is recommended for a patient with chronic kidney
disease?
A. High-potassium foods
B. High-phosphate foods
C. Protein restriction
D. Low-carbohydrate diet
C. Protein restriction
Rationale: Limiting protein intake reduces the accumulation of nitrogenous waste, which
can slow the progression of kidney disease.
9. A patient with diabetes mellitus has a blood glucose level of 320 mg/dL and fruity-
smelling breath. What is the nurse’s priority action?
A. Encourage oral fluids
B. Administer insulin as prescribed
C. Monitor urine output
D. Recheck blood glucose in 2 hours
B. Administer insulin as prescribed
Rationale: The patient is exhibiting signs of hyperglycemia and possible diabetic
ketoacidosis (DKA). Prompt insulin administration is essential to lower blood glucose and
prevent complications.
10. A patient with deep vein thrombosis (DVT) is prescribed enoxaparin. Which lab test
should the nurse monitor?
A. INR
B. aPTT
C. Platelet count
D. Hemoglobin
C. Platelet count
Rationale: Low molecular weight heparins like enoxaparin can cause heparin-induced
thrombocytopenia, so monitoring platelet counts is necessary.
11. Which sign indicates a possible myocardial infarction in a female patient?
A. Sudden, severe chest pain radiating to the left arm
B. Jaw pain, fatigue, and nausea
C. Sharp stabbing chest pain relieved by movement
D. Intermittent palpitations
