RELIAS ED RN A EXAM VERSION 1
COMPREHENSIVE PRACTICE EXAM LATEST
UPDATED ACTUAL FINAL EXAM WITH ALL
POSSIBLE MOST TESTED 100 PRACTICE QUESTIONS
AND 100% CORRECT VERIFIED ANSWERS FULLY
SOLVED WITH DETAILED RATIONALES PLUS
EXPERT ANSWER KEY 2026-2027 FINAL EXAM
UPDATED VERSION 100% GUARANTEED PASS MOST
RECENT!!!
1. A patient present with chest pain, diaphoresis,
and nausea. The ECG shows ST-segment elevation in
leads II, III, and aVF. What is the most likely
diagnosis?
A. Anterior myocardial infarction
B. Inferior myocardial infarction
C. Lateral myocardial infarction
D. Posterior myocardial infarction
Correct Answer: B. Inferior myocardial infarction
Rationale: ST elevation in inferior leads (II, III, aVF)
indicates inferior wall MI. Anterior MI shows
,changes in V1–V4, lateral in I, aVL, V5–V6, and
posterior with reciprocal changes in V1–V2.
2. A 65-year-old male with a history of COPD
presents with worsening dyspnea and a barrel-
shaped chest. Which arterial blood gas finding is
most consistent with chronic respiratory acidosis?
A. pH 7.30, PaCO2 55, HCO3 30
B. pH 7.48, PaCO2 30, HCO3 24
C. pH 7.25, PaCO2 60, HCO3 22
D. pH 7.35, PaCO2 45, HCO3 26
Correct Answer: A. pH 7.30, PaCO2 55, HCO3 30
Rationale: Chronic respiratory acidosis shows low
pH, high PaCO2, and elevated HCO3 due to renal
compensation. Option A fits this pattern. Option C
suggests acute with no compensation.
3. A patient with atrial fibrillation is receiving
heparin infusion. The aPTT is 120 seconds. What is
the priority nursing action?
A. Continue the infusion as ordered
B. Increase the infusion rate
C. Decrease the infusion rate or stop it
,D. Administer protamine sulfate immediately
Correct Answer: C. Decrease the infusion rate or
stop it
Rationale: Therapeutic aPTT for heparin is typically
1.5–2.5 times control (about 60–80 seconds). aPTT
of 120 indicates over-anticoagulation, so rate
reduction or pause is required. Protamine is for
severe bleeding reversal.
4. Which finding is a classic sign of acute
pericarditis?
A. Pleural friction rub
B. Pericardial friction rub that worsens with leaning
forward
C. Murmur that increases with inspiration
D. Distended neck veins and muffled heart sounds
Correct Answer: B. Pericardial friction rub that
worsens with leaning forward
Rationale: Pericardial friction rub is heard best
with the patient leaning forward. Pleural rub is for
pleuritis. Muffled heart sounds and distended neck
veins suggest cardiac tamponade.
, 5. A 50-year-old female presents with sudden severe
headache, photophobia, and nuchal rigidity. Vital
signs: BP 180/100, HR 55, RR 20. What is the most
likely diagnosis?
A. Migraine
B. Subarachnoid hemorrhage
C. Bacterial meningitis
D. Tension headache
Correct Answer: B. Subarachnoid hemorrhage
Rationale: Sudden thunderclap headache, nuchal
rigidity, and hypertension with bradycardia
(Cushing’s triad) suggest subarachnoid
hemorrhage. Meningitis typically has fever and
gradual onset.
6. A patient with heart failure receives furosemide
40 mg IV. Which laboratory value requires
immediate notification of the provider?
A. Sodium 135 mEq/L
B. Potassium 3.0 mEq/L
C. Chloride 100 mEq/L
D. BUN 20 mg/dL
Correct Answer: B. Potassium 3.0 mEq/L
COMPREHENSIVE PRACTICE EXAM LATEST
UPDATED ACTUAL FINAL EXAM WITH ALL
POSSIBLE MOST TESTED 100 PRACTICE QUESTIONS
AND 100% CORRECT VERIFIED ANSWERS FULLY
SOLVED WITH DETAILED RATIONALES PLUS
EXPERT ANSWER KEY 2026-2027 FINAL EXAM
UPDATED VERSION 100% GUARANTEED PASS MOST
RECENT!!!
1. A patient present with chest pain, diaphoresis,
and nausea. The ECG shows ST-segment elevation in
leads II, III, and aVF. What is the most likely
diagnosis?
A. Anterior myocardial infarction
B. Inferior myocardial infarction
C. Lateral myocardial infarction
D. Posterior myocardial infarction
Correct Answer: B. Inferior myocardial infarction
Rationale: ST elevation in inferior leads (II, III, aVF)
indicates inferior wall MI. Anterior MI shows
,changes in V1–V4, lateral in I, aVL, V5–V6, and
posterior with reciprocal changes in V1–V2.
2. A 65-year-old male with a history of COPD
presents with worsening dyspnea and a barrel-
shaped chest. Which arterial blood gas finding is
most consistent with chronic respiratory acidosis?
A. pH 7.30, PaCO2 55, HCO3 30
B. pH 7.48, PaCO2 30, HCO3 24
C. pH 7.25, PaCO2 60, HCO3 22
D. pH 7.35, PaCO2 45, HCO3 26
Correct Answer: A. pH 7.30, PaCO2 55, HCO3 30
Rationale: Chronic respiratory acidosis shows low
pH, high PaCO2, and elevated HCO3 due to renal
compensation. Option A fits this pattern. Option C
suggests acute with no compensation.
3. A patient with atrial fibrillation is receiving
heparin infusion. The aPTT is 120 seconds. What is
the priority nursing action?
A. Continue the infusion as ordered
B. Increase the infusion rate
C. Decrease the infusion rate or stop it
,D. Administer protamine sulfate immediately
Correct Answer: C. Decrease the infusion rate or
stop it
Rationale: Therapeutic aPTT for heparin is typically
1.5–2.5 times control (about 60–80 seconds). aPTT
of 120 indicates over-anticoagulation, so rate
reduction or pause is required. Protamine is for
severe bleeding reversal.
4. Which finding is a classic sign of acute
pericarditis?
A. Pleural friction rub
B. Pericardial friction rub that worsens with leaning
forward
C. Murmur that increases with inspiration
D. Distended neck veins and muffled heart sounds
Correct Answer: B. Pericardial friction rub that
worsens with leaning forward
Rationale: Pericardial friction rub is heard best
with the patient leaning forward. Pleural rub is for
pleuritis. Muffled heart sounds and distended neck
veins suggest cardiac tamponade.
, 5. A 50-year-old female presents with sudden severe
headache, photophobia, and nuchal rigidity. Vital
signs: BP 180/100, HR 55, RR 20. What is the most
likely diagnosis?
A. Migraine
B. Subarachnoid hemorrhage
C. Bacterial meningitis
D. Tension headache
Correct Answer: B. Subarachnoid hemorrhage
Rationale: Sudden thunderclap headache, nuchal
rigidity, and hypertension with bradycardia
(Cushing’s triad) suggest subarachnoid
hemorrhage. Meningitis typically has fever and
gradual onset.
6. A patient with heart failure receives furosemide
40 mg IV. Which laboratory value requires
immediate notification of the provider?
A. Sodium 135 mEq/L
B. Potassium 3.0 mEq/L
C. Chloride 100 mEq/L
D. BUN 20 mg/dL
Correct Answer: B. Potassium 3.0 mEq/L
