Relias Medical-Surgical RN A (2026/2027) –
Verified Questions and Detailed Answers
Question 1
A client with heart failure has crackles and JVD. Which action first?
A) Administer furosemide IV
B) *Place in high-Fowler’s and apply oxygen
C) Give metoprolol
D) Start digoxin
Answer
Answer: B
Rationale
Positioning and oxygenation are immediate priorities for pulmonary congestion.
Question 2
A client on heparin has aPTT 110 sec. What should the nurse do?
A) Increase heparin
B) *Hold heparin and notify provider
C) Give vitamin K
D) Continue same rate
Answer
Answer: B
Rationale
aPTT is supratherapeutic; risk of bleeding.
Question 3
,A client with COPD has SpO2 88% on 2 L. What is the target SpO2?
A) 100%
B) *88–92%
C) 94–98%
D) 80–85%
Answer
Answer: B
Rationale
Avoid oxygen-induced hypercapnia in COPD.
Question 4
A client post-op day 1 has fever 38.9°C and chills. First action?
A) Give acetaminophen
B) *Assess lung sounds and wound
C) Apply cooling blanket
D) Notify provider immediately
Answer
Answer: B
Rationale
Fever may indicate atelectasis, pneumonia, or infection.
Question 5
A client with DKA has K+ 3.0. Insulin drip ordered. What first?
A) Start insulin
B) *Hold insulin and replace potassium
C) Give bicarbonate
D) Give calcium
Answer
2
,Answer: B
Rationale
Insulin drives K+ intracellularly; severe hypokalemia can cause arrhythmias.
Question 6
A client with a new colostomy has purple stoma. What action?
A) Document normal
B) *Notify surgeon immediately
C) Apply warm compress
D) Reassure client
Answer
Answer: B
Rationale
Purple/black stoma indicates ischemia/necrosis.
Question 7
A client with chest tube has continuous bubbling in water seal. What first?
A) Increase suction
B) *Assess for air leak
C) Clamp tube
D) Document
Answer
Answer: B
Rationale
Continuous bubbling suggests air leak; find source.
Question 8
3
, A client with acute pancreatitis reports severe pain. Best position?
A) Supine
B) *Fetal position
C) Prone
D) High-Fowler’s
Answer
Answer: B
Rationale
Fetal position reduces pancreatic tension and pain.
Question 9
A client on digoxin has HR 52 and nausea. What first?
A) Give digoxin
B) *Hold digoxin and notify provider
C) Give atropine
D) Increase fluids
Answer
Answer: B
Rationale
Bradycardia and nausea suggest digoxin toxicity.
Question 10
A client with seizure disorder has aura. What should nurse do?
A) Restrain client
B) *Protect client from injury
C) Insert tongue blade
D) Give oral meds
Answer
4
Verified Questions and Detailed Answers
Question 1
A client with heart failure has crackles and JVD. Which action first?
A) Administer furosemide IV
B) *Place in high-Fowler’s and apply oxygen
C) Give metoprolol
D) Start digoxin
Answer
Answer: B
Rationale
Positioning and oxygenation are immediate priorities for pulmonary congestion.
Question 2
A client on heparin has aPTT 110 sec. What should the nurse do?
A) Increase heparin
B) *Hold heparin and notify provider
C) Give vitamin K
D) Continue same rate
Answer
Answer: B
Rationale
aPTT is supratherapeutic; risk of bleeding.
Question 3
,A client with COPD has SpO2 88% on 2 L. What is the target SpO2?
A) 100%
B) *88–92%
C) 94–98%
D) 80–85%
Answer
Answer: B
Rationale
Avoid oxygen-induced hypercapnia in COPD.
Question 4
A client post-op day 1 has fever 38.9°C and chills. First action?
A) Give acetaminophen
B) *Assess lung sounds and wound
C) Apply cooling blanket
D) Notify provider immediately
Answer
Answer: B
Rationale
Fever may indicate atelectasis, pneumonia, or infection.
Question 5
A client with DKA has K+ 3.0. Insulin drip ordered. What first?
A) Start insulin
B) *Hold insulin and replace potassium
C) Give bicarbonate
D) Give calcium
Answer
2
,Answer: B
Rationale
Insulin drives K+ intracellularly; severe hypokalemia can cause arrhythmias.
Question 6
A client with a new colostomy has purple stoma. What action?
A) Document normal
B) *Notify surgeon immediately
C) Apply warm compress
D) Reassure client
Answer
Answer: B
Rationale
Purple/black stoma indicates ischemia/necrosis.
Question 7
A client with chest tube has continuous bubbling in water seal. What first?
A) Increase suction
B) *Assess for air leak
C) Clamp tube
D) Document
Answer
Answer: B
Rationale
Continuous bubbling suggests air leak; find source.
Question 8
3
, A client with acute pancreatitis reports severe pain. Best position?
A) Supine
B) *Fetal position
C) Prone
D) High-Fowler’s
Answer
Answer: B
Rationale
Fetal position reduces pancreatic tension and pain.
Question 9
A client on digoxin has HR 52 and nausea. What first?
A) Give digoxin
B) *Hold digoxin and notify provider
C) Give atropine
D) Increase fluids
Answer
Answer: B
Rationale
Bradycardia and nausea suggest digoxin toxicity.
Question 10
A client with seizure disorder has aura. What should nurse do?
A) Restrain client
B) *Protect client from injury
C) Insert tongue blade
D) Give oral meds
Answer
4
