RELIAS RN Pharmacology Exam, Relias, 2026–2027 –
Latest Actual Test Bank with Verified Answers (A+
Graded)
RELIAS RN PHARMACOLOGY EXAM
Complete Test Bank | 2026 Update | Verified Questions & Answers
RELIAS RN Pharmacology Competency Assessment | 80-100+ Actual Exam
Questions with Correct Answers, Rationales, and Clinical Applications
This comprehensive examination preparation guide simulates the rigor and scope
of the 2026 Relias RN Pharmacology Exam. Questions are organized by clinical
domain and reflect current ISMP medication safety standards, evidence-based
prescribing practices, and the Institute for Safe Medication Practices (ISMP) 2025-
2026 High-Alert Medication Guidelines. All answers are verified across multiple
2026 test bank sources .
DOMAIN 1: MEDICATION SAFETY & SIX RIGHTS
Question 1
The nurse is preparing to administer a medication and verifies the "Six Rights" of
medication administration. Which of the following is NOT included in the Six
Rights?
A. Right patient
B. Right drug
C. Right documentation
D. Right pharmacy
Answer-; D. Right pharmacy
,Rationale: The Six Rights of medication administration are: right patient, right
drug, right dose, right route, right time, and right documentation. "Right
pharmacy" is not part of this foundational safety framework. Adherence to these
rights is a fundamental nursing standard to prevent medication errors per ISMP
Guidelines and Nursing Scope of Practice .
Question 2
A physician's written order for the person you are caring for is as follows: "Insulin
glargine (Lantus), 10 U, subQ QD." What changes would you suggest for safety
and to avoid the use of "do not use" abbreviations?
A. Change to "10 units subcutaneously daily"
B. Spell out "units" and "daily"
C. Write "10U subQ every day"
D. Change to "10 units SQ daily"
Answer-; B. Spell out units and daily
Rationale: The Joint Commission's "Do Not Use" list prohibits the abbreviation
"U" for units (can be mistaken for "0" or "4") and "QD" (can be mistaken for
"QOD"). The correct order should spell out "units" and "daily." Insulin is a high-
alert medication requiring independent double-checks .
Question 3
What statement is correct for determining you have the correct patient before
administering a drug?
A. Verify the room number on the MAR
B. Ask them to state their name and DOB and compare it to the MAR and wrist
band
C. Call the patient by their first name
D. Check the chart only
Answer-; B. Ask them to state their name and DOB and compare it to the MAR
and wrist band
,Rationale: Two unique patient identifiers (e.g., name and date of birth) must be
verified against the MAR and wristband. Room number is not an acceptable
identifier. Passive identification (calling name) is inferior to active verification .
Question 4
A patient refuses a dose of IV medication. What is the MOST appropriate action?
A. Document the refusal in the medical record
B. Notify the healthcare provider
C. Document the refusal and notify the MD
D. Leave the medication at the bedside
Answer-; C. Document the refusal and notify the MD
Rationale: The nurse must respect patient autonomy and the right to refuse
treatment. Documentation must include the refusal, patient education provided,
and notification of the provider. Simply documenting without provider
notification is incomplete .
Question 5
An order has been placed for sublingual medication. The patient has an NG tube.
What is the most appropriate action?
A. Crush the tablet and administer via NG
B. Administer the medication sublingually as ordered
C. Hold the medication and notify pharmacy
D. Dissolve the tablet in water and give via NG
Answer-; B. Administer the medication sublingually as ordered
Rationale: Sublingual medications are specifically formulated for rapid absorption
through the oral mucosa. NG administration bypasses this route and may alter
bioavailability. The presence of an NG tube does not change the prescribed
route .
, DOMAIN 2: CARDIOVASCULAR PHARMACOLOGY
Question 6
A patient is prescribed warfarin (Coumadin). Which laboratory value is most
important for the nurse to monitor routinely?
A. Serum creatinine
B. International Normalized Ratio (INR)
C. Hemoglobin A1c
D. Alanine aminotransferase (ALT)
Answer-; B. International Normalized Ratio (INR)
Rationale: Warfarin inhibits vitamin K-dependent clotting factors. The INR is the
standardized test to monitor its anticoagulant effect. Therapeutic range is
typically INR 2.0–3.0 for most indications (atrial fibrillation, DVT, mechanical heart
valves). INR >4.0 significantly increases bleeding risk .
Question 7
Which statement, if made by the person you are caring for, reflects the need for
further education regarding a new prescription of warfarin (Coumadin)?
A. "I will call my provider if I notice bleeding gums or dark stools."
B. "If I get headaches, aspirin is my best option for pain."
C. "I should avoid leafy green vegetables inconsistently."
D. "I need regular blood tests to check my levels."
Answer-; B. "If I get headaches, aspirin is my best option for pain."
Rationale: Aspirin is an antiplatelet medication that, when combined with
warfarin, significantly increases bleeding risk. Patients should be educated to
avoid aspirin and NSAIDs. Acetaminophen is the preferred analgesic for patients
on anticoagulation .
Question 8
Latest Actual Test Bank with Verified Answers (A+
Graded)
RELIAS RN PHARMACOLOGY EXAM
Complete Test Bank | 2026 Update | Verified Questions & Answers
RELIAS RN Pharmacology Competency Assessment | 80-100+ Actual Exam
Questions with Correct Answers, Rationales, and Clinical Applications
This comprehensive examination preparation guide simulates the rigor and scope
of the 2026 Relias RN Pharmacology Exam. Questions are organized by clinical
domain and reflect current ISMP medication safety standards, evidence-based
prescribing practices, and the Institute for Safe Medication Practices (ISMP) 2025-
2026 High-Alert Medication Guidelines. All answers are verified across multiple
2026 test bank sources .
DOMAIN 1: MEDICATION SAFETY & SIX RIGHTS
Question 1
The nurse is preparing to administer a medication and verifies the "Six Rights" of
medication administration. Which of the following is NOT included in the Six
Rights?
A. Right patient
B. Right drug
C. Right documentation
D. Right pharmacy
Answer-; D. Right pharmacy
,Rationale: The Six Rights of medication administration are: right patient, right
drug, right dose, right route, right time, and right documentation. "Right
pharmacy" is not part of this foundational safety framework. Adherence to these
rights is a fundamental nursing standard to prevent medication errors per ISMP
Guidelines and Nursing Scope of Practice .
Question 2
A physician's written order for the person you are caring for is as follows: "Insulin
glargine (Lantus), 10 U, subQ QD." What changes would you suggest for safety
and to avoid the use of "do not use" abbreviations?
A. Change to "10 units subcutaneously daily"
B. Spell out "units" and "daily"
C. Write "10U subQ every day"
D. Change to "10 units SQ daily"
Answer-; B. Spell out units and daily
Rationale: The Joint Commission's "Do Not Use" list prohibits the abbreviation
"U" for units (can be mistaken for "0" or "4") and "QD" (can be mistaken for
"QOD"). The correct order should spell out "units" and "daily." Insulin is a high-
alert medication requiring independent double-checks .
Question 3
What statement is correct for determining you have the correct patient before
administering a drug?
A. Verify the room number on the MAR
B. Ask them to state their name and DOB and compare it to the MAR and wrist
band
C. Call the patient by their first name
D. Check the chart only
Answer-; B. Ask them to state their name and DOB and compare it to the MAR
and wrist band
,Rationale: Two unique patient identifiers (e.g., name and date of birth) must be
verified against the MAR and wristband. Room number is not an acceptable
identifier. Passive identification (calling name) is inferior to active verification .
Question 4
A patient refuses a dose of IV medication. What is the MOST appropriate action?
A. Document the refusal in the medical record
B. Notify the healthcare provider
C. Document the refusal and notify the MD
D. Leave the medication at the bedside
Answer-; C. Document the refusal and notify the MD
Rationale: The nurse must respect patient autonomy and the right to refuse
treatment. Documentation must include the refusal, patient education provided,
and notification of the provider. Simply documenting without provider
notification is incomplete .
Question 5
An order has been placed for sublingual medication. The patient has an NG tube.
What is the most appropriate action?
A. Crush the tablet and administer via NG
B. Administer the medication sublingually as ordered
C. Hold the medication and notify pharmacy
D. Dissolve the tablet in water and give via NG
Answer-; B. Administer the medication sublingually as ordered
Rationale: Sublingual medications are specifically formulated for rapid absorption
through the oral mucosa. NG administration bypasses this route and may alter
bioavailability. The presence of an NG tube does not change the prescribed
route .
, DOMAIN 2: CARDIOVASCULAR PHARMACOLOGY
Question 6
A patient is prescribed warfarin (Coumadin). Which laboratory value is most
important for the nurse to monitor routinely?
A. Serum creatinine
B. International Normalized Ratio (INR)
C. Hemoglobin A1c
D. Alanine aminotransferase (ALT)
Answer-; B. International Normalized Ratio (INR)
Rationale: Warfarin inhibits vitamin K-dependent clotting factors. The INR is the
standardized test to monitor its anticoagulant effect. Therapeutic range is
typically INR 2.0–3.0 for most indications (atrial fibrillation, DVT, mechanical heart
valves). INR >4.0 significantly increases bleeding risk .
Question 7
Which statement, if made by the person you are caring for, reflects the need for
further education regarding a new prescription of warfarin (Coumadin)?
A. "I will call my provider if I notice bleeding gums or dark stools."
B. "If I get headaches, aspirin is my best option for pain."
C. "I should avoid leafy green vegetables inconsistently."
D. "I need regular blood tests to check my levels."
Answer-; B. "If I get headaches, aspirin is my best option for pain."
Rationale: Aspirin is an antiplatelet medication that, when combined with
warfarin, significantly increases bleeding risk. Patients should be educated to
avoid aspirin and NSAIDs. Acetaminophen is the preferred analgesic for patients
on anticoagulation .
Question 8
