1
RELIAS LEARNING NURSING TEST Actual Exam
2026/2027: Comprehensive Questions with Multiple
Choices | Verified & Revised Answers for Nursing
Success – Pass Guaranteed - A+ Graded
Section 1: Patient Safety & Quality Improvement (10 Questions)
Q1: A nurse is preparing to administer medications to a patient who was recently transferred
from the ICU. The patient has an allergy to penicillin documented in the electronic health record.
What is the priority action the nurse must take before administering any medications?
A. Verify the patient's identity using the room number and name on the wristband
B. Check the medication administration record (MAR) for any penicillin-based antibiotics
ordered
C. Ask the patient to state their name and date of birth while checking the wristband
D. Review the patient's allergy band to ensure it matches the EHR documentation
Correct Answer: C
Rationale: The Joint Commission's National Patient Safety Goal (NPSG.01.01.01) requires
using two patient identifiers (neither to be the patient's room number) before any medication
administration. While checking for penicillin allergies (B) is important, verifying identity with
two identifiers is the priority safety action. Option A is incorrect because room number is not an
acceptable identifier. Option D is incomplete as it doesn't fulfill the two-identifier requirement.
Q2: A 78-year-old patient with a history of falls is admitted to the medical-surgical unit. The
nurse completes the Morse Fall Scale and scores the patient at 65. What is the appropriate
nursing intervention based on this score?
A. Implement standard fall precautions; score indicates low fall risk
B. Initiate high-risk fall precautions including hourly rounding and bed alarm
C. Place the patient in restraints to prevent falls
D. Transfer the patient to the ICU for continuous observation
Correct Answer: B
Rationale: A Morse Fall Scale score ≥51 indicates high fall risk requiring intensive
interventions. High-risk precautions include hourly rounding, bed alarms, low bed position,
nonslip footwear, and ensuring call light is within reach. Option A is incorrect as 65 indicates
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high, not low, risk. Option C violates restraint reduction principles and should only be used as a
last resort. Option D is unnecessary and not indicated by fall risk alone.
Q3: During a surgical time-out, the circulating nurse notices the surgical site marked by the
surgeon differs from the consent form. What is the nurse's priority action?
A. Proceed with surgery as the surgeon has ultimate authority
B. Immediately stop the procedure and notify the surgeon of the discrepancy
C. Ask the patient to confirm which site is correct
D. Document the discrepancy and continue with the scheduled procedure
Correct Answer: B
Rationale: The Universal Protocol and Joint Commission NPSG.06.01.01 mandate that all team
members immediately speak up when they identify discrepancies during the time-out. The
procedure must not proceed until the discrepancy is resolved. Option A violates patient safety
standards. Option C places responsibility on the patient rather than the healthcare team. Option D
fails to prevent wrong-site surgery.
Q4: A nurse is caring for a patient with a Braden Scale score of 12. Which intervention is most
appropriate for this patient's pressure injury prevention plan?
A. Reposition every 4 hours and use standard hospital mattress
B. Implement turning schedule every 2 hours and pressure-redistributing mattress
C. Massage bony prominences every shift to increase circulation
D. Place the patient in a chair for 4 hours to relieve sacral pressure
Correct Answer: B
Rationale: A Braden Scale score of 12 indicates high risk for pressure injury (scores ≤18
indicate risk; ≤12 indicates high risk). Evidence-based prevention includes turning every 2 hours,
pressure-redistributing surfaces, moisture management, and nutrition optimization. Option A is
insufficient for high-risk patients. Option C is contraindicated as massage can damage deep
tissue. Option D increases risk of ischial pressure injuries.
Q5: A nurse discovers a medication error where a patient received hydralazine 20mg IV instead
of the ordered hydroxyzine 25mg PO. The patient is currently asymptomatic with stable vital
signs. What is the nurse's first priority action?
A. Complete an incident report and notify the risk management department
B. Assess the patient thoroughly and notify the provider immediately
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C. Document the error in the patient's medical record with detailed explanation
D. Administer the correct medication (hydroxyzine) to replace the wrong dose
Correct Answer: B
Rationale: Patient safety requires immediate assessment and provider notification when a
medication error occurs, even if the patient appears asymptomatic. Hydralazine can cause
significant hypotension. Option A should occur after patient stabilization. Option C should focus
on facts without assigning blame or using terms like "error." Option D could compound the error
without provider assessment first.
Q6: A patient with diabetes is receiving insulin via infusion pump. The alarm sounds indicating
occlusion. What is the nurse's priority action?
A. Immediately stop the pump and assess the IV site and tubing
B. Silence the alarm and continue monitoring the patient
C. Increase the infusion rate to overcome the occlusion
D. Remove the pump and convert to subcutaneous insulin injections
Correct Answer: A
Rationale: Alarm safety (NPSG.06.01.01) requires timely response to clinical alarms. An
occlusion alarm indicates potential delivery interruption requiring immediate assessment of the
site, tubing, and patient. Option B delays critical assessment. Option C is dangerous and could
cause bolus dosing when occlusion clears. Option D is unnecessary without first troubleshooting
the cause.
Q7: A nurse is preparing to administer potassium chloride IV to a patient with hypokalemia. The
provider orders 40 mEq in 100mL NS to infuse over 2 hours via peripheral IV. What is the
nurse's appropriate action?
A. Administer the infusion as ordered through the peripheral IV
B. Request central line placement before administering this concentration
C. Question the order as peripheral administration should not exceed 10 mEq/hour
D. Dilute the potassium further in 250mL NS and administer over 4 hours
Correct Answer: C
Rationale: Potassium chloride administration via peripheral IV should not exceed 10 mEq/hour
due to risk of phlebitis and tissue damage. The ordered rate of 20 mEq/hour (40 mEq/2 hours)
exceeds safe peripheral limits. Options A and B are incorrect; central lines allow higher
concentrations but the immediate action is to clarify the order. Option D changes the order
without provider consultation.
RELIAS LEARNING NURSING TEST Actual Exam
2026/2027: Comprehensive Questions with Multiple
Choices | Verified & Revised Answers for Nursing
Success – Pass Guaranteed - A+ Graded
Section 1: Patient Safety & Quality Improvement (10 Questions)
Q1: A nurse is preparing to administer medications to a patient who was recently transferred
from the ICU. The patient has an allergy to penicillin documented in the electronic health record.
What is the priority action the nurse must take before administering any medications?
A. Verify the patient's identity using the room number and name on the wristband
B. Check the medication administration record (MAR) for any penicillin-based antibiotics
ordered
C. Ask the patient to state their name and date of birth while checking the wristband
D. Review the patient's allergy band to ensure it matches the EHR documentation
Correct Answer: C
Rationale: The Joint Commission's National Patient Safety Goal (NPSG.01.01.01) requires
using two patient identifiers (neither to be the patient's room number) before any medication
administration. While checking for penicillin allergies (B) is important, verifying identity with
two identifiers is the priority safety action. Option A is incorrect because room number is not an
acceptable identifier. Option D is incomplete as it doesn't fulfill the two-identifier requirement.
Q2: A 78-year-old patient with a history of falls is admitted to the medical-surgical unit. The
nurse completes the Morse Fall Scale and scores the patient at 65. What is the appropriate
nursing intervention based on this score?
A. Implement standard fall precautions; score indicates low fall risk
B. Initiate high-risk fall precautions including hourly rounding and bed alarm
C. Place the patient in restraints to prevent falls
D. Transfer the patient to the ICU for continuous observation
Correct Answer: B
Rationale: A Morse Fall Scale score ≥51 indicates high fall risk requiring intensive
interventions. High-risk precautions include hourly rounding, bed alarms, low bed position,
nonslip footwear, and ensuring call light is within reach. Option A is incorrect as 65 indicates
,2
high, not low, risk. Option C violates restraint reduction principles and should only be used as a
last resort. Option D is unnecessary and not indicated by fall risk alone.
Q3: During a surgical time-out, the circulating nurse notices the surgical site marked by the
surgeon differs from the consent form. What is the nurse's priority action?
A. Proceed with surgery as the surgeon has ultimate authority
B. Immediately stop the procedure and notify the surgeon of the discrepancy
C. Ask the patient to confirm which site is correct
D. Document the discrepancy and continue with the scheduled procedure
Correct Answer: B
Rationale: The Universal Protocol and Joint Commission NPSG.06.01.01 mandate that all team
members immediately speak up when they identify discrepancies during the time-out. The
procedure must not proceed until the discrepancy is resolved. Option A violates patient safety
standards. Option C places responsibility on the patient rather than the healthcare team. Option D
fails to prevent wrong-site surgery.
Q4: A nurse is caring for a patient with a Braden Scale score of 12. Which intervention is most
appropriate for this patient's pressure injury prevention plan?
A. Reposition every 4 hours and use standard hospital mattress
B. Implement turning schedule every 2 hours and pressure-redistributing mattress
C. Massage bony prominences every shift to increase circulation
D. Place the patient in a chair for 4 hours to relieve sacral pressure
Correct Answer: B
Rationale: A Braden Scale score of 12 indicates high risk for pressure injury (scores ≤18
indicate risk; ≤12 indicates high risk). Evidence-based prevention includes turning every 2 hours,
pressure-redistributing surfaces, moisture management, and nutrition optimization. Option A is
insufficient for high-risk patients. Option C is contraindicated as massage can damage deep
tissue. Option D increases risk of ischial pressure injuries.
Q5: A nurse discovers a medication error where a patient received hydralazine 20mg IV instead
of the ordered hydroxyzine 25mg PO. The patient is currently asymptomatic with stable vital
signs. What is the nurse's first priority action?
A. Complete an incident report and notify the risk management department
B. Assess the patient thoroughly and notify the provider immediately
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C. Document the error in the patient's medical record with detailed explanation
D. Administer the correct medication (hydroxyzine) to replace the wrong dose
Correct Answer: B
Rationale: Patient safety requires immediate assessment and provider notification when a
medication error occurs, even if the patient appears asymptomatic. Hydralazine can cause
significant hypotension. Option A should occur after patient stabilization. Option C should focus
on facts without assigning blame or using terms like "error." Option D could compound the error
without provider assessment first.
Q6: A patient with diabetes is receiving insulin via infusion pump. The alarm sounds indicating
occlusion. What is the nurse's priority action?
A. Immediately stop the pump and assess the IV site and tubing
B. Silence the alarm and continue monitoring the patient
C. Increase the infusion rate to overcome the occlusion
D. Remove the pump and convert to subcutaneous insulin injections
Correct Answer: A
Rationale: Alarm safety (NPSG.06.01.01) requires timely response to clinical alarms. An
occlusion alarm indicates potential delivery interruption requiring immediate assessment of the
site, tubing, and patient. Option B delays critical assessment. Option C is dangerous and could
cause bolus dosing when occlusion clears. Option D is unnecessary without first troubleshooting
the cause.
Q7: A nurse is preparing to administer potassium chloride IV to a patient with hypokalemia. The
provider orders 40 mEq in 100mL NS to infuse over 2 hours via peripheral IV. What is the
nurse's appropriate action?
A. Administer the infusion as ordered through the peripheral IV
B. Request central line placement before administering this concentration
C. Question the order as peripheral administration should not exceed 10 mEq/hour
D. Dilute the potassium further in 250mL NS and administer over 4 hours
Correct Answer: C
Rationale: Potassium chloride administration via peripheral IV should not exceed 10 mEq/hour
due to risk of phlebitis and tissue damage. The ordered rate of 20 mEq/hour (40 mEq/2 hours)
exceeds safe peripheral limits. Options A and B are incorrect; central lines allow higher
concentrations but the immediate action is to clarify the order. Option D changes the order
without provider consultation.
