RELIAS PROPHECY CORE MANDATORY
PART II NURSING 2026 COMPLETE EXAM
QUESTIONS AND ANSWERS | ACCURATE
VERIFIED SOLUTIONS | A+ PASSED | LATEST
UPDATED VERSION
RELIAS PROPHECY CORE MANDATORY PART II NURSING 2026
Complete Exam Questions and Answers | Verified Solutions | A+ Passed |
Latest Updated Version
• This material covers all core mandatory nursing competencies tested in the Relias
Prophecy Part II exam, with verified correct answers and detailed EXPERT
RATIONALE to reinforce clinical understanding.
• Study by reading each question carefully, selecting your answer before checking
the highlighted correct option, then reviewing the EXPERT RATIONALE to solidify
the reasoning behind each answer.
QUESTION 1
A nurse is caring for a patient who is on a continuous cardiac monitor. The
monitor shows a rhythm with no visible P waves, an irregular RR interval, and
a wavy baseline. Which dysrhythmia does the nurse recognize?
A. Ventricular fibrillation
B. Sinus tachycardia
C. First-degree AV block
D. Atrial fibrillation
E. Atrial flutter
,✦ EXPERT RATIONALE: Atrial fibrillation is characterized by the absence of distinct
P waves, an irregularly irregular rhythm, and a chaotic/wavy baseline due to
disorganized atrial electrical activity.
QUESTION 2
A patient's telemetry shows a wide QRS complex tachycardia at a rate of 180
bpm with no identifiable P waves. The nurse should first suspect:
A. Supraventricular tachycardia
B. Atrial flutter with 2:1 block
C. Normal sinus rhythm with aberrancy
D. Ventricular tachycardia
E. Sinus tachycardia
✦ EXPERT RATIONALE: Ventricular tachycardia presents with a wide QRS (>0.12
sec), a rate of 100–250 bpm, and absent or dissociated P waves. It is a life-
threatening dysrhythmia requiring immediate intervention.
QUESTION 3
When a nurse observes ventricular fibrillation on the monitor and the patient
is unresponsive and pulseless, the priority intervention is:
A. Administer amiodarone IV push
B. Insert an oral airway
C. Obtain a 12-lead ECG
D. Defibrillate immediately
E. Initiate transcutaneous pacing
,✦ EXPERT RATIONALE: Ventricular fibrillation is a shockable rhythm. The priority is
immediate defibrillation, as each minute without defibrillation decreases survival by
7–10%.
QUESTION 4
A nurse is assessing a patient and notes the following: HR 42 bpm, BP 78/50
mmHg, altered mental status, and diaphoresis. Which intervention is most
appropriate?
A. Administer metoprolol
B. Perform a 12-lead ECG only
C. Reposition the patient
D. Prepare for transcutaneous pacing
E. Administer adenosine
✦ EXPERT RATIONALE: This patient has symptomatic bradycardia with
hemodynamic instability. Per ACLS guidelines, transcutaneous pacing is indicated
when atropine is ineffective or the patient is unstable.
QUESTION 5
A nurse is caring for a patient receiving IV heparin. Which laboratory value is
most important to monitor?
A. PT/INR
B. Platelet count only
C. Serum potassium
D. Activated partial thromboplastin time (aPTT)
E. Complete blood count
, ✦ EXPERT RATIONALE: The aPTT monitors the effectiveness of heparin therapy.
The therapeutic range is typically 60–100 seconds (1.5–2.5 times normal), ensuring
adequate anticoagulation without excess bleeding risk.
QUESTION 6
A patient is prescribed warfarin. Which value should the nurse monitor to
assess therapeutic effectiveness?
A. aPTT
B. Anti-Xa level
C. Serum albumin
D. INR
E. Fibrinogen level
✦ EXPERT RATIONALE: The INR (International Normalized Ratio) is used to monitor
warfarin therapy. The therapeutic range for most indications is 2.0–3.0, with higher
targets for mechanical heart valves.
QUESTION 7
A nurse is preparing to administer a blood transfusion. Which action is the
highest priority before initiating the transfusion?
A. Obtain IV access with an 18-gauge catheter
B. Prime the tubing with normal saline
C. Verify the blood is at room temperature
D. Verify the patient's identity and blood product compatibility at the bedside
with two nurses
E. Obtain vital signs 30 minutes prior
PART II NURSING 2026 COMPLETE EXAM
QUESTIONS AND ANSWERS | ACCURATE
VERIFIED SOLUTIONS | A+ PASSED | LATEST
UPDATED VERSION
RELIAS PROPHECY CORE MANDATORY PART II NURSING 2026
Complete Exam Questions and Answers | Verified Solutions | A+ Passed |
Latest Updated Version
• This material covers all core mandatory nursing competencies tested in the Relias
Prophecy Part II exam, with verified correct answers and detailed EXPERT
RATIONALE to reinforce clinical understanding.
• Study by reading each question carefully, selecting your answer before checking
the highlighted correct option, then reviewing the EXPERT RATIONALE to solidify
the reasoning behind each answer.
QUESTION 1
A nurse is caring for a patient who is on a continuous cardiac monitor. The
monitor shows a rhythm with no visible P waves, an irregular RR interval, and
a wavy baseline. Which dysrhythmia does the nurse recognize?
A. Ventricular fibrillation
B. Sinus tachycardia
C. First-degree AV block
D. Atrial fibrillation
E. Atrial flutter
,✦ EXPERT RATIONALE: Atrial fibrillation is characterized by the absence of distinct
P waves, an irregularly irregular rhythm, and a chaotic/wavy baseline due to
disorganized atrial electrical activity.
QUESTION 2
A patient's telemetry shows a wide QRS complex tachycardia at a rate of 180
bpm with no identifiable P waves. The nurse should first suspect:
A. Supraventricular tachycardia
B. Atrial flutter with 2:1 block
C. Normal sinus rhythm with aberrancy
D. Ventricular tachycardia
E. Sinus tachycardia
✦ EXPERT RATIONALE: Ventricular tachycardia presents with a wide QRS (>0.12
sec), a rate of 100–250 bpm, and absent or dissociated P waves. It is a life-
threatening dysrhythmia requiring immediate intervention.
QUESTION 3
When a nurse observes ventricular fibrillation on the monitor and the patient
is unresponsive and pulseless, the priority intervention is:
A. Administer amiodarone IV push
B. Insert an oral airway
C. Obtain a 12-lead ECG
D. Defibrillate immediately
E. Initiate transcutaneous pacing
,✦ EXPERT RATIONALE: Ventricular fibrillation is a shockable rhythm. The priority is
immediate defibrillation, as each minute without defibrillation decreases survival by
7–10%.
QUESTION 4
A nurse is assessing a patient and notes the following: HR 42 bpm, BP 78/50
mmHg, altered mental status, and diaphoresis. Which intervention is most
appropriate?
A. Administer metoprolol
B. Perform a 12-lead ECG only
C. Reposition the patient
D. Prepare for transcutaneous pacing
E. Administer adenosine
✦ EXPERT RATIONALE: This patient has symptomatic bradycardia with
hemodynamic instability. Per ACLS guidelines, transcutaneous pacing is indicated
when atropine is ineffective or the patient is unstable.
QUESTION 5
A nurse is caring for a patient receiving IV heparin. Which laboratory value is
most important to monitor?
A. PT/INR
B. Platelet count only
C. Serum potassium
D. Activated partial thromboplastin time (aPTT)
E. Complete blood count
, ✦ EXPERT RATIONALE: The aPTT monitors the effectiveness of heparin therapy.
The therapeutic range is typically 60–100 seconds (1.5–2.5 times normal), ensuring
adequate anticoagulation without excess bleeding risk.
QUESTION 6
A patient is prescribed warfarin. Which value should the nurse monitor to
assess therapeutic effectiveness?
A. aPTT
B. Anti-Xa level
C. Serum albumin
D. INR
E. Fibrinogen level
✦ EXPERT RATIONALE: The INR (International Normalized Ratio) is used to monitor
warfarin therapy. The therapeutic range for most indications is 2.0–3.0, with higher
targets for mechanical heart valves.
QUESTION 7
A nurse is preparing to administer a blood transfusion. Which action is the
highest priority before initiating the transfusion?
A. Obtain IV access with an 18-gauge catheter
B. Prime the tubing with normal saline
C. Verify the blood is at room temperature
D. Verify the patient's identity and blood product compatibility at the bedside
with two nurses
E. Obtain vital signs 30 minutes prior
