Relias/Prophecy General ICU RN A v3 | Complete
Study Guide with Actual Exam Questions with
Correct Answers and Detailed Rationales | Latest
Update 2026/2027 - Rated A+
Question 1
One of your patients coded but is now stabilized and you are catching up on charting.
The step-down unit calls to get report on your other patient who is to be transferred.
The nurses near you do not appear busy. How should you prioritize your time?
Answer: Give report and ask the nurses to prepare the patient for transfer. ✔✔
Rationale: Transfer reports are a priority for continuity of care. Delegating preparation
tasks to available nurses allows efficient use of resources while ensuring the transfer is
not delayed.
Question 2
Your patient was intubated but still has oral medications on their list of medications.
How should you ensure they receive their medications?
Answer: Ask the provider to update the route of administration. ✔✔
Rationale: Intubated patients cannot take oral medications. The provider must change
the route to IV or enteral (via NG/OG tube) to ensure safe and effective drug delivery.
Question 3
What laboratory value should you monitor closely if your patient is vomiting coffee
ground emesis?
Answer: Hemoglobin. ✔✔
Rationale: Coffee ground emesis indicates upper GI bleeding. Hemoglobin levels
should be monitored to assess the extent of blood loss and guide transfusion needs.
Question 4
What ECG finding is indicative of hyperkalemia?
Answer: Peaked T waves. ✔✔
pg. 1
,Rationale: Peaked (tall, tented) T waves are an early ECG sign of hyperkalemia,
indicating increased serum potassium levels.
Question 5
You witness a patient that is not assigned to you fall out of bed and begin crying for help
but you do not see the assigned nurse to assist the patient. What should you do first?
Answer: Check on the patient's status and call for assistance. ✔✔
Rationale: Patient safety is the priority. The nurse should immediately assess the
patient's condition and call for help, regardless of assignment.
Question 6
When assessing for fever in your intubated patient, placement of the thermometer in
which area would be most accurate?
Answer: Pulmonary artery or bladder. ✔✔
Rationale: Core temperature measurements (pulmonary artery or bladder) are most
accurate for intubated patients, as oral and axillary readings may be affected by the
endotracheal tube.
Question 7
Your patient has just completed IV potassium replacement. When should you collect
their repeat potassium level?
Answer: 30-60 minutes. ✔✔
Rationale: Potassium levels should be rechecked 30-60 minutes after IV replacement
to assess response and prevent hyperkalemia.
Question 8
Your patient is receiving an anti-arrhythmic agent. Which of the following assessment
parameters is the MOST important for you to evaluate?
Answer: ECG. ✔✔
Rationale: Continuous ECG monitoring is essential to assess the therapeutic effect and
detect arrhythmias or QT prolongation caused by anti-arrhythmic medications.
pg. 2
, Question 9
Your patient is undergoing a weaning trial from the ventilator. Fifteen minutes into the
trial the patient's heart rate increases to 140 bpm and they start to grab at their oxygen
and IV tubing. What should you do NEXT?
Answer: Stop weaning and rest the patient. ✔✔
Rationale: Tachycardia and agitation during a weaning trial indicate respiratory
distress or intolerance. The patient should be rested and reassessed before further
attempts.
Question 10
While assessing a patient just admitted to the hospital, he admits to drinking 12 cans of
beer a day, with the last drink being right before admission. What is the expected onset
of delirium tremens?
Answer: Within 48-72 hours. ✔✔
Rationale: Delirium tremens typically begins 48-72 hours after the last alcohol intake,
peaking in severity. Early recognition and intervention are crucial.
Question 11
You have administered a pain medication that has a half-life of 120 minutes, onset of
action 6 min, Tmax of 15 minutes, and is mostly excreted in the urine. When can the
patient expect the medication to start working?
Answer: 6 minutes. ✔✔
Rationale: Onset of action is the time it takes for the medication to begin producing a
therapeutic effect, which is 6 minutes for this medication.
Question 12
A lethargic but oriented patient is being admitted for sepsis and their family member is
in the waiting area. Their belongings include a ring, cell phone, and wallet. The patient
asks if they can keep the ring on and phone at bedside. What is your BEST response?
Answer: It is best if your family takes your belongings. ✔✔
Rationale: Valuables should be sent home with family to prevent loss or theft,
especially in a critical care setting where the patient may become confused or undergo
procedures requiring removal of items.
pg. 3
Study Guide with Actual Exam Questions with
Correct Answers and Detailed Rationales | Latest
Update 2026/2027 - Rated A+
Question 1
One of your patients coded but is now stabilized and you are catching up on charting.
The step-down unit calls to get report on your other patient who is to be transferred.
The nurses near you do not appear busy. How should you prioritize your time?
Answer: Give report and ask the nurses to prepare the patient for transfer. ✔✔
Rationale: Transfer reports are a priority for continuity of care. Delegating preparation
tasks to available nurses allows efficient use of resources while ensuring the transfer is
not delayed.
Question 2
Your patient was intubated but still has oral medications on their list of medications.
How should you ensure they receive their medications?
Answer: Ask the provider to update the route of administration. ✔✔
Rationale: Intubated patients cannot take oral medications. The provider must change
the route to IV or enteral (via NG/OG tube) to ensure safe and effective drug delivery.
Question 3
What laboratory value should you monitor closely if your patient is vomiting coffee
ground emesis?
Answer: Hemoglobin. ✔✔
Rationale: Coffee ground emesis indicates upper GI bleeding. Hemoglobin levels
should be monitored to assess the extent of blood loss and guide transfusion needs.
Question 4
What ECG finding is indicative of hyperkalemia?
Answer: Peaked T waves. ✔✔
pg. 1
,Rationale: Peaked (tall, tented) T waves are an early ECG sign of hyperkalemia,
indicating increased serum potassium levels.
Question 5
You witness a patient that is not assigned to you fall out of bed and begin crying for help
but you do not see the assigned nurse to assist the patient. What should you do first?
Answer: Check on the patient's status and call for assistance. ✔✔
Rationale: Patient safety is the priority. The nurse should immediately assess the
patient's condition and call for help, regardless of assignment.
Question 6
When assessing for fever in your intubated patient, placement of the thermometer in
which area would be most accurate?
Answer: Pulmonary artery or bladder. ✔✔
Rationale: Core temperature measurements (pulmonary artery or bladder) are most
accurate for intubated patients, as oral and axillary readings may be affected by the
endotracheal tube.
Question 7
Your patient has just completed IV potassium replacement. When should you collect
their repeat potassium level?
Answer: 30-60 minutes. ✔✔
Rationale: Potassium levels should be rechecked 30-60 minutes after IV replacement
to assess response and prevent hyperkalemia.
Question 8
Your patient is receiving an anti-arrhythmic agent. Which of the following assessment
parameters is the MOST important for you to evaluate?
Answer: ECG. ✔✔
Rationale: Continuous ECG monitoring is essential to assess the therapeutic effect and
detect arrhythmias or QT prolongation caused by anti-arrhythmic medications.
pg. 2
, Question 9
Your patient is undergoing a weaning trial from the ventilator. Fifteen minutes into the
trial the patient's heart rate increases to 140 bpm and they start to grab at their oxygen
and IV tubing. What should you do NEXT?
Answer: Stop weaning and rest the patient. ✔✔
Rationale: Tachycardia and agitation during a weaning trial indicate respiratory
distress or intolerance. The patient should be rested and reassessed before further
attempts.
Question 10
While assessing a patient just admitted to the hospital, he admits to drinking 12 cans of
beer a day, with the last drink being right before admission. What is the expected onset
of delirium tremens?
Answer: Within 48-72 hours. ✔✔
Rationale: Delirium tremens typically begins 48-72 hours after the last alcohol intake,
peaking in severity. Early recognition and intervention are crucial.
Question 11
You have administered a pain medication that has a half-life of 120 minutes, onset of
action 6 min, Tmax of 15 minutes, and is mostly excreted in the urine. When can the
patient expect the medication to start working?
Answer: 6 minutes. ✔✔
Rationale: Onset of action is the time it takes for the medication to begin producing a
therapeutic effect, which is 6 minutes for this medication.
Question 12
A lethargic but oriented patient is being admitted for sepsis and their family member is
in the waiting area. Their belongings include a ring, cell phone, and wallet. The patient
asks if they can keep the ring on and phone at bedside. What is your BEST response?
Answer: It is best if your family takes your belongings. ✔✔
Rationale: Valuables should be sent home with family to prevent loss or theft,
especially in a critical care setting where the patient may become confused or undergo
procedures requiring removal of items.
pg. 3
