RELIAS MEDICAL SURGICAL TELEMETRY EXAM COMPLETE 200-
QUESTION PRACTICE Q-BANK – COVERING EKG RHYTHMS,
HEART FAILURE, PHARMACOLOGY, VENTILATION, RENAL, AND
PRIORITY TRIAGE WITH VERIFIED ANSWERS & EXPERT
RATIONALES
1. While in a supine position your patient states "I'm tired and cannot
catch my breath." Physical assessment reveals jugular vein distention
and a 3rd heart sound (S3). These symptoms are indicative of what
condition?
A. Pneumonia
B. Heart failure
C. Pulmonary embolism
D. Cardiac tamponade
Answer: B – S3 heart sound, JVD, and dyspnea in a supine position are
classic signs of left-sided heart failure with fluid overload.
2. Upon entry to your patient's room, you find her sitting in high
Fowler's position and complaining of shortness of breath. Her
respiratory rate is 34 breaths/min and SpO₂ is 84%. Which mode of
oxygen delivery would most likely reverse the symptoms?
A. Nasal cannula at 2 L/min
B. Simple face mask at 6 L/min
C. Non-rebreather mask
D. Venturi mask at 40%
,Answer: C – A non-rebreather mask delivers the highest FiO₂ (up to
90-100%) and is indicated for severe hypoxemia with respiratory
distress.
3. Your patient continues to pull at their IV located in their left forearm
despite verbal reminders and increased observation. The nursing
assistant recommends using soft mitt restraints on the patient. What is
your recommendation?
A. Apply wrist restraints immediately for safety
B. Request and order for soft mitts as they are the least restrictive
C. Use a vest restraint to prevent arm movement
D. Discontinue the IV and restart later
Answer: B – Soft mitts are the least restrictive physical restraint and
should be used only with a physician’s order after trying alternatives.
4. What is an early symptom that a patient is developing a complication
of heart failure?
A. Crackles in the lung bases
B. Edema in the legs and feet
C. Jugular vein distention
D. Paroxysmal nocturnal dyspnea
Answer: B – Edema in the legs and feet (peripheral edema) is often an
early sign of right-sided heart failure due to fluid retention, occurring
before more severe signs like crackles or JVD.
,5. You were hired to work the medical unit and when you arrive at work
the charge nurse has assigned you to the post-surgical unit since they
are understaffed. Which is the most appropriate action?
A. Refuse the assignment and go home
B. Report to the post-surgical unit
C. Call the nursing supervisor to complain
D. Ask to float to a different unit
Answer: B – As a hired nurse, you are expected to float to areas where
you have competency; reporting to the assigned unit is the appropriate
professional response.
6. What type of personal protective equipment (PPE) is applied prior to
entering a room for a patient with C. diff?
A. Gown and gloves
B. N95 mask and goggles
C. Gown, gloves, and mask
D. Surgical mask and gloves
Answer: A – C. diff requires contact precautions; gown and gloves are
required. Mask is not needed unless there is a risk of splash.
7. When would sucralfate (Carafate) 4 times daily be scheduled for?
A. 1 hour before meals and at bedtime
B. With meals and at bedtime
C. 2 hours after meals and at morning
D. On an empty stomach only in the morning
Answer: A – Sucralfate forms a protective barrier in the stomach; it
, should be given 1 hour before meals and at bedtime to coat the ulcer
site.
8. Your new patient was admitted with blunt force trauma to the
abdomen following a motor vehicle accident. An NG tube is in place for
decompression, however, you note during the assessment that the
stomach is rigid and hard during palpation. What condition do you
suspect?
A. Gastric perforation
B. Hemorrhage
C. Peritonitis
D. Intestinal obstruction
Answer: B – A rigid, hard abdomen after blunt trauma suggests
intra-abdominal bleeding (hemorrhage) leading to peritoneal irritation.
9. What is clubbing of the fingers most likely associated with?
A. Acute pneumonia
B. Chronic oxygen deficiency
C. Renal failure
D. Liver cirrhosis
Answer: B – Clubbing is a sign of chronic hypoxia, often seen in
conditions like COPD, congenital heart disease, or cystic fibrosis.
10. A patient with heart failure is prescribed digoxin. Which finding
indicates digoxin toxicity?
A. Heart rate 72 bpm
QUESTION PRACTICE Q-BANK – COVERING EKG RHYTHMS,
HEART FAILURE, PHARMACOLOGY, VENTILATION, RENAL, AND
PRIORITY TRIAGE WITH VERIFIED ANSWERS & EXPERT
RATIONALES
1. While in a supine position your patient states "I'm tired and cannot
catch my breath." Physical assessment reveals jugular vein distention
and a 3rd heart sound (S3). These symptoms are indicative of what
condition?
A. Pneumonia
B. Heart failure
C. Pulmonary embolism
D. Cardiac tamponade
Answer: B – S3 heart sound, JVD, and dyspnea in a supine position are
classic signs of left-sided heart failure with fluid overload.
2. Upon entry to your patient's room, you find her sitting in high
Fowler's position and complaining of shortness of breath. Her
respiratory rate is 34 breaths/min and SpO₂ is 84%. Which mode of
oxygen delivery would most likely reverse the symptoms?
A. Nasal cannula at 2 L/min
B. Simple face mask at 6 L/min
C. Non-rebreather mask
D. Venturi mask at 40%
,Answer: C – A non-rebreather mask delivers the highest FiO₂ (up to
90-100%) and is indicated for severe hypoxemia with respiratory
distress.
3. Your patient continues to pull at their IV located in their left forearm
despite verbal reminders and increased observation. The nursing
assistant recommends using soft mitt restraints on the patient. What is
your recommendation?
A. Apply wrist restraints immediately for safety
B. Request and order for soft mitts as they are the least restrictive
C. Use a vest restraint to prevent arm movement
D. Discontinue the IV and restart later
Answer: B – Soft mitts are the least restrictive physical restraint and
should be used only with a physician’s order after trying alternatives.
4. What is an early symptom that a patient is developing a complication
of heart failure?
A. Crackles in the lung bases
B. Edema in the legs and feet
C. Jugular vein distention
D. Paroxysmal nocturnal dyspnea
Answer: B – Edema in the legs and feet (peripheral edema) is often an
early sign of right-sided heart failure due to fluid retention, occurring
before more severe signs like crackles or JVD.
,5. You were hired to work the medical unit and when you arrive at work
the charge nurse has assigned you to the post-surgical unit since they
are understaffed. Which is the most appropriate action?
A. Refuse the assignment and go home
B. Report to the post-surgical unit
C. Call the nursing supervisor to complain
D. Ask to float to a different unit
Answer: B – As a hired nurse, you are expected to float to areas where
you have competency; reporting to the assigned unit is the appropriate
professional response.
6. What type of personal protective equipment (PPE) is applied prior to
entering a room for a patient with C. diff?
A. Gown and gloves
B. N95 mask and goggles
C. Gown, gloves, and mask
D. Surgical mask and gloves
Answer: A – C. diff requires contact precautions; gown and gloves are
required. Mask is not needed unless there is a risk of splash.
7. When would sucralfate (Carafate) 4 times daily be scheduled for?
A. 1 hour before meals and at bedtime
B. With meals and at bedtime
C. 2 hours after meals and at morning
D. On an empty stomach only in the morning
Answer: A – Sucralfate forms a protective barrier in the stomach; it
, should be given 1 hour before meals and at bedtime to coat the ulcer
site.
8. Your new patient was admitted with blunt force trauma to the
abdomen following a motor vehicle accident. An NG tube is in place for
decompression, however, you note during the assessment that the
stomach is rigid and hard during palpation. What condition do you
suspect?
A. Gastric perforation
B. Hemorrhage
C. Peritonitis
D. Intestinal obstruction
Answer: B – A rigid, hard abdomen after blunt trauma suggests
intra-abdominal bleeding (hemorrhage) leading to peritoneal irritation.
9. What is clubbing of the fingers most likely associated with?
A. Acute pneumonia
B. Chronic oxygen deficiency
C. Renal failure
D. Liver cirrhosis
Answer: B – Clubbing is a sign of chronic hypoxia, often seen in
conditions like COPD, congenital heart disease, or cystic fibrosis.
10. A patient with heart failure is prescribed digoxin. Which finding
indicates digoxin toxicity?
A. Heart rate 72 bpm
