RELIAS MEDICAL SURGICAL TELEMETRY EXAM – QUESTIONS AND ANSWERS |
VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES | DOWNLOAD
AND PASS | LATEST EXAM UPDATE 2026/2027
Core Domains
1. Cardiovascular System and Hemodynamics
2. Respiratory System and Oxygenation
3. Neurological and Sensory System Assessment
4. Renal and Genitourinary Function
5. Gastrointestinal and Nutritional Support
6. Endocrine and Metabolic Disorders
7. Infectious Diseases and Immunity
8. Pain Management, Wound Care, and Integumentary System
9. Legal, Ethical, and Professional Standards in Nursing
10. Telemetry Monitoring and Cardiac Rhythm Interpretation
Introduction
This comprehensive examination is designed to evaluate the foundational and
applied knowledge essential for safe and effective medical-surgical telemetry
nursing practice. It assesses a wide range of competencies, including the
interpretation of cardiac rhythms, the management of complex patients with multi-
system disorders, and the application of critical thinking in high-acuity situations.
The assessment utilizes a combination of multiple-choice and scenario-based
questions to measure clinical judgment, prioritization, and decision-making skills.
Emphasis is placed on the integration of theoretical knowledge with real-world
clinical applications, ensuring that the test-taker is prepared to handle the dynamic
challenges of a telemetry unit. This exam serves as a vital tool for gauging
readiness and identifying areas for continued professional development.
,Section One: Questions 1–50
1. A patient is admitted with sinus bradycardia. Which of the following is the
most appropriate initial nursing action?
A. Prepare for transcutaneous pacing.
B. Administer atropine 0.5 mg IV push.
C. Assess the patient's level of consciousness and vital signs.
D. Document the rhythm and continue to monitor.
🟢 Correct Answer: C. Assess the patient's level of consciousness and vital signs.
🔴 Explanation: The initial step in managing any dysrhythmia is to assess the
patient's clinical status. A patient with sinus bradycardia who is asymptomatic and
hemodynamically stable requires monitoring, not immediate intervention.
Assessing the patient allows the nurse to determine if the bradycardia is causing
symptoms, which then dictates the appropriate treatment.
2. What is the primary purpose of applying an SCD (Sequential Compression
Device) to a post-operative patient?
A. To prevent deep vein thrombosis (DVT).
B. To improve arterial circulation in the lower extremities.
C. To reduce post-operative pain.
D. To monitor blood pressure continuously.
🟢 Correct Answer: A. To prevent deep vein thrombosis (DVT).
🔴 Explanation: SCDs are a form of mechanical prophylaxis that promote venous
return from the lower extremities, reducing venous stasis and the subsequent risk
of deep vein thrombosis and pulmonary embolism. They do not significantly
affect arterial circulation or directly reduce pain.
,3. A patient on a telemetry unit suddenly develops a rapid, irregular heart
rhythm with no discernible P waves. Which rhythm should the nurse suspect?
A. Atrial flutter.
B. Atrial fibrillation.
C. Ventricular tachycardia.
D. Sinus tachycardia.
🟢 Correct Answer: B. Atrial fibrillation.
🔴 Explanation: Atrial fibrillation is characterized by chaotic, rapid electrical
activity in the atria, leading to an irregularly irregular ventricular rhythm with no
identifiable P waves. Atrial flutter typically presents with a "saw-tooth" pattern of
flutter waves, while ventricular tachycardia originates in the ventricles.
4. A patient's lab results show a serum potassium level of 2.8 mEq/L. The nurse
should prioritize which assessment?
A. Neurological status.
B. Respiratory rate and depth.
C. Cardiac rhythm and ECG.
D. Bowel sounds.
🟢 Correct Answer: C. Cardiac rhythm and ECG.
🔴 Explanation: Hypokalemia (low potassium) significantly impacts cardiac
electrical conduction and can lead to life-threatening dysrhythmias such as
ventricular fibrillation and cardiac arrest. While other assessments are relevant,
cardiac monitoring is the highest priority due to the immediate risk.
5. Which of the following is an early sign of hypovolemic shock?
A. Oliguria.
B. Bradycardia.
, C. Increased urine specific gravity.
D. Hypotension.
🟢 Correct Answer: C. Increased urine specific gravity.
🔴 Explanation: In the early stages of hypovolemic shock, the body attempts to
conserve fluid. This leads to an increase in urine concentration, indicated by a
high specific gravity, and tachycardia (not bradycardia). Hypotension and oliguria
are late signs that occur as compensatory mechanisms fail.
6. The nurse is caring for a patient with a chest tube. The water seal chamber is
continuously bubbling. What does this indicate?
A. The system is functioning correctly.
B. There is a small air leak in the system.
C. The patient's lung has fully re-expanded.
D. The suction pressure is too high.
🟢 Correct Answer: B. There is a small air leak in the system.
🔴 Explanation: Continuous bubbling in the water seal chamber indicates an air
leak in the chest tube system or from the patient's pleural space. Intermittent
bubbling is expected with exhalation or coughing. The absence of bubbling
indicates the lung is re-expanded or the system is blocked.
7. A patient with heart failure is prescribed furosemide. Which of the following
assessment findings indicates that the medication is having the desired effect?
A. Heart rate decreases from 110 to 90 bpm.
B. Urine output increases from 25 mL/hr to 80 mL/hr.
C. Serum potassium level increases from 3.5 to 4.0 mEq/L.
D. Blood pressure increases from 90/60 to 110/70 mmHg.
🟢 Correct Answer: B. Urine output increases from 25 mL/hr to 80 mL/hr.
VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES | DOWNLOAD
AND PASS | LATEST EXAM UPDATE 2026/2027
Core Domains
1. Cardiovascular System and Hemodynamics
2. Respiratory System and Oxygenation
3. Neurological and Sensory System Assessment
4. Renal and Genitourinary Function
5. Gastrointestinal and Nutritional Support
6. Endocrine and Metabolic Disorders
7. Infectious Diseases and Immunity
8. Pain Management, Wound Care, and Integumentary System
9. Legal, Ethical, and Professional Standards in Nursing
10. Telemetry Monitoring and Cardiac Rhythm Interpretation
Introduction
This comprehensive examination is designed to evaluate the foundational and
applied knowledge essential for safe and effective medical-surgical telemetry
nursing practice. It assesses a wide range of competencies, including the
interpretation of cardiac rhythms, the management of complex patients with multi-
system disorders, and the application of critical thinking in high-acuity situations.
The assessment utilizes a combination of multiple-choice and scenario-based
questions to measure clinical judgment, prioritization, and decision-making skills.
Emphasis is placed on the integration of theoretical knowledge with real-world
clinical applications, ensuring that the test-taker is prepared to handle the dynamic
challenges of a telemetry unit. This exam serves as a vital tool for gauging
readiness and identifying areas for continued professional development.
,Section One: Questions 1–50
1. A patient is admitted with sinus bradycardia. Which of the following is the
most appropriate initial nursing action?
A. Prepare for transcutaneous pacing.
B. Administer atropine 0.5 mg IV push.
C. Assess the patient's level of consciousness and vital signs.
D. Document the rhythm and continue to monitor.
🟢 Correct Answer: C. Assess the patient's level of consciousness and vital signs.
🔴 Explanation: The initial step in managing any dysrhythmia is to assess the
patient's clinical status. A patient with sinus bradycardia who is asymptomatic and
hemodynamically stable requires monitoring, not immediate intervention.
Assessing the patient allows the nurse to determine if the bradycardia is causing
symptoms, which then dictates the appropriate treatment.
2. What is the primary purpose of applying an SCD (Sequential Compression
Device) to a post-operative patient?
A. To prevent deep vein thrombosis (DVT).
B. To improve arterial circulation in the lower extremities.
C. To reduce post-operative pain.
D. To monitor blood pressure continuously.
🟢 Correct Answer: A. To prevent deep vein thrombosis (DVT).
🔴 Explanation: SCDs are a form of mechanical prophylaxis that promote venous
return from the lower extremities, reducing venous stasis and the subsequent risk
of deep vein thrombosis and pulmonary embolism. They do not significantly
affect arterial circulation or directly reduce pain.
,3. A patient on a telemetry unit suddenly develops a rapid, irregular heart
rhythm with no discernible P waves. Which rhythm should the nurse suspect?
A. Atrial flutter.
B. Atrial fibrillation.
C. Ventricular tachycardia.
D. Sinus tachycardia.
🟢 Correct Answer: B. Atrial fibrillation.
🔴 Explanation: Atrial fibrillation is characterized by chaotic, rapid electrical
activity in the atria, leading to an irregularly irregular ventricular rhythm with no
identifiable P waves. Atrial flutter typically presents with a "saw-tooth" pattern of
flutter waves, while ventricular tachycardia originates in the ventricles.
4. A patient's lab results show a serum potassium level of 2.8 mEq/L. The nurse
should prioritize which assessment?
A. Neurological status.
B. Respiratory rate and depth.
C. Cardiac rhythm and ECG.
D. Bowel sounds.
🟢 Correct Answer: C. Cardiac rhythm and ECG.
🔴 Explanation: Hypokalemia (low potassium) significantly impacts cardiac
electrical conduction and can lead to life-threatening dysrhythmias such as
ventricular fibrillation and cardiac arrest. While other assessments are relevant,
cardiac monitoring is the highest priority due to the immediate risk.
5. Which of the following is an early sign of hypovolemic shock?
A. Oliguria.
B. Bradycardia.
, C. Increased urine specific gravity.
D. Hypotension.
🟢 Correct Answer: C. Increased urine specific gravity.
🔴 Explanation: In the early stages of hypovolemic shock, the body attempts to
conserve fluid. This leads to an increase in urine concentration, indicated by a
high specific gravity, and tachycardia (not bradycardia). Hypotension and oliguria
are late signs that occur as compensatory mechanisms fail.
6. The nurse is caring for a patient with a chest tube. The water seal chamber is
continuously bubbling. What does this indicate?
A. The system is functioning correctly.
B. There is a small air leak in the system.
C. The patient's lung has fully re-expanded.
D. The suction pressure is too high.
🟢 Correct Answer: B. There is a small air leak in the system.
🔴 Explanation: Continuous bubbling in the water seal chamber indicates an air
leak in the chest tube system or from the patient's pleural space. Intermittent
bubbling is expected with exhalation or coughing. The absence of bubbling
indicates the lung is re-expanded or the system is blocked.
7. A patient with heart failure is prescribed furosemide. Which of the following
assessment findings indicates that the medication is having the desired effect?
A. Heart rate decreases from 110 to 90 bpm.
B. Urine output increases from 25 mL/hr to 80 mL/hr.
C. Serum potassium level increases from 3.5 to 4.0 mEq/L.
D. Blood pressure increases from 90/60 to 110/70 mmHg.
🟢 Correct Answer: B. Urine output increases from 25 mL/hr to 80 mL/hr.
