Prophecy Relias RN Medical-Surgical Form A
Exam 2026/2027 EXAM
PRACTICE 250 QUESTIONS |ORIGINAL
QUESTIONS &
ANSWERS |DETAILED RATIONALES |HINTED
COMPLETE EXAM PREP GRADED A+*INSTANT
DOWNLOAD PDF
1. A nurse is caring for a patient with acute pulmonary edema.
Which finding requires immediate intervention?
A. Bilateral ankle edema
B. Blood pressure of 148/88 mmHg
C. Pink, frothy sputum
D. Respiratory rate of 24/min
Answer: C. Pink, frothy sputum
Pink, frothy sputum is characteristic of acute pulmonary edema and
indicates severe fluid accumulation in the alveoli. This compromises
gas exchange and requires immediate intervention.
2. A patient with heart failure is prescribed furosemide. Which
laboratory value is most important for the nurse to monitor?
A. Hemoglobin
B. Potassium
C. Platelet count
D. Amylase
Answer: B. Potassium
,Furosemide is a loop diuretic that can cause significant potassium
loss. Hypokalemia increases the risk of cardiac dysrhythmias.
3. A patient with chronic obstructive pulmonary disease (COPD) is
receiving oxygen. Which prescription should the nurse question?
A. Oxygen at 1–2 L/min via nasal cannula
B. Oxygen adjusted to maintain the prescribed saturation target
C. Oxygen at 10 L/min via nonrebreather mask for stable chronic
hypoxemia
D. Pulse oximetry monitoring
Answer: C. Oxygen at 10 L/min via nonrebreather mask for stable
chronic hypoxemia
Stable COPD generally requires carefully titrated oxygen rather than
unnecessarily high concentrations. Excessive oxygen can worsen
hypercapnia in susceptible patients.
4. Which assessment finding is most concerning in a patient with
pneumonia?
A. Productive cough
B. Temperature of 38.2°C (100.8°F)
C. Oxygen saturation of 86%
D. Fatigue
Answer: C. Oxygen saturation of 86%
An oxygen saturation of 86% indicates significant hypoxemia and
requires prompt assessment and intervention.
5. A patient is admitted with suspected bacterial meningitis. Which
intervention has the highest priority?
,A. Encourage oral fluids
B. Initiate appropriate isolation precautions
C. Provide a high-protein diet
D. Encourage ambulation
Answer: B. Initiate appropriate isolation precautions
Suspected bacterial meningitis requires prompt implementation of
appropriate transmission-based precautions, typically droplet
precautions initially, along with urgent antimicrobial therapy and
other supportive care.
6. A patient with increased intracranial pressure is being
monitored. Which finding should the nurse report immediately?
A. Headache
B. Increasing level of consciousness
C. Mild nausea
D. Photophobia
Answer: B. Increasing level of consciousness
A declining level of consciousness is an important indicator of
worsening neurologic function and potentially increasing intracranial
pressure.
7. Which position is generally appropriate for a patient with
increased intracranial pressure?
A. Flat with the neck flexed
B. Trendelenburg
C. Head of bed elevated with the neck in neutral alignment
D. Prone with the head turned laterally
Answer: C. Head of bed elevated with the neck in neutral alignment
, Elevating the head of the bed and maintaining neutral neck
alignment can promote venous drainage from the brain and help
reduce intracranial pressure.
8. A patient with a head injury develops a unilateral dilated pupil.
What should the nurse do?
A. Document the finding as expected
B. Reassess in 4 hours
C. Notify the provider immediately
D. Offer oral fluids
Answer: C. Notify the provider immediately
A new unilateral dilated pupil can indicate neurologic deterioration
and possible cerebral herniation. Immediate evaluation is required.
9. A patient with a stroke has difficulty swallowing. Which
intervention is appropriate before giving oral food or medications?
A. Give water to test swallowing
B. Perform or obtain a swallowing assessment
C. Place the patient flat
D. Encourage rapid eating
Answer: B. Perform or obtain a swallowing assessment
Stroke can impair swallowing and increase the risk of aspiration. Oral
intake should be withheld until swallowing safety has been assessed.
10. Which finding is most characteristic of a left-sided stroke?
A. Aphasia
B. Impulsivity only
Exam 2026/2027 EXAM
PRACTICE 250 QUESTIONS |ORIGINAL
QUESTIONS &
ANSWERS |DETAILED RATIONALES |HINTED
COMPLETE EXAM PREP GRADED A+*INSTANT
DOWNLOAD PDF
1. A nurse is caring for a patient with acute pulmonary edema.
Which finding requires immediate intervention?
A. Bilateral ankle edema
B. Blood pressure of 148/88 mmHg
C. Pink, frothy sputum
D. Respiratory rate of 24/min
Answer: C. Pink, frothy sputum
Pink, frothy sputum is characteristic of acute pulmonary edema and
indicates severe fluid accumulation in the alveoli. This compromises
gas exchange and requires immediate intervention.
2. A patient with heart failure is prescribed furosemide. Which
laboratory value is most important for the nurse to monitor?
A. Hemoglobin
B. Potassium
C. Platelet count
D. Amylase
Answer: B. Potassium
,Furosemide is a loop diuretic that can cause significant potassium
loss. Hypokalemia increases the risk of cardiac dysrhythmias.
3. A patient with chronic obstructive pulmonary disease (COPD) is
receiving oxygen. Which prescription should the nurse question?
A. Oxygen at 1–2 L/min via nasal cannula
B. Oxygen adjusted to maintain the prescribed saturation target
C. Oxygen at 10 L/min via nonrebreather mask for stable chronic
hypoxemia
D. Pulse oximetry monitoring
Answer: C. Oxygen at 10 L/min via nonrebreather mask for stable
chronic hypoxemia
Stable COPD generally requires carefully titrated oxygen rather than
unnecessarily high concentrations. Excessive oxygen can worsen
hypercapnia in susceptible patients.
4. Which assessment finding is most concerning in a patient with
pneumonia?
A. Productive cough
B. Temperature of 38.2°C (100.8°F)
C. Oxygen saturation of 86%
D. Fatigue
Answer: C. Oxygen saturation of 86%
An oxygen saturation of 86% indicates significant hypoxemia and
requires prompt assessment and intervention.
5. A patient is admitted with suspected bacterial meningitis. Which
intervention has the highest priority?
,A. Encourage oral fluids
B. Initiate appropriate isolation precautions
C. Provide a high-protein diet
D. Encourage ambulation
Answer: B. Initiate appropriate isolation precautions
Suspected bacterial meningitis requires prompt implementation of
appropriate transmission-based precautions, typically droplet
precautions initially, along with urgent antimicrobial therapy and
other supportive care.
6. A patient with increased intracranial pressure is being
monitored. Which finding should the nurse report immediately?
A. Headache
B. Increasing level of consciousness
C. Mild nausea
D. Photophobia
Answer: B. Increasing level of consciousness
A declining level of consciousness is an important indicator of
worsening neurologic function and potentially increasing intracranial
pressure.
7. Which position is generally appropriate for a patient with
increased intracranial pressure?
A. Flat with the neck flexed
B. Trendelenburg
C. Head of bed elevated with the neck in neutral alignment
D. Prone with the head turned laterally
Answer: C. Head of bed elevated with the neck in neutral alignment
, Elevating the head of the bed and maintaining neutral neck
alignment can promote venous drainage from the brain and help
reduce intracranial pressure.
8. A patient with a head injury develops a unilateral dilated pupil.
What should the nurse do?
A. Document the finding as expected
B. Reassess in 4 hours
C. Notify the provider immediately
D. Offer oral fluids
Answer: C. Notify the provider immediately
A new unilateral dilated pupil can indicate neurologic deterioration
and possible cerebral herniation. Immediate evaluation is required.
9. A patient with a stroke has difficulty swallowing. Which
intervention is appropriate before giving oral food or medications?
A. Give water to test swallowing
B. Perform or obtain a swallowing assessment
C. Place the patient flat
D. Encourage rapid eating
Answer: B. Perform or obtain a swallowing assessment
Stroke can impair swallowing and increase the risk of aspiration. Oral
intake should be withheld until swallowing safety has been assessed.
10. Which finding is most characteristic of a left-sided stroke?
A. Aphasia
B. Impulsivity only
