Prophecy Relias RN Medical-Surgical Form A Exam 2026/2027 | Practice Questions, Answers & Detailed Rationales | RN Med-Surg Exam Prep

Prophecy Relias RN Medical-Surgical Form A
Exam 2026/2027 | Practice Questions,
Answers & Detailed Rationales | RN Med-
Surg Exam Prep
PROPHECY RELIAS RN MEDICAL-SURGICAL FORM A EXAM 2026/2027

Practice Questions, Answers & Detailed Rationales | RN Med-Surg Exam Prep



DOCUMENT OVERVIEW

• This comprehensive study material contains 200 practice questions specifically
designed to prepare RN candidates for the Prophecy Relias Medical-Surgical
Nursing examination, covering all major body systems and clinical competencies
required in medical-surgical nursing practice.

• Study effectively by reviewing each question, attempting to answer before
checking the correct response, reading the detailed rationale to reinforce learning,
and identifying weak areas for targeted review before your actual exam.



QUESTIONS BEGIN HERE



QUESTION 1: CARDIOVASCULAR NURSING

A nurse is caring for a client with acute MI who presents with chest pain,
diaphoresis, and shortness of breath. What is the priority nursing action?

A) Administer oxygen and establish IV access

B) Obtain a 12-lead ECG

C) Provide morphine for pain relief

D) Prepare for cardiac catheterization

E) Notify the family of the admission

CORRECT ANSWER: A) Administer oxygen and establish IV access

,RATIONALE: In acute MI, the priority nursing action follows the ABCs of emergency
care. Establishing oxygenation (airway and breathing) and establishing IV access for
medication administration and fluid management are the first priority
interventions. While ECG, pain relief, and cardiac catheterization are important,
they follow after basic stabilization measures are implemented to prevent further
myocardial damage and maintain hemodynamic stability.



QUESTION 2: CARDIOVASCULAR NURSING

A client recovering from coronary artery bypass graft (CABG) surgery develops
atrial fibrillation on postoperative day 2. What is the most common cause of
postoperative atrial fibrillation?

A) Myocardial infarction

B) Surgical trauma and inflammation of the atria

C) Inadequate pain management

D) Hypokalemia

E) Excessive fluid administration

CORRECT ANSWER: B) Surgical trauma and inflammation of the atria

RATIONALE: Postoperative atrial fibrillation is a common arrhythmia after cardiac
surgery, occurring in approximately 20-40% of CABG patients. The primary cause is
surgical trauma to the atria during the procedure, which causes inflammation and
irritability of the atrial muscle. This disrupts the normal conduction pathways and
triggers ectopic activity. While other factors like electrolyte imbalances and pain can
contribute, the direct surgical trauma to atrial tissue is the most common primary
cause. This arrhythmia typically resolves within 24-48 hours with appropriate
management.



QUESTION 3: CARDIOVASCULAR NURSING

,A nurse teaches a client with hypertension about dietary modifications.
Which statement by the client indicates understanding of the DASH diet?

A) "I will eliminate all dairy products from my diet"

B) "I will eat plenty of fruits, vegetables, and lean proteins while limiting sodium"

C) "I will avoid all grains and focus only on protein"

D) "I will reduce my potassium intake significantly"

E) "I will follow a high-fat diet with limited carbohydrates"

CORRECT ANSWER: B) "I will eat plenty of fruits, vegetables, and lean proteins
while limiting sodium"

RATIONALE: The DASH (Dietary Approaches to Stop Hypertension) diet emphasizes
consumption of fruits, vegetables, whole grains, lean proteins, and low-fat dairy
products while restricting sodium, saturated fats, and added sugars. This diet has
been proven to reduce blood pressure by 8-14 mmHg and improve overall
cardiovascular health. Eliminating dairy, avoiding grains, reducing potassium (which
is beneficial in hypertension), and increasing fat are all contraindicated in the DASH
diet and would be inappropriate teaching outcomes.



QUESTION 4: CARDIOVASCULAR NURSING

A client is scheduled for a heart transplant and asks the nurse about
rejection. What is the primary cause of acute graft rejection?

A) Immunological response to foreign antigen

B) Infection of the transplanted organ

C) Inadequate immunosuppressive therapy

D) Surgical technique failure

E) Progressive atherosclerosis

CORRECT ANSWER: A) Immunological response to foreign antigen

, RATIONALE: Acute graft rejection occurs when the recipient's immune system
recognizes the donor heart as foreign and mounts an immune response against it.
This is mediated primarily by T-cells and antibodies directed against the donor's
human leukocyte antigens (HLA) and other alloantigens. Rejection can occur
despite immunosuppressive therapy, particularly in the first days to weeks after
transplantation. While infection and inadequate immunosuppression can increase
rejection risk, and progressive atherosclerosis causes chronic rejection, the
fundamental mechanism of acute rejection is the immunological recognition of
foreign antigens.



QUESTION 5: CARDIOVASCULAR NURSING

A nurse monitors a client on heparin therapy. What is the primary laboratory
value that must be monitored to assess therapeutic effectiveness?

A) Platelet count

B) Activated partial thromboplastin time (aPTT)

C) Prothrombin time (PT)

D) International normalized ratio (INR)

E) Complete blood count (CBC)

CORRECT ANSWER: B) Activated partial thromboplastin time (aPTT)

RATIONALE: Heparin is an anticoagulant that works through the intrinsic
coagulation pathway. The aPTT (activated partial thromboplastin time) is the
specific laboratory test used to monitor heparin therapy and assess its
effectiveness. The therapeutic range is typically 1.5 to 2.5 times the control value.
While platelet count should be monitored for heparin-induced thrombocytopenia
(HIT), it is not the primary indicator of therapeutic effectiveness. PT and INR are
used to monitor warfarin, not heparin.



QUESTION 6: RESPIRATORY NURSING