RELIAS RN MEDICAL SURGICAL TELEMETRY EXAM 2025 NEWEST
ACTUAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS PLUS RATIONALES) |ALREADY GRADED A+
//BRAND NEW!!
Question 1
Which adaptive equipment would be most appropriate to use for transferring a severely contracted
patient who is unable to bear any weight from their bed to a chair?
A) Gait belt
B) Stand-assist lift
C) Transfer board
D) Patient lift (e.g., Hoyer lift)
E) Wheelchair
Correct Answer: D) Patient lift (e.g., Hoyer lift)
Rationale: A patient lift is the safest and most appropriate choice. This equipment is designed
for non-weight-bearing patients and can lift the patient completely, minimizing risk of injury
to both the patient and the caregiver. A gait belt, stand-assist lift, and transfer board all
require the patient to bear some weight and would not be safe.
Question 2
A patient with end-stage renal disease (ESRD) is on a regular hemodialysis schedule. Which of the
following lab values would be expected for this patient prior to a dialysis treatment?
A) BUN 10 mg/dL, Creatinine 1.0 mg/dL
B) BUN 32 mg/dL, Creatinine 8.3 mg/dL
C) BUN 5 mg/dL, Creatinine 0.5 mg/dL
D) BUN 15 mg/dL, Creatinine 1.2 mg/dL
E) BUN 50 mg/dL, Creatinine 0.8 mg/dL
Correct Answer: B) BUN 32 mg/dL, Creatinine 8.3 mg/dL
Rationale: ESRD is characterized by the kidneys' inability to filter waste products from the
blood. This leads to an accumulation of urea and creatinine. Therefore, elevated Blood Urea
Nitrogen (BUN) and Creatinine levels are expected findings. The other options show normal
or inconsistent values.
Question 3
An 85-year-old patient with atrial fibrillation, who takes warfarin, fell at home three days ago. Since
admission, she has had several episodes of acute confusion. What is the most important order the
nurse should anticipate from the provider?
A) Apply soft restraints for confusion.
B) Obtain a STAT head CT scan.
C) Insert an indwelling urinary catheter.
D) Hold warfarin (Coumadin) for the next 48 hours.
E) Administer a sedative for agitation.
,Correct Answer: B) Obtain a STAT head CT scan. (Rationale based on clinical priority over the
provided answer)
Rationale: The combination of a fall, anticoagulant use (warfarin), and a new onset of acute
confusion is highly suggestive of an intracranial hemorrhage. The most critical priority is to
diagnose this life-threatening condition, which requires a STAT head CT scan. While holding
warfarin is also important, diagnosing the bleed is the absolute first step.
Question 4
A new admission presents with a persistent cough, unintentional weight loss, frequent night sweats,
and hemoptysis (bloody sputum). What type of isolation precautions should the nurse initiate
immediately?
A) Droplet precautions
B) Contact precautions
C) Standard precautions only
D) Airborne precautions
E) Protective isolation
Correct Answer: D) Airborne precautions
Rationale: These are the classic signs and symptoms of active pulmonary tuberculosis (TB).
TB is transmitted via small airborne particles when an infected person coughs, sneezes, or
talks. Airborne precautions, including a negative pressure room and N95 masks for staff, are
required to prevent transmission.
Question 5
Upon entering a patient's room, you witness them having a generalized tonic-clonic seizure. What is
the nurse's first priority action?
A) Insert a padded tongue blade into the mouth.
B) Restrain the patient's limbs to prevent injury.
C) Position the patient on their side to maintain a patent airway.
D) Go to the nurse's station to call the provider.
E) Administer emergency anti-seizure medication.
Correct Answer: C) Position the patient on their side to maintain a patent airway.
Rationale: The immediate priority during a seizure is to prevent aspiration and maintain a
patent airway. Turning the patient on their side allows the tongue to fall forward and
secretions to drain from the mouth. Restraining the patient can cause injury, and nothing
should ever be placed in the mouth.
Question 6
You find a coworker looking through the electronic medical record of your patient. She states, "How
is Mr. Smith doing? He is my best friend's dad. We are so worried about him." What is the best
course of action?
A) Give her a brief, general update to ease her worry.
,B) Ignore her actions as she is also a healthcare professional.
C) Tell her you cannot give her information and report her actions to your manager.
D) Allow her to continue looking since she has a personal connection to the patient.
E) Suggest she call the patient's family for an update.
Correct Answer: C) Tell her you cannot give her information and report her actions to your
manager.
Rationale: This is a violation of the Health Insurance Portability and Accountability Act
(HIPAA). Accessing a patient's record without a direct clinical need is a breach of privacy.
The correct response is to protect the patient's information and report the breach to the
appropriate authority, such as the nurse manager or compliance officer.
Question 7
A male patient complains of discomfort as you are inflating the balloon during the insertion of an
indwelling urinary catheter. What is the most appropriate nursing action?
A) Immediately remove the catheter completely.
B) Tell the patient the discomfort is normal and will pass.
C) Inflate the balloon with only half the recommended amount of sterile water.
D) Deflate the balloon, advance the catheter further, then reinflate the balloon.
E) Aspirate for urine return before inflating the balloon.
Correct Answer: D) Deflate the balloon, advance the catheter further, then reinflate the balloon.
Rationale: Pain upon balloon inflation indicates that the balloon is likely still in the prostatic
urethra and not fully in the bladder. The correct procedure is to stop, deflate the balloon,
advance the catheter another 1-2 inches to ensure it is in the bladder, and then slowly
reinflate.
Question 8
A patient takes a combination of regular insulin and NPH insulin in the morning and in the evening.
The patient should be taught to be most alert for signs of hypoglycemia during which times?
A) Immediately after injection and at bedtime
B) Mid-morning and mid-afternoon
C) Late afternoon and early morning
D) Only during the night while sleeping
E) Around noon and midnight
Correct Answer: C) Late afternoon and early morning
Rationale: Hypoglycemia occurs at the peak action time of insulin. Regular insulin peaks in 2-
4 hours. NPH, an intermediate-acting insulin, peaks in 4-12 hours. The morning NPH dose will
peak in the late afternoon. The evening NPH dose will peak overnight into the early morning
hours.
, Question 9
A patient is prescribed a proton pump inhibitor (PPI), such as pantoprazole (Protonix). What is the
primary therapeutic action of this medication?
A) To neutralize existing stomach acid
B) To form a protective barrier over an ulcer
C) To reduce gastric acid secretion
D) To increase the motility of the gastrointestinal tract
E) To kill H. pylori bacteria
Correct Answer: C) To reduce gastric acid secretion
Rationale: Proton pump inhibitors work by irreversibly blocking the H+/K+ ATPase enzyme
system (the "proton pump") in the gastric parietal cells. This action suppresses the final step
in gastric acid production, leading to a significant reduction in stomach acid secretion.
Question 10
A patient has a non-productive cough and you note the presence of secretions in his tracheostomy
tube. Prior to suctioning the patient, what should the nurse do first?
A) Instill normal saline into the tracheostomy.
B) Ask the patient to cough forcefully.
C) Hyperoxygenate the patient.
D) Change the tracheostomy inner cannula.
E) Check the suction regulator pressure.
Correct Answer: C) Hyperoxygenate the patient.
Rationale: Suctioning removes oxygen along with secretions, which can cause significant
hypoxemia. To prevent this, it is standard practice to provide the patient with 100% oxygen
for a brief period (30 seconds to a minute) immediately before inserting the suction catheter.
Question 11
Dietary teaching for a patient with chronic renal failure (CRF) who is not on dialysis should include
choices that are:
A) High in potassium, high in protein
B) Low in potassium, low in protein
C) Low in sodium, high in protein
D) High in phosphorus, low in fat
E) Unrestricted in protein and potassium
Correct Answer: B) Low in potassium, low in protein
Rationale: In CRF, the kidneys are unable to effectively excrete potassium, leading to a risk of
hyperkalemia. Protein metabolism creates nitrogenous waste products (BUN) that the
kidneys cannot clear. Therefore, a renal diet for a pre-dialysis patient restricts potassium and
protein to reduce the workload on the kidneys and prevent complications.
ACTUAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS PLUS RATIONALES) |ALREADY GRADED A+
//BRAND NEW!!
Question 1
Which adaptive equipment would be most appropriate to use for transferring a severely contracted
patient who is unable to bear any weight from their bed to a chair?
A) Gait belt
B) Stand-assist lift
C) Transfer board
D) Patient lift (e.g., Hoyer lift)
E) Wheelchair
Correct Answer: D) Patient lift (e.g., Hoyer lift)
Rationale: A patient lift is the safest and most appropriate choice. This equipment is designed
for non-weight-bearing patients and can lift the patient completely, minimizing risk of injury
to both the patient and the caregiver. A gait belt, stand-assist lift, and transfer board all
require the patient to bear some weight and would not be safe.
Question 2
A patient with end-stage renal disease (ESRD) is on a regular hemodialysis schedule. Which of the
following lab values would be expected for this patient prior to a dialysis treatment?
A) BUN 10 mg/dL, Creatinine 1.0 mg/dL
B) BUN 32 mg/dL, Creatinine 8.3 mg/dL
C) BUN 5 mg/dL, Creatinine 0.5 mg/dL
D) BUN 15 mg/dL, Creatinine 1.2 mg/dL
E) BUN 50 mg/dL, Creatinine 0.8 mg/dL
Correct Answer: B) BUN 32 mg/dL, Creatinine 8.3 mg/dL
Rationale: ESRD is characterized by the kidneys' inability to filter waste products from the
blood. This leads to an accumulation of urea and creatinine. Therefore, elevated Blood Urea
Nitrogen (BUN) and Creatinine levels are expected findings. The other options show normal
or inconsistent values.
Question 3
An 85-year-old patient with atrial fibrillation, who takes warfarin, fell at home three days ago. Since
admission, she has had several episodes of acute confusion. What is the most important order the
nurse should anticipate from the provider?
A) Apply soft restraints for confusion.
B) Obtain a STAT head CT scan.
C) Insert an indwelling urinary catheter.
D) Hold warfarin (Coumadin) for the next 48 hours.
E) Administer a sedative for agitation.
,Correct Answer: B) Obtain a STAT head CT scan. (Rationale based on clinical priority over the
provided answer)
Rationale: The combination of a fall, anticoagulant use (warfarin), and a new onset of acute
confusion is highly suggestive of an intracranial hemorrhage. The most critical priority is to
diagnose this life-threatening condition, which requires a STAT head CT scan. While holding
warfarin is also important, diagnosing the bleed is the absolute first step.
Question 4
A new admission presents with a persistent cough, unintentional weight loss, frequent night sweats,
and hemoptysis (bloody sputum). What type of isolation precautions should the nurse initiate
immediately?
A) Droplet precautions
B) Contact precautions
C) Standard precautions only
D) Airborne precautions
E) Protective isolation
Correct Answer: D) Airborne precautions
Rationale: These are the classic signs and symptoms of active pulmonary tuberculosis (TB).
TB is transmitted via small airborne particles when an infected person coughs, sneezes, or
talks. Airborne precautions, including a negative pressure room and N95 masks for staff, are
required to prevent transmission.
Question 5
Upon entering a patient's room, you witness them having a generalized tonic-clonic seizure. What is
the nurse's first priority action?
A) Insert a padded tongue blade into the mouth.
B) Restrain the patient's limbs to prevent injury.
C) Position the patient on their side to maintain a patent airway.
D) Go to the nurse's station to call the provider.
E) Administer emergency anti-seizure medication.
Correct Answer: C) Position the patient on their side to maintain a patent airway.
Rationale: The immediate priority during a seizure is to prevent aspiration and maintain a
patent airway. Turning the patient on their side allows the tongue to fall forward and
secretions to drain from the mouth. Restraining the patient can cause injury, and nothing
should ever be placed in the mouth.
Question 6
You find a coworker looking through the electronic medical record of your patient. She states, "How
is Mr. Smith doing? He is my best friend's dad. We are so worried about him." What is the best
course of action?
A) Give her a brief, general update to ease her worry.
,B) Ignore her actions as she is also a healthcare professional.
C) Tell her you cannot give her information and report her actions to your manager.
D) Allow her to continue looking since she has a personal connection to the patient.
E) Suggest she call the patient's family for an update.
Correct Answer: C) Tell her you cannot give her information and report her actions to your
manager.
Rationale: This is a violation of the Health Insurance Portability and Accountability Act
(HIPAA). Accessing a patient's record without a direct clinical need is a breach of privacy.
The correct response is to protect the patient's information and report the breach to the
appropriate authority, such as the nurse manager or compliance officer.
Question 7
A male patient complains of discomfort as you are inflating the balloon during the insertion of an
indwelling urinary catheter. What is the most appropriate nursing action?
A) Immediately remove the catheter completely.
B) Tell the patient the discomfort is normal and will pass.
C) Inflate the balloon with only half the recommended amount of sterile water.
D) Deflate the balloon, advance the catheter further, then reinflate the balloon.
E) Aspirate for urine return before inflating the balloon.
Correct Answer: D) Deflate the balloon, advance the catheter further, then reinflate the balloon.
Rationale: Pain upon balloon inflation indicates that the balloon is likely still in the prostatic
urethra and not fully in the bladder. The correct procedure is to stop, deflate the balloon,
advance the catheter another 1-2 inches to ensure it is in the bladder, and then slowly
reinflate.
Question 8
A patient takes a combination of regular insulin and NPH insulin in the morning and in the evening.
The patient should be taught to be most alert for signs of hypoglycemia during which times?
A) Immediately after injection and at bedtime
B) Mid-morning and mid-afternoon
C) Late afternoon and early morning
D) Only during the night while sleeping
E) Around noon and midnight
Correct Answer: C) Late afternoon and early morning
Rationale: Hypoglycemia occurs at the peak action time of insulin. Regular insulin peaks in 2-
4 hours. NPH, an intermediate-acting insulin, peaks in 4-12 hours. The morning NPH dose will
peak in the late afternoon. The evening NPH dose will peak overnight into the early morning
hours.
, Question 9
A patient is prescribed a proton pump inhibitor (PPI), such as pantoprazole (Protonix). What is the
primary therapeutic action of this medication?
A) To neutralize existing stomach acid
B) To form a protective barrier over an ulcer
C) To reduce gastric acid secretion
D) To increase the motility of the gastrointestinal tract
E) To kill H. pylori bacteria
Correct Answer: C) To reduce gastric acid secretion
Rationale: Proton pump inhibitors work by irreversibly blocking the H+/K+ ATPase enzyme
system (the "proton pump") in the gastric parietal cells. This action suppresses the final step
in gastric acid production, leading to a significant reduction in stomach acid secretion.
Question 10
A patient has a non-productive cough and you note the presence of secretions in his tracheostomy
tube. Prior to suctioning the patient, what should the nurse do first?
A) Instill normal saline into the tracheostomy.
B) Ask the patient to cough forcefully.
C) Hyperoxygenate the patient.
D) Change the tracheostomy inner cannula.
E) Check the suction regulator pressure.
Correct Answer: C) Hyperoxygenate the patient.
Rationale: Suctioning removes oxygen along with secretions, which can cause significant
hypoxemia. To prevent this, it is standard practice to provide the patient with 100% oxygen
for a brief period (30 seconds to a minute) immediately before inserting the suction catheter.
Question 11
Dietary teaching for a patient with chronic renal failure (CRF) who is not on dialysis should include
choices that are:
A) High in potassium, high in protein
B) Low in potassium, low in protein
C) Low in sodium, high in protein
D) High in phosphorus, low in fat
E) Unrestricted in protein and potassium
Correct Answer: B) Low in potassium, low in protein
Rationale: In CRF, the kidneys are unable to effectively excrete potassium, leading to a risk of
hyperkalemia. Protein metabolism creates nitrogenous waste products (BUN) that the
kidneys cannot clear. Therefore, a renal diet for a pre-dialysis patient restricts potassium and
protein to reduce the workload on the kidneys and prevent complications.
