Relias Learning Nursing Test Exam (2026/2027) – Nursing
Competency Assessment | Exam Script with Full Correct
Solution Set
1. The primary purpose of hand hygiene in healthcare settings is to:
A. Protect the nurse from chemicals
B. Prevent the spread of microorganisms
C. Improve patient comfort
D. Meet documentation requirements
Rationale: Hand hygiene is the most effective method to reduce healthcare-associated
infections.
2. Which position is most appropriate for a patient experiencing dyspnea?
A. Supine
B. High Fowler’s
C. Trendelenburg
D. Prone
Rationale: High Fowler’s maximizes lung expansion and oxygenation.
3. A patient is at risk for developing pressure injuries. Which intervention is most effective?
A. Massage reddened skin
B. Reposition every two hours
C. Limit oral fluids
D. Apply heat packs
Rationale: Regular repositioning reduces prolonged pressure on tissues.
4. What is the normal adult respiratory rate?
A. 8–12 breaths/min
B. 12–20 breaths/min
C. 20–28 breaths/min
D. 28–36 breaths/min
Rationale: Normal adult respiratory rate is 12–20 breaths per minute.
5. A nurse discovers a patient on the floor. What is the nurse’s first action?
A. Complete an incident report
B. Assess the patient for injuries
C. Help the patient back to bed
D. Notify the provider
Rationale: Immediate assessment ensures patient safety.
Vital Signs & Assessment (26–40)
6. Which blood pressure reading indicates hypertension?
A. 110/70 mmHg
B. 118/76 mmHg
C. 148/92 mmHg
, D. 120/80 mmHg
Rationale: Hypertension is defined as BP ≥140/90 mmHg.
7. An oxygen saturation of 88% indicates:
A. Normal oxygenation
B. Mild hypoxia
C. Significant hypoxia
D. Hyperventilation
Rationale: Normal SpO₂ is ≥95%.
8. Which finding should be reported immediately?
A. Heart rate of 82 bpm
B. Sudden confusion
C. Temperature of 99°F
D. Pain rating of 4/10
Rationale: Acute mental status changes may indicate hypoxia or stroke.
9. A nurse assesses capillary refill of 4 seconds. This indicates:
A. Normal circulation
B. Poor perfusion
C. Fluid overload
D. Dehydration
Rationale: Normal capillary refill is ≤2 seconds.
10. The most accurate way to measure core temperature is:
A. Oral
B. Axillary
C. Rectal
D. Temporal
Rationale: Rectal temperature best reflects core temperature.
Pharmacology (41–70)
11. Which medication requires apical pulse assessment before administration?
A. Digoxin
B. Acetaminophen
C. Insulin
D. Ceftriaxone
Rationale: Digoxin affects heart rate and rhythm.
12. A patient receiving morphine should be monitored for:
A. Hypertension
B. Respiratory depression
C. Hyperglycemia
D. Tachycardia
Rationale: Opioids suppress respiratory drive.
13. Which laboratory value indicates hyperkalemia?
A. 3.2 mEq/L
B. 4.1 mEq/L
Competency Assessment | Exam Script with Full Correct
Solution Set
1. The primary purpose of hand hygiene in healthcare settings is to:
A. Protect the nurse from chemicals
B. Prevent the spread of microorganisms
C. Improve patient comfort
D. Meet documentation requirements
Rationale: Hand hygiene is the most effective method to reduce healthcare-associated
infections.
2. Which position is most appropriate for a patient experiencing dyspnea?
A. Supine
B. High Fowler’s
C. Trendelenburg
D. Prone
Rationale: High Fowler’s maximizes lung expansion and oxygenation.
3. A patient is at risk for developing pressure injuries. Which intervention is most effective?
A. Massage reddened skin
B. Reposition every two hours
C. Limit oral fluids
D. Apply heat packs
Rationale: Regular repositioning reduces prolonged pressure on tissues.
4. What is the normal adult respiratory rate?
A. 8–12 breaths/min
B. 12–20 breaths/min
C. 20–28 breaths/min
D. 28–36 breaths/min
Rationale: Normal adult respiratory rate is 12–20 breaths per minute.
5. A nurse discovers a patient on the floor. What is the nurse’s first action?
A. Complete an incident report
B. Assess the patient for injuries
C. Help the patient back to bed
D. Notify the provider
Rationale: Immediate assessment ensures patient safety.
Vital Signs & Assessment (26–40)
6. Which blood pressure reading indicates hypertension?
A. 110/70 mmHg
B. 118/76 mmHg
C. 148/92 mmHg
, D. 120/80 mmHg
Rationale: Hypertension is defined as BP ≥140/90 mmHg.
7. An oxygen saturation of 88% indicates:
A. Normal oxygenation
B. Mild hypoxia
C. Significant hypoxia
D. Hyperventilation
Rationale: Normal SpO₂ is ≥95%.
8. Which finding should be reported immediately?
A. Heart rate of 82 bpm
B. Sudden confusion
C. Temperature of 99°F
D. Pain rating of 4/10
Rationale: Acute mental status changes may indicate hypoxia or stroke.
9. A nurse assesses capillary refill of 4 seconds. This indicates:
A. Normal circulation
B. Poor perfusion
C. Fluid overload
D. Dehydration
Rationale: Normal capillary refill is ≤2 seconds.
10. The most accurate way to measure core temperature is:
A. Oral
B. Axillary
C. Rectal
D. Temporal
Rationale: Rectal temperature best reflects core temperature.
Pharmacology (41–70)
11. Which medication requires apical pulse assessment before administration?
A. Digoxin
B. Acetaminophen
C. Insulin
D. Ceftriaxone
Rationale: Digoxin affects heart rate and rhythm.
12. A patient receiving morphine should be monitored for:
A. Hypertension
B. Respiratory depression
C. Hyperglycemia
D. Tachycardia
Rationale: Opioids suppress respiratory drive.
13. Which laboratory value indicates hyperkalemia?
A. 3.2 mEq/L
B. 4.1 mEq/L
