RELIAS ED RN EXAM WITH 300+ PRACTICE
QUESTIONS & CORRECT ANSWERS DETAILED
RATIONALES 2026/2027
1. A patient presents with acute onset of central chest pain. The patient is tachycardic and
tachypneic and appears very anxious and restless. What would be the MOST important initial
intervention for this patient?
A) Obtain an electrocardiogram
B) Administer nitroglycerin
C) Administer oxygen
D) Obtain venous blood gas
Answer C: Administer oxygen
Rationale: In any suspected cardiac or respiratory emergency, airway and oxygenation are the priority.
2. What is the current recommended dose of intravenous or intraosseous epinephrine in adult
patients with cardiac arrest?
A) 10 mg every 10 minutes
B) 1 mg every 3-5 minutes
C) 1 mg every 7 minutes
D) 0.1 mg every 2 minutes
Answer B: 1 mg every 3-5 minutes
Rationale: Current ACLS guidelines recommend 1 mg of epinephrine every 3-5 minutes during cardiac
arrest.
3. A patient with a traumatic brain injury (TBI) is MOST likely to suffer from what condition?
A) Syndrome of inappropriate antidiuretic hormone (SIADH)
B) Diabetes mellitus
,C) Diabetes insipidus
D) Adrenal insufficiency
Answer C: Diabetes insipidus
Rationale: TBI can damage the hypothalamus or pituitary, leading to ADH deficiency and diabetes
insipidus.
4. A 22-year-old female who is 8 weeks pregnant presents with a sudden onset of left lower
abdominal pain and vaginal bleeding. The patient's family member stated that she had a syncopal
episode shortly after that. What is the MOST likely diagnosis for her?
A) Ruptured appendix
B) Placenta previa
C) Abruptio placentae
D) Ruptured ectopic pregnancy
Answer D: Ruptured ectopic pregnancy
Rationale: Abdominal pain, vaginal bleeding, and syncope in early pregnancy suggest ruptured ectopic
pregnancy.
5. What ESI (Emergency Severity Index) level should be assigned to a patient with acute stroke
symptoms (right-sided weakness, facial droop, slurred speech) with onset 45 minutes ago?
A) ESI Level 1
B) ESI Level 2
C) ESI Level 3
D) ESI Level 4
Answer B: ESI Level 2
Rationale: Acute stroke symptoms within the thrombolytic window constitute a high-risk, time-sensitive
condition (ESI Level 2).
,6. A patient presents with a regular, narrow-complex tachycardia at a rate of 180 beats/minute.
The patient is alert but complains of chest tightness, and the blood pressure is 88/52 mmHg. What
is the immediate priority intervention?
A) Administering a fluid bolus of 1 Liter Normal Saline
B) Performing immediate synchronized cardioversion
C) Administering Adenosine 6 mg rapid IV push
D) Initiating transcutaneous pacing at 60 beats/minute
Answer B: Performing immediate synchronized cardioversion
Rationale: Unstable tachyarrhythmia with hypotension requires immediate synchronized cardioversion.
7. A confused patient is trying to grasp at their IV with their right hand. Which is the LEAST
restrictive measure to maintain patient safety?
A) 2-point restraint on right arm and left leg
B) Safety "mitt" for both hands
C) 2-point restraints on upper limbs
D) Safety "mitt" for right hand only
Answer D: Safety "mitt" for right hand only
Rationale: The least restrictive measure should be used first to maintain patient safety while preserving
autonomy.
8. Which of the following wounds has the highest risk for developing osteomyelitis?
A) Closed fracture of tibia resulting from trauma
B) Contusion and bruising to the head from a fall
C) Puncture wound from stepping on a rusty nail
D) Laceration of the face from breaking glass
Answer C: Puncture wound from stepping on a rusty nail
Rationale: Puncture wounds have a high risk of deep infection and osteomyelitis due to inoculation of
bacteria.
, 9. What is the appropriate ESI triage level for a stable patient requiring multiple resources (e.g., IV
fluids, medications, labs, imaging)?
A) ESI Level 1
B) ESI Level 2
C) ESI Level 3
D) ESI Level 4
Answer C: ESI Level 3
Rationale: ESI Level 3 is appropriate for stable patients requiring two or more resources.
10. A patient presents after an intentional overdose of propranolol approximately 2 hours ago.
The patient has severe hypotension and bradycardia. IV fluids and vasopressors are initiated. What
nursing assessment finding indicates the treatment has been effective?
A) Decreasing pulse pressure
B) Decreasing central venous pressure
C) Increasing serum glucose
D) Increasing serum cortisol
Answer C: Increasing serum glucose
Rationale: Effective vasopressor therapy is associated with increased serum glucose levels.
11. A patient who is 27 weeks pregnant presents with painless bright red vaginal bleeding. What
condition correlates with the presenting symptoms?
A) Abruptio placentae
B) Placenta previa
C) Ectopic pregnancy
D) Premature rupture of membranes (PROM)
Answer B: Placenta previa
Rationale: Painless bright red vaginal bleeding in the second or third trimester is classic for placenta
previa.
QUESTIONS & CORRECT ANSWERS DETAILED
RATIONALES 2026/2027
1. A patient presents with acute onset of central chest pain. The patient is tachycardic and
tachypneic and appears very anxious and restless. What would be the MOST important initial
intervention for this patient?
A) Obtain an electrocardiogram
B) Administer nitroglycerin
C) Administer oxygen
D) Obtain venous blood gas
Answer C: Administer oxygen
Rationale: In any suspected cardiac or respiratory emergency, airway and oxygenation are the priority.
2. What is the current recommended dose of intravenous or intraosseous epinephrine in adult
patients with cardiac arrest?
A) 10 mg every 10 minutes
B) 1 mg every 3-5 minutes
C) 1 mg every 7 minutes
D) 0.1 mg every 2 minutes
Answer B: 1 mg every 3-5 minutes
Rationale: Current ACLS guidelines recommend 1 mg of epinephrine every 3-5 minutes during cardiac
arrest.
3. A patient with a traumatic brain injury (TBI) is MOST likely to suffer from what condition?
A) Syndrome of inappropriate antidiuretic hormone (SIADH)
B) Diabetes mellitus
,C) Diabetes insipidus
D) Adrenal insufficiency
Answer C: Diabetes insipidus
Rationale: TBI can damage the hypothalamus or pituitary, leading to ADH deficiency and diabetes
insipidus.
4. A 22-year-old female who is 8 weeks pregnant presents with a sudden onset of left lower
abdominal pain and vaginal bleeding. The patient's family member stated that she had a syncopal
episode shortly after that. What is the MOST likely diagnosis for her?
A) Ruptured appendix
B) Placenta previa
C) Abruptio placentae
D) Ruptured ectopic pregnancy
Answer D: Ruptured ectopic pregnancy
Rationale: Abdominal pain, vaginal bleeding, and syncope in early pregnancy suggest ruptured ectopic
pregnancy.
5. What ESI (Emergency Severity Index) level should be assigned to a patient with acute stroke
symptoms (right-sided weakness, facial droop, slurred speech) with onset 45 minutes ago?
A) ESI Level 1
B) ESI Level 2
C) ESI Level 3
D) ESI Level 4
Answer B: ESI Level 2
Rationale: Acute stroke symptoms within the thrombolytic window constitute a high-risk, time-sensitive
condition (ESI Level 2).
,6. A patient presents with a regular, narrow-complex tachycardia at a rate of 180 beats/minute.
The patient is alert but complains of chest tightness, and the blood pressure is 88/52 mmHg. What
is the immediate priority intervention?
A) Administering a fluid bolus of 1 Liter Normal Saline
B) Performing immediate synchronized cardioversion
C) Administering Adenosine 6 mg rapid IV push
D) Initiating transcutaneous pacing at 60 beats/minute
Answer B: Performing immediate synchronized cardioversion
Rationale: Unstable tachyarrhythmia with hypotension requires immediate synchronized cardioversion.
7. A confused patient is trying to grasp at their IV with their right hand. Which is the LEAST
restrictive measure to maintain patient safety?
A) 2-point restraint on right arm and left leg
B) Safety "mitt" for both hands
C) 2-point restraints on upper limbs
D) Safety "mitt" for right hand only
Answer D: Safety "mitt" for right hand only
Rationale: The least restrictive measure should be used first to maintain patient safety while preserving
autonomy.
8. Which of the following wounds has the highest risk for developing osteomyelitis?
A) Closed fracture of tibia resulting from trauma
B) Contusion and bruising to the head from a fall
C) Puncture wound from stepping on a rusty nail
D) Laceration of the face from breaking glass
Answer C: Puncture wound from stepping on a rusty nail
Rationale: Puncture wounds have a high risk of deep infection and osteomyelitis due to inoculation of
bacteria.
, 9. What is the appropriate ESI triage level for a stable patient requiring multiple resources (e.g., IV
fluids, medications, labs, imaging)?
A) ESI Level 1
B) ESI Level 2
C) ESI Level 3
D) ESI Level 4
Answer C: ESI Level 3
Rationale: ESI Level 3 is appropriate for stable patients requiring two or more resources.
10. A patient presents after an intentional overdose of propranolol approximately 2 hours ago.
The patient has severe hypotension and bradycardia. IV fluids and vasopressors are initiated. What
nursing assessment finding indicates the treatment has been effective?
A) Decreasing pulse pressure
B) Decreasing central venous pressure
C) Increasing serum glucose
D) Increasing serum cortisol
Answer C: Increasing serum glucose
Rationale: Effective vasopressor therapy is associated with increased serum glucose levels.
11. A patient who is 27 weeks pregnant presents with painless bright red vaginal bleeding. What
condition correlates with the presenting symptoms?
A) Abruptio placentae
B) Placenta previa
C) Ectopic pregnancy
D) Premature rupture of membranes (PROM)
Answer B: Placenta previa
Rationale: Painless bright red vaginal bleeding in the second or third trimester is classic for placenta
previa.
