Medical-Surgical RN A Prophecy Relias Exam Study Guide |
Complete Practice Exam Questions with Verified Answers and
Detailed Rationales (100% Correct Solutions) | Latest Update
2026/2027 | Already Graded A+
Question 1. A patient with heart failure suddenly develops severe dyspnea,
crackles throughout both lungs, and pink, frothy sputum. Which intervention
should the nurse perform first?
A. Place the patient in a high-Fowler position
B. Encourage oral fluids
C. Place the patient flat in bed
D. Administer a large fluid bolus
Correct Answer: A. Place the patient in a high-Fowler position
Rationale: Acute pulmonary edema is a life-threatening complication of heart
failure. High-Fowler positioning improves lung expansion and decreases
venous return to the heart, which can reduce pulmonary congestion. Oxygen
and prescribed medications such as diuretics are also commonly required.
Question 2. A patient with COPD is receiving oxygen therapy. Which
assessment finding requires the nurse's closest attention?
A. Respiratory rate of 18/min
B. Oxygen saturation of 90%
C. Increasing drowsiness and confusion
D. Mild chronic cough
Correct Answer: C. Increasing drowsiness and confusion
Rationale: Increasing drowsiness and confusion can indicate worsening
hypercapnia or respiratory failure. Some patients with chronic CO₂ retention
require carefully titrated oxygen therapy. A change in mental status should
prompt immediate reassessment of ventilation and oxygenation.
pg. 1
,Question 3. A patient develops sudden facial drooping and weakness of the
right arm. What is the nurse's priority action?
A. Give oral fluids
B. Determine the time the symptoms began
C. Place the patient in Trendelenburg position
D. Encourage the patient to walk
Correct Answer: B. Determine the time the symptoms began
Rationale: Sudden focal neurological deficits suggest an acute stroke. The
exact time of symptom onset is critical because eligibility for certain time-
sensitive treatments depends on when symptoms began or when the patient
was last known well.
Question 4. Which finding is most concerning in a patient with a suspected
stroke?
A. Mild headache
B. Sudden unilateral weakness
C. Chronic fatigue
D. Mild nausea
Correct Answer: B. Sudden unilateral weakness
Rationale: Sudden unilateral weakness is a classic manifestation of acute
neurological dysfunction and requires immediate stroke evaluation. Rapid
assessment can reduce delays in diagnosis and treatment.
Question 5. A patient with diabetes is pale, diaphoretic, shaky, and confused.
What should the nurse do first?
A. Administer long-acting insulin
B. Check the blood glucose level
C. Encourage exercise
D. Restrict carbohydrates
pg. 2
,Correct Answer: B. Check the blood glucose level
Rationale: The symptoms strongly suggest hypoglycemia. The nurse should
rapidly assess the blood glucose level. If hypoglycemia is confirmed and the
patient can safely swallow, a rapidly absorbed carbohydrate is generally given
according to the treatment protocol.
Question 6. Which finding is most consistent with hypoglycemia?
A. Polyuria
B. Fruity breath
C. Diaphoresis and tremors
D. Deep, rapid respirations
Correct Answer: C. Diaphoresis and tremors
Rationale: Hypoglycemia stimulates the sympathetic nervous system,
producing sweating, tremors, palpitations, anxiety, and hunger. Severe
hypoglycemia can progress to confusion, seizures, loss of consciousness, and
coma.
Question 7. A patient with diabetic ketoacidosis is receiving IV fluids and
insulin. Which laboratory value requires particularly close monitoring?
A. Potassium
B. Hemoglobin
C. Platelets
D. Albumin
Correct Answer: A. Potassium
Rationale: Insulin drives potassium into cells, potentially causing or
worsening hypokalemia during treatment of DKA. Potassium must therefore
be monitored closely and replaced when indicated.
pg. 3
, Question 8. Which assessment finding is expected in a patient with
dehydration?
A. Bounding pulse
B. Increased urine output
C. Dry mucous membranes
D. Peripheral edema
Correct Answer: C. Dry mucous membranes
Rationale: Fluid volume deficit commonly causes dry mucous membranes,
decreased urine output, tachycardia, orthostatic changes, thirst, and
concentrated urine.
Question 9. A patient with chronic kidney disease is prescribed a diet
restricted in potassium. Which food should the nurse identify as high in
potassium?
A. White rice
B. Apples
C. Bananas
D. Bread
Correct Answer: C. Bananas
Rationale: Bananas are potassium-rich. Patients with advanced kidney
disease may develop hyperkalemia because impaired renal function decreases
potassium excretion. Other potassium-rich foods include oranges, potatoes,
tomatoes, and dried fruits.
Question 10. Which ECG change is commonly associated with hyperkalemia?
A. Peaked T waves
B. Prolonged QT interval only
C. ST elevation in every lead
D. Narrowed QRS with absent T waves
pg. 4
Complete Practice Exam Questions with Verified Answers and
Detailed Rationales (100% Correct Solutions) | Latest Update
2026/2027 | Already Graded A+
Question 1. A patient with heart failure suddenly develops severe dyspnea,
crackles throughout both lungs, and pink, frothy sputum. Which intervention
should the nurse perform first?
A. Place the patient in a high-Fowler position
B. Encourage oral fluids
C. Place the patient flat in bed
D. Administer a large fluid bolus
Correct Answer: A. Place the patient in a high-Fowler position
Rationale: Acute pulmonary edema is a life-threatening complication of heart
failure. High-Fowler positioning improves lung expansion and decreases
venous return to the heart, which can reduce pulmonary congestion. Oxygen
and prescribed medications such as diuretics are also commonly required.
Question 2. A patient with COPD is receiving oxygen therapy. Which
assessment finding requires the nurse's closest attention?
A. Respiratory rate of 18/min
B. Oxygen saturation of 90%
C. Increasing drowsiness and confusion
D. Mild chronic cough
Correct Answer: C. Increasing drowsiness and confusion
Rationale: Increasing drowsiness and confusion can indicate worsening
hypercapnia or respiratory failure. Some patients with chronic CO₂ retention
require carefully titrated oxygen therapy. A change in mental status should
prompt immediate reassessment of ventilation and oxygenation.
pg. 1
,Question 3. A patient develops sudden facial drooping and weakness of the
right arm. What is the nurse's priority action?
A. Give oral fluids
B. Determine the time the symptoms began
C. Place the patient in Trendelenburg position
D. Encourage the patient to walk
Correct Answer: B. Determine the time the symptoms began
Rationale: Sudden focal neurological deficits suggest an acute stroke. The
exact time of symptom onset is critical because eligibility for certain time-
sensitive treatments depends on when symptoms began or when the patient
was last known well.
Question 4. Which finding is most concerning in a patient with a suspected
stroke?
A. Mild headache
B. Sudden unilateral weakness
C. Chronic fatigue
D. Mild nausea
Correct Answer: B. Sudden unilateral weakness
Rationale: Sudden unilateral weakness is a classic manifestation of acute
neurological dysfunction and requires immediate stroke evaluation. Rapid
assessment can reduce delays in diagnosis and treatment.
Question 5. A patient with diabetes is pale, diaphoretic, shaky, and confused.
What should the nurse do first?
A. Administer long-acting insulin
B. Check the blood glucose level
C. Encourage exercise
D. Restrict carbohydrates
pg. 2
,Correct Answer: B. Check the blood glucose level
Rationale: The symptoms strongly suggest hypoglycemia. The nurse should
rapidly assess the blood glucose level. If hypoglycemia is confirmed and the
patient can safely swallow, a rapidly absorbed carbohydrate is generally given
according to the treatment protocol.
Question 6. Which finding is most consistent with hypoglycemia?
A. Polyuria
B. Fruity breath
C. Diaphoresis and tremors
D. Deep, rapid respirations
Correct Answer: C. Diaphoresis and tremors
Rationale: Hypoglycemia stimulates the sympathetic nervous system,
producing sweating, tremors, palpitations, anxiety, and hunger. Severe
hypoglycemia can progress to confusion, seizures, loss of consciousness, and
coma.
Question 7. A patient with diabetic ketoacidosis is receiving IV fluids and
insulin. Which laboratory value requires particularly close monitoring?
A. Potassium
B. Hemoglobin
C. Platelets
D. Albumin
Correct Answer: A. Potassium
Rationale: Insulin drives potassium into cells, potentially causing or
worsening hypokalemia during treatment of DKA. Potassium must therefore
be monitored closely and replaced when indicated.
pg. 3
, Question 8. Which assessment finding is expected in a patient with
dehydration?
A. Bounding pulse
B. Increased urine output
C. Dry mucous membranes
D. Peripheral edema
Correct Answer: C. Dry mucous membranes
Rationale: Fluid volume deficit commonly causes dry mucous membranes,
decreased urine output, tachycardia, orthostatic changes, thirst, and
concentrated urine.
Question 9. A patient with chronic kidney disease is prescribed a diet
restricted in potassium. Which food should the nurse identify as high in
potassium?
A. White rice
B. Apples
C. Bananas
D. Bread
Correct Answer: C. Bananas
Rationale: Bananas are potassium-rich. Patients with advanced kidney
disease may develop hyperkalemia because impaired renal function decreases
potassium excretion. Other potassium-rich foods include oranges, potatoes,
tomatoes, and dried fruits.
Question 10. Which ECG change is commonly associated with hyperkalemia?
A. Peaked T waves
B. Prolonged QT interval only
C. ST elevation in every lead
D. Narrowed QRS with absent T waves
pg. 4
