1
MEDICAL-SURGICAL RN A PROPHECY
RELIAS TEST | LATEST UPDATE 2026/2027 |
150+ PRACTICE QUESTIONS AND VERIFIED
ANSWERS | EXAM REVIEW | STUDY GUIDE.
Table of Contents
1. Prioritization and Delegation
2. Cardiovascular and Hematologic Nursing
3. Respiratory and Thoracic Nursing
4. Gastrointestinal and Hepatobiliary Nursing
5. Renal, Genitourinary, and Electrolyte Management
6. Musculoskeletal, Neurological, Endocrine, and Immune Nursing
7. Pharmacology, Calculations, and Fluid Management
8. Patient Safety, Infection Control, and Postoperative Care
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Question 1: If your patient with a known history of diabetes is displaying symptoms of
diaphoresis, cool skin, lethargy, and shakiness, what is your first action?
A) Administer insulin
B) Check the patient's blood glucose level
C) Call the provider
D) Give the patient orange juice
Correct Answer: B) Check the patient's blood glucose level
Diaphoresis, cool skin, lethargy, and shakiness are classic signs of hypoglycemia. The
priority nursing action is to obtain a capillary blood glucose level to confirm the diagnosis
before initiating any intervention. Administering insulin would worsen hypoglycemia. Calling
the provider is premature without objective data. Orange juice may be given after confirming
hypoglycemia, not before.
Question 2: Your post-op patient has a Jackson-Pratt (JP) drain in place. How do you ensure
effective drain function?
A) Connect the bulb to wall suction
B) Leave the port open for gravity drainage
C) Compress the drain, then plug the bulb to establish suction
D) Change the bulb every hour
Correct Answer: C) Compress the drain, then plug the bulb to establish suction
Jackson-Pratt drains operate on self-contained negative pressure. The bulb must be
compressed and then plugged to create suction that draws fluid from the surgical site. Wall
suction applies excessive force that can damage tissue. Leaving the port open breaks the
vacuum. Routine hourly changes are unnecessary and break the sterile closed system.
Question 3: Your male patient complains of discomfort while inflating the balloon during
insertion of an indwelling urinary catheter. What would be the MOST appropriate action?
A) Inflate the balloon more rapidly
B) Deflate the balloon, advance the catheter further, then reinflate
C) Remove the catheter and notify the provider
D) Continue inflation and reassure the patient
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Correct Answer: B) Deflate the balloon, advance the catheter further, then reinflate
Discomfort during balloon inflation indicates the balloon is still within the urethra, not the
bladder. The nurse must deflate the balloon, advance the catheter further into the bladder,
and then reinflate. Continuing inflation can cause urethral trauma. Removing the catheter is
unnecessary if the issue can be resolved with proper advancement.
Question 4: Your patient has symptomatic anemia but is refusing a blood transfusion for
religious reasons. What is an appropriate response?
A) Respect his wishes and notify the provider
B) Administer a sedative and proceed with transfusion
C) Ask the family to convince the patient
D) Document refusal and take no further action
Correct Answer: A) Respect his wishes and notify the provider
Patient autonomy and religious beliefs must be respected. The nurse should honor the refusal,
notify the provider, and document the patient's decision. Proceeding with transfusion against
the patient's wishes violates ethical and legal standards. Involving family to pressure the
patient is inappropriate. Simply documenting without notifying the provider fails to ensure
alternative treatments are explored.
Question 5: Your patient is admitted with diverticulitis. What type of diet do you expect to be
ordered for the patient?
A) High-fiber diet
B) Clear liquids
C) Regular diet
D) Full liquid diet
Correct Answer: B) Clear liquids
Acute diverticulitis requires bowel rest to reduce inflammation. Clear liquids are initially
ordered to allow the bowel to rest while maintaining hydration. A high-fiber diet is
contraindicated during acute episodes. Regular and full liquid diets are advanced gradually
as inflammation resolves.
Question 6: You were hired to work the medical unit and when you arrive at work the charge
nurse has assigned you to the post-surgical unit since they are understaffed. Which is the
MOST appropriate action?
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A) Refuse the assignment because it is not your usual unit
B) Report to the post-surgical unit
C) Ask to be floated to a different unit
D) Call the nursing supervisor to complain
Correct Answer: B) Report to the post-surgical unit
Nurses are expected to be flexible and report to the assigned unit when floated. Refusing an
assignment without a valid safety concern can be considered insubordination. The nurse
should report to the assigned unit and provide safe care within their scope of practice. If the
assignment poses a genuine safety risk, the nurse should discuss concerns with the charge
nurse or supervisor.
Question 7: Your patient is 4 hours post open appendectomy and has not voided yet. You note
his lower abdomen is distended. What should you do NEXT?
A) Perform a bladder scan
B) Insert an indwelling urinary catheter immediately
C) Encourage the patient to drink more fluids
D) Document the finding and reassess in 4 hours
Correct Answer: A) Perform a bladder scan
A bladder scan is a non-invasive method to assess for urinary retention after surgery. The
patient is likely experiencing postoperative urinary retention due to anesthesia and
immobility. The scan will determine the volume of urine in the bladder and guide the need for
catheterization. Inserting a catheter without assessment is premature. Encouraging fluids
may worsen distention. Documenting and reassessing later delays necessary intervention.
Question 8: What is a proton pump inhibitor, such as pantoprazole (Protonix), used for?
A) Acid reduction
B) Blood pressure control
C) Pain relief
D) Infection prevention
Correct Answer: A) Acid reduction
Proton pump inhibitors (PPIs) such as pantoprazole reduce gastric acid secretion by
inhibiting the proton pump in gastric parietal cells. They are used to treat gastroesophageal
MEDICAL-SURGICAL RN A PROPHECY
RELIAS TEST | LATEST UPDATE 2026/2027 |
150+ PRACTICE QUESTIONS AND VERIFIED
ANSWERS | EXAM REVIEW | STUDY GUIDE.
Table of Contents
1. Prioritization and Delegation
2. Cardiovascular and Hematologic Nursing
3. Respiratory and Thoracic Nursing
4. Gastrointestinal and Hepatobiliary Nursing
5. Renal, Genitourinary, and Electrolyte Management
6. Musculoskeletal, Neurological, Endocrine, and Immune Nursing
7. Pharmacology, Calculations, and Fluid Management
8. Patient Safety, Infection Control, and Postoperative Care
,2
Question 1: If your patient with a known history of diabetes is displaying symptoms of
diaphoresis, cool skin, lethargy, and shakiness, what is your first action?
A) Administer insulin
B) Check the patient's blood glucose level
C) Call the provider
D) Give the patient orange juice
Correct Answer: B) Check the patient's blood glucose level
Diaphoresis, cool skin, lethargy, and shakiness are classic signs of hypoglycemia. The
priority nursing action is to obtain a capillary blood glucose level to confirm the diagnosis
before initiating any intervention. Administering insulin would worsen hypoglycemia. Calling
the provider is premature without objective data. Orange juice may be given after confirming
hypoglycemia, not before.
Question 2: Your post-op patient has a Jackson-Pratt (JP) drain in place. How do you ensure
effective drain function?
A) Connect the bulb to wall suction
B) Leave the port open for gravity drainage
C) Compress the drain, then plug the bulb to establish suction
D) Change the bulb every hour
Correct Answer: C) Compress the drain, then plug the bulb to establish suction
Jackson-Pratt drains operate on self-contained negative pressure. The bulb must be
compressed and then plugged to create suction that draws fluid from the surgical site. Wall
suction applies excessive force that can damage tissue. Leaving the port open breaks the
vacuum. Routine hourly changes are unnecessary and break the sterile closed system.
Question 3: Your male patient complains of discomfort while inflating the balloon during
insertion of an indwelling urinary catheter. What would be the MOST appropriate action?
A) Inflate the balloon more rapidly
B) Deflate the balloon, advance the catheter further, then reinflate
C) Remove the catheter and notify the provider
D) Continue inflation and reassure the patient
,3
Correct Answer: B) Deflate the balloon, advance the catheter further, then reinflate
Discomfort during balloon inflation indicates the balloon is still within the urethra, not the
bladder. The nurse must deflate the balloon, advance the catheter further into the bladder,
and then reinflate. Continuing inflation can cause urethral trauma. Removing the catheter is
unnecessary if the issue can be resolved with proper advancement.
Question 4: Your patient has symptomatic anemia but is refusing a blood transfusion for
religious reasons. What is an appropriate response?
A) Respect his wishes and notify the provider
B) Administer a sedative and proceed with transfusion
C) Ask the family to convince the patient
D) Document refusal and take no further action
Correct Answer: A) Respect his wishes and notify the provider
Patient autonomy and religious beliefs must be respected. The nurse should honor the refusal,
notify the provider, and document the patient's decision. Proceeding with transfusion against
the patient's wishes violates ethical and legal standards. Involving family to pressure the
patient is inappropriate. Simply documenting without notifying the provider fails to ensure
alternative treatments are explored.
Question 5: Your patient is admitted with diverticulitis. What type of diet do you expect to be
ordered for the patient?
A) High-fiber diet
B) Clear liquids
C) Regular diet
D) Full liquid diet
Correct Answer: B) Clear liquids
Acute diverticulitis requires bowel rest to reduce inflammation. Clear liquids are initially
ordered to allow the bowel to rest while maintaining hydration. A high-fiber diet is
contraindicated during acute episodes. Regular and full liquid diets are advanced gradually
as inflammation resolves.
Question 6: You were hired to work the medical unit and when you arrive at work the charge
nurse has assigned you to the post-surgical unit since they are understaffed. Which is the
MOST appropriate action?
, 4
A) Refuse the assignment because it is not your usual unit
B) Report to the post-surgical unit
C) Ask to be floated to a different unit
D) Call the nursing supervisor to complain
Correct Answer: B) Report to the post-surgical unit
Nurses are expected to be flexible and report to the assigned unit when floated. Refusing an
assignment without a valid safety concern can be considered insubordination. The nurse
should report to the assigned unit and provide safe care within their scope of practice. If the
assignment poses a genuine safety risk, the nurse should discuss concerns with the charge
nurse or supervisor.
Question 7: Your patient is 4 hours post open appendectomy and has not voided yet. You note
his lower abdomen is distended. What should you do NEXT?
A) Perform a bladder scan
B) Insert an indwelling urinary catheter immediately
C) Encourage the patient to drink more fluids
D) Document the finding and reassess in 4 hours
Correct Answer: A) Perform a bladder scan
A bladder scan is a non-invasive method to assess for urinary retention after surgery. The
patient is likely experiencing postoperative urinary retention due to anesthesia and
immobility. The scan will determine the volume of urine in the bladder and guide the need for
catheterization. Inserting a catheter without assessment is premature. Encouraging fluids
may worsen distention. Documenting and reassessing later delays necessary intervention.
Question 8: What is a proton pump inhibitor, such as pantoprazole (Protonix), used for?
A) Acid reduction
B) Blood pressure control
C) Pain relief
D) Infection prevention
Correct Answer: A) Acid reduction
Proton pump inhibitors (PPIs) such as pantoprazole reduce gastric acid secretion by
inhibiting the proton pump in gastric parietal cells. They are used to treat gastroesophageal
