(2026/2027) | EXAM SCRIPT WITH FULL
CORRECT SOLUTION SET
Relias Learning Nursing Competency Assessment | Core Domains: Clinical Knowledge Application,
Patient Safety & Risk Reduction, Medication Safety & Administration, Disease Process Management,
Patient Education Principles, Professional Standards & Ethics, Documentation & Communication, and
Age-Specific & Cultural Considerations | Nursing Competency & Continuing Education Focus |
Standardized Competency Assessment Format
Exam Structure
Relias Learning Nursing exams are typically modular and vary by topic. A comprehensive
competency assessment exam generally contains 50–75 multiple-choice and
select-all-that-apply questions per module.
Introduction
This Relias Learning Nursing Test Exam script and solution set for the 2026/2027 cycle is modeled on
Relias's competency-based assessment format. The content is designed to validate nursing knowledge,
ensure adherence to safety protocols, and assess the application of evidence-based practice in clinical
scenarios commonly used for onboarding, annual competency verification, and continuing education in
healthcare organizations.
Solution Set Format
All correct answers and required nursing actions are presented in bold and green, followed by a full
solution rationale that references current clinical guidelines, safety standards (e.g., The Joint Commission
NPSGs), and evidence-based practice to justify the correct response and clarify common errors.
1. A nurse is preparing to administer IV potassium chloride. Which action is
essential before administration?
A. A. Give the dose as an IV push over 5 minutes
B. B. Dilute the potassium in IV fluid and infuse via an infusion pump
C. C. Administer without a second nurse’s verification
D. D. Use a peripheral IV site without concern for concentration
B. Dilute the potassium in IV fluid and infuse via an infusion pump
,IV potassium must never be given as a bolus (IV push) due to risk of cardiac arrest. It must be
diluted and infused slowly via an infusion pump. The Joint Commission National Patient
Safety Goal (NPSG.03.05.01) requires independent double-check for high-alert medications
like potassium. Peripheral infusions should not exceed 40 mEq/L to avoid phlebitis.
2. A patient is receiving heparin via continuous IV infusion. Which lab value
should the nurse monitor to evaluate therapy?
A. A. PT/INR
B. B. aPTT
C. C. Platelet count
D. D. Both B and C
D. Both B and C
Heparin’s anticoagulant effect is monitored via activated partial thromboplastin time (aPTT),
which should be 1.5–2.5 times the control. Additionally, the nurse must monitor platelet count
daily to detect heparin-induced thrombocytopenia (HIT), a life-threatening complication.
PT/INR is used for warfarin, not heparin.
3. When using the SBAR communication tool, what does the “A” stand for?
A. A. Assessment
B. B. Action
C. C. Analysis
D. D. Alert
A. Assessment
SBAR stands for Situation, Background, Assessment, Recommendation. It is a structured
communication tool endorsed by The Joint Commission to reduce communication errors
during handoffs and critical patient updates. “Assessment” includes the nurse’s clinical
judgment about the patient’s condition.
4. A nurse is caring for a patient with a history of falls. Which intervention is most
effective in reducing fall risk?
A. A. Place the patient in a room far from the nurses’ station
B. B. Keep the bed in the highest position
, C. C. Use a bed alarm and keep the call light within reach
D. D. Restrict bathroom privileges
C. Use a bed alarm and keep the call light within reach
Fall prevention requires individualized, non-restrictive interventions. Bed alarms, non-slip
footwear, clear pathways, and keeping the call light within reach empower patients while
enhancing safety. The Joint Commission NPSG.09.02.01 emphasizes fall risk assessment and
tailored interventions. Restricting mobility increases risk of deconditioning and skin
breakdown.
5. Which statement by a patient newly diagnosed with type 2 diabetes indicates
effective teaching?
A. A. “I’ll check my blood sugar once a week.”
B. B. “I can skip my metformin if I eat healthy.”
C. C. “I will monitor my blood glucose daily as prescribed.”
D. D. “I only need to watch my sugar if I feel shaky.”
C. “I will monitor my blood glucose daily as prescribed.”
Patient education must emphasize adherence to prescribed monitoring and medication
regimens. Metformin should not be skipped without provider approval. Blood glucose should
be checked as directed (often daily), not just when symptomatic. Effective teaching aligns with
ADA standards and promotes self-management.
6. A nurse is preparing to administer a medication that requires a high-alert
double-check. Who should perform the second verification?
A. A. A nursing assistant
B. B. Another licensed nurse
C. C. The patient
D. D. A unit clerk
B. Another licensed nurse
High-alert medications (e.g., insulin, opioids, anticoagulants) require independent
double-check by two licensed professionals per ISMP and The Joint Commission guidelines.
Unlicensed personnel cannot verify medications due to scope of practice limitations.