Medical Surgical RN A Prophecy Relias Exam Questions and Answers, Exams of Nursing

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HOSMERIT

MEDICAL SURGICAL RN A PROPHECY RELIAS

EXAM LATEST 2025 GRADED A+

1.2 milligrams is equal to how many micrograms? A. 1200 mcg B. 120 mcg C. 12,000 mcg D. 1,200,000 mcg Answer: A. 1200 mcg Your post-op patient has a Jackson-Pratt (JP) drain in place. How do you ensure effective drain function? A. Keep the drain open B. Compress the drain, then plug the bulb to establish suction C. Leave the bulb disconnected D. Change the bulb every hour Answer: B. Compress the drain, then plug the bulb to establish suction 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. Deflate the balloon, advance the catheter further, then reinflate the balloon B. Inflate the balloon more C. Remove the catheter and let him rest

D. Call the physician Answer: A. Deflate the balloon, advance the catheter further, then reinflate the balloon Your patient has symptomatic anemia but is refusing a blood transfusion for religious reasons. What is an appropriate response? A. Persuade him to take the transfusion B. Respect his wishes and notify the provider C. Ignore his choice D. Document refusal only Answer: B. Respect his wishes and notify the provider Your patient is admitted with diverticulitis. What type of diet do you expect to be ordered for the patient? A. Clear liquids B. Broth, jello, soft fruit no skin C. Full solid diet D. High fiber diet Answer: B. Broth, jello, soft fruit no skin 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? A. Refuse to go B. Report to the post-surgical unit C. Wait for another assignment

D. Ask for training on the medical unit Answer: B. Report to the post-surgical unit What is a proton pump inhibitor, such as pantoprazole (Protonix), used for? A. Blood pressure regulation B. Acid reduction C. Pain relief D. Cholesterol management Answer: B. Acid reduction Which adaptive equipment would be MOST appropriate to use for a severely contracted patient who is unable to bear weight when transferring from the bed to the chair? A. Walker B. Patient lift (e.g., Hoyer) C. Bed rails D. Wheelchair ramp Answer: B. Patient lift (e.g., Hoyer) Which tool should you use to assess pain in your 80-year-old patient with severe dementia? A. Numeric scale B. FACES scale C. PAINAD scale D. Wong-Baker scale Answer: C. PAINAD scale Your patient is admitted from the ED with failure to thrive and advanced dementia. You note he is extremely underweight, appears unbathed for some time, and has a stage 4 pressure injury to

his coccyx. You were told in report that he lives at home with family members. What should you do? A. Notify the charge nurse and social worker of your concerns B. Document your findings C. Wait for further orders D. Discuss with the family Answer: A. Notify the charge nurse and social worker of your concerns Your 85-year-old patient with atrial fibrillation fell at home 3 days ago. You notice she has been having several episodes of acute confusion since being admitted to your unit. What is the MOST important order you should anticipate from the provider? A. Routine blood work B. Stat CT of head C. MRI of the brain D. X-ray of the pelvis Answer: B. Stat CT of head Your patient has a temp of 102.3 F, HR 122, and has had 15 mL of urine from the indwelling urinary catheter in the last 2 hours. What is your patient MOST likely experiencing? A. Dehydration B. Heart failure C. Sepsis D. Fever Answer: C. Sepsis

What type of personal protective equipment (PPE) is applied prior to entering a room for a patient with C. diff? A. Mask and gloves B. Gown and gloves C. Face shield and goggles D. No PPE required Answer: B. Gown and gloves Your patient continues to pull at their IV site located in their left forearm despite verbal reminders and increased observation. The nursing assistant recommends using soft mitt restraints on the patient. What is your recommendation? A. Request an order for soft mitts as they are the least restrictive B. Use hard restraints C. Ignore the recommendation D. Allow the patient to pull at their IV Answer: A. Request an order for soft mitts as they are the least restrictive Your patient was admitted for a hypertensive crisis and has a history of HTN, Parkinson's disease, depression, and alcohol use. On his second hospitalized day, you notice he is more anxious and restless than his baseline. What would be your FIRST nursing intervention? A. Ask the patient when his last drink of alcohol was B. Administer anxiety medication C. Call the psychiatrist D. Document your observations Answer: A. Ask the patient when his last drink of alcohol was

What is the BEST indication of an acute neurological problem? A. Change in level of consciousness B. Severe headache C. Loss of motor function D. Tingling sensations Answer: A. Change in level of consciousness While in a supine position your patient states, "I'm tired and cannot catch my breath." Physical assessment reveals jugular vein distention and a third heart sound (S3). These symptoms are indicative of what condition? A. Myocardial infarction B. Heart failure C. Pulmonary embolism D. Pneumothorax Answer: B. Heart failure Your new admission presents with a cough, unintentional weight loss, frequent night sweats, and bloody sputum. What type of isolation precautions should you initiate, if any? A. Contact precautions B. Droplet precautions C. Airborne precautions D. No isolation required Answer: C. Airborne precautions Patients with diabetes are at high risk for complications from damage to what body areas? A. Lungs and heart

B. Skin and muscles C. Nerve and kidney damage D. Liver and pancreas Answer: C. Nerve and kidney damage 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 physician D. Document findings Answer: B. Check the patient's blood glucose level Your patient tells you, "I hope I don't die, but if I do, I don't want to be brought back." You notice on her chart and wristband that she is a full code. What would be the MOST appropriate action? A. Contact a family member B. Discuss code status with the patient and follow up with the provider to ensure the medical record reflects her wishes C. Ignore her comment D. Reassure her she will be fine Answer: B. Discuss code status with the patient and follow up with the provider to ensure the medical record reflects her wishes Your coworker posted photos on social media from a birthday party they had for her in the unit breakroom. What should be your NEXT course of action?

A. Report to HR immediately B. No action is necessary because no PHI was displayed C. Discuss it with the coworker D. Contact the patient’s family Answer: B. No action is necessary because no PHI was displayed Your new patient understands very limited English. How should you communicate with them when completing the admission assessment? A. Use hand gestures B. Speak louder and slower C. Use the organization's interpreter services D. Ask a bilingual staff member to assist Answer: C. Use the organization's interpreter services You are caring for a patient with a history of diabetes mellitus. You walk into the room and find the patient lethargic and diaphoretic. What is your first action? A. Call the physician B. Obtain capillary blood glucose level C. Administer D D. Check vital signs Answer: B. Obtain capillary blood glucose level 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 a Foley catheter

C. Ask the patient to try to void D. Call the physician Answer: A. Perform a bladder scan A patient with peritonitis presents with tachycardia, hypotension, and dehydration. What other assessment finding would you anticipate as part of your physical assessment? A. Severe abdominal pain or rebound tenderness B. Lethargy C. Decreased respiratory rate D. Increased appetite Answer: A. Severe abdominal pain or rebound tenderness What is the EARLIEST sign indicating increased intracranial pressure (ICP)? A. Severe headache B. Level of consciousness C. Vomiting D. Pupillary signs Answer: B. Level of consciousness In addition to pain, pallor, and pulselessness, a neurovascular assessment also includes checking for: A. Swelling B. Paresthesia and paralysis C. Warmth D. Capillary refill Answer: B. Paresthesia and paralysis

You received a report on a patient that sustained a right hemisphere CVA 48 hours ago. What do you expect the patient to exhibit? A. Right-sided weakness of the leg, arm, and face B. Left-sided weakness of the leg, arm, and face C. No weakness D. Unilateral vision loss Answer: B. Left-sided weakness of the leg, arm, and face You are ordered to give digoxin (Lanoxin). Your patient's vital signs are: BP 130/70, Temp 97.9F, HR 52, RR 16, O2 Sat 100% on room air. What should you do NEXT? A. Hold digoxin (Lanoxin) and call the provider B. Administer the medication C. Check a potassium level D. Document the patient's status Answer: A. Hold digoxin (Lanoxin) and call the provider Upon entry to your patient's room, you find her sitting in High Fowler's position and complaining of shortness of breath. Her respiratory rate is 34 breaths/min and O2 sat is 84%. Which mode of oxygen delivery would MOST likely reverse these symptoms? A. Nasal cannula B. CPAP C. Non-rebreather mask D. Venturi mask Answer: C. Non-rebreather mask

Your patient is on contact precautions for active MRSA. What proper PPE should you use before entering the room? A. Surgical mask B. Gown and gloves C. N95 mask D. No PPE necessary Answer: B. Gown and gloves Your patient recently had a G-tube placed and intermittent enteral feedings have been initiated. What symptoms may indicate intolerance to the feedings? A. Constipation B. Vomiting and diarrhea C. Weight gain D. Abdominal cramps Answer: B. Vomiting and diarrhea Upon entering your patient's room, you note that they are having a seizure. What is your FIRST action? A. Call for help B. Position the patient on their side to maintain the airway C. Restrain the patient D. Document the event Answer: B. Position the patient on their side to maintain the airway Your 18-year-old female patient was admitted with dehydration secondary to anorexia nervosa. During your assessment, you note she has a flat affect and says, "I just want to die. I'm tired of

my life." What should be your FIRST intervention? A. Stay with the patient and ask if she has a plan to carry out this wish B. Notify the physician immediately C. Document the statement D. Refer to a psychiatrist Answer: A. Stay with the patient and ask if she has a plan to carry out this wish Your patient has a non-productive cough and presence of secretions in his tracheostomy. Prior to suctioning the patient, what should you do FIRST? A. Suction the tracheostomy B. Hyperoxygenate patient C. Raise the head of the bed D. Call the physician Answer: B. Hyperoxygenate patient Your patient takes 5 mg of warfarin (Coumadin/Jantoven) daily and reports having black colored stool today. What do you most likely suspect? A. Gastrointestinal bleeding B. Iron supplementation C. Hemorrhoids D. Food intolerance Answer: A. Gastrointestinal bleeding Your new patient was admitted with blunt force trauma to the abdomen following a motor vehicle accident (MVA). An NG tube is in place for decompression; however, you note during the assessment that the stomach is rigid and hard during palpation. What condition do you

suspect? A. Pneumonia B. Bowel obstruction C. Hemorrhage D. Gastritis Answer: C. Hemorrhage Which of the following nursing diagnoses is MOST important for a patient with chronic obstructive pulmonary disease (COPD)? A. Impaired gas exchange B. Risk for falls C. Knowledge deficit D. Ineffective tissue perfusion Answer: A. Impaired gas exchange You have a patient going for dialysis. Their medications include lisinopril (Prinivil), ondansetron (Zofran), famotidine (Pepcid), and atorvastatin (Lipitor). Which medication would you possibly hold and seek clarification? A. Lisinopril (Prinivil) B. Ondansetron (Zofran) C. Famotidine (Pepcid) D. Atorvastatin (Lipitor) Answer: C. Famotidine (Pepcid) What is an early symptom that the patient is developing a complication of heart failure? A. Dyspnea on exertion

B. Chest pain C. Palpitations D. Edema in the legs and feet Answer: D. Edema in the legs and feet Black and tarry colored stools are CLASSIC symptoms of what condition? A. Diverticulitis B. Gastrointestinal bleeding C. Constipation D. Hemorrhoids Answer: B. Gastrointestinal bleeding You have 4 patients who have high-priority needs. One needs to go to surgery, one needs STAT lab draws from a PICC line, another has chest pain rated 8/10, and another needs toileting. Which patient should you tend to FIRST? A. The patient who needs to go to surgery B. The patient with chest pain C. The patient needs lab draws D. The patient who needs toileting Answer: B. The patient with chest pain Your patient with hepatitis C exhibits signs of jaundice and a distended abdomen. What procedure would you anticipate being performed by the provider at the bedside for this patient? A. ERCP B. Paracentesis C. Laparoscopy

D. Ultrasound Answer: B. Paracentesis What is clubbing of the fingers MOST likely associated with? A. Anemia B. Chronic oxygen deficiency C. Diabetes mellitus D. High blood pressure Answer: B. Chronic oxygen deficiency A patient on warfarin (Coumadin/Jantoven) has an INR of 6. Which medication would you anticipate administering? A. Aspirin B. Heparin C. Vitamin K D. Protamine sulfate Answer: C. Vitamin K To reduce the risk of infection and phlebitis in an adult patient with a peripheral IV, what is the MINIMUM duration the catheter should remain in place before ROUTINE replacement? A. 48 hours B. 72 hours C. 96 hours D. 24 hours Answer: B. 72 hours

You are caring for a patient post-lobectomy with a chest tube in place for drainage. What is a priority in care for this patient? A. Monitor vital signs B. Administer analgesics C. Encourage the patient to cough and deep breathe D. Assess the insertion site Answer: C. Encourage the patient to cough and deep breathe What patient population is the pneumococcal vaccine, PPSV23, indicated for? A. Adults aged 18-50 years B. Children under 2 years C. Adults aged 65 years and older D. All adults Answer: C. Adults aged 65 years and older Your patient with stage IV terminal lung cancer continues to experience increasing pain as each day passes. What would you anticipate the provider ordering for this patient? A. Palliative care consult B. Chemotherapy C. Full code status D. Physical therapy Answer: A. Palliative care consult The provider gives you a telephone order to explain a surgical procedure to your patient and obtain surgical consent. How should you respond? A. Inform the provider that explaining the procedure is outside the nurse's scope of practice

B. Proceed to explain the procedure C. Ask the surgeon to come and explain it D. Refer the patient to the charge nurse Answer: A. Inform the provider that explaining the procedure is outside the nurse's scope of practice The patient has diltiazem HCl (Cardizem CD) ordered and is requesting the capsule be mixed into her morning yogurt. How should you respond? A. "Sorry, it is a slow-release medication that cannot be opened or crushed." B. "That's fine, go ahead." C. "You can chew it if you'd like." D. "I will ask the pharmacist." Answer: A. "Sorry, it is a slow-release medication that cannot be opened or crushed." Your 72-year-old male patient is admitted for colon cancer related complications and has a history of CHF, stroke, and a recent knee replacement. Based on your patient's risk assessment, you determine he is at risk for venous thromboembolism (VTE). What is an appropriate VTE prophylaxis order for this patient? A. Compression stockings B. Aspirin C. Enoxaparin (Lovenox) once daily and intermittent pneumatic compressions (IPC) D. Bed Rest Answer: C. Enoxaparin (Lovenox) once daily and intermittent pneumatic compressions (IPC)

You receive a provider's order that is not consistent with evidence-based practice. What is your FIRST step? A. Prepare to follow the order B. Clarify the order with the provider C. Document the order D. Refer to the nursing supervisor Answer: B. Clarify the order with the provider When would sucralfate (Carafate) 4 times daily be scheduled for? A. At the same time as other medications B. 1 hour before meals and at bedtime C. After meals D. Whenever the patient remembers Answer: B. 1 hour before meals and at bedtime Your patient's morning labs revealed a hemoglobin level of 6.3 and hematocrit of 18. What blood product do you expect to administer? A. Platelets B. Fresh frozen plasma C. PRBCs D. Whole blood Answer: C. PRBCs In post-operative care, a nurse assesses for the presence of ileus. What is a common sign of this condition? A. Fever

B. Abdominal distension and absence of bowel sounds C. Nausea D. Diarrhea Answer: B. Abdominal distension and absence of bowel sounds A patient with a newly diagnosed seizure disorder is started on phenytoin. What information is important to include in your teaching? A. "You will need to take this medication only when you have a seizure." B. "Avoid large amounts of alcohol while taking this medication." C. "You can stop taking this medication if you feel fine." D. "It is safe to drive while taking this medication." Answer: B. "Avoid large amounts of alcohol while taking this medication." Your 68-year-old patient is a Type 1 diabetic with a history of schizophrenia and exhibits signs and symptoms of tardive dyskinesia. What long-term medication is associated with signs and symptoms of tardive dyskinesia? A. Risperidone B. Levothyroxine C. Metformin D. Amlodipine Answer: A. Risperidone A patient with a history of heart failure and a low sodium diet is also diabetic. What intervention is essential for this patient? A. Restricting fluid intake even more B. Monitoring blood glucose levels closely

C. Offering high-sodium snacks D. Discouraging weight checks Answer: B. Monitoring blood glucose levels closely A client has been diagnosed with hyperthyroidism and is being treated with methimazole. What is the priority teaching for this client? A. "You will need to limit your cold exposure." B. "This medication will cause early weight gain." C. "Monitor for signs of hypothyroidism such as fatigue." D. "You can stop taking this medication when you feel better." Answer: C. "Monitor for signs of hypothyroidism such as fatigue." Your 80-year-old patient is being discharged home post-CVA. She lives alone, yet still requires assistance with ADLs. What referral is MOST appropriate to ensure her needs are met? A. Case Manager B. Social Worker C. Physical Therapy D. Occupational Therapy Answer: A. Case Manager Central Telemetry calls and tells you your patient is experiencing bradycardia. What is the first thing you should do after entering the room? A. Prepare to administer medications B. Assess the patient and take vital signs C. Document your findings

D. Call the physician Answer: B. Assess the patient and take vital signs Your patient is currently under 1:1 observation for suicide precautions. He states he needs to have a bowel movement and would like some privacy to use the bathroom. What is the MOST appropriate response? A. "I can leave the room." B. "I must be within an arm's length view of you at all times for your safety." C. "You can wait until afterward." D. "Go ahead; I will be outside." Answer: B. "I must be within an arm's length view of you at all times for your safety." A nurse caring for a patient with hepatitis B must follow which standard precaution? A. Gloves, gown, mask B. Droplet precautions C. Airborne precautions D. Standard precautions Answer: D. Standard precautions The healthcare provider prescribes methylprednisolone for a patient with an autoimmune disease. What is a common side effect of this medication? A. Weight loss B. Hypoglycemia C. Fluid retention D. Bradycardia Answer: C. Fluid retention

A nurse is caring for a patient with a high fever. Which intervention is appropriate first? A. Administer an antipyretic B. Obtain blood cultures C. Assess the temperature D. Cover with a warm blanket Answer: C. Assess the temperature The nurse is teaching a patient about the importance of vaccinations. What key point should the nurse emphasize? A. "Vaccines are only needed for children." B. "Vaccinations help prevent some diseases by building immunity." C. "Vaccines can cause serious side effects and should be avoided." D. "Once you have a vaccine, you don’t need any others." Answer: B. "Vaccinations help prevent some diseases by building immunity." A female patient requests a female nurse to provide care for her based on her religious beliefs. What is the MOST appropriate action to take? A. Accommodate her request if possible B. Deny the request C. Ask another staff member to assist D. Document the request Answer: A. Accommodate her request if possible The priority nursing intervention for a patient with a newly diagnosed seizure disorder includes: A. Medications teaching B. Education about seizure triggers

C. Ensuring the patient's safety D. Scheduling follow-up appointments Answer: C. Ensuring the patient's safety Your patient is experiencing severe anxiety before a medical procedure. What is the most appropriate nursing intervention? A. Tell the patient to calm down B. Offer to stay with the patient and provide reassurance C. Dismiss the patient’s concerns D. Discuss the procedure details immediately Answer: B. Offer to stay with the patient and provide reassurance Your patient is a 40-year-old female with a recent history of hair loss, extremely dry skin, and a 20 - point weight loss in the last 3 weeks. She also exhibits occasional episodes of tremors in her upper extremities. What condition do these symptoms MOST likely indicate? A. Hypothyroidism B. Hyperthyroidism C. Diabetes D. Anemia Answer: B. Hyperthyroidism The healthcare provider prescribes atorvastatin for a patient with high cholesterol. What should the nurse teach the patient about this medication? A. "You should take it on an empty stomach." B. "Avoid grapefruit juice while taking this medication." C. "It's safe to take during pregnancy."

D. "No side effects are expected." Answer: B. "Avoid grapefruit juice while taking this medication." A nurse is monitoring a patient’s INR levels who is on warfarin therapy. What level is considered therapeutic? A. 1- 2 B. 2- 3 C. 3- 4 D. 4- 5 Answer: B. 2- 3 Insulin lispro (Humalog) is ordered via sliding scale a.c. for your patient with diabetes. When is the best time to administer insulin lispro (Humalog)? A. 30 minutes after meals B. Immediately after meals C. 15 minutes before the meal arrives D. 1 hour before meals Answer: C. 15 minutes before the meal arrives Which of the following would be used as part of the preop procedure to prevent infection? A. Prophylactic antibiotics B. Preoperative checklist C. Informed consent D. Patient education Answer: A. Prophylactic antibiotics

Two days after surgery, your 72-year-old patient is showing signs of agitation and confusion, which is not his baseline. The severity fluctuates throughout the day. His medications include hydromorphone (Dilaudid), amlodipine (Norvasc), alprazolam (Xanax), and carbidopa-levodopa (Sinemet). What condition do you MOST likely suspect? A. Dementia B. Delirium C. Stroke D. Sedation Answer: B. Delirium What is the proper technique when suctioning a tracheostomy? A. Suction continuously while inserting the catheter B. Suction in a circular motion while the catheter is being pulled out C. Suction only while inserting the catheter D. Have the patient take a deep breath before suctioning Answer: B. Suction in a circular motion while the catheter is being pulled out A patient scheduled for surgery presents with a fever and elevated white blood cell count. What action should the nurse take? A. Continue with the surgery as planned B. Notify the surgeon and hold the surgery C. Administer antipyretics D. Document findings for post-op care Answer: B. Notify the surgeon and hold the surgery