RELIAS ED RN A – QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD
PDF.
*CORE DOMAINS*
*Triage and Patient Prioritization*
*Cardiac Emergency Management*
*Respiratory Distress Protocols*
*Neurological Assessment and Stroke*
*Trauma and Shock Stabilization*
*Pharmacology and Medication Safety*
*Pediatric Emergency Considerations*
*Psychiatric and Behavioral Crises*
*Legal, Ethical, and Regulatory Standards*
*INTRODUCTION*
The Relias ED RN A assessment is designed to evaluate the clinical proficiency and critical thinking skills of Emergency Department registered
nurses. This comprehensive exam focuses on the rapid assessment, stabilization, and management of patients across the lifespan presenting with
acute illnesses and life-threatening injuries. The assessment utilizes a combination of foundational knowledge questions and complex, scenario-
based vignettes to mirror real-world clinical decision-making. Nurses are tested on their ability to prioritize care, implement evidence-based
interventions, and maintain safety and regulatory compliance in high-pressure environments. By emphasizing clinical judgment and technical skill,
this exam ensures that practitioners are prepared to provide high-quality emergency care.
SECTION ONE: QUESTIONS 1–100
1. A 55-year-old male presents to the ED with crushing chest pain radiating to the left jaw. The initial 12-lead ECG shows ST-segment elevation
in leads II, III, and aVF. Which area of the heart is most likely affected?
A. Anterior wall
B. Lateral wall
🟢 C. Inferior wall
D. Septal wall
🔴 RATIONALE: ST-segment elevation in leads II, III, and aVF is diagnostic of an inferior wall myocardial infarction, typically involving the right
coronary artery.
, 2. A patient with a history of heart failure presents with severe dyspnea and pink, frothy sputum. Which medication should the nurse anticipate
administering first to reduce preload?
🟢 A. Furosemide
B. Metoprolol
C. Amiodarone
D. Dopamine
🔴 RATIONALE: Pink, frothy sputum is a hallmark of acute pulmonary edema. Furosemide is a loop diuretic that rapidly reduces preload through
diuresis and venous dilation.
3. According to the Emergency Severity Index (ESI), which patient should be classified as ESI Level 1?
A. A patient with a simple forearm fracture and stable vitals.
B. A patient with a high fever and productive cough.
C. A patient with abdominal pain and a history of gallstones.
🟢 D. A patient in cardiac arrest receiving chest compressions.
🔴 RATIONALE: ESI Level 1 is reserved for patients requiring immediate life-saving intervention, such as those in respiratory or cardiac arrest.
4. A nurse is caring for a patient with a suspected tension pneumothorax. What is the definitive immediate intervention for this condition?
A. Endotracheal intubation
B. Administration of high-flow oxygen
🟢 C. Needle decompression
D. Urgent chest X-ray
🔴 RATIONALE: A tension pneumothorax is a life-threatening emergency requiring immediate needle decompression to relieve intrapleural pressure
before a chest tube is inserted.
5. Which of the following is an early sign of increased intracranial pressure (ICP) in a patient with a head injury?
🟢 A. Decreased level of consciousness
B. Cushing's triad
C. Dilated, non-reactive pupils
D. Decerebrate posturing
🔴 RATIONALE: A change or decrease in the level of consciousness is the most sensitive and earliest indicator of increasing ICP.
6. A patient presents with a deep vein thrombosis (DVT) in the right leg. The nurse should monitor specifically for which life-threatening
complication?
, A. Ischemic stroke
🟢 B. Pulmonary embolism
C. Myocardial infarction
D. Hypovolemic shock
🔴 RATIONALE: The primary risk of a DVT is the detachment of the clot, which can travel through the venous system to the lungs, causing a
pulmonary embolism.
7. In a patient experiencing anaphylactic shock, which medication is the priority to reverse bronchospasm and hypotension?
A. Diphenhydramine
B. Methylprednisolone
🟢 C. Epinephrine
D. Albuterol
🔴 RATIONALE: Epinephrine is the first-line treatment for anaphylaxis as it provides alpha-adrenergic vasoconstriction and beta-adrenergic
bronchodilation.
8. A patient is brought to the ED after being found down in an alley. The patient is somnolent with a respiratory rate of 6 breaths/minute and
pinpoint pupils. Which medication should be administered?
A. Flumazenil
🟢 B. Naloxone
C. Glucagon
D. Activated charcoal
🔴 RATIONALE: The triad of respiratory depression, somnolence, and miosis (pinpoint pupils) is highly suggestive of opioid overdose, which is
reversed by naloxone.
9. What is the primary goal of the primary survey during trauma resuscitation?
🟢 A. To identify and treat life-threatening injuries
B. To obtain a complete medical history
C. To perform a head-to-toe physical assessment
D. To facilitate transfer to the operating room
🔴 RATIONALE: The primary survey (ABCDE) is designed to systematically identify and immediately manage life-threatening conditions in trauma
victims.
10. A nurse is caring for a patient with diabetic ketoacidosis (DKA). Which electrolyte imbalance is of greatest concern during the initial phase of
insulin therapy?
PDF.
*CORE DOMAINS*
*Triage and Patient Prioritization*
*Cardiac Emergency Management*
*Respiratory Distress Protocols*
*Neurological Assessment and Stroke*
*Trauma and Shock Stabilization*
*Pharmacology and Medication Safety*
*Pediatric Emergency Considerations*
*Psychiatric and Behavioral Crises*
*Legal, Ethical, and Regulatory Standards*
*INTRODUCTION*
The Relias ED RN A assessment is designed to evaluate the clinical proficiency and critical thinking skills of Emergency Department registered
nurses. This comprehensive exam focuses on the rapid assessment, stabilization, and management of patients across the lifespan presenting with
acute illnesses and life-threatening injuries. The assessment utilizes a combination of foundational knowledge questions and complex, scenario-
based vignettes to mirror real-world clinical decision-making. Nurses are tested on their ability to prioritize care, implement evidence-based
interventions, and maintain safety and regulatory compliance in high-pressure environments. By emphasizing clinical judgment and technical skill,
this exam ensures that practitioners are prepared to provide high-quality emergency care.
SECTION ONE: QUESTIONS 1–100
1. A 55-year-old male presents to the ED with crushing chest pain radiating to the left jaw. The initial 12-lead ECG shows ST-segment elevation
in leads II, III, and aVF. Which area of the heart is most likely affected?
A. Anterior wall
B. Lateral wall
🟢 C. Inferior wall
D. Septal wall
🔴 RATIONALE: ST-segment elevation in leads II, III, and aVF is diagnostic of an inferior wall myocardial infarction, typically involving the right
coronary artery.
, 2. A patient with a history of heart failure presents with severe dyspnea and pink, frothy sputum. Which medication should the nurse anticipate
administering first to reduce preload?
🟢 A. Furosemide
B. Metoprolol
C. Amiodarone
D. Dopamine
🔴 RATIONALE: Pink, frothy sputum is a hallmark of acute pulmonary edema. Furosemide is a loop diuretic that rapidly reduces preload through
diuresis and venous dilation.
3. According to the Emergency Severity Index (ESI), which patient should be classified as ESI Level 1?
A. A patient with a simple forearm fracture and stable vitals.
B. A patient with a high fever and productive cough.
C. A patient with abdominal pain and a history of gallstones.
🟢 D. A patient in cardiac arrest receiving chest compressions.
🔴 RATIONALE: ESI Level 1 is reserved for patients requiring immediate life-saving intervention, such as those in respiratory or cardiac arrest.
4. A nurse is caring for a patient with a suspected tension pneumothorax. What is the definitive immediate intervention for this condition?
A. Endotracheal intubation
B. Administration of high-flow oxygen
🟢 C. Needle decompression
D. Urgent chest X-ray
🔴 RATIONALE: A tension pneumothorax is a life-threatening emergency requiring immediate needle decompression to relieve intrapleural pressure
before a chest tube is inserted.
5. Which of the following is an early sign of increased intracranial pressure (ICP) in a patient with a head injury?
🟢 A. Decreased level of consciousness
B. Cushing's triad
C. Dilated, non-reactive pupils
D. Decerebrate posturing
🔴 RATIONALE: A change or decrease in the level of consciousness is the most sensitive and earliest indicator of increasing ICP.
6. A patient presents with a deep vein thrombosis (DVT) in the right leg. The nurse should monitor specifically for which life-threatening
complication?
, A. Ischemic stroke
🟢 B. Pulmonary embolism
C. Myocardial infarction
D. Hypovolemic shock
🔴 RATIONALE: The primary risk of a DVT is the detachment of the clot, which can travel through the venous system to the lungs, causing a
pulmonary embolism.
7. In a patient experiencing anaphylactic shock, which medication is the priority to reverse bronchospasm and hypotension?
A. Diphenhydramine
B. Methylprednisolone
🟢 C. Epinephrine
D. Albuterol
🔴 RATIONALE: Epinephrine is the first-line treatment for anaphylaxis as it provides alpha-adrenergic vasoconstriction and beta-adrenergic
bronchodilation.
8. A patient is brought to the ED after being found down in an alley. The patient is somnolent with a respiratory rate of 6 breaths/minute and
pinpoint pupils. Which medication should be administered?
A. Flumazenil
🟢 B. Naloxone
C. Glucagon
D. Activated charcoal
🔴 RATIONALE: The triad of respiratory depression, somnolence, and miosis (pinpoint pupils) is highly suggestive of opioid overdose, which is
reversed by naloxone.
9. What is the primary goal of the primary survey during trauma resuscitation?
🟢 A. To identify and treat life-threatening injuries
B. To obtain a complete medical history
C. To perform a head-to-toe physical assessment
D. To facilitate transfer to the operating room
🔴 RATIONALE: The primary survey (ABCDE) is designed to systematically identify and immediately manage life-threatening conditions in trauma
victims.
10. A nurse is caring for a patient with diabetic ketoacidosis (DKA). Which electrolyte imbalance is of greatest concern during the initial phase of
insulin therapy?
