Medical-Surgical RN A Prophecy Relias Test 2025/Actual Exam
questions and detailed answers with Rationales
Question 1
1.2 milligrams is equal to how many micrograms?
A. 120 mcg
B. 1200 mcg
C. 12,000 mcg
D. 0.0012 mcg
E. 120,000 mcg
Correct Answer: B) 1200 mcg
Rationale: There are 1000 micrograms (mcg) in 1 milligram (mg). So, 1.2 mg x 1000
mcg/mg = 1200 mcg.
Question 2
Your post-op patient has a Jackson-Pratt (JP) drain in place. How do you ensure effective drain
function?
A. Compress the drain, then plug the bulb to establish suction.
B. Keep the bulb open to air to allow for passive drainage.
C. Position the drain above the level of the insertion site.
D. Irrigate the drain with sterile saline every shift.
E. Remove the plug when the bulb is full of drainage.
Correct Answer: A) Compress the drain, then plug the bulb to establish suction.
Rationale: The JP drain works by creating negative pressure (suction) through
compression of the bulb, which pulls fluid from the surgical site. This suction must
be re-established after emptying.
,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. Continue inflating the balloon rapidly.
B. Remove the catheter immediately.
C. Deflate the balloon, advance the catheter further, then reinflate the balloon.
D. Ask the patient to bear down forcefully.
E. Administer a local anesthetic.
Correct Answer: C) Deflate the balloon, advance the catheter further, then reinflate
the balloon.
Rationale: Discomfort during balloon inflation suggests the balloon may still be in the
urethra. Deflating, advancing, and reinflating ensures the balloon is in the bladder,
where inflation should be painless.
Question 4
Your patient has symptomatic anemia but is refusing a blood transfusion for religious reasons.
What is an appropriate response?
A. Explain the risks of not receiving the transfusion and insist.
B. Attempt to persuade the patient to accept the transfusion.
C. Respect his wishes and notify the provider.
D. Document the refusal and administer the transfusion anyway.
E. Ask family members to convince him.
Correct Answer: C) Respect his wishes and notify the provider.
Rationale: Clients have the right to refuse treatment, even if it is life-saving. The
, nurse's role is to respect this autonomy, ensure informed refusal, and inform the
provider to discuss alternative treatments or further care planning.
Question 5
Your patient is admitted with diverticulitis. What type of diet do you expect to be ordered for
the patient during an acute flare-up?
A. High-fiber diet, whole grains.
B. Full liquid diet with milk and pureed vegetables.
C. Regular diet with increased fruits.
D. Clear liquid diet (e.g., broth, jello), progressing to low-fiber/soft diet.
E. Low-fat, high-protein diet.
Correct Answer: D) Clear liquid diet (e.g., broth, jello), progressing to low-fiber/soft
diet.
Rationale: During an acute episode of diverticulitis, a clear liquid diet allows the
bowel to rest. As symptoms improve, a low-fiber/soft diet is typically introduced to
minimize irritation.
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?
A. Refuse the assignment as it's not your primary unit.
B. Request to go home due to unsafe staffing.
C. Report to the post-surgical unit.
D. Demand additional orientation for the new unit.
questions and detailed answers with Rationales
Question 1
1.2 milligrams is equal to how many micrograms?
A. 120 mcg
B. 1200 mcg
C. 12,000 mcg
D. 0.0012 mcg
E. 120,000 mcg
Correct Answer: B) 1200 mcg
Rationale: There are 1000 micrograms (mcg) in 1 milligram (mg). So, 1.2 mg x 1000
mcg/mg = 1200 mcg.
Question 2
Your post-op patient has a Jackson-Pratt (JP) drain in place. How do you ensure effective drain
function?
A. Compress the drain, then plug the bulb to establish suction.
B. Keep the bulb open to air to allow for passive drainage.
C. Position the drain above the level of the insertion site.
D. Irrigate the drain with sterile saline every shift.
E. Remove the plug when the bulb is full of drainage.
Correct Answer: A) Compress the drain, then plug the bulb to establish suction.
Rationale: The JP drain works by creating negative pressure (suction) through
compression of the bulb, which pulls fluid from the surgical site. This suction must
be re-established after emptying.
,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. Continue inflating the balloon rapidly.
B. Remove the catheter immediately.
C. Deflate the balloon, advance the catheter further, then reinflate the balloon.
D. Ask the patient to bear down forcefully.
E. Administer a local anesthetic.
Correct Answer: C) Deflate the balloon, advance the catheter further, then reinflate
the balloon.
Rationale: Discomfort during balloon inflation suggests the balloon may still be in the
urethra. Deflating, advancing, and reinflating ensures the balloon is in the bladder,
where inflation should be painless.
Question 4
Your patient has symptomatic anemia but is refusing a blood transfusion for religious reasons.
What is an appropriate response?
A. Explain the risks of not receiving the transfusion and insist.
B. Attempt to persuade the patient to accept the transfusion.
C. Respect his wishes and notify the provider.
D. Document the refusal and administer the transfusion anyway.
E. Ask family members to convince him.
Correct Answer: C) Respect his wishes and notify the provider.
Rationale: Clients have the right to refuse treatment, even if it is life-saving. The
, nurse's role is to respect this autonomy, ensure informed refusal, and inform the
provider to discuss alternative treatments or further care planning.
Question 5
Your patient is admitted with diverticulitis. What type of diet do you expect to be ordered for
the patient during an acute flare-up?
A. High-fiber diet, whole grains.
B. Full liquid diet with milk and pureed vegetables.
C. Regular diet with increased fruits.
D. Clear liquid diet (e.g., broth, jello), progressing to low-fiber/soft diet.
E. Low-fat, high-protein diet.
Correct Answer: D) Clear liquid diet (e.g., broth, jello), progressing to low-fiber/soft
diet.
Rationale: During an acute episode of diverticulitis, a clear liquid diet allows the
bowel to rest. As symptoms improve, a low-fiber/soft diet is typically introduced to
minimize irritation.
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?
A. Refuse the assignment as it's not your primary unit.
B. Request to go home due to unsafe staffing.
C. Report to the post-surgical unit.
D. Demand additional orientation for the new unit.
