RELIAS ED RN A, Exam (Latest 2026/2027) Questions & Answers (Verified Solutions), 100% Guaranteed Pass || Complete A+ Guide
OBJECTIVE ASSESSMENT - EXAM
RELIAS ED RN A, Exam (Latest 2026/2027)
Questions & Answers (Verified Solutions),
100% Guaranteed Pass || Complete A+
Guide
Nightingale Complete Certification Series Study Guide
100 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Medical Emergencies & Sepsis Protocol Psychiatric & Behavioral De-escalation
Trauma & Surgical Resuscitation EMTALA Compliance & Legal Practice
Pediatric Emergencies & Triage Emergency Severity Index (ESI) Triage
COVER PAGE -- 1
, SECTION 1 | MEDICAL EMERGENCIES | Q1-Q20 | RELIAS ED RN A, Exam (Latest 2026/2027) Questions & Answers (Verified Solutions), 100% Guaranteed Pass
Q1 Question 1 of 100
A 56-year-old male presents with severe substernal chest pain radiating to his left shoulder. He is
diaphoretic, has a heart rate of 108, and a blood pressure of 142/90. Which action should the ED nurse
implement first?
A. Administer a 325 mg chewable aspirin
B. Draw blood for cardiac troponin levels
C. Obtain a diagnostic 12-lead electrocardiogram (ECG)
D. Administer sublingual nitroglycerin as prescribed
Correct Answer: C
Rationale:
For any patient presenting with suspected acute coronary syndrome (ACS), the immediate priority is to obtain a
12-lead ECG within 10 minutes of arrival to differentiate between STEMI and NSTEMI/UA. While aspirin and
nitroglycerin are standard, the diagnostic ECG directs the entire treatment pathway, and troponins are drawn
secondary.
Q2 Question 2 of 100
A 45-year-old female presents to the emergency department in severe respiratory distress. Her husband
states she was stung by a wasp 15 minutes ago. On assessment, the nurse notes loud laryngeal stridor,
intercostal retractions, and a blood pressure of 82/40. Which medication must be administered immediately?
A. Epinephrine 0.3 mg intramuscularly (IM)
B. Methylprednisolone 125 mg intravenously (IV)
C. Diphenhydramine 50 mg intravenously (IV)
D. Albuterol 2.5 mg nebulized inhalation
Correct Answer: A
Rationale:
In severe anaphylaxis with airway compromise (stridor) and hypotension, IM epinephrine in the anterolateral thigh
is the gold standard, first-line intervention to cause rapid vasoconstriction and bronchodilation. Antihistamines,
corticosteroids, and nebulizers are secondary therapies that do not act quickly enough to prevent
cardiorespiratory collapse.
AS ED RN A, Exam (Latest 2026/2027) Questions & Answers (Verified Solutions), 100% Guaranteed Pass || Complete A+ Guide -- 2026/2027 | Passing Score: 80% | Page 2
, Q3 Question 3 of 100
A 68-year-old male with a history of chronic obstructive pulmonary disease (COPD) is admitted with an acute
exacerbation. He is drowsy, has a respiratory rate of 10, and his arterial blood gas (ABG) shows a pH of 7.25
and PaCO2 of 68 mmHg on a 4L nasal cannula. What is the most appropriate next action for the nurse?
A. Increase the nasal cannula oxygen flow rate to 10 L/min
B. Prepare to assist with non-invasive positive pressure ventilation (BiPAP)
C. Administer a rapid-acting intravenous loop diuretic
D. Obtain a portable chest X-ray to rule out a pneumothorax
Correct Answer: B
Rationale:
BiPAP is the first-line intervention for patients with acute hypercapnic respiratory failure (respiratory acidosis) due
to a COPD exacerbation. It assists with ventilation, decreases work of breathing, and helps blow off retained
CO2. Increasing supplemental oxygen alone will worsen hypercapnia by suppressing the hypoxic drive, and
diuretics are for volume overload.
Q4 Question 4 of 100
A 24-year-old female presents with rapid, deep breathing, dry mucous membranes, and abdominal pain. Her
capillary blood glucose is 480 mg/dL, and her breath has a distinct fruity odor. What is the nurse's primary
initial therapeutic goal?
A. Initiate a continuous intravenous regular insulin infusion
B. Infuse 0.9% Sodium Chloride (Normal Saline) for volume repletion
C. Administer an intravenous bolus of sodium bicarbonate
D. Obtain a urine specimen for ketone and glucose analysis
Correct Answer: B
Rationale:
In Diabetic Ketoacidosis (DKA), the immediate priority is fluid resuscitation to restore intravascular volume,
improve renal perfusion, and decrease blood glucose levels through dilution. Insulin is critical but should only be
started after fluid volume is partially restored and potassium levels are confirmed to be >3.3 mEq/L.
AS ED RN A, Exam (Latest 2026/2027) Questions & Answers (Verified Solutions), 100% Guaranteed Pass || Complete A+ Guide -- 2026/2027 | Passing Score: 80% | Page 3
, Q5 Question 5 of 100
A 35-year-old male is brought to the emergency department after being found unresponsive in an alley. On
assessment, he has a respiratory rate of 6, pinpoint pupils, and a pulse oximetry reading of 82% on room air.
What is the immediate priority for this patient?
A. Administer intravenous naloxone as prescribed
B. Perform a fingerstick blood glucose measurement
C. Assist ventilation with a bag-valve-mask (BVM) and oxygen
D. Establish large-bore intravenous access in the antecubital fossa
Correct Answer: C
Rationale:
The immediate priority for any patient with severe respiratory depression is to support oxygenation and ventilation
using a BVM with high-flow oxygen. While naloxone is indicated for suspected opioid overdose (indicated by
pinpoint pupils and low respiratory rate), ventilatory support must be initiated first to address life-threatening
hypoxia.
Q6 Question 6 of 100
A 72-year-old female presents with sudden onset of right-sided weakness and expressive aphasia that began
2 hours ago. Her CT scan of the head is negative for intracranial hemorrhage, and her blood pressure is
170/95. Which nursing intervention is most critical?
A. Administer intravenous tissue plasminogen activator (tPA) as prescribed
B. Place an indwelling urinary catheter to monitor output
C. Administer an intravenous antihypertensive to lower her blood pressure below 120/80
D. Schedule a magnetic resonance imaging (MRI) scan of the brain
Correct Answer: A
Rationale:
The patient is presenting with signs of an acute ischemic stroke within the therapeutic window (under 3 to 4.5
hours from symptom onset) and has no hemorrhage on CT, making tPA administration the top priority. Lowering
blood pressure too aggressively is contraindicated as it reduces cerebral perfusion, and urinary catheterization
should be deferred to avoid bleeding risk.
AS ED RN A, Exam (Latest 2026/2027) Questions & Answers (Verified Solutions), 100% Guaranteed Pass || Complete A+ Guide -- 2026/2027 | Passing Score: 80% | Page 4
OBJECTIVE ASSESSMENT - EXAM
RELIAS ED RN A, Exam (Latest 2026/2027)
Questions & Answers (Verified Solutions),
100% Guaranteed Pass || Complete A+
Guide
Nightingale Complete Certification Series Study Guide
100 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Medical Emergencies & Sepsis Protocol Psychiatric & Behavioral De-escalation
Trauma & Surgical Resuscitation EMTALA Compliance & Legal Practice
Pediatric Emergencies & Triage Emergency Severity Index (ESI) Triage
COVER PAGE -- 1
, SECTION 1 | MEDICAL EMERGENCIES | Q1-Q20 | RELIAS ED RN A, Exam (Latest 2026/2027) Questions & Answers (Verified Solutions), 100% Guaranteed Pass
Q1 Question 1 of 100
A 56-year-old male presents with severe substernal chest pain radiating to his left shoulder. He is
diaphoretic, has a heart rate of 108, and a blood pressure of 142/90. Which action should the ED nurse
implement first?
A. Administer a 325 mg chewable aspirin
B. Draw blood for cardiac troponin levels
C. Obtain a diagnostic 12-lead electrocardiogram (ECG)
D. Administer sublingual nitroglycerin as prescribed
Correct Answer: C
Rationale:
For any patient presenting with suspected acute coronary syndrome (ACS), the immediate priority is to obtain a
12-lead ECG within 10 minutes of arrival to differentiate between STEMI and NSTEMI/UA. While aspirin and
nitroglycerin are standard, the diagnostic ECG directs the entire treatment pathway, and troponins are drawn
secondary.
Q2 Question 2 of 100
A 45-year-old female presents to the emergency department in severe respiratory distress. Her husband
states she was stung by a wasp 15 minutes ago. On assessment, the nurse notes loud laryngeal stridor,
intercostal retractions, and a blood pressure of 82/40. Which medication must be administered immediately?
A. Epinephrine 0.3 mg intramuscularly (IM)
B. Methylprednisolone 125 mg intravenously (IV)
C. Diphenhydramine 50 mg intravenously (IV)
D. Albuterol 2.5 mg nebulized inhalation
Correct Answer: A
Rationale:
In severe anaphylaxis with airway compromise (stridor) and hypotension, IM epinephrine in the anterolateral thigh
is the gold standard, first-line intervention to cause rapid vasoconstriction and bronchodilation. Antihistamines,
corticosteroids, and nebulizers are secondary therapies that do not act quickly enough to prevent
cardiorespiratory collapse.
AS ED RN A, Exam (Latest 2026/2027) Questions & Answers (Verified Solutions), 100% Guaranteed Pass || Complete A+ Guide -- 2026/2027 | Passing Score: 80% | Page 2
, Q3 Question 3 of 100
A 68-year-old male with a history of chronic obstructive pulmonary disease (COPD) is admitted with an acute
exacerbation. He is drowsy, has a respiratory rate of 10, and his arterial blood gas (ABG) shows a pH of 7.25
and PaCO2 of 68 mmHg on a 4L nasal cannula. What is the most appropriate next action for the nurse?
A. Increase the nasal cannula oxygen flow rate to 10 L/min
B. Prepare to assist with non-invasive positive pressure ventilation (BiPAP)
C. Administer a rapid-acting intravenous loop diuretic
D. Obtain a portable chest X-ray to rule out a pneumothorax
Correct Answer: B
Rationale:
BiPAP is the first-line intervention for patients with acute hypercapnic respiratory failure (respiratory acidosis) due
to a COPD exacerbation. It assists with ventilation, decreases work of breathing, and helps blow off retained
CO2. Increasing supplemental oxygen alone will worsen hypercapnia by suppressing the hypoxic drive, and
diuretics are for volume overload.
Q4 Question 4 of 100
A 24-year-old female presents with rapid, deep breathing, dry mucous membranes, and abdominal pain. Her
capillary blood glucose is 480 mg/dL, and her breath has a distinct fruity odor. What is the nurse's primary
initial therapeutic goal?
A. Initiate a continuous intravenous regular insulin infusion
B. Infuse 0.9% Sodium Chloride (Normal Saline) for volume repletion
C. Administer an intravenous bolus of sodium bicarbonate
D. Obtain a urine specimen for ketone and glucose analysis
Correct Answer: B
Rationale:
In Diabetic Ketoacidosis (DKA), the immediate priority is fluid resuscitation to restore intravascular volume,
improve renal perfusion, and decrease blood glucose levels through dilution. Insulin is critical but should only be
started after fluid volume is partially restored and potassium levels are confirmed to be >3.3 mEq/L.
AS ED RN A, Exam (Latest 2026/2027) Questions & Answers (Verified Solutions), 100% Guaranteed Pass || Complete A+ Guide -- 2026/2027 | Passing Score: 80% | Page 3
, Q5 Question 5 of 100
A 35-year-old male is brought to the emergency department after being found unresponsive in an alley. On
assessment, he has a respiratory rate of 6, pinpoint pupils, and a pulse oximetry reading of 82% on room air.
What is the immediate priority for this patient?
A. Administer intravenous naloxone as prescribed
B. Perform a fingerstick blood glucose measurement
C. Assist ventilation with a bag-valve-mask (BVM) and oxygen
D. Establish large-bore intravenous access in the antecubital fossa
Correct Answer: C
Rationale:
The immediate priority for any patient with severe respiratory depression is to support oxygenation and ventilation
using a BVM with high-flow oxygen. While naloxone is indicated for suspected opioid overdose (indicated by
pinpoint pupils and low respiratory rate), ventilatory support must be initiated first to address life-threatening
hypoxia.
Q6 Question 6 of 100
A 72-year-old female presents with sudden onset of right-sided weakness and expressive aphasia that began
2 hours ago. Her CT scan of the head is negative for intracranial hemorrhage, and her blood pressure is
170/95. Which nursing intervention is most critical?
A. Administer intravenous tissue plasminogen activator (tPA) as prescribed
B. Place an indwelling urinary catheter to monitor output
C. Administer an intravenous antihypertensive to lower her blood pressure below 120/80
D. Schedule a magnetic resonance imaging (MRI) scan of the brain
Correct Answer: A
Rationale:
The patient is presenting with signs of an acute ischemic stroke within the therapeutic window (under 3 to 4.5
hours from symptom onset) and has no hemorrhage on CT, making tPA administration the top priority. Lowering
blood pressure too aggressively is contraindicated as it reduces cerebral perfusion, and urinary catheterization
should be deferred to avoid bleeding risk.
AS ED RN A, Exam (Latest 2026/2027) Questions & Answers (Verified Solutions), 100% Guaranteed Pass || Complete A+ Guide -- 2026/2027 | Passing Score: 80% | Page 4
