RELIAS PROGRESSIVE CARE RN ASSESSMENT A
EXAM QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES (LATEST UPDATE 2026/2027) GRADED A+
Question 1
A patient with heart failure is receiving IV furosemide. Which assessment finding
best indicates the medication is effective?
A. Decreased blood pressure
B. Reduced peripheral edema
C. Increased heart rate
D. Improved appetite
Correct Answer: B
Rationale: Reduction in edema reflects effective removal of excess fluid and
improved volume status.
Question 2
A patient with sepsis has a lactate level of 5.1 mmol/L. What does this indicate?
A. Adequate tissue perfusion
B. Respiratory alkalosis
C. Tissue hypoxia
D. Renal failure
Correct Answer: C
Rationale: Elevated lactate reflects anaerobic metabolism due to inadequate
tissue oxygenation.
,Question 3
A patient develops sudden hypotension after receiving IV antibiotics. Which
action is the priority?
A. Stop the infusion
B. Administer antihistamine
C. Assess airway and breathing
D. Obtain blood cultures
Correct Answer: C
Rationale: Airway and breathing take priority in a suspected anaphylactic
reaction.
Question 5
A patient on telemetry develops ventricular fibrillation. What is the nurse’s first
action?
A. Administer epinephrine
B. Begin CPR
C. Defibrillate
D. Check blood pressure
Correct Answer: C
Rationale: Ventricular fibrillation is a shockable rhythm requiring immediate
defibrillation.
Question 6
A patient receiving morphine IV becomes increasingly somnolent with shallow
respirations. Which intervention is most appropriate?
A. Reduce oxygen flow
B. Administer naloxone
C. Place in Trendelenburg
D. Encourage coughing
,Correct Answer: B
Rationale: Naloxone reverses opioid-induced respiratory depression.
Question 7
Which lab value places a patient at highest risk for dysrhythmias?
A. Sodium 132 mEq/L
B. Calcium 9.1 mg/dL
C. Potassium 2.9 mEq/L
D. Magnesium 1.9 mg/dL
Correct Answer: C
Rationale: Hypokalemia significantly increases the risk of life-threatening
arrhythmias.
Question 8
A patient with COPD is receiving oxygen at 6 L/min via nasal cannula. Which
finding indicates oxygen therapy should be adjusted?
A. SpO₂ 90%
B. PaCO₂ 60 mm Hg
C. RR 20/min
D. Mild wheezing
Correct Answer: B
Rationale: Elevated CO₂ suggests hypoventilation and CO₂ retention, requiring
careful oxygen titration.
Question 9
A patient with GI bleeding has tachycardia and hypotension. What complication
is most likely developing?
A. Fluid overload
, B. Hypovolemic shock
C. Septic shock
D. Cardiogenic shock
Correct Answer: B
Rationale: Blood loss leads to decreased circulating volume and hypovolemic
shock.
Question 4
Which patient finding requires immediate provider notification?
A. Potassium 3.4 mEq/L
B. New-onset confusion
C. Blood glucose 165 mg/dL
D. Oxygen saturation 94%
Correct Answer: B
Rationale: Acute mental status changes may indicate hypoxia, stroke, or sepsis.
Question 10
Which intervention best prevents aspiration in a patient receiving tube feedings?
A. Supine positioning
B. Checking residual volumes
C. Rapid infusion
D. Cold formula
Correct Answer: B
Rationale: Monitoring residuals reduces the risk of gastric overdistention and
aspiration.
EXAM QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES (LATEST UPDATE 2026/2027) GRADED A+
Question 1
A patient with heart failure is receiving IV furosemide. Which assessment finding
best indicates the medication is effective?
A. Decreased blood pressure
B. Reduced peripheral edema
C. Increased heart rate
D. Improved appetite
Correct Answer: B
Rationale: Reduction in edema reflects effective removal of excess fluid and
improved volume status.
Question 2
A patient with sepsis has a lactate level of 5.1 mmol/L. What does this indicate?
A. Adequate tissue perfusion
B. Respiratory alkalosis
C. Tissue hypoxia
D. Renal failure
Correct Answer: C
Rationale: Elevated lactate reflects anaerobic metabolism due to inadequate
tissue oxygenation.
,Question 3
A patient develops sudden hypotension after receiving IV antibiotics. Which
action is the priority?
A. Stop the infusion
B. Administer antihistamine
C. Assess airway and breathing
D. Obtain blood cultures
Correct Answer: C
Rationale: Airway and breathing take priority in a suspected anaphylactic
reaction.
Question 5
A patient on telemetry develops ventricular fibrillation. What is the nurse’s first
action?
A. Administer epinephrine
B. Begin CPR
C. Defibrillate
D. Check blood pressure
Correct Answer: C
Rationale: Ventricular fibrillation is a shockable rhythm requiring immediate
defibrillation.
Question 6
A patient receiving morphine IV becomes increasingly somnolent with shallow
respirations. Which intervention is most appropriate?
A. Reduce oxygen flow
B. Administer naloxone
C. Place in Trendelenburg
D. Encourage coughing
,Correct Answer: B
Rationale: Naloxone reverses opioid-induced respiratory depression.
Question 7
Which lab value places a patient at highest risk for dysrhythmias?
A. Sodium 132 mEq/L
B. Calcium 9.1 mg/dL
C. Potassium 2.9 mEq/L
D. Magnesium 1.9 mg/dL
Correct Answer: C
Rationale: Hypokalemia significantly increases the risk of life-threatening
arrhythmias.
Question 8
A patient with COPD is receiving oxygen at 6 L/min via nasal cannula. Which
finding indicates oxygen therapy should be adjusted?
A. SpO₂ 90%
B. PaCO₂ 60 mm Hg
C. RR 20/min
D. Mild wheezing
Correct Answer: B
Rationale: Elevated CO₂ suggests hypoventilation and CO₂ retention, requiring
careful oxygen titration.
Question 9
A patient with GI bleeding has tachycardia and hypotension. What complication
is most likely developing?
A. Fluid overload
, B. Hypovolemic shock
C. Septic shock
D. Cardiogenic shock
Correct Answer: B
Rationale: Blood loss leads to decreased circulating volume and hypovolemic
shock.
Question 4
Which patient finding requires immediate provider notification?
A. Potassium 3.4 mEq/L
B. New-onset confusion
C. Blood glucose 165 mg/dL
D. Oxygen saturation 94%
Correct Answer: B
Rationale: Acute mental status changes may indicate hypoxia, stroke, or sepsis.
Question 10
Which intervention best prevents aspiration in a patient receiving tube feedings?
A. Supine positioning
B. Checking residual volumes
C. Rapid infusion
D. Cold formula
Correct Answer: B
Rationale: Monitoring residuals reduces the risk of gastric overdistention and
aspiration.
