RELIAS Medical-Surgical Telemetry
Exam 2026 PDF | Comprehensive
Actual Question Practice Exam with
Answers and Rationales
1. A patient with atrial fibrillation is receiving anticoagulation therapy.
Which lab value is most important to monitor?
A) INR
B) Potassium
C) Sodium
D) Hemoglobin
Answer: A – INR
Rationale: INR ensures therapeutic anticoagulation to prevent
thromboembolism.
2. Which rhythm is characterized by absent P waves and irregularly
irregular R-R intervals?
A) Atrial fibrillation
B) Sinus tachycardia
C) Ventricular tachycardia
D) Junctional rhythm
Answer: A – Atrial fibrillation
Rationale: Classic ECG finding in AF.
3. A patient has ST elevation in leads II, III, and aVF. Which coronary artery
is most likely involved?
A) Right coronary artery
B) Left anterior descending
C) Circumflex artery
D) Left main
,Answer: A – Right coronary artery
Rationale: Inferior MI is typically caused by RCA occlusion.
4. Which electrolyte imbalance is most commonly associated with
prolonged QT interval?
A) Hypokalemia
B) Hypernatremia
C) Hypercalcemia
D) Hypermagnesemia
Answer: A – Hypokalemia
Rationale: Low potassium delays repolarization, prolonging QT.
5. Which drug class is first-line for acute management of supraventricular
tachycardia (SVT)?
A) Adenosine
B) Amiodarone
C) Digoxin
D) Atropine
Answer: A – Adenosine
Rationale: Rapid IV push can terminate re-entrant SVT.
6. Which sign indicates early hypoxia in a post-op patient?
A) Restlessness
B) Cyanosis only
C) Bradypnea only
D) Hypotension only
Answer: A – Restlessness
Rationale: CNS changes are an early hypoxia indicator.
7. A patient on telemetry reports palpitations and dizziness. ECG shows
wide QRS with no P waves. What is the likely rhythm?
A) Ventricular tachycardia
B) Atrial fibrillation
C) Sinus bradycardia
D) SVT
,Answer: A – Ventricular tachycardia
Rationale: Wide complex tachycardia with absent P waves indicates VT.
8. Which medication is commonly used to treat ventricular fibrillation
during cardiac arrest?
A) Epinephrine and amiodarone
B) Adenosine only
C) Digoxin only
D) Atropine only
Answer: A – Epinephrine and amiodarone
Rationale: ACLS protocol recommends these drugs for VF.
9. Which electrolyte is most critical to monitor in a patient receiving
furosemide?
A) Potassium
B) Sodium only
C) Calcium only
D) Magnesium only
Answer: A – Potassium
Rationale: Loop diuretics cause hypokalemia, increasing arrhythmia risk.
10. A patient has chest pain and elevated troponin. Which type of MI is
indicated?
A) Non-ST elevation MI (NSTEMI)
B) STEMI only
C) Unstable angina only
D) Prinzmetal angina
Answer: A – Non-ST elevation MI (NSTEMI)
Rationale: Elevated cardiac markers without ST elevation indicate NSTEMI.
11. Which symptom is most concerning for acute decompensated heart
failure?
A) Sudden weight gain and dyspnea
B) Mild fatigue only
C) Headache only
D) Nausea only
, Answer: A – Sudden weight gain and dyspnea
Rationale: Rapid fluid accumulation indicates worsening HF.
12. Which heart sound is commonly heard in left-sided heart failure?
A) S3 gallop
B) S1 only
C) S2 only
D) S4 only
Answer: A – S3 gallop
Rationale: S3 occurs due to rapid ventricular filling in failing ventricles.
13. A patient has COPD exacerbation with PaO2 of 55 mmHg. What is the
priority intervention?
A) Administer supplemental oxygen carefully
B) Encourage deep breathing only
C) Give diuretics only
D) Start IV fluids only
Answer: A – Administer supplemental oxygen carefully
Rationale: Hypoxemia requires oxygen; too much may depress respiratory drive
in COPD.
14. Which lab indicates acute kidney injury?
A) Elevated creatinine
B) Low sodium only
C) High potassium only
D) Elevated hemoglobin only
Answer: A – Elevated creatinine
Rationale: Rising creatinine reflects impaired renal function.
15. Which ECG change is most consistent with hyperkalemia?
A) Peaked T waves
B) ST elevation only
C) U waves only
D) Prolonged PR only
Answer: A – Peaked T waves
Rationale: Hyperkalemia affects cardiac repolarization.
Exam 2026 PDF | Comprehensive
Actual Question Practice Exam with
Answers and Rationales
1. A patient with atrial fibrillation is receiving anticoagulation therapy.
Which lab value is most important to monitor?
A) INR
B) Potassium
C) Sodium
D) Hemoglobin
Answer: A – INR
Rationale: INR ensures therapeutic anticoagulation to prevent
thromboembolism.
2. Which rhythm is characterized by absent P waves and irregularly
irregular R-R intervals?
A) Atrial fibrillation
B) Sinus tachycardia
C) Ventricular tachycardia
D) Junctional rhythm
Answer: A – Atrial fibrillation
Rationale: Classic ECG finding in AF.
3. A patient has ST elevation in leads II, III, and aVF. Which coronary artery
is most likely involved?
A) Right coronary artery
B) Left anterior descending
C) Circumflex artery
D) Left main
,Answer: A – Right coronary artery
Rationale: Inferior MI is typically caused by RCA occlusion.
4. Which electrolyte imbalance is most commonly associated with
prolonged QT interval?
A) Hypokalemia
B) Hypernatremia
C) Hypercalcemia
D) Hypermagnesemia
Answer: A – Hypokalemia
Rationale: Low potassium delays repolarization, prolonging QT.
5. Which drug class is first-line for acute management of supraventricular
tachycardia (SVT)?
A) Adenosine
B) Amiodarone
C) Digoxin
D) Atropine
Answer: A – Adenosine
Rationale: Rapid IV push can terminate re-entrant SVT.
6. Which sign indicates early hypoxia in a post-op patient?
A) Restlessness
B) Cyanosis only
C) Bradypnea only
D) Hypotension only
Answer: A – Restlessness
Rationale: CNS changes are an early hypoxia indicator.
7. A patient on telemetry reports palpitations and dizziness. ECG shows
wide QRS with no P waves. What is the likely rhythm?
A) Ventricular tachycardia
B) Atrial fibrillation
C) Sinus bradycardia
D) SVT
,Answer: A – Ventricular tachycardia
Rationale: Wide complex tachycardia with absent P waves indicates VT.
8. Which medication is commonly used to treat ventricular fibrillation
during cardiac arrest?
A) Epinephrine and amiodarone
B) Adenosine only
C) Digoxin only
D) Atropine only
Answer: A – Epinephrine and amiodarone
Rationale: ACLS protocol recommends these drugs for VF.
9. Which electrolyte is most critical to monitor in a patient receiving
furosemide?
A) Potassium
B) Sodium only
C) Calcium only
D) Magnesium only
Answer: A – Potassium
Rationale: Loop diuretics cause hypokalemia, increasing arrhythmia risk.
10. A patient has chest pain and elevated troponin. Which type of MI is
indicated?
A) Non-ST elevation MI (NSTEMI)
B) STEMI only
C) Unstable angina only
D) Prinzmetal angina
Answer: A – Non-ST elevation MI (NSTEMI)
Rationale: Elevated cardiac markers without ST elevation indicate NSTEMI.
11. Which symptom is most concerning for acute decompensated heart
failure?
A) Sudden weight gain and dyspnea
B) Mild fatigue only
C) Headache only
D) Nausea only
, Answer: A – Sudden weight gain and dyspnea
Rationale: Rapid fluid accumulation indicates worsening HF.
12. Which heart sound is commonly heard in left-sided heart failure?
A) S3 gallop
B) S1 only
C) S2 only
D) S4 only
Answer: A – S3 gallop
Rationale: S3 occurs due to rapid ventricular filling in failing ventricles.
13. A patient has COPD exacerbation with PaO2 of 55 mmHg. What is the
priority intervention?
A) Administer supplemental oxygen carefully
B) Encourage deep breathing only
C) Give diuretics only
D) Start IV fluids only
Answer: A – Administer supplemental oxygen carefully
Rationale: Hypoxemia requires oxygen; too much may depress respiratory drive
in COPD.
14. Which lab indicates acute kidney injury?
A) Elevated creatinine
B) Low sodium only
C) High potassium only
D) Elevated hemoglobin only
Answer: A – Elevated creatinine
Rationale: Rising creatinine reflects impaired renal function.
15. Which ECG change is most consistent with hyperkalemia?
A) Peaked T waves
B) ST elevation only
C) U waves only
D) Prolonged PR only
Answer: A – Peaked T waves
Rationale: Hyperkalemia affects cardiac repolarization.
