MEDICAL-SURGICAL RN A PROPHECY RELIAS
COMPETENCY ASSESSMENT 2026 | Latest Version |
Scored 100% | RN Med Surg Test | Pass Guaranteed -
A+ Graded
Section 1: Clinical Judgment & Prioritization (Maslow, ABCs, Safety) (Questions 1-
15)
Q1. A nurse receives report on four patients. Which patient requires the FIRST priority
assessment using Maslow's hierarchy and ABC framework?
A. Patient with stable chronic back pain requesting pain medication
B. Patient with COPD on 2L nasal cannula with SpO2 88% and increased work of
breathing [CORRECT]
C. Patient scheduled for discharge who needs medication education
D. Patient with a healing surgical incision requesting a dressing change
Correct Answer: B
Rationale: Using Maslow's hierarchy and ABC prioritization, airway and breathing
take precedence over all other needs. A COPD patient with SpO2 88% (below 90%
target) and increased work of breathing represents an immediate threat to
physiological safety. Option A addresses pain (higher-level need). Option C is a
discharge task (low priority). Option D is a routine intervention.
Q2. During morning rounds, the nurse finds a patient unresponsive with snoring
respirations and cyanotic lips. What is the FIRST nursing action?
A. Check the patient's blood glucose level
,B. Open the airway using the head-tilt chin-lift maneuver and assess for breathing
[CORRECT]
C. Place the patient in the recovery position
D. Administer supplemental oxygen via non-rebreather mask
Correct Answer: B
Rationale: The ABC framework mandates opening the airway first in an unresponsive
patient. Snoring respirations suggest airway obstruction (likely tongue). Opening the
airway with head-tilt chin-lift (or jaw thrust if trauma suspected) allows assessment of
breathing before any other intervention. Option A delays critical airway management.
Option C is appropriate after airway is open. Option D is ineffective if the airway is
obstructed.
Q3. A nurse has four tasks to delegate. According to the five rights of delegation,
which task is MOST appropriate to delegate to a UAP (Unlicensed Assistive
Personnel)?
A. Administering a subcutaneous insulin injection per sliding scale
B. Assisting a stable patient with ambulation to the bathroom [CORRECT]
C. Performing a sterile dressing change on a postoperative wound
D. Teaching a newly diagnosed diabetic patient about foot care
Correct Answer: B
Rationale: The five rights of delegation require matching task complexity to scope of
practice. UAPs can assist with activities of daily living (ambulation, bathing, vital signs
in stable patients). Insulin administration (Option A) is a high-alert medication
requiring an RN. Sterile dressing changes (Option C) require sterile technique and
assessment skills. Patient education (Option D) is an RN responsibility.
,Q4. A nurse is caring for four patients on a medical-surgical unit. Which patient
should be assessed FIRST based on stability criteria?
A. Patient admitted 2 days ago for community-acquired pneumonia, afebrile, on
room air
B. Patient post-MI day 3 with new-onset chest pain rated 8/10 and diaphoresis
[CORRECT]
C. Patient with heart failure being discharged this afternoon
D. Patient with osteoarthritis requesting PRN acetaminophen
Correct Answer: B
Rationale: The post-MI patient with new chest pain and diaphoresis represents an
unstable patient with potential recurrent ischemia or infarction—a life-threatening
emergency requiring immediate assessment and intervention. Options A, C, and D
represent stable patients with non-urgent needs.
Q5. Using Maslow's hierarchy of needs, which nursing intervention addresses the
LOWEST level need for a patient admitted with acute asthma exacerbation?
A. Providing reassurance and emotional support during dyspneic episodes
B. Administering bronchodilator therapy to improve airway patency [CORRECT]
C. Arranging for family visitation to meet love and belonging needs
D. Facilitating participation in a patient support group for chronic disease
management
Correct Answer: B
Rationale: Maslow's hierarchy prioritizes physiological needs (airway, breathing,
circulation, hydration, nutrition) as the foundation. Administering bronchodilators
addresses the most basic need—oxygenation and airway patency. Options A, C, and
D address higher-level psychological and social needs that cannot be met if
physiological needs are compromised.
, Q6. A nurse receives a handoff report on four patients. Which patient should be seen
FIRST after receiving report?
A. Patient with a stage 2 pressure injury requiring wound dressing change
B. Patient with new-onset atrial fibrillation with RVR, heart rate 156 bpm, BP 88/52
mmHg [CORRECT]
C. Patient requesting assistance with meal tray setup
D. Patient with chronic osteoarthritis pain rated 3/10
Correct Answer: B
Rationale: The patient with new-onset A-fib with RVR and hypotension (88/52) is
hemodynamically unstable with compromised circulation—an immediate threat
requiring urgent assessment, cardiac monitoring, and potential intervention. Options
A, C, and D are non-urgent and can be addressed after the unstable patient is
stabilized.
Q7. Which task is APPROPRIATE to delegate to an LPN (Licensed Practical Nurse)
under RN supervision on a medical-surgical unit?
A. Developing the initial nursing care plan for a newly admitted patient
B. Administering an oral antibiotic to a stable patient per standing orders [CORRECT]
C. Assessing a postoperative patient for signs of hemorrhage
D. Teaching a patient about warfarin therapy and dietary restrictions
Correct Answer: B
Rationale: LPNs can administer oral medications to stable patients with predictable
outcomes under RN supervision. Initial care planning (Option A) requires RN
assessment and critical thinking. Postoperative hemorrhage assessment (Option C)
requires RN-level assessment of unstable patients. Warfarin education (Option D)
requires RN teaching scope due to complexity and safety implications.
COMPETENCY ASSESSMENT 2026 | Latest Version |
Scored 100% | RN Med Surg Test | Pass Guaranteed -
A+ Graded
Section 1: Clinical Judgment & Prioritization (Maslow, ABCs, Safety) (Questions 1-
15)
Q1. A nurse receives report on four patients. Which patient requires the FIRST priority
assessment using Maslow's hierarchy and ABC framework?
A. Patient with stable chronic back pain requesting pain medication
B. Patient with COPD on 2L nasal cannula with SpO2 88% and increased work of
breathing [CORRECT]
C. Patient scheduled for discharge who needs medication education
D. Patient with a healing surgical incision requesting a dressing change
Correct Answer: B
Rationale: Using Maslow's hierarchy and ABC prioritization, airway and breathing
take precedence over all other needs. A COPD patient with SpO2 88% (below 90%
target) and increased work of breathing represents an immediate threat to
physiological safety. Option A addresses pain (higher-level need). Option C is a
discharge task (low priority). Option D is a routine intervention.
Q2. During morning rounds, the nurse finds a patient unresponsive with snoring
respirations and cyanotic lips. What is the FIRST nursing action?
A. Check the patient's blood glucose level
,B. Open the airway using the head-tilt chin-lift maneuver and assess for breathing
[CORRECT]
C. Place the patient in the recovery position
D. Administer supplemental oxygen via non-rebreather mask
Correct Answer: B
Rationale: The ABC framework mandates opening the airway first in an unresponsive
patient. Snoring respirations suggest airway obstruction (likely tongue). Opening the
airway with head-tilt chin-lift (or jaw thrust if trauma suspected) allows assessment of
breathing before any other intervention. Option A delays critical airway management.
Option C is appropriate after airway is open. Option D is ineffective if the airway is
obstructed.
Q3. A nurse has four tasks to delegate. According to the five rights of delegation,
which task is MOST appropriate to delegate to a UAP (Unlicensed Assistive
Personnel)?
A. Administering a subcutaneous insulin injection per sliding scale
B. Assisting a stable patient with ambulation to the bathroom [CORRECT]
C. Performing a sterile dressing change on a postoperative wound
D. Teaching a newly diagnosed diabetic patient about foot care
Correct Answer: B
Rationale: The five rights of delegation require matching task complexity to scope of
practice. UAPs can assist with activities of daily living (ambulation, bathing, vital signs
in stable patients). Insulin administration (Option A) is a high-alert medication
requiring an RN. Sterile dressing changes (Option C) require sterile technique and
assessment skills. Patient education (Option D) is an RN responsibility.
,Q4. A nurse is caring for four patients on a medical-surgical unit. Which patient
should be assessed FIRST based on stability criteria?
A. Patient admitted 2 days ago for community-acquired pneumonia, afebrile, on
room air
B. Patient post-MI day 3 with new-onset chest pain rated 8/10 and diaphoresis
[CORRECT]
C. Patient with heart failure being discharged this afternoon
D. Patient with osteoarthritis requesting PRN acetaminophen
Correct Answer: B
Rationale: The post-MI patient with new chest pain and diaphoresis represents an
unstable patient with potential recurrent ischemia or infarction—a life-threatening
emergency requiring immediate assessment and intervention. Options A, C, and D
represent stable patients with non-urgent needs.
Q5. Using Maslow's hierarchy of needs, which nursing intervention addresses the
LOWEST level need for a patient admitted with acute asthma exacerbation?
A. Providing reassurance and emotional support during dyspneic episodes
B. Administering bronchodilator therapy to improve airway patency [CORRECT]
C. Arranging for family visitation to meet love and belonging needs
D. Facilitating participation in a patient support group for chronic disease
management
Correct Answer: B
Rationale: Maslow's hierarchy prioritizes physiological needs (airway, breathing,
circulation, hydration, nutrition) as the foundation. Administering bronchodilators
addresses the most basic need—oxygenation and airway patency. Options A, C, and
D address higher-level psychological and social needs that cannot be met if
physiological needs are compromised.
, Q6. A nurse receives a handoff report on four patients. Which patient should be seen
FIRST after receiving report?
A. Patient with a stage 2 pressure injury requiring wound dressing change
B. Patient with new-onset atrial fibrillation with RVR, heart rate 156 bpm, BP 88/52
mmHg [CORRECT]
C. Patient requesting assistance with meal tray setup
D. Patient with chronic osteoarthritis pain rated 3/10
Correct Answer: B
Rationale: The patient with new-onset A-fib with RVR and hypotension (88/52) is
hemodynamically unstable with compromised circulation—an immediate threat
requiring urgent assessment, cardiac monitoring, and potential intervention. Options
A, C, and D are non-urgent and can be addressed after the unstable patient is
stabilized.
Q7. Which task is APPROPRIATE to delegate to an LPN (Licensed Practical Nurse)
under RN supervision on a medical-surgical unit?
A. Developing the initial nursing care plan for a newly admitted patient
B. Administering an oral antibiotic to a stable patient per standing orders [CORRECT]
C. Assessing a postoperative patient for signs of hemorrhage
D. Teaching a patient about warfarin therapy and dietary restrictions
Correct Answer: B
Rationale: LPNs can administer oral medications to stable patients with predictable
outcomes under RN supervision. Initial care planning (Option A) requires RN
assessment and critical thinking. Postoperative hemorrhage assessment (Option C)
requires RN-level assessment of unstable patients. Warfarin education (Option D)
requires RN teaching scope due to complexity and safety implications.
