Relias Practice and Application 2 — Questions and Answers
Question 1: A healthcare worker notices a patient exhibiting sudden confusion, slurred speech, and facial drooping. What is the most appropriate immediate action?
- Document the symptoms and notify the charge nurse at the next shift change
- Activate the stroke protocol and call for emergency assistance immediately (Correct answer)
- Administer oxygen and wait 15 minutes to see if symptoms resolve
- Ask the patient to rest and reassess in one hour
Correct answer: Activate the stroke protocol and call for emergency assistance immediately
Sudden neurological symptoms such as confusion, slurred speech, and facial drooping are classic stroke signs requiring immediate emergency response via established stroke protocols.
Question 2: When applying the SBAR communication framework during a patient handoff, which component involves describing the current status of the patient?
- Situation
- Background
- Assessment (Correct answer)
- Recommendation
Correct answer: Assessment
The Assessment component of SBAR involves the clinician's interpretation and evaluation of the patient's current condition and status.
Question 3: A nurse is preparing to administer a high-alert medication. According to best practice, which safety check is most critical before administration?
- Checking the patient's dietary restrictions
- Performing an independent double-check with a second qualified clinician (Correct answer)
- Verifying the patient's insurance coverage
- Confirming the patient's preferred pharmacy
Correct answer: Performing an independent double-check with a second qualified clinician
High-alert medications require an independent double-check by a second qualified clinician to reduce the risk of serious harm from medication errors.
Question 4: In a long-term care setting, a resident refuses to take their prescribed medications. What is the best initial response?
- Crush the medication and hide it in the resident's food
- Respect the refusal, document it, and notify the prescribing provider (Correct answer)
- Administer the medication anyway to maintain the treatment plan
- Discharge the resident for non-compliance
Correct answer: Respect the refusal, document it, and notify the prescribing provider
Competent adults have the right to refuse treatment; the appropriate response is to document the refusal and inform the provider to determine next steps.
Question 5: A patient's blood pressure reads 88/52 mmHg after surgery. The nurse should first:
- Reposition the patient to a high Fowler's position
- Reassess blood pressure in 30 minutes before acting
- Notify the surgeon and prepare for a possible fluid challenge (Correct answer)
- Administer a PRN antihypertensive as ordered
Correct answer: Notify the surgeon and prepare for a possible fluid challenge
Hypotension post-surgery may indicate hemorrhage or hemodynamic instability, requiring immediate provider notification and preparation for intervention.
Question 6: Which of the following best describes the purpose of a root cause analysis (RCA) after an adverse event?
- To assign blame to the staff member responsible for the error
- To identify systemic factors contributing to the event and prevent recurrence (Correct answer)
- To determine disciplinary action for involved personnel
- To satisfy accreditation requirements with minimal investigation
Correct answer: To identify systemic factors contributing to the event and prevent recurrence
RCA is a systems-focused, non-punitive process designed to uncover underlying causes of adverse events to improve safety and prevent future occurrences.
Question 7: When using motivational interviewing techniques with a patient resistant to lifestyle changes, which approach is most effective?
- Lecturing the patient on the health consequences of their current behavior
- Exploring the patient's own reasons for change using open-ended questions (Correct answer)
- Prescribing strict behavioral changes and monitoring compliance
- Ignoring resistance and repeating the same health education
Correct answer: Exploring the patient's own reasons for change using open-ended questions
Motivational interviewing uses open-ended questions to elicit the patient's intrinsic motivation for change, which is more effective than provider-directed advice.
Relias Practice and Application 2
A healthcare worker notices a patient exhibiting sudden confusion, slurred speech, and facial drooping.
What is the most appropriate immediate action?