# Relias Helpful Hints

Relias Testing Helpful Hints

Before starting your Relias exam, read any/all documents provided by Relias. Also, read all the screen information and open any available links before starting the test.

If you log out of the computer while taking the test, the test will pick up where you left off. If you feel stressed during the test and need to take a break, log off for a minute and regain your focus.

**Specialty Tests**

- These are “textbook” tests like the NCLEX or other licensure/certification tests, so the questions are based more on textbook situations, not on real-world situations
- Don’t answer based on your individual experience at any particular facility

**CORE Tests**

All the CORE tests have a manual with all the information tested for each of these tests.

- It is important to read these manuals
- Print out the manuals, if you can, for ease of access

**Math Ability Tests**

- PRINT the calculation formulas provided by Relias and use these formulas to determine the answer
- Have scratch paper, a pencil, and a calculator ready – write out the formula using the appropriate numbers in the problem and then do your calculations
- Don’t round the answer you get when converting lbs to kg – use the full result on your calculator in your calculations – this is VERY important!
- Become familiar with metric conversions
- 1 mg = 1000 mcg
- 1 kg = 1000 g
- 1 g = 1000 mg
- 1 kg = 2.2 lbs

- Make sure to answer with the appropriate number of decimals as specified in the problem, rounding correctly
- Make sure the answer makes sense! If unsure, plug your answer back into the calculation to make sure it’s the correct answer
- Use critical thinking to reason through how to determine the answer if you are struggling with a question
- Keep in mind that sometimes there is more information in the problem than you need to answer the question
- If you are struggling with figuring out an answer, try a different mathematical approach to the problem

**Dysrhythmia Tests **

The following helpful hints are based on reviewing the most common incorrect answers by FlexCare RNs and are meant to help you focus your studying, as well as to help you successfully pass the exam on the first attempt.

- Review
**BOTH**the Basic and Advanced EKG Refreshers provided by your recruiter (even if you are taking the Basic Dysrhythmia exam). These are wonderful EKG refreshers for the Relias Dysrhythmia exams - PRACTICE! PRACTICE! PRACTICE!
- Use any other resources you can find to practice reading different strips of the different rhythms, especially for the rhythms you have the most difficulty with
- Know how to measure!
- Hover the cursor over the strip, and that part of the strip will magnify to make it easier to count the number of “little” boxes
- Check the Basic EKG Refresher document provided by your recruiter to review how to measure PR and QRS intervals
- Know both ways to determine rates:
- Count the number of R’s, then multiply by 10 OR
- Use the rate chart after counting the number of little boxes between R’s (see the Basic EKG Refresher document for the rate chart – have this handy when you take the exam)

- NEVER just “look” at a rhythm or think “it looks like” a particular rhythm to determine the rhythm unless it is clear and unmistakable, like asystole (example: SR may actually be SR with first degree AV block, but you wouldn’t know that if you didn’t measure the PR interval)
**IMPORTANT**–*it is always best to use a routine process for reviewing each strip. The answers to each step will help rule out certain rhythms and will help steer you to the correct rhythm:*- What is the RATE?
- Is the rate REGULAR or IRREGULAR?
- Is there a P WAVE?
- What is the PR INTERVAL?
- What does the QRS look like?
- Know the hallmarks of certain rhythms to help reduce confusion when determining the correct rhythm. Have a cheat sheet with this information available while you take the test. DO NOT use multiple resources to refer to while taking the test, as it will only slow you down as you flip through pages and pages to find what you are looking for.
**Blocks:**- First Degree: PR is prolonged >.20
- Second Degree Type I: PR gets progressively longer than a QRS is dropped
- Second Degree Type II: PR interval is constant with randomly dropped QRS, underlying rhythm is regular (note the PR interval for this block could be > .20)
- Third Degree – no correlation between P’s and QRS’s, P waves usually march out consistently, even if buried in another wave

**Junctional Rhythms:**- P wave is absent or inverted
- If P wave is present, the PR interval will be short (< 0.12)
- Know rates to determine the correct Junctional rhythm
- Junctional rhythm – rate is 40-60 bpm
- Accelerated Junctional – rate is 61 – 100 bpm
- Junctional Tachycardia – rate is > 100 bpm

**Idioventricular Rhythms:**- NO P waves AND widening of QRS
- Know the rates to determine the correct Idioventricular rhythm
- Idioventricular rhythm – rate is < 40 bpm
- Accelerated Idioventricular – rate is 40 – 100 bpm
- VTach – rate is >100 bpm

- Know ventricular bigeminy, trigeminy, and couplets - check the refresher documents for review
- Pacer spikes - Every pacer spike (if capturing) should have either a P wave or a QRS complex following it, depending on if the pacer is atrial, ventricular or both
- Don’t confuse:
**Afib and Aflutter**- AFiB
- Rate is always irregular (irregularly irregular)
- No distinguishable P waves
- Atrial activity won’t always be the same before each QRS

- Aflutter
- Sawtooth “like” pattern –may be more rounded than pointed
- Atrial rhythm is regular and ventricular rhythm may be irregular

- AFiB
**PACs and PVCs**- PACs
- A normal beat, but it occurs early
- Will have P wave with normal-looking QRS
- Irregular rhythm is the result of the PAC, would be regular otherwise

- PVCs
- QRS is always wide and bizarre compared to a “normal” beat
- P wave will be absent before the QRS

- PACs
**ST and SVT**- ST – rate is 101-160 BPM
- SVT – rate is 150-250 BPM; P waves and PR intervals are not usually discernable