CMSRN FREE CMSRN Medical-Surgical Nursing General Questions and Answers 2 — Questions and Answers
Question 1: A patient with heart failure is prescribed furosemide 40 mg IV. Which assessment finding should the nurse report immediately?
- Potassium level of 2.8 mEq/L (Correct answer)
- Urine output of 200 mL in 2 hours
- Blood pressure of 128/78 mmHg
- Mild pedal edema
Correct answer: Potassium level of 2.8 mEq/L
A potassium level of 2.8 mEq/L indicates hypokalemia, a dangerous side effect of loop diuretics that can cause fatal cardiac dysrhythmias.
Question 2: Which intervention is the priority for a postoperative patient with a PCA pump who has a respiratory rate of 8 breaths per minute?
- Stop the PCA infusion and administer naloxone as ordered (Correct answer)
- Encourage deep breathing exercises
- Reposition the patient to a semi-Fowler's position
- Document the finding and reassess in 15 minutes
Correct answer: Stop the PCA infusion and administer naloxone as ordered
A respiratory rate of 8 indicates opioid-induced respiratory depression requiring immediate cessation of the PCA and naloxone administration.
Question 3: A nurse is caring for a patient with cirrhosis who has developed ascites. Which dietary modification is most appropriate?
- Sodium restriction to 2 g per day (Correct answer)
- High-protein diet of 100 g per day
- Fluid intake of 3 liters per day
- Increased potassium-rich foods
Correct answer: Sodium restriction to 2 g per day
Sodium restriction helps reduce fluid retention and ascites formation in patients with cirrhosis.
Question 4: A patient with type 2 diabetes has a blood glucose of 648 mg/dL, serum osmolality of 340 mOsm/kg, and no ketonuria. Which condition does the nurse suspect?
- Hyperosmolar hyperglycemic state (Correct answer)
- Diabetic ketoacidosis
- Addisonian crisis
- Syndrome of inappropriate ADH secretion
Correct answer: Hyperosmolar hyperglycemic state
Markedly elevated glucose and osmolality without ketones is characteristic of hyperosmolar hyperglycemic state, seen in type 2 diabetes.
Question 5: Which assessment finding in a patient 6 hours post-thyroidectomy requires the most urgent nursing intervention?
- Tingling and numbness around the mouth and fingertips (Correct answer)
- Mild hoarseness when speaking
- Incisional pain rated 5 out of 10
- Low-grade temperature of 99.2°F
Correct answer: Tingling and numbness around the mouth and fingertips
Perioral and fingertip tingling indicates hypocalcemia from accidental parathyroid removal, which can progress to tetany and laryngospasm.
Question 6: A nurse is preparing to administer a unit of packed red blood cells. Which action is correct regarding transfusion safety?
- Verify the blood product with two licensed nurses at the bedside (Correct answer)
- Infuse the unit rapidly within the first 30 minutes
- Use a 22-gauge catheter in the antecubital vein
- Add normal saline and dextrose to the blood bag
Correct answer: Verify the blood product with two licensed nurses at the bedside
Two licensed nurses must independently verify patient identity and blood product compatibility at the bedside before transfusion.
CMSRN FREE CMSRN Medical-Surgical Nursing General Questions and Answers 2
A patient with heart failure is prescribed furosemide 40 mg IV.
Which assessment finding should the nurse report immediately?