CMSRN FREE CMSRN Medical-Surgical Nursing Guide Questions and Answers 2 — Questions and Answers
Question 1: A patient with chronic kidney disease has a potassium level of 6.2 mEq/L. Which intervention should the nurse prioritize?
- Administer sodium polystyrene sulfonate as ordered (Correct answer)
- Encourage intake of potassium-rich foods
- Increase IV normal saline rate
- Apply a warming blanket
Correct answer: Administer sodium polystyrene sulfonate as ordered
Sodium polystyrene sulfonate binds potassium in the GI tract to lower dangerously elevated serum potassium levels.
Question 2: Which assessment finding in a postoperative patient most strongly suggests the development of a pulmonary embolism?
- Sudden onset of dyspnea with pleuritic chest pain (Correct answer)
- Bilateral lower extremity edema
- Temperature of 100.2°F on postoperative day two
- Productive cough with yellow sputum
Correct answer: Sudden onset of dyspnea with pleuritic chest pain
Sudden dyspnea accompanied by pleuritic chest pain is the hallmark presentation of a pulmonary embolism.
Question 3: A nurse is caring for a patient receiving a blood transfusion who develops fever, flank pain, and dark urine. What is the priority nursing action?
- Stop the transfusion immediately (Correct answer)
- Slow the infusion rate
- Administer diphenhydramine
- Obtain a urine specimen first
Correct answer: Stop the transfusion immediately
These symptoms indicate an acute hemolytic transfusion reaction, requiring immediate cessation of the transfusion to prevent further harm.
Question 4: Which laboratory value should the nurse monitor most closely in a patient receiving heparin therapy?
- Activated partial thromboplastin time (aPTT)
- Prothrombin time (PT)
- Platelet count and aPTT (Correct answer)
- Hemoglobin A1C
Correct answer: Platelet count and aPTT
Both aPTT for therapeutic effectiveness and platelet count for heparin-induced thrombocytopenia must be monitored during heparin therapy.
Question 5: A patient with heart failure is prescribed furosemide 40 mg IV. Which electrolyte imbalance should the nurse anticipate?
- Hyperkalemia
- Hypokalemia (Correct answer)
- Hypernatremia
- Hypercalcemia
Correct answer: Hypokalemia
Furosemide is a loop diuretic that causes significant potassium loss, leading to hypokalemia.
Question 6: A patient with type 2 diabetes presents with blood glucose of 680 mg/dL, serum osmolality of 340 mOsm/kg, and no ketonuria. Which condition does the nurse suspect?
- Diabetic ketoacidosis
- Hyperosmolar hyperglycemic state (Correct answer)
- Addisonian crisis
- Syndrome of inappropriate ADH secretion
Correct answer: Hyperosmolar hyperglycemic state
Extremely elevated glucose with high serum osmolality and absent ketones is characteristic of hyperosmolar hyperglycemic state.
CMSRN FREE CMSRN Medical-Surgical Nursing Guide Questions and Answers 2
A patient with chronic kidney disease has a potassium level of 6.2 mEq/L.
Which intervention should the nurse prioritize?