CMSRN FREE CMSRN Medical-Surgical Nursing MCQ 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 infusion rate
- Apply a warm compress to the AV fistula
Correct answer: Administer sodium polystyrene sulfonate as ordered
Sodium polystyrene sulfonate binds potassium in the GI tract and promotes its excretion, which is the priority intervention for hyperkalemia.
Question 2: A nurse is caring for a patient 12 hours after a total hip arthroplasty. Which assessment finding requires immediate intervention?
- Serosanguineous drainage on the surgical dressing
- Inability to dorsiflex the affected foot (Correct answer)
- Mild pain rated 3 out of 10 with movement
- Temperature of 99.2°F (37.3°C)
Correct answer: Inability to dorsiflex the affected foot
Inability to dorsiflex the foot may indicate peroneal nerve damage or neurovascular compromise, requiring immediate evaluation.
Question 3: Which laboratory value should the nurse monitor most closely in a patient receiving vancomycin therapy?
- Serum creatinine and trough levels (Correct answer)
- Prothrombin time and INR
- Hemoglobin A1C
- Serum lipase
Correct answer: Serum creatinine and trough levels
Vancomycin is nephrotoxic, so monitoring serum creatinine and trough drug levels is essential to prevent kidney damage.
Question 4: A patient with heart failure is prescribed furosemide 40 mg IV push. Which electrolyte imbalance should the nurse anticipate?
- Hypernatremia
- Hyperkalemia
- Hypokalemia (Correct answer)
- Hypercalcemia
Correct answer: Hypokalemia
Furosemide is a loop diuretic that causes significant potassium loss in the urine, leading to hypokalemia.
Question 5: A patient with type 2 diabetes is admitted with a blood glucose of 680 mg/dL, serum osmolality of 340 mOsm/kg, and no ketones in the urine. Which condition does the nurse suspect?
- Diabetic ketoacidosis
- Hyperosmolar hyperglycemic state (Correct answer)
- Addisonian crisis
- Myxedema coma
Correct answer: Hyperosmolar hyperglycemic state
Extremely elevated glucose with high serum osmolality and absent ketones is characteristic of hyperosmolar hyperglycemic state.
Question 6: A nurse is preparing to administer a blood transfusion. Which action is essential before starting the infusion?
- Administer prophylactic diphenhydramine to all patients
- Verify patient identity and blood product with two licensed nurses at the bedside (Correct answer)
- Warm the blood product in a microwave for 30 seconds
- Run the blood through IV tubing with dextrose solution
Correct answer: Verify patient identity and blood product with two licensed nurses at the bedside
Two licensed nurses must verify patient identification and blood product compatibility at the bedside to prevent transfusion reactions.
CMSRN FREE CMSRN Medical-Surgical Nursing MCQ 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?