CMSRN FREE CMSRN Medical-Surgical Nursing 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 ECG change should the nurse anticipate?
- Peaked T waves (Correct answer)
- Prolonged QT interval
- ST segment depression
- U waves
Correct answer: Peaked T waves
Hyperkalemia causes tall, peaked T waves due to altered cardiac cell repolarization.
Question 2: Which intervention is the priority for a patient experiencing autonomic dysreflexia?
- Elevate the head of the bed to 90 degrees (Correct answer)
- Administer a PRN antihypertensive
- Insert a urinary catheter
- Remove constrictive clothing
Correct answer: Elevate the head of the bed to 90 degrees
Raising the head of the bed uses orthostatic effects to immediately lower dangerously elevated blood pressure.
Question 3: A nurse is caring for a patient 2 hours post-thyroidectomy. Which assessment finding requires immediate intervention?
- Tingling and numbness around the mouth (Correct answer)
- Mild sore throat with hoarseness
- Serosanguineous drainage on the dressing
- Pain rated 4 out of 10
Correct answer: Tingling and numbness around the mouth
Perioral tingling indicates hypocalcemia from inadvertent parathyroid removal, a serious post-thyroidectomy complication.
Question 4: A patient with cirrhosis develops hepatorenal syndrome. Which finding is most characteristic of this condition?
- Oliguria with low urine sodium (Correct answer)
- Hematuria with proteinuria
- Polyuria with high urine sodium
- Anuria with flank pain
Correct answer: Oliguria with low urine sodium
Hepatorenal syndrome presents with oliguria and very low urine sodium due to intense renal vasoconstriction.
Question 5: Which assessment technique should the nurse use to evaluate for asterixis in a patient with hepatic encephalopathy?
- Ask the patient to extend the arms with wrists dorsiflexed (Correct answer)
- Tap the facial nerve anterior to the ear
- Inflate a blood pressure cuff above systolic pressure
- Stroke the lateral aspect of the sole of the foot
Correct answer: Ask the patient to extend the arms with wrists dorsiflexed
Asterixis, or liver flap, is assessed by having the patient hold the arms outstretched with wrists hyperextended and observing for flapping tremor.
Question 6: A patient with acute pancreatitis has a Ranson score of 6 on admission. What does this indicate to the nurse?
- High mortality risk requiring ICU-level care (Correct answer)
- Mild disease manageable on a medical unit
- Need for immediate surgical intervention
- Readiness for oral diet advancement
Correct answer: High mortality risk requiring ICU-level care
A Ranson score of 6 or higher indicates severe acute pancreatitis with a mortality rate exceeding 50%, requiring intensive monitoring.
CMSRN FREE CMSRN Medical-Surgical Nursing Questions and Answers 2
A patient with chronic kidney disease has a potassium level of 6.2 mEq/L.
Which ECG change should the nurse anticipate?