CMSRN FREE Medical Surgical Nurse 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 anticipate first?
- Administer sodium polystyrene sulfonate (Correct answer)
- Encourage increased oral fluid intake
- Apply a warm compress to the IV site
- Administer a bolus of normal saline
Correct answer: Administer sodium polystyrene sulfonate
Sodium polystyrene sulfonate (Kayexalate) binds potassium in the GI tract and is a priority intervention for hyperkalemia.
Question 2: Which assessment finding in a patient 6 hours post-thyroidectomy requires immediate nursing intervention?
- Hoarseness when speaking
- Tingling around the mouth and fingertips (Correct answer)
- Mild incisional swelling
- A sore throat with difficulty swallowing
Correct answer: Tingling around the mouth and fingertips
Perioral and fingertip tingling indicates hypocalcemia from accidental parathyroid removal, which can progress to tetany and requires urgent calcium replacement.
Question 3: A nurse is caring for a patient receiving a blood transfusion who develops fever, chills, and flank pain 15 minutes into the infusion. What is the priority action?
- Slow the transfusion rate and monitor vital signs
- Stop the transfusion immediately and keep the IV open with normal saline (Correct answer)
- Administer diphenhydramine and continue the transfusion
- Obtain a urine sample and continue the transfusion at a slower rate
Correct answer: Stop the transfusion immediately and keep the IV open with normal saline
Fever, chills, and flank pain suggest an acute hemolytic transfusion reaction, requiring immediate cessation of the transfusion while maintaining IV access.
Question 4: Which finding would the nurse expect in a patient with right-sided heart failure?
- Crackles in bilateral lung fields
- Frothy pink sputum
- Jugular venous distention and peripheral edema (Correct answer)
- Orthopnea relieved by sitting upright
Correct answer: Jugular venous distention and peripheral edema
Right-sided heart failure causes systemic venous congestion, manifesting as jugular venous distention, hepatomegaly, and dependent peripheral edema.
Question 5: A patient with a chest tube has continuous bubbling in the water seal chamber. What does this indicate?
- The lung has fully re-expanded
- There is an air leak in the system (Correct answer)
- The suction pressure is set correctly
- The drainage system needs to be replaced
Correct answer: There is an air leak in the system
Continuous bubbling in the water seal chamber indicates an air leak either at the insertion site, in the tubing connections, or from the lung itself.
Question 6: A nurse is teaching a patient newly diagnosed with type 2 diabetes about sick-day management. Which statement by the patient indicates correct understanding?
- I should stop taking my diabetes medication when I am sick
- I need to check my blood glucose more frequently when I am ill (Correct answer)
- I should skip meals to keep my blood sugar from going too high
- I only need to call my doctor if my temperature exceeds 103 degrees
Correct answer: I need to check my blood glucose more frequently when I am ill
During illness, blood glucose levels can fluctuate significantly, so more frequent monitoring is essential to guide medication adjustments and prevent complications.
CMSRN FREE Medical Surgical Nurse Questions and Answers 2
A patient with chronic kidney disease has a potassium level of 6.2 mEq/L.
Which intervention should the nurse anticipate first?