CMSRN - Medical-Surgical Nursing CMSRN-FREE Cmsrn Medical Surgical Nursing 1

Question 1

A nurse is caring for a post-operative patient who underwent a bowel resection 24 hours ago. The patient's abdomen is distended and he reports no bowel sounds. Which intervention should the nurse prioritize?

Accepted Answer

Encourage the patient to ambulate in the hallway

Answer

Early ambulation stimulates peristalsis and helps resolve post-operative ileus, which is the most common cause of abdominal distension after bowel surgery. It is the first-line, least invasive intervention before escalating to NGT insertion.

Question 2

A patient with type 2 diabetes is scheduled for a CT scan with contrast dye in the morning. The nurse notes the patient takes metformin 1000 mg twice daily. What is the priority nursing action?

Accepted Answer

Hold the metformin and notify the provider before the procedure

Answer

Metformin must be held before and after contrast administration due to the risk of contrast-induced nephropathy, which can reduce renal clearance of metformin and lead to lactic acidosis, a life-threatening complication.

Question 3

A nurse is assessing a patient with deep vein thrombosis who is receiving a heparin infusion. The patient's aPTT is 180 seconds. What is the nurse's priority action?

Accepted Answer

Stop the infusion and notify the provider immediately

Answer

A therapeutic aPTT for heparin therapy is 60–100 seconds (1.5–2.5 times the normal of 30–40 seconds). An aPTT of 180 seconds indicates supratherapeutic anticoagulation and a high bleeding risk, requiring immediate cessation of the infusion and provider notification.

Question 4

A patient is admitted with an acute exacerbation of COPD. The nurse notes the patient's SpO2 is 88% on room air. Which oxygen delivery device is most appropriate for this patient?

Accepted Answer

Venturi mask set to deliver 28% FiO2

Answer

Patients with COPD rely on hypoxic drive and require controlled, low-flow oxygen. The Venturi mask delivers a precise, consistent FiO2 (starting at 24–28%), preventing excessive oxygen delivery that could suppress the hypoxic drive and cause respiratory depression.

Question 5

A nurse is caring for a patient with a serum sodium of 122 mEq/L who is confused and complaining of a headache. Which intervention should the nurse implement first?

Accepted Answer

Place the patient on seizure precautions and notify the provider

Answer

A serum sodium of 122 mEq/L with neurological symptoms (confusion, headache) indicates severe symptomatic hyponatremia with risk of seizures and cerebral edema. The priority is patient safety — implementing seizure precautions and notifying the provider for further orders.

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN - Medical-Surgical Nursing CMSRN-FREE Cmsrn Medical Surgical Nursing 1