CMSRN Cardiovascular and Hematological Care 2

Question 1

A patient with heart failure has a BNP level of 900 pg/mL. What does this finding indicate?

Accepted Answer

Severe ventricular wall stress and volume overload

Answer

Elevated BNP (>100 pg/mL) reflects ventricular wall stress due to volume or pressure overload, commonly seen in decompensated heart failure.

Question 2

A patient on heparin therapy develops sudden thrombocytopenia and a new arterial clot on day 8. Which complication should the nurse suspect?

Accepted Answer

Heparin-induced thrombocytopenia (HIT)

Answer

HIT typically presents 5–10 days after heparin initiation with paradoxical thrombosis and a platelet drop, requiring immediate discontinuation of heparin.

Question 3

Which assessment finding best indicates right-sided heart failure?

Accepted Answer

Jugular venous distension and peripheral edema

Answer

Right-sided heart failure causes systemic venous congestion, manifesting as JVD, hepatomegaly, and dependent edema.

Question 4

A patient with sickle cell disease is admitted in vaso-occlusive crisis. What is the priority nursing intervention?

Accepted Answer

Provide IV fluids and analgesics

Answer

Hydration reverses sickling by diluting the blood and analgesics address the severe pain caused by microvascular occlusion.

Question 5

A patient receiving a blood transfusion develops sudden flank pain, hemoglobinuria, and fever within 15 minutes. What should the nurse do first?

Accepted Answer

Stop the transfusion and infuse normal saline

Answer

Signs of acute hemolytic reaction require immediate transfusion cessation and IV saline to maintain renal perfusion and prevent acute kidney injury.

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN Cardiovascular and Hematological Care 2