CMSRN Medical-Surgical Nursing MCQ 3

Question 1

A patient with liver cirrhosis develops confusion, asterixis, and elevated ammonia levels. Which dietary modification is most appropriate?

Accepted Answer

Restrict protein to 0.5-1.0 g/kg/day

Answer

Protein restriction reduces ammonia production from protein metabolism, helping to manage hepatic encephalopathy while maintaining adequate nutrition.

Question 2

A patient is 24 hours post-total knee replacement. Which finding indicates a potential deep vein thrombosis?

Accepted Answer

Calf pain with dorsiflexion of the foot

Answer

Calf pain with dorsiflexion (Homans' sign) may indicate DVT, though duplex ultrasound is required for definitive diagnosis.

Question 3

A patient with acute pancreatitis is prescribed nothing by mouth (NPO). After 48 hours the patient requests food. What is the nurse's best response?

Accepted Answer

Explain that pancreatic rest is needed and foods stimulate enzyme secretion

Answer

Food stimulates pancreatic enzyme secretion, which worsens inflammation in acute pancreatitis; NPO status allows pancreatic rest and reduces enzyme-mediated autodigestion.

Question 4

Which parameter is the most accurate indicator of fluid resuscitation adequacy in a patient with burns covering 40% TBSA?

Accepted Answer

Urine output of 0.5-1 mL/kg/hr

Answer

Urine output of 0.5-1 mL/kg/hr is the gold-standard endpoint for Parkland formula fluid resuscitation in major burns, reflecting adequate renal perfusion.

Question 5

A patient taking warfarin has an INR of 5.8 and is not bleeding. Which action should the nurse anticipate?

Accepted Answer

Hold warfarin and monitor closely

Answer

For supratherapeutic INR without active bleeding, the standard approach is to hold warfarin doses and monitor until INR returns to the therapeutic range.

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN Medical-Surgical Nursing MCQ 3