CMSRN Trivia 3 — Questions and Answers
Question 1: Which position is most appropriate for a patient immediately after a lumbar puncture?
- High Fowler's (60-90 degrees)
- Supine (flat) (Correct answer)
- Trendelenburg
- Left lateral Sims
Correct answer: Supine (flat)
Lying flat after a lumbar puncture helps prevent post-procedural headache by reducing CSF leakage through the puncture site.
Question 2: A nurse is caring for a patient with syndrome of inappropriate antidiuretic hormone (SIADH). Which finding does the nurse expect?
- Hypernatremia and increased urine output
- Hyponatremia and decreased urine output (Correct answer)
- Hyperkalemia and increased urine specific gravity
- Hyponatremia and decreased urine specific gravity
Correct answer: Hyponatremia and decreased urine output
SIADH causes excess ADH, leading to water retention, dilutional hyponatremia, and concentrated urine with decreased output.
Question 3: Which intervention is the nurse's highest priority when caring for a patient in sickle cell crisis?
- Administering supplemental oxygen
- Ensuring adequate hydration with IV fluids
- Providing pain management (Correct answer)
- Monitoring hemoglobin levels
Correct answer: Providing pain management
Pain management is the highest priority because vaso-occlusive crises cause severe, debilitating pain that requires immediate intervention.
Question 4: A patient with a new tracheostomy requires suctioning. What is the maximum recommended suction duration per pass?
- 5 seconds
- 10 seconds (Correct answer)
- 15 seconds
- 20 seconds
Correct answer: 10 seconds
Each suction pass should not exceed 10 seconds to prevent hypoxia, mucosal trauma, and vagal stimulation.
Question 5: Which assessment finding in a patient with a long-leg cast warrants immediate intervention?
- Mild itching under the cast
- Capillary refill of 3 seconds in the toes (Correct answer)
- Pain relieved by elevation
- Slight warmth over the cast site
Correct answer: Capillary refill of 3 seconds in the toes
Capillary refill greater than 2 seconds indicates compromised circulation and possible compartment syndrome requiring immediate action.
Question 6: A patient with cirrhosis develops asterixis. This finding is most associated with which condition?
- Hypoglycemia
- Hepatic encephalopathy (Correct answer)
- Portal hypertension
- Spontaneous bacterial peritonitis
Correct answer: Hepatic encephalopathy
Asterixis (flapping tremor of the hands) is a classic sign of hepatic encephalopathy due to ammonia accumulation in the brain.
Question 7: Which dietary instruction is most important for a patient newly diagnosed with gout?
- Increase dairy intake
- Avoid foods high in purines such as red meat and organ meats (Correct answer)
- Restrict dietary calcium
- Increase intake of citrus fruits
Correct answer: Avoid foods high in purines such as red meat and organ meats
Purine-rich foods are metabolized into uric acid, which crystallizes in joints, triggering gout attacks.
CMSRN Trivia 3
Which position is most appropriate for a patient immediately after a lumbar puncture?