CMSRN Trivia 5 — Questions and Answers
Question 1: Which intervention is the priority for a patient experiencing a myocardial infarction in the emergency department?
- Obtain a 12-lead ECG
- Administer morphine for pain
- Establish IV access
- Administer aspirin 325 mg (Correct answer)
Correct answer: Administer aspirin 325 mg
Aspirin inhibits platelet aggregation and is the most time-critical intervention that reduces mortality in acute MI.
Question 2: A nurse is caring for a patient who had an abdominal hysterectomy 2 days ago. The patient reports a sudden onset of shortness of breath and pleuritic chest pain. The nurse's first action should be to:
- Elevate the head of the bed and apply oxygen (Correct answer)
- Obtain a stat ECG
- Notify the rapid response team
- Prepare for chest x-ray
Correct answer: Elevate the head of the bed and apply oxygen
Positioning upright and applying oxygen immediately addresses hypoxia while further evaluation is initiated for suspected pulmonary embolism.
Question 3: Which finding on a patient with a burn injury indicates adequate fluid resuscitation during the first 24 hours?
- Urine output of 15 mL/hr
- Urine output of 30-50 mL/hr (Correct answer)
- Systolic blood pressure of 80 mmHg
- Heart rate of 120 beats/min
Correct answer: Urine output of 30-50 mL/hr
A urine output of 30-50 mL/hr in adults indicates adequate renal perfusion and effective fluid resuscitation in burn patients.
Question 4: A patient with peripheral arterial disease reports leg pain that occurs with walking and is relieved by rest. The nurse documents this as:
- Venous claudication
- Intermittent claudication (Correct answer)
- Rest pain
- Raynaud's phenomenon
Correct answer: Intermittent claudication
Intermittent claudication is the classic symptom of PAD, characterized by reproducible muscle pain during exertion that resolves with rest.
Question 5: Which early sign of digoxin toxicity should the nurse assess for?
- Tachycardia and hypertension
- Visual disturbances including yellow-green halos (Correct answer)
- Decreased urine output
- Hypokalemia
Correct answer: Visual disturbances including yellow-green halos
Visual disturbances, especially yellow-green halos around lights, are a classic early sign of digoxin toxicity.
Question 6: A patient returns from a cardiac catheterization via the femoral artery. Which assessment is the highest priority?
- Monitor for chest pain
- Check the puncture site for bleeding or hematoma (Correct answer)
- Assess blood pressure every hour
- Encourage fluid intake
Correct answer: Check the puncture site for bleeding or hematoma
The femoral artery puncture site must be monitored closely because arterial bleeding can be rapid and life-threatening.
Question 7: Which finding distinguishes nephrotic syndrome from nephritic syndrome?
- Hematuria
- Hypertension
- Massive proteinuria (>3.5 g/day) and edema (Correct answer)
- Oliguria
Correct answer: Massive proteinuria (>3.5 g/day) and edema
Nephrotic syndrome is defined by massive proteinuria leading to hypoalbuminemia and pitting edema, distinguishing it from the hematuria-dominant nephritic syndrome.
CMSRN Trivia 5
Which intervention is the priority for a patient experiencing a myocardial infarction in the emergency department?