CMSRN Neurological and Musculoskeletal Care 3

Question 1

A nurse is providing discharge education to a patient prescribed oral prednisone for rheumatoid arthritis. Which instruction is most important?

Accepted Answer

Do not stop the medication abruptly

Answer

Long-term corticosteroid use suppresses adrenal function; abrupt discontinuation can cause adrenal crisis, so tapering under physician guidance is essential.

Question 2

The nurse is caring for a patient with multiple sclerosis (MS) who is experiencing an exacerbation. Which intervention addresses fatigue, the most common MS symptom?

Accepted Answer

Plan rest periods between activities and prioritize energy conservation

Answer

Energy conservation techniques and scheduled rest periods help MS patients manage fatigue, which is exacerbated by overexertion and heat.

Question 3

A patient is admitted with acute exacerbation of gout. Which dietary teaching is most appropriate?

Accepted Answer

Limit high-purine foods such as red meat, shellfish, and alcohol

Answer

High-purine foods elevate uric acid levels, which precipitate gout attacks; dietary restriction of these foods helps reduce the frequency of exacerbations.

Question 4

Which nursing intervention is the priority for a patient who has just returned from surgery for an open reduction internal fixation (ORIF) of a tibial fracture?

Accepted Answer

Perform neurovascular checks every 1–2 hours

Answer

Frequent neurovascular assessments after ORIF detect early signs of compartment syndrome, vascular injury, or nerve damage, which are the most serious post-operative complications.

Question 5

A patient with myasthenia gravis is admitted for a myasthenic crisis. Which clinical manifestation differentiates a myasthenic crisis from a cholinergic crisis?

Accepted Answer

Muscle weakness responds to edrophonium (Tensilon) test — improvement indicates myasthenic crisis

Answer

In the Tensilon test, improvement in muscle strength indicates myasthenic crisis (under-medication), while worsening indicates cholinergic crisis (over-medication).

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN Neurological and Musculoskeletal Care 3