CMSRN - Medical-Surgical Nursing CMSRN-FREE Cmsrn Medical Surgical Nursing 1

Question 1

A nurse is caring for a post-operative patient who underwent a bowel resection 24 hours ago.
The patient's abdomen is distended and he reports no bowel sounds.
Which intervention should the nurse prioritize?

Accepted Answer

Encourage the patient to ambulate in the hallway

Answer

Administer a Fleet enema as ordered

Answer

Insert a nasogastric tube and connect to suction

Answer

Increase the IV fluid rate to 150 mL/hr

Question 2

A patient with type 2 diabetes is scheduled for a CT scan with contrast dye in the morning. The nurse notes the patient takes metformin 1000 mg twice daily. What is the priority nursing action?

Accepted Answer

Hold the metformin and notify the provider before the procedure

Answer

Administer the metformin dose as scheduled the morning of the procedure

Answer

Switch the patient to insulin coverage for the day of the procedure

Answer

Increase the patient's IV fluid rate to prevent dehydration

Question 3

A nurse is assessing a patient with deep vein thrombosis who is receiving a heparin infusion. The patient's aPTT is 180 seconds. What is the nurse's priority action?

Accepted Answer

Stop the infusion and notify the provider immediately

Answer

Continue the infusion at the current rate and recheck in 6 hours

Answer

Increase the heparin infusion rate per the protocol

Answer

Administer vitamin K as an antidote

Question 4

A patient is admitted with an acute exacerbation of COPD. The nurse notes the patient's SpO2 is 88% on room air. Which oxygen delivery device is most appropriate for this patient?

Accepted Answer

Venturi mask set to deliver 28% FiO2

Answer

Non-rebreather mask at 15 L/min

Answer

Nasal cannula at 6 L/min

Answer

Simple face mask at 8 L/min

Question 5

A nurse is caring for a patient with a serum sodium of 122 mEq/L who is confused and complaining of a headache. Which intervention should the nurse implement first?

Accepted Answer

Place the patient on seizure precautions and notify the provider

Answer

Administer 0.9% normal saline IV bolus at 500 mL over 1 hour

Answer

Encourage oral fluid intake to dilute the sodium concentration

Answer

Restrict IV fluid administration to prevent further dilution

Question 6

A patient with a pulmonary embolism is receiving thrombolytic therapy with alteplase. During the infusion, the nurse observes new-onset neurological changes and facial drooping. What is the nurse's priority action?

Accepted Answer

Stop the alteplase infusion immediately and notify the provider

Answer

Slow the infusion rate and continue monitoring neurological status

Answer

Administer protamine sulfate to reverse the thrombolytic

Answer

Obtain a stat ECG and increase oxygen delivery