CMSRN - Medical-Surgical Nursing Medical Surgical Nurse 1

Question 1

A patient recovering from a sigmoid colectomy on postoperative day 2 reports nausea and abdominal distension.
Bowel sounds are hypoactive and the patient has not passed flatus.
What is the priority nursing intervention?

Accepted Answer

Encourage the patient to ambulate in the hallway

Answer

Administer an antiemetic and advance the diet to clear liquids

Answer

Insert a rectal tube to relieve accumulated gas

Answer

Request an order for a stimulant laxative

Question 2

A nurse is reviewing laboratory results for a patient suspected of having SIADH. Which finding is most consistent with this diagnosis?

Accepted Answer

Urine specific gravity 1.030

Answer

Serum sodium 152 mEq/L

Answer

Serum osmolality 310 mOsm/kg

Answer

Blood urea nitrogen 8 mg/dL

Question 3

A patient develops sudden pleuritic chest pain, dyspnea, and tachycardia 72 hours after a total hip arthroplasty. What is the nurse's priority action?

Accepted Answer

Administer supplemental oxygen and notify the provider immediately

Answer

Obtain a 12-lead ECG and prepare for cardioversion

Answer

Place the patient in a high Fowler's position and administer an analgesic

Answer

Encourage deep breathing and splinted coughing

Question 4

A patient admitted with acute pancreatitis has a serum amylase of 520 U/L, back-radiating pain rated 9/10, Cullen's sign, and a blood pressure of 84/52 mmHg. Which finding requires the most immediate nursing intervention?

Accepted Answer

Blood pressure of 84/52 mmHg

Answer

Serum amylase of 520 U/L

Answer

Pain radiating to the back rated 9/10

Answer

Periumbilical ecchymosis (Cullen's sign)

Question 5

A patient with a traumatic brain injury has an intracranial pressure (ICP) reading of 24 mmHg. Which nursing intervention should be implemented first?

Accepted Answer

Elevate the head of the bed to 30–45 degrees

Answer

Administer acetaminophen for pain management

Answer

Apply sequential compression devices to the lower extremities

Answer

Encourage the patient to cough and perform deep breathing exercises

Question 6

A patient with a crush injury to the right lower leg reports pain that is unrelieved by IV opioids, along with tingling and numbness in the foot. On assessment, the extremity is pale, tense to palpation, and cool. Which condition does the nurse most suspect?

Accepted Answer

Compartment syndrome

Answer

Deep vein thrombosis

Answer

Acute arterial occlusion

Answer

Rhabdomyolysis