CMSRN - Medical-Surgical Nursing Medical-Surgical Nursing 1

Question 1

A patient with a traumatic brain injury has a Glasgow Coma Scale score of 8 and begins exhibiting Cushing's triad. Which set of vital signs best represents this triad?

Accepted Answer

Hypertension, bradycardia, and irregular respirations

Answer

Hypotension, tachycardia, and irregular respirations

Answer

Hypertension, tachycardia, and shallow respirations

Answer

Hypotension, bradycardia, and deep rapid respirations

Question 2

A patient is admitted with an acute exacerbation of COPD and an arterial blood gas showing pH 7.28, PaCO2 62 mmHg, HCO3 26 mEq/L, and PaO2 54 mmHg. How should the nurse interpret these results?

Accepted Answer

Respiratory acidosis, uncompensated

Answer

Metabolic acidosis, uncompensated

Answer

Respiratory alkalosis, partially compensated

Answer

Metabolic alkalosis, compensated

Question 3

A nurse is caring for a postoperative patient who suddenly develops a PaO2 of 58 mmHg, dyspnea, pleuritic chest pain, and hemoptysis 3 days after a total hip replacement. What is the priority nursing action?

Accepted Answer

Administer supplemental oxygen and notify the physician immediately

Answer

Administer prescribed bronchodilators via nebulizer

Answer

Place the patient in Trendelenburg position and notify the physician

Answer

Obtain a sputum specimen for culture and sensitivity

Question 4

A patient with type 1 diabetes is found unresponsive with a blood glucose of 28 mg/dL. The patient has no IV access and is unable to swallow. Which intervention should the nurse perform first?

Accepted Answer

Administer 1 mg of glucagon intramuscularly

Answer

Administer 25 g of 50% dextrose (D50) orally dissolved in water

Answer

Initiate a peripheral IV line and infuse D5W at 125 mL/hr

Answer

Apply a glucose gel to the buccal mucosa

Question 5

A patient with acute pancreatitis is prescribed morphine for pain management. The nurse understands that which laboratory value should be monitored most closely due to this drug's pharmacological effect?

Accepted Answer

Serum amylase and lipase levels

Answer

Serum calcium and magnesium levels

Answer

International Normalized Ratio (INR)

Answer

Blood urea nitrogen and creatinine levels

Question 6

A patient recovering from a myocardial infarction develops a new holosystolic murmur at the left sternal border with signs of acute heart failure on day 3 post-MI. Which complication does the nurse suspect?

Accepted Answer

Ventricular septal rupture

Answer

Pericarditis with pericardial friction rub

Answer

Aortic stenosis exacerbation

Answer

Mitral valve prolapse