CMSRN-FREE Cmsrn Medical Surgical Nursing 1 Flashcards
6 cards from real CMSRN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 CMSRN-FREE Cmsrn Medical Surgical Nursing 1 flashcards as text
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?
Answer: Encourage the patient to ambulate in the hallway
Early ambulation stimulates peristalsis and helps resolve post-operative ileus, which is the most common cause of abdominal distension after bowel surgery. It is the first-line, least invasive intervention before escalating to NGT insertion.
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?
Answer: Hold the metformin and notify the provider before the procedure
Metformin must be held before and after contrast administration due to the risk of contrast-induced nephropathy, which can reduce renal clearance of metformin and lead to lactic acidosis, a life-threatening complication.
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?
Answer: Stop the infusion and notify the provider immediately
A therapeutic aPTT for heparin therapy is 60–100 seconds (1.5–2.5 times the normal of 30–40 seconds). An aPTT of 180 seconds indicates supratherapeutic anticoagulation and a high bleeding risk, requiring immediate cessation of the infusion and provider notification.
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?
Answer: Venturi mask set to deliver 28% FiO2
Patients with COPD rely on hypoxic drive and require controlled, low-flow oxygen. The Venturi mask delivers a precise, consistent FiO2 (starting at 24–28%), preventing excessive oxygen delivery that could suppress the hypoxic drive and cause respiratory depression.
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?
Answer: Place the patient on seizure precautions and notify the provider
A serum sodium of 122 mEq/L with neurological symptoms (confusion, headache) indicates severe symptomatic hyponatremia with risk of seizures and cerebral edema. The priority is patient safety — implementing seizure precautions and notifying the provider for further orders.
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?
Answer: Stop the alteplase infusion immediately and notify the provider
New neurological changes during thrombolytic therapy are a critical warning sign of intracranial hemorrhage, the most serious complication. The infusion must be stopped immediately and the provider notified for emergent neuroimaging and management.