Mixed Deck — All CMSRN Topics Flashcards
100 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 20 Mixed Deck — All CMSRN Topics flashcards as text
A nurse is caring for a patient with heart failure who develops frothy, pink-tinged sputum and severe dyspnea. What is the priority nursing intervention?
Answer: Position the patient upright and administer oxygen
Frothy pink-tinged sputum indicates pulmonary edema, and the priority is to position upright to reduce preload and administer supplemental oxygen.
Three days ago, the patient under the nurse's care underwent kidney transplant surgery. Urine levels drop suddenly and abruptly, as noted by the nurse. When thrombosis is detected, the nurse notifies the medical professional. Which priority idea is the foundation of this complexity?
Answer: Perfusion
A sudden and abrupt drop in urine output, especially when thrombosis is detected, points to a severe issue with blood flow to the transplanted kidney. Thrombosis obstructs the blood vessels, impairing the kidney's perfusion. Adequate perfusion is fundamental for the kidney to filter blood and produce urine, making it the underlying physiological concept affected by this complication.
During spinal anesthesia, a patient's blood pressure drops from 130/80 to 75/40 mmHg. Which intervention should the nurse anticipate FIRST?
Answer: Administer ephedrine or phenylephrine and IV fluid bolus
Hypotension following spinal anesthesia results from sympathetic blockade; vasopressors (ephedrine or phenylephrine) combined with IV fluids are the first-line treatment.
A patient with hepatic encephalopathy is prescribed lactulose. What is the primary therapeutic goal of this medication?
Answer: Decrease serum ammonia levels
Lactulose acidifies the colon, trapping ammonia as ammonium ion and promoting its fecal excretion, thereby reducing the serum ammonia causing encephalopathy.
A nurse is caring for a patient who had an abdominal hysterectomy 2 days ago. The patient reports a sudden onset of shortness of breath and pleuritic chest pain. The nurse's first action should be to:
Answer: Elevate the head of the bed and apply oxygen
Positioning upright and applying oxygen immediately addresses hypoxia while further evaluation is initiated for suspected pulmonary embolism.
A nurse is caring for a patient receiving a blood transfusion who develops fever, flank pain, and dark urine. What is the priority nursing action?
Answer: Stop the transfusion immediately
These symptoms indicate an acute hemolytic transfusion reaction, requiring immediate cessation of the transfusion to prevent further harm.
A patient who just had a colostomy surgery expresses distress about body image changes. Which nursing intervention is the priority?
Answer: Allow the patient to verbalize feelings and validate their concerns
Establishing therapeutic communication by allowing the patient to express feelings and validating concerns is the priority before education or referrals when addressing psychosocial distress.
Except for the following, all of the following list phosphodiasterase inhibitors:
Answer: Vasoconstrictor
Phosphodiesterase inhibitors (PDEIs) like milrinone are known for their positive inotropic effects (increasing cardiac contractility) and their ability to cause vasodilation, which decreases systemic vascular resistance (SVR). They achieve this by preventing the breakdown of cyclic AMP (cAMP), leading to increased intracellular calcium in cardiac cells and smooth muscle relaxation in blood vessels. Therefore, 'Vasoconstrictor' is the characteristic that does NOT describe the action of phosphodiesterase inhibitors.
A patient with an acute MI reports sudden, severe midscapular tearing back pain. What complication should the nurse suspect first?
Answer: Aortic dissection
Tearing or ripping back pain radiating to the interscapular region is the hallmark presentation of aortic dissection, a life-threatening emergency.
A patient with a new diagnosis of atrial fibrillation asks why anticoagulation therapy is necessary. What is the nurse's best response?
Answer: Atrial fibrillation causes blood to pool in the atria, increasing the risk of clot formation and stroke
In atrial fibrillation, ineffective atrial contraction causes blood stasis, increasing thrombus formation risk and subsequent stroke.
A patient with chronic kidney disease has a glomerular filtration rate of 12 mL/min. Which clinical manifestation should the nurse anticipate?
Answer: Uremic frost and pruritus
A GFR of 12 mL/min indicates stage 5 CKD where uremic toxins accumulate, causing uremic frost, pruritus, and other systemic symptoms.
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?
Answer: Hypertension, bradycardia, and irregular respirations
Cushing's triad is a late sign of increased intracranial pressure consisting of hypertension (widened pulse pressure), bradycardia, and irregular respirations (often Cheyne-Stokes). It signals impending brainstem herniation and requires immediate intervention.
A nurse is preparing to administer a unit of packed red blood cells. Which action is correct regarding transfusion safety?
Answer: Verify the blood product with two licensed nurses at the bedside
Two licensed nurses must independently verify patient identity and blood product compatibility at the bedside before transfusion.
Which parameter is the most accurate indicator of fluid resuscitation adequacy in a patient with burns covering 40% TBSA?
Answer: Urine output of 0.5-1 mL/kg/hr
Urine output of 0.5-1 mL/kg/hr is the gold-standard endpoint for Parkland formula fluid resuscitation in major burns, reflecting adequate renal perfusion.
During the intraoperative phase, the circulating nurse notices a break in sterile technique by a surgical team member. What is the appropriate immediate action?
Answer: Immediately notify the team member and the surgeon of the break
The circulating nurse is responsible for monitoring sterile technique and must immediately communicate any break to the team so corrective action can be taken to prevent surgical site infection.
A nurse is providing education to a patient newly diagnosed with deep vein thrombosis (DVT) who is being discharged on enoxaparin. Which statement by the patient indicates a need for further teaching?
Answer: "I will have my INR checked weekly to make sure the medication is working."
Enoxaparin is a low-molecular-weight heparin (LMWH). Routine coagulation monitoring, such as INR or aPTT, is not required for LMWH as it is for warfarin or unfractionated heparin. This statement indicates a misunderstanding of the medication. The other statements reflect correct understanding of anticoagulant precautions and proper administration technique.
Which best describes the primary focus of the CMSRN Core Curriculum when used as a study resource?
Answer: Comprehensive review of adult medical-surgical nursing across body systems and domains
The CMSRN Core Curriculum provides a comprehensive, exam-aligned review of adult med-surg nursing content organized by body system and care domain.
Which assessment finding is most indicative of a perforated peptic ulcer requiring emergency intervention?
Answer: Sudden severe pain with board-like abdominal rigidity
Sudden severe pain with board-like abdominal rigidity indicates peritonitis from gastric contents leaking into the peritoneal cavity, a surgical emergency.
A patient with heart failure has a BNP level of 900 pg/mL. What does this finding indicate?
Answer: Severe ventricular wall stress and volume overload
Elevated BNP (>100 pg/mL) reflects ventricular wall stress due to volume or pressure overload, commonly seen in decompensated heart failure.
A patient on telemetry develops ventricular fibrillation. What is the immediate priority intervention?
Answer: Initiate CPR and prepare for defibrillation
Ventricular fibrillation is a pulseless rhythm requiring immediate CPR and unsynchronized defibrillation as the definitive treatment per ACLS guidelines.