Sample Questions and Answers CMSN Exam
A nurse is assessing a patient with hyperkalemia. Which of the following ECG changes should the nurse expect to find in this patient?
A) Peaked T waves
B) ST-segment depression
C) Prolonged QT interval
D) Shortened PR interval
Answer: A) Peaked T waves
Explanation: Hyperkalemia can cause peaked T waves on the ECG, which is an important early sign of elevated potassium levels and may indicate the need for prompt treatment.
A nurse is caring for a patient with a diagnosis of ulcerative colitis. Which of the following dietary recommendations is most appropriate for this patient?
A) High-fiber foods to promote bowel regularity
B) Low-fat, low-residue foods to decrease irritation of the intestines
C) Large meals to improve nutritional intake
D) Dairy products to increase calcium intake
Answer: B) Low-fat, low-residue foods to decrease irritation of the intestines
Explanation: A low-fat, low-residue diet helps reduce bowel irritation and is typically recommended for patients with ulcerative colitis during flare-ups.
A nurse is caring for a patient with a newly diagnosed seizure disorder. The nurse should prioritize teaching the patient about which of the following?
A) The importance of taking antiepileptic medications as prescribed
B) How to monitor blood pressure regularly
C) The need to avoid exposure to sunlight
D) The benefits of using a diet high in sodium
Answer: A) The importance of taking antiepileptic medications as prescribed
Explanation: Taking antiepileptic medications as prescribed is crucial for controlling seizures and preventing further episodes. Non-compliance with medication is a common cause of seizure recurrence.
A nurse is caring for a patient with Parkinson’s disease who is receiving levodopa therapy. Which of the following adverse effects should the nurse monitor for?
A) Tachycardia
B) Hypoglycemia
C) Orthostatic hypotension
D) Constipation
Answer: C) Orthostatic hypotension
Explanation: Levodopa therapy can cause orthostatic hypotension, which increases the risk of falls. The nurse should monitor the patient’s blood pressure and assist with position changes to prevent this complication.
A nurse is assessing a patient’s wound that is in the proliferative phase of healing. Which of the following findings is most characteristic of this phase?
A) Red, swollen tissue at the wound site
B) Presence of necrotic tissue
C) Formation of a dry scab over the wound
D) Presence of a fibrin clot
Answer: A) Red, swollen tissue at the wound site
Explanation: The proliferative phase of wound healing is characterized by the formation of new tissue, capillaries, and collagen, leading to a red, swollen appearance. This phase promotes tissue repair.
A nurse is caring for a patient who is postoperatively recovering from a colostomy. Which of the following nursing interventions should be a priority?
A) Monitoring the stoma for signs of infection or ischemia
B) Encouraging the patient to drink fluids with high sugar content
C) Keeping the patient in a flat position for comfort
D) Restricting oral intake for the first 48 hours after surgery
Answer: A) Monitoring the stoma for signs of infection or ischemia
Explanation: Monitoring the stoma for infection, necrosis, or ischemia is essential to prevent complications. Proper stoma care is critical to the success of the colostomy.
A nurse is caring for a patient with a diagnosis of tuberculosis (TB). Which of the following precautions should the nurse implement?
A) Contact precautions
B) Droplet precautions
C) Airborne precautions
D) Standard precautions
Answer: C) Airborne precautions
Explanation: Tuberculosis is an airborne disease, and patients with TB should be placed on airborne precautions, which include wearing a mask, using a negative-pressure room, and ensuring proper ventilation.
A nurse is caring for a patient who is receiving warfarin therapy. Which of the following laboratory tests should be monitored regularly?
A) Prothrombin time (PT) and International Normalized Ratio (INR)
B) Hemoglobin and hematocrit levels
C) Blood glucose levels
D) Liver enzymes
Answer: A) Prothrombin time (PT) and International Normalized Ratio (INR)
Explanation: Warfarin therapy affects the clotting cascade, so regular monitoring of PT and INR is necessary to ensure the therapeutic level of anticoagulation and avoid bleeding complications.
A nurse is caring for a patient with a diagnosis of rheumatoid arthritis (RA). Which of the following interventions should the nurse include in the plan of care?
A) Encourage regular rest periods between activities
B) Instruct the patient to avoid using assistive devices
C) Promote weight-bearing exercises to strengthen joints
D) Provide a high-protein diet to increase muscle mass
Answer: A) Encourage regular rest periods between activities
Explanation: RA can cause joint inflammation and fatigue. Regular rest periods help manage fatigue and prevent exacerbation of symptoms during flare-ups.
A nurse is caring for a patient with a diagnosis of acute pancreatitis. Which of the following interventions should the nurse prioritize?
A) Administering intravenous fluids to maintain hydration
B) Encouraging the patient to eat small, frequent meals
C) Offering antacids to reduce stomach acid secretion
D) Positioning the patient in a prone position for comfort
Answer: A) Administering intravenous fluids to maintain hydration
Explanation: Acute pancreatitis often leads to fluid loss and dehydration, so administering intravenous fluids is crucial to maintain adequate hydration and electrolyte balance.
A nurse is caring for a patient with hypertension who is prescribed a calcium channel blocker. Which of the following side effects should the nurse monitor for?
A) Bradycardia and hypotension
B) Tachycardia and hyperglycemia
C) Hypokalemia and constipation
D) Tachypnea and dizziness
Answer: A) Bradycardia and hypotension
Explanation: Calcium channel blockers can cause bradycardia and hypotension as they work to dilate blood vessels and slow the heart rate, so monitoring for these side effects is important.
A nurse is caring for a patient who has received a kidney transplant. Which of the following medications will the nurse expect the patient to take long-term to prevent organ rejection?
A) Insulin
B) Antithyroid medications
C) Immunosuppressive agents
D) Antidepressants
Answer: C) Immunosuppressive agents
Explanation: Immunosuppressive medications are prescribed to prevent organ rejection in transplant patients by suppressing the immune response against the transplanted kidney.
A nurse is providing education to a patient with chronic obstructive pulmonary disease (COPD). Which of the following statements by the patient indicates a need for further teaching?
A) “I will try to avoid smoking and other respiratory irritants.”
B) “I should limit my physical activity to prevent fatigue.”
C) “I will use my inhaler as prescribed, even if I feel fine.”
D) “I need to get a flu shot every year.”
Answer: B) “I should limit my physical activity to prevent fatigue.”
Explanation: It is important for COPD patients to engage in regular physical activity to improve respiratory function and endurance. Limiting activity can lead to further deconditioning.
A nurse is caring for a patient with a history of deep vein thrombosis (DVT). Which of the following assessments is most important to monitor for in the early postoperative period?
A) Signs of infection at the surgical site
B) Chest pain and shortness of breath
C) Blood pressure and pulse rate
D) Serum electrolyte levels
Answer: B) Chest pain and shortness of breath
Explanation: A patient with a history of DVT is at increased risk for a pulmonary embolism. Monitoring for chest pain and shortness of breath is essential to detect a potential embolism early.
A nurse is assessing a patient with a diagnosis of dehydration. Which of the following findings is most indicative of severe dehydration?
A) Moist skin and pink mucous membranes
B) A decrease in blood pressure and increased heart rate
C) Clear urine with a low specific gravity
D) Weight gain and puffiness of the face
Answer: B) A decrease in blood pressure and increased heart rate
Explanation: Severe dehydration causes hypovolemia, leading to a decrease in blood pressure and an increased heart rate as the body attempts to compensate for fluid loss.
A nurse is caring for a patient with a postoperative infection. Which of the following laboratory results would the nurse expect to see in this patient?
A) Decreased white blood cell (WBC) count
B) Increased C-reactive protein (CRP) level
C) Decreased erythrocyte sedimentation rate (ESR)
D) Increased platelet count
Answer: B) Increased C-reactive protein (CRP) level
Explanation: CRP is an acute-phase reactant that increases in response to infection or inflammation. A high CRP level indicates the presence of an infection.
A nurse is caring for a patient with a history of heart failure. Which of the following medications should the nurse expect to be prescribed to help reduce fluid retention?
A) Furosemide (Lasix)
B) Metoprolol (Lopressor)
C) Lisinopril (Prinivil)
D) Digoxin (Lanoxin)
Answer: A) Furosemide (Lasix)
Explanation: Furosemide is a loop diuretic that helps reduce fluid retention in heart failure by increasing urine output and reducing edema.
A nurse is caring for a patient receiving intravenous potassium chloride. Which of the following actions should the nurse take to ensure patient safety?
A) Administer the potassium quickly to restore electrolyte balance
B) Monitor the patient for signs of hyperkalemia
C) Discontinue the potassium infusion if the patient complains of chest pain
D) Provide the patient with oral potassium supplements simultaneously
Answer: B) Monitor the patient for signs of hyperkalemia
Explanation: Potassium chloride can cause hyperkalemia, which can be life-threatening. The nurse should closely monitor the patient’s potassium levels and signs of hyperkalemia, such as arrhythmias.
A nurse is caring for a patient with a newly diagnosed myocardial infarction (MI). Which of the following interventions should be a priority?
A) Administering analgesics as prescribed for pain relief
B) Encouraging early mobilization to prevent deep vein thrombosis
C) Monitoring for signs of stroke or intracranial hemorrhage
D) Providing emotional support and reassurance to the patient
Answer: A) Administering analgesics as prescribed for pain relief
Explanation: Pain relief is a priority in managing MI to reduce myocardial oxygen demand. Analgesics such as morphine are commonly prescribed to control pain and relieve anxiety.
A nurse is caring for a patient with diabetic ketoacidosis (DKA). Which of the following laboratory values is most consistent with this condition?
A) Blood glucose level of 120 mg/dL
B) Arterial pH of 7.30
C) Serum potassium level of 3.0 mEq/L
D) Sodium bicarbonate level of 30 mEq/L
Answer: B) Arterial pH of 7.30
Explanation: DKA causes metabolic acidosis, which is reflected by a low arterial pH, usually less than 7.35. Elevated blood glucose and low bicarbonate levels also support the diagnosis.
A nurse is assessing a postoperative patient for signs of infection. Which of the following findings should the nurse report immediately?
A) Temperature of 38.5°C (101.3°F)
B) Purulent drainage from the surgical wound
C) Mild redness around the surgical site
D) Blood pressure of 110/70 mmHg
Answer: B) Purulent drainage from the surgical wound
Explanation: Purulent drainage indicates the presence of infection. This finding should be reported immediately to initiate appropriate interventions.
A nurse is caring for a patient with a diagnosis of cirrhosis. Which of the following is a common complication of cirrhosis that the nurse should monitor for?
A) Hypokalemia
B) Bleeding due to thrombocytopenia
C) Hyperthyroidism
D) Hyperglycemia
Answer: B) Bleeding due to thrombocytopenia
Explanation: Cirrhosis can cause splenic sequestration and decreased platelet production, leading to thrombocytopenia and an increased risk of bleeding. Monitoring for bleeding is essential.
A nurse is caring for a patient with a history of epilepsy. Which of the following statements by the patient indicates a need for further teaching regarding seizure management?
A) “I will take my anticonvulsant medication every day as prescribed.”
B) “I should avoid alcohol because it can trigger a seizure.”
C) “I should stop taking my medication if I feel fine.”
D) “I will wear a medical alert bracelet to inform others of my condition.”
Answer: C) “I should stop taking my medication if I feel fine.”
Explanation: Discontinuing anticonvulsant medication without medical guidance can lead to seizures. Patients should continue their medication regimen as prescribed to prevent recurrence.
A nurse is caring for a patient with acute respiratory distress syndrome (ARDS). Which of the following interventions should be a priority?
A) Administering diuretics to reduce fluid overload
B) Maintaining oxygenation with mechanical ventilation
C) Encouraging deep breathing exercises to improve lung compliance
D) Providing nutritional support with high-calorie meals
Answer: B) Maintaining oxygenation with mechanical ventilation
Explanation: ARDS results in severe hypoxia, and mechanical ventilation with adequate oxygenation is critical to prevent further respiratory compromise and support gas exchange.
A nurse is caring for a patient who is postoperatively recovering from a cholecystectomy. Which of the following instructions should the nurse provide to the patient?
A) “You may resume your regular diet immediately after surgery.”
B) “You should avoid fatty foods for the next few weeks.”
C) “You should increase your fluid intake to avoid dehydration.”
D) “You may lift heavy objects to promote healing.”
Answer: B) “You should avoid fatty foods for the next few weeks.”
Explanation: After a cholecystectomy, the patient should avoid fatty foods, as the body may have difficulty digesting them without a gallbladder to store bile.
A nurse is caring for a patient who is receiving a blood transfusion. The nurse observes the patient developing chills, fever, and back pain. Which of the following actions should the nurse take?
A) Slow the rate of the blood transfusion and continue to monitor
B) Stop the transfusion immediately and notify the healthcare provider
C) Administer acetaminophen for the fever
D) Increase the rate of the blood transfusion to flush the system
Answer: B) Stop the transfusion immediately and notify the healthcare provider
Explanation: The patient is showing signs of a transfusion reaction, and the transfusion should be stopped immediately to prevent further complications. The healthcare provider should be notified for further management.
A nurse is caring for a patient who is receiving a diuretic for heart failure. Which of the following laboratory results should the nurse monitor closely?
A) Potassium levels
B) Hemoglobin levels
C) Liver function tests
D) Creatinine clearance
Answer: A) Potassium levels
Explanation: Diuretics, especially loop diuretics like furosemide, can cause hypokalemia by increasing potassium excretion. Close monitoring of potassium levels is important to prevent cardiac arrhythmias.
A nurse is caring for a patient who has undergone a left-sided mastectomy. Which of the following interventions is most important to prevent complications related to the surgery?
A) Encouraging the patient to move the left arm and shoulder frequently
B) Applying pressure to the left breast to promote healing
C) Restricting fluid intake to reduce swelling
D) Ensuring the patient avoids any physical therapy for the first few weeks
Answer: A) Encouraging the patient to move the left arm and shoulder frequently
Explanation: After a mastectomy, encouraging movement of the arm and shoulder is essential to prevent lymphedema and improve circulation to the area. Restricting movement can lead to stiffness and delayed recovery.
A nurse is teaching a patient with chronic kidney disease about dietary modifications. Which of the following foods should the nurse advise the patient to limit?
A) Apples
B) Whole grains
C) Potatoes
D) Fish
Answer: C) Potatoes
Explanation: Potatoes are high in potassium, which is often restricted in patients with chronic kidney disease to avoid hyperkalemia. Whole grains, apples, and fish are generally acceptable in moderation.
A nurse is assessing a patient with acute peritonitis. Which of the following signs and symptoms would the nurse most likely observe?
A) Abdominal distention and rigid abdomen
B) Decreased white blood cell count
C) Sudden increase in blood pressure
D) Decreased bowel sounds in all quadrants
Answer: A) Abdominal distention and rigid abdomen
Explanation: Acute peritonitis is characterized by abdominal pain, distention, and rigidity, which result from inflammation of the peritoneal lining. Decreased bowel sounds are also common due to peritoneal irritation.
A nurse is caring for a patient who has a diagnosis of pneumonia. Which of the following interventions should be prioritized?
A) Administering oxygen to maintain oxygen saturation
B) Encouraging high-fiber foods to prevent constipation
C) Encouraging the patient to engage in deep breathing exercises
D) Providing a quiet environment for the patient to rest
Answer: A) Administering oxygen to maintain oxygen saturation
Explanation: Pneumonia often causes hypoxia, so maintaining oxygen saturation is crucial for the patient’s safety. Oxygen therapy is a priority intervention for improving oxygenation.
A nurse is caring for a patient with a history of stroke. Which of the following signs indicates the potential development of aspiration pneumonia?
A) Sudden increase in temperature and productive cough
B) Decreased blood pressure and dizziness
C) Sudden loss of vision in one eye
D) Bradycardia and weakness on one side of the body
Answer: A) Sudden increase in temperature and productive cough
Explanation: Aspiration pneumonia occurs when food or liquids enter the lungs, leading to infection. A sudden increase in temperature, productive cough, and shortness of breath are indicative of aspiration pneumonia.
A nurse is caring for a patient diagnosed with deep vein thrombosis (DVT). Which of the following interventions should be implemented to reduce the risk of a pulmonary embolism?
A) Encouraging the patient to increase mobility and ambulate
B) Applying compression stockings to both legs
C) Administering anticoagulants as prescribed
D) Massaging the affected leg to promote circulation
Answer: C) Administering anticoagulants as prescribed
Explanation: Anticoagulants such as heparin or warfarin are crucial in preventing the formation of additional clots and reducing the risk of a pulmonary embolism in patients with DVT.
A nurse is caring for a patient with liver cirrhosis. Which of the following findings should the nurse prioritize for further investigation?
A) Jaundice and abdominal swelling
B) Increased appetite and weight gain
C) Yellow sclera and clear urine
D) Low blood pressure and elevated heart rate
Answer: D) Low blood pressure and elevated heart rate
Explanation: These symptoms can indicate hypovolemia or variceal bleeding, which can occur in cirrhosis and are serious complications requiring immediate attention.
A nurse is preparing to administer a dose of morphine to a patient. Before administering the medication, the nurse should assess which of the following?
A) Urinary output
B) Respiratory rate
C) Blood glucose level
D) Liver function tests
Answer: B) Respiratory rate
Explanation: Morphine is a potent opioid that can cause respiratory depression, so it is crucial to assess the patient’s respiratory rate before administration. A rate of less than 12 breaths per minute is a warning sign for possible overdose.
A nurse is caring for a patient who is prescribed a proton pump inhibitor (PPI) for the treatment of gastroesophageal reflux disease (GERD). Which of the following should the nurse teach the patient about the medication?
A) “You should take the PPI with meals to increase absorption.”
B) “Avoid drinking alcohol while taking this medication.”
C) “It is safe to take antacids with the PPI if you have heartburn.”
D) “You should discontinue the medication once your symptoms resolve.”
Answer: B) “Avoid drinking alcohol while taking this medication.”
Explanation: Alcohol can increase the risk of stomach irritation and decrease the effectiveness of the medication. PPIs should be taken on an empty stomach for optimal absorption.
A nurse is caring for a patient with a diagnosis of diabetes mellitus. Which of the following symptoms should the nurse identify as an indication of hypoglycemia?
A) Polydipsia, polyuria, and blurred vision
B) Tremors, sweating, and confusion
C) Weight loss, fatigue, and muscle cramps
D) Dry skin, fever, and nausea
Answer: B) Tremors, sweating, and confusion
Explanation: Hypoglycemia occurs when blood glucose levels are too low and can cause symptoms such as tremors, sweating, confusion, and irritability.
A nurse is caring for a patient who is prescribed a diuretic for heart failure. Which of the following assessments should the nurse perform regularly to monitor for adverse effects?
A) Blood glucose levels
B) Electrolyte levels
C) Serum creatinine levels
D) Liver function tests
Answer: B) Electrolyte levels
Explanation: Diuretics can cause electrolyte imbalances, especially hypokalemia. Regular monitoring of electrolytes, especially potassium, is crucial in preventing complications.
A nurse is caring for a patient with a chest tube for a pneumothorax. Which of the following findings would indicate that the pneumothorax has been resolved?
A) The patient reports feeling short of breath
B) The chest tube drainage is bright red in color
C) The patient has equal breath sounds bilaterally
D) The patient develops tachypnea and hypotension
Answer: C) The patient has equal breath sounds bilaterally
Explanation: Equal breath sounds bilaterally indicate that the lung has re-expanded and the pneumothorax has resolved.
A nurse is caring for a patient with a diagnosis of systemic lupus erythematosus (SLE). Which of the following symptoms should the nurse prioritize?
A) Butterfly-shaped rash on the face
B) Painful joints and muscle weakness
C) Increased fatigue and low-grade fever
D) Severe chest pain and difficulty breathing
Answer: D) Severe chest pain and difficulty breathing
Explanation: Chest pain and difficulty breathing could indicate lupus-related complications such as pleuritis or pericarditis, which require immediate medical intervention.
A nurse is caring for a patient who has undergone a liver biopsy. Which of the following positions should the nurse encourage the patient to assume post-procedure to prevent bleeding?
A) Prone position with legs elevated
B) Left lateral position with the right side up
C) Right lateral position with the left side up
D) Supine position with the head elevated
Answer: C) Right lateral position with the left side up
Explanation: The right lateral position with the left side up helps to apply pressure to the liver biopsy site to reduce the risk of bleeding.
A nurse is providing discharge teaching to a patient with chronic obstructive pulmonary disease (COPD). Which of the following instructions should the nurse prioritize?
A) “You should limit your fluid intake to prevent fluid retention.”
B) “It is important to quit smoking to prevent further lung damage.”
C) “Engage in high-intensity exercise to improve lung function.”
D) “Avoid all physical activity to conserve energy.”
Answer: B) “It is important to quit smoking to prevent further lung damage.”
Explanation: Smoking cessation is the most important intervention to slow the progression of COPD and reduce further lung damage.
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