CMSRN EXAM BANK 2025/2026 |
ACCURATE REAL EXAM 150 QUESTIONS
AND ANSWERS WITH DETAILED
RATIONALES EACH | CURRENTLY
TESTING AND FREQUENTLY TESTED
VERSIONS | EXPERT VERIFIED FOR
GUARANTEED PASS | LATEST UPDATE
CARDIOVASCULAR SYSTEM
Question 1
A patient with heart failure is prescribed furosemide (Lasix). Which
laboratory value requires immediate notification of the healthcare
provider?
A) Sodium 138 mEq/L
B) Chloride 100 mEq/L
C) Potassium 2.8 mEq/L
D) Magnesium 2.0 mEq/L
Rationale: Furosemide is a loop diuretic that causes potassium wasting.
A potassium level of 2.8 mEq/L indicates severe hypokalemia (normal
range 3.5-5.0 mEq/L). Hypokalemia increases the risk of life-threatening
dysrhythmias, especially in patients on digoxin. The nurse should hold
the next dose and notify the provider immediately .
,Question 2
A patient with atrial fibrillation is prescribed warfarin (Coumadin).
Which statement by the patient indicates understanding of this
medication?
A) "I will take ibuprofen for my headaches."
B) "I will eat more green leafy vegetables daily."
C) "I will report any unusual bleeding to my provider."
D) "I will check my blood sugar before each dose."
Rationale: Warfarin is an anticoagulant that increases bleeding risk.
Patients must report signs of bleeding such as bruising, blood in
urine/stool, or bleeding gums. Ibuprofen increases bleeding risk and
should be avoided. Consistent vitamin K intake (green leafy vegetables)
is important, not increased intake .
Question 3
A patient presents with chest pain, diaphoresis, and shortness of breath.
The ECG shows ST-segment elevation in leads II, III, and aVF. Which
intervention should the nurse prioritize?
A) Administer sublingual nitroglycerin
B) Obtain a complete blood count
C) Activate the cardiac catheterization lab
D) Apply oxygen at 2 L/min via nasal cannula
Rationale: ST-elevations in inferior leads (II, III, aVF) indicate an
inferior wall myocardial infarction. The priority is rapid reperfusion via
,percutaneous coronary intervention (PCI). While oxygen and
nitroglycerin may be appropriate, the critical action is activating the cath
lab to restore blood flow .
Question 4
The nurse is assessing a patient with left-sided heart failure. Which
finding is most consistent with this condition?
A) Jugular venous distention
B) Peripheral edema
C) Crackles in the lung bases
D) Hepatomegaly
Rationale: Left-sided heart failure causes blood to back up into the
pulmonary circulation, resulting in pulmonary congestion manifested as
crackles (rales) on auscultation. Jugular venous distention, peripheral
edema, and hepatomegaly are signs of right-sided heart failure .
Question 5
A patient returns from cardiac catheterization via the femoral artery.
Which assessment finding requires immediate nursing action?
A) Heart rate 68 beats per minute
B) Bleeding at the insertion site
C) Blood pressure 118/76 mm Hg
D) Urine output 60 mL in the past hour
, Rationale: Bleeding at the femoral artery insertion site indicates
potential loss of hemostasis and can lead to rapid hemorrhage and
hypovolemic shock. The nurse should immediately apply firm pressure
above the site and notify the provider. Urine output of 60 mL/hour is
adequate .
Question 6
A patient with hypertension is started on lisinopril. Which adverse effect
is most important to teach the patient about?
A) Dry cough
B) Angioedema
C) Headache
D) Fatigue
Rationale: Lisinopril (an ACE inhibitor) can cause angioedema—
swelling of the lips, tongue, or throat that can compromise the airway.
This is a life-threatening emergency requiring immediate medical
attention. While dry cough is a common side effect (often leading to
medication discontinuation), it is not immediately life-threatening .
Question 7
The nurse is caring for a patient with infective endocarditis. Which
assessment finding is most concerning?
A) Fever of 101.2°F (38.4°C)
B) Sudden onset of left-sided weakness
ACCURATE REAL EXAM 150 QUESTIONS
AND ANSWERS WITH DETAILED
RATIONALES EACH | CURRENTLY
TESTING AND FREQUENTLY TESTED
VERSIONS | EXPERT VERIFIED FOR
GUARANTEED PASS | LATEST UPDATE
CARDIOVASCULAR SYSTEM
Question 1
A patient with heart failure is prescribed furosemide (Lasix). Which
laboratory value requires immediate notification of the healthcare
provider?
A) Sodium 138 mEq/L
B) Chloride 100 mEq/L
C) Potassium 2.8 mEq/L
D) Magnesium 2.0 mEq/L
Rationale: Furosemide is a loop diuretic that causes potassium wasting.
A potassium level of 2.8 mEq/L indicates severe hypokalemia (normal
range 3.5-5.0 mEq/L). Hypokalemia increases the risk of life-threatening
dysrhythmias, especially in patients on digoxin. The nurse should hold
the next dose and notify the provider immediately .
,Question 2
A patient with atrial fibrillation is prescribed warfarin (Coumadin).
Which statement by the patient indicates understanding of this
medication?
A) "I will take ibuprofen for my headaches."
B) "I will eat more green leafy vegetables daily."
C) "I will report any unusual bleeding to my provider."
D) "I will check my blood sugar before each dose."
Rationale: Warfarin is an anticoagulant that increases bleeding risk.
Patients must report signs of bleeding such as bruising, blood in
urine/stool, or bleeding gums. Ibuprofen increases bleeding risk and
should be avoided. Consistent vitamin K intake (green leafy vegetables)
is important, not increased intake .
Question 3
A patient presents with chest pain, diaphoresis, and shortness of breath.
The ECG shows ST-segment elevation in leads II, III, and aVF. Which
intervention should the nurse prioritize?
A) Administer sublingual nitroglycerin
B) Obtain a complete blood count
C) Activate the cardiac catheterization lab
D) Apply oxygen at 2 L/min via nasal cannula
Rationale: ST-elevations in inferior leads (II, III, aVF) indicate an
inferior wall myocardial infarction. The priority is rapid reperfusion via
,percutaneous coronary intervention (PCI). While oxygen and
nitroglycerin may be appropriate, the critical action is activating the cath
lab to restore blood flow .
Question 4
The nurse is assessing a patient with left-sided heart failure. Which
finding is most consistent with this condition?
A) Jugular venous distention
B) Peripheral edema
C) Crackles in the lung bases
D) Hepatomegaly
Rationale: Left-sided heart failure causes blood to back up into the
pulmonary circulation, resulting in pulmonary congestion manifested as
crackles (rales) on auscultation. Jugular venous distention, peripheral
edema, and hepatomegaly are signs of right-sided heart failure .
Question 5
A patient returns from cardiac catheterization via the femoral artery.
Which assessment finding requires immediate nursing action?
A) Heart rate 68 beats per minute
B) Bleeding at the insertion site
C) Blood pressure 118/76 mm Hg
D) Urine output 60 mL in the past hour
, Rationale: Bleeding at the femoral artery insertion site indicates
potential loss of hemostasis and can lead to rapid hemorrhage and
hypovolemic shock. The nurse should immediately apply firm pressure
above the site and notify the provider. Urine output of 60 mL/hour is
adequate .
Question 6
A patient with hypertension is started on lisinopril. Which adverse effect
is most important to teach the patient about?
A) Dry cough
B) Angioedema
C) Headache
D) Fatigue
Rationale: Lisinopril (an ACE inhibitor) can cause angioedema—
swelling of the lips, tongue, or throat that can compromise the airway.
This is a life-threatening emergency requiring immediate medical
attention. While dry cough is a common side effect (often leading to
medication discontinuation), it is not immediately life-threatening .
Question 7
The nurse is caring for a patient with infective endocarditis. Which
assessment finding is most concerning?
A) Fever of 101.2°F (38.4°C)
B) Sudden onset of left-sided weakness
