• CMSRN Exam 09/11/2026
Med-Surg Certification Test Bank 3 Questions
Real Exam Questions real exam questions with
verified correct answers for the Certified
Medical-Surgical Registered Nurse (CMSRN)
A female client taking oral contraceptives reports to the nurse that she is experiencing calf pain. Which action
should the nurse implement?
Determine if the client has also experienced breast tenderness and weight gain.
Encourage the client to begin a regular, daily program of walking and exercise.
Advise the client to notify the healthcare provider for immediate medical attention.
Tell the client to stop taking the medication for a week to see if symptoms subside. –
Correct Answer :Advise the client to notify the healthcare provider for immediate medical attention.
P 1
, • CMSRN Exam 09/11/2026
Calf pain is indicative of thrombophlebitis, a serious, life-threatening complication associated with the use of oral
contraceptives which requires further assessment and possibly immediate medical intervention.
The healthcare provider prescribes aluminum and magnesium hydroxide, 1 tablet PO PRN, for a client with
chronic kidney disease (CKD) who is complaining of indigestion. Which intervention should the nurse implement?
Administer 30 minutes before eating.
Evaluate the effectiveness 1 hour after administration.
Instruct the client to swallow the tablet whole.
Question the healthcare provider's prescription. - Correct Answer :Question the healthcare provider's
prescription.
Magnesium agents are not usually used for clients with CKD due to the risk of hypermagnesemia, so this
prescription should be questioned by the nurse.
A client has been taking oral corticosteroids for the past five days because of seasonal allergies. Which
assessment finding is of most concern to the nurse?
White blood count of 10,000 mm3.
Serum glucose of 115 mg/dl.
Purulent sputum.
Excessive hunger. - Correct Answer :Purulent sputum.
Steroids cause immunosuppression, and purulent sputum is an indication of infection, so this symptom is of
greatest concern.
A client with multiple sclerosis has experienced an exacerbation of symptoms, including paresthesias, diplopia,
and nystagmus. Which instruction should the nurse provide?
Stay out of direct sunlight.
Restrict intake of high protein foods.
Schedule extra rest periods.
Go to the emergency room immediately. - Correct Answer :Schedule extra rest periods.
P 2
, • CMSRN Exam 09/11/2026
Exacerbations of the symptoms of MS occur most commonly as the result of fatigue and stress. The client
should be encouraged to schedule extra rest periods to help reduce the symptoms.
The nurse is assessing a client with bacterial meningitis. Which assessment finding indicates the client may have
developed septic emboli?
Cyanosis of the fingertips.
Bradycardia and bradypnea.
Presence of S3 and S4 heart sounds.
3+ pitting edema of the lower extremities.
. - Correct Answer :Cyanosis of the fingertips.
Septic emboli secondary to meningitis commonly lodge in the small arterioles of the extremities, causing a
decrease in circulation to the hands which may lead to gangrene
A 58-year-old client, who has no health problems, asks the nurse about the Pneumovax vaccine. The nurse's
response to the client should be based on which information?
The vaccine is given annually before the flu season to those over 50 years of age.
The immunization is administered once to older adults or persons with a history of chronic illness.
The vaccine is for all ages and is given primarily to those persons traveling overseas to areas of infection.
The vaccine will prevent the occurrence of pneumococcal pneumonia for up to five years. - Correct Answer
:The immunization is administered once to older adults or persons with a history of chronic illness.
It is recommended by the CDC (Dec 2016) that persons over 65 years of age and those with a history of chronic
illness receive the vaccine once in a lifetime.
An elderly client is admitted with a diagnosis of bacterial pneumonia. When observing the client for the first signs
of decreasing oxygenation, the nurse should assess for which clinical cues?
P 3
, • CMSRN Exam 09/11/2026
Abominal distention.
Undue fatigue.
Cyanosis of the lips.
Confusion and tachycardia. - Correct Answer :Confusion and tachycardia.
The onset of pneumonia in the elderly may be signaled by general deterioration, confusion, increased heart rate
or increased respiratory rate due to the decreased oxygen- carbon dioxide exchange at the alveoli, known as the
V-Q mismatch. Cyanosis is a very late sign.
An older adult male client comes to the geriatric screening clinic complaining of pain in his left calf. The nurse
notices a reddened area on the calf of his right leg which is warm to the touch and suspects it might be
thrombophlebitis. Which type of pain would further confirm this suspicion?
Pain in the calf awakening him from a sound sleep.
Calf pain on exertion which stops when standing in one place.
Pain in the calf upon exertion which is relieved by rest and elevating the extremity.
Pain upon arising in the morning which is relieved after some stretching and exercise. - Correct Answer :pain in
the calf upon exertion which is relieved by rest and elevating the extremity.
Thrombophlebitis pain is relieved by rest and elevation of the extremity. It typically occurs with exercise at the
site of the thrombus, and is aggravated by placing the extremity in a dependent position, such as standing in one
place.
An 81-year-old male client has emphysema. He lives at home with his cat and manages self-care with no difficulty.
When making a home visit, the nurse notices that his tongue is somewhat cracked and his eyeballs are sunken
into his head. Which nursing intervention is indicated?
Help the client to determine ways to increase his fluid intake.
Obtain an appointment for the client to see an ear, nose, and throat specialist.
Schedule an appointment with an allergist to determine if the client is allergic to the cat.
P 4
Med-Surg Certification Test Bank 3 Questions
Real Exam Questions real exam questions with
verified correct answers for the Certified
Medical-Surgical Registered Nurse (CMSRN)
A female client taking oral contraceptives reports to the nurse that she is experiencing calf pain. Which action
should the nurse implement?
Determine if the client has also experienced breast tenderness and weight gain.
Encourage the client to begin a regular, daily program of walking and exercise.
Advise the client to notify the healthcare provider for immediate medical attention.
Tell the client to stop taking the medication for a week to see if symptoms subside. –
Correct Answer :Advise the client to notify the healthcare provider for immediate medical attention.
P 1
, • CMSRN Exam 09/11/2026
Calf pain is indicative of thrombophlebitis, a serious, life-threatening complication associated with the use of oral
contraceptives which requires further assessment and possibly immediate medical intervention.
The healthcare provider prescribes aluminum and magnesium hydroxide, 1 tablet PO PRN, for a client with
chronic kidney disease (CKD) who is complaining of indigestion. Which intervention should the nurse implement?
Administer 30 minutes before eating.
Evaluate the effectiveness 1 hour after administration.
Instruct the client to swallow the tablet whole.
Question the healthcare provider's prescription. - Correct Answer :Question the healthcare provider's
prescription.
Magnesium agents are not usually used for clients with CKD due to the risk of hypermagnesemia, so this
prescription should be questioned by the nurse.
A client has been taking oral corticosteroids for the past five days because of seasonal allergies. Which
assessment finding is of most concern to the nurse?
White blood count of 10,000 mm3.
Serum glucose of 115 mg/dl.
Purulent sputum.
Excessive hunger. - Correct Answer :Purulent sputum.
Steroids cause immunosuppression, and purulent sputum is an indication of infection, so this symptom is of
greatest concern.
A client with multiple sclerosis has experienced an exacerbation of symptoms, including paresthesias, diplopia,
and nystagmus. Which instruction should the nurse provide?
Stay out of direct sunlight.
Restrict intake of high protein foods.
Schedule extra rest periods.
Go to the emergency room immediately. - Correct Answer :Schedule extra rest periods.
P 2
, • CMSRN Exam 09/11/2026
Exacerbations of the symptoms of MS occur most commonly as the result of fatigue and stress. The client
should be encouraged to schedule extra rest periods to help reduce the symptoms.
The nurse is assessing a client with bacterial meningitis. Which assessment finding indicates the client may have
developed septic emboli?
Cyanosis of the fingertips.
Bradycardia and bradypnea.
Presence of S3 and S4 heart sounds.
3+ pitting edema of the lower extremities.
. - Correct Answer :Cyanosis of the fingertips.
Septic emboli secondary to meningitis commonly lodge in the small arterioles of the extremities, causing a
decrease in circulation to the hands which may lead to gangrene
A 58-year-old client, who has no health problems, asks the nurse about the Pneumovax vaccine. The nurse's
response to the client should be based on which information?
The vaccine is given annually before the flu season to those over 50 years of age.
The immunization is administered once to older adults or persons with a history of chronic illness.
The vaccine is for all ages and is given primarily to those persons traveling overseas to areas of infection.
The vaccine will prevent the occurrence of pneumococcal pneumonia for up to five years. - Correct Answer
:The immunization is administered once to older adults or persons with a history of chronic illness.
It is recommended by the CDC (Dec 2016) that persons over 65 years of age and those with a history of chronic
illness receive the vaccine once in a lifetime.
An elderly client is admitted with a diagnosis of bacterial pneumonia. When observing the client for the first signs
of decreasing oxygenation, the nurse should assess for which clinical cues?
P 3
, • CMSRN Exam 09/11/2026
Abominal distention.
Undue fatigue.
Cyanosis of the lips.
Confusion and tachycardia. - Correct Answer :Confusion and tachycardia.
The onset of pneumonia in the elderly may be signaled by general deterioration, confusion, increased heart rate
or increased respiratory rate due to the decreased oxygen- carbon dioxide exchange at the alveoli, known as the
V-Q mismatch. Cyanosis is a very late sign.
An older adult male client comes to the geriatric screening clinic complaining of pain in his left calf. The nurse
notices a reddened area on the calf of his right leg which is warm to the touch and suspects it might be
thrombophlebitis. Which type of pain would further confirm this suspicion?
Pain in the calf awakening him from a sound sleep.
Calf pain on exertion which stops when standing in one place.
Pain in the calf upon exertion which is relieved by rest and elevating the extremity.
Pain upon arising in the morning which is relieved after some stretching and exercise. - Correct Answer :pain in
the calf upon exertion which is relieved by rest and elevating the extremity.
Thrombophlebitis pain is relieved by rest and elevation of the extremity. It typically occurs with exercise at the
site of the thrombus, and is aggravated by placing the extremity in a dependent position, such as standing in one
place.
An 81-year-old male client has emphysema. He lives at home with his cat and manages self-care with no difficulty.
When making a home visit, the nurse notices that his tongue is somewhat cracked and his eyeballs are sunken
into his head. Which nursing intervention is indicated?
Help the client to determine ways to increase his fluid intake.
Obtain an appointment for the client to see an ear, nose, and throat specialist.
Schedule an appointment with an allergist to determine if the client is allergic to the cat.
P 4
