CMSRN Study Guide Practice Questions with Solution
2026 Complete Exam Prep||Newest Exam!!!
The nurse receives all of the following stat orders for Mr.
Palmer. Which one should the nurse question?
1) Oxygen per nasal cannula at 4 L per minute.
2) Enoxaparin (Lovenox) 40 mg subcutaneously.
3) Troponin level.
4) Computed tomography (CT) angiogram. - Answers-
Rationale: The nurse should questions the order for
Lovenox because the patient is receiving a heparin drip.
Christine Warren, 45 years old, has a long history of
ulcerative colitis, and non-surgical treatment no longer
relieved her symptoms. She underwent a total
proctocolectomy and a permanent ileostomy 12 hours
ago.
The nurse should contact the physician immediately if Mrs.
Warren has which of these findings?
1) The stoma appears pale and dry.
2) The stoma appears red and shiny.
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3) There is 200 mL of dark green output from the stoma.
4) There is 50 mL of serosanguinous drainage from the
stoma. - Answers-1) The stoma appears pale and dry.
Rationale: If there is an adequate blood supply to the
stoma, the color is pink or red, and the stoma is moist as a
result of mucous production. A pale dry color suggests
ischemia of the stoma or bowel and must be reported
immediately to the physician. With an ileostomy initially
after surgery, the output is a loose, dark green liquid that
may contain some blood. The ileostomy usually begins to
drain within 24 of surgery at more than one liter per day.
When changing Mrs. Warren's ileostomy bag, the nurse
notices that the peristomal skin is irritated.
Which of these actions by the nurse would be appropriate
before reapplying the appliance?
1) Wash the area with antiseptic soap and water.
2) Clean the site with Dakin's solution.
3) Use a solid skin barrier.
4) Obtain an order for a topical antibiotic. - Answers-3)
Use a solid skin barrier.
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Rationale: The drainage from the stoma can quickly irritate
the surrounding tissue. Therefore, a solid skin barrier, with
a pectin base or karaya wafer that has a measurable
thickness and hydrocolloid adhesive properties, should be
applied.
Which of these comments, if made by Mrs. Warren before
her surgery, would indicate that she had concerns about
her body image?
1) "I will have to stop my aerobics classes."
2) "I'm so afraid I may not survive the surgery."
3) "I need to go shopping for some loose, baggy clothes."
4) "I'm concerned that this may be only the first of many
surgeries." - Answers-3) "I need to go shopping for some
loose, baggy clothes."
Rationale:Body image refers to a person's perception of
self and determines how the person interacts with others.
One does not need to purchase special clothing after
ileostomy surgery, although some minor adjustments may
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be needed for comfort, e.g., stretch underwear or
pantyhose for support.
Lewis Palmer, 45 years old, has a history of multiple
myocardial infarctions and is a heavy smoker. He takes
warfarin sodium (Coumadin) daily. Two weeks ago, he had
a right femoral-popliteal bypass, which became occluded
24 hours ago. He is admitted following an angioplasty of
the femoral-popliteal bypass graft. Mr. Palmer is receiving
continuous IV heparin.
Because Mr. Palmer is receiving heparin, it is essential for
the nurse to
1) monitor his prothrombin time.
2) observe him for signs of pulmonary embolism.
3) limit his intake of foods high in vitamin K.
4) check the femoral puncture site at frequent intervals. -
Answers-4) check the femoral puncture site at frequent
intervals.
Rationale: Since bleeding is a common side effect of
heparin, it is vital to check the operative site, the femoral
puncture area, for signs of bleeding.