CMSRN EXAM AND PRACTICE EXAM NEWEST 2026/
2027 TEST BANK| 2 VERSIONS (VERSION A & B) WITH
400 REAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) GRADED A+| CMSRN
CERTIFICATION EXAM PREP (BRAND NEW!!)
1. A patient with ascites is admitted to the medical-surgical
unit. Which pathophysiological finding contributes most
directly to the development of ascites?
A. High epinephrine levels
B. Low plasma albumin levels
C. High plasma oncotic pressure
D. Elevated blood pressure
Answer: B
Rationale: Low plasma albumin levels reduce plasma oncotic
pressure, allowing fluid to shift from the vascular space into the
1
,peritoneal cavity. This is a common finding in patients with
cirrhosis or liver disease. Albumin maintains oncotic pressure;
when low, fluid leaks into interstitial and peritoneal spaces .
2. A patient with end-stage liver disease presents with
abdominal distension, shortness of breath, and a positive
fluid wave. The nurse notes a protruding umbilicus. What is
the priority nursing intervention?
A. Administer a stool softener as prescribed
B. Place the patient on strict bed rest
C. Measure abdominal girth daily and monitor respiratory status
D. Restrict all oral fluids to 500 mL per day
Answer: C
Rationale: Ascites requires close monitoring of abdominal girth
and respiratory status as large volumes of fluid can compromise
diaphragmatic movement and breathing. Daily girth
measurements and respiratory assessment are essential. Fluid
2
,restriction is determined by sodium levels, not automatically
indicated.
3. A patient with cirrhosis develops ascites and is started on
spironolactone. Which laboratory value requires the most
immediate nursing intervention?
A. Serum sodium 135 mEq/L
B. Serum potassium 5.9 mEq/L
C. Serum albumin 2.8 g/dL
D. Blood urea nitrogen 18 mg/dL
Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic. A
serum potassium of 5.9 mEq/L indicates hyperkalemia, which can
cause life-threatening cardiac dysrhythmias. The nurse should
hold the medication and notify the provider immediately.
4. A patient presents with sudden onset of shortness of
breath, sharp chest pain worsened by inspiration, and
3
, hypoxia. The nurse suspects a pulmonary embolism. Which
diagnostic test is most specific for confirming this diagnosis?
A. Chest X-ray
B. D-dimer
C. CT pulmonary angiography (CTPA)
D. Arterial blood gas (ABG)
Answer: C
Rationale: CT pulmonary angiography (CTPA) is the gold
standard for diagnosing pulmonary embolism, providing direct
visualization of clots in the pulmonary arteries. D-dimer is a
sensitive but not specific screening test. Chest X-ray and ABG are
supportive but not diagnostic .
5. A patient with a suspected pulmonary embolism has a D-
dimer test result of 850 ng/mL (normal <500 ng/mL). What is
the nurse's best interpretation of this finding?
4
2027 TEST BANK| 2 VERSIONS (VERSION A & B) WITH
400 REAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) GRADED A+| CMSRN
CERTIFICATION EXAM PREP (BRAND NEW!!)
1. A patient with ascites is admitted to the medical-surgical
unit. Which pathophysiological finding contributes most
directly to the development of ascites?
A. High epinephrine levels
B. Low plasma albumin levels
C. High plasma oncotic pressure
D. Elevated blood pressure
Answer: B
Rationale: Low plasma albumin levels reduce plasma oncotic
pressure, allowing fluid to shift from the vascular space into the
1
,peritoneal cavity. This is a common finding in patients with
cirrhosis or liver disease. Albumin maintains oncotic pressure;
when low, fluid leaks into interstitial and peritoneal spaces .
2. A patient with end-stage liver disease presents with
abdominal distension, shortness of breath, and a positive
fluid wave. The nurse notes a protruding umbilicus. What is
the priority nursing intervention?
A. Administer a stool softener as prescribed
B. Place the patient on strict bed rest
C. Measure abdominal girth daily and monitor respiratory status
D. Restrict all oral fluids to 500 mL per day
Answer: C
Rationale: Ascites requires close monitoring of abdominal girth
and respiratory status as large volumes of fluid can compromise
diaphragmatic movement and breathing. Daily girth
measurements and respiratory assessment are essential. Fluid
2
,restriction is determined by sodium levels, not automatically
indicated.
3. A patient with cirrhosis develops ascites and is started on
spironolactone. Which laboratory value requires the most
immediate nursing intervention?
A. Serum sodium 135 mEq/L
B. Serum potassium 5.9 mEq/L
C. Serum albumin 2.8 g/dL
D. Blood urea nitrogen 18 mg/dL
Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic. A
serum potassium of 5.9 mEq/L indicates hyperkalemia, which can
cause life-threatening cardiac dysrhythmias. The nurse should
hold the medication and notify the provider immediately.
4. A patient presents with sudden onset of shortness of
breath, sharp chest pain worsened by inspiration, and
3
, hypoxia. The nurse suspects a pulmonary embolism. Which
diagnostic test is most specific for confirming this diagnosis?
A. Chest X-ray
B. D-dimer
C. CT pulmonary angiography (CTPA)
D. Arterial blood gas (ABG)
Answer: C
Rationale: CT pulmonary angiography (CTPA) is the gold
standard for diagnosing pulmonary embolism, providing direct
visualization of clots in the pulmonary arteries. D-dimer is a
sensitive but not specific screening test. Chest X-ray and ABG are
supportive but not diagnostic .
5. A patient with a suspected pulmonary embolism has a D-
dimer test result of 850 ng/mL (normal <500 ng/mL). What is
the nurse's best interpretation of this finding?
4
