CMN 150V EXAM QUESTIONS AND
CORRECT ANSWERS WITH DETAILED
RATIONALES
Medical-Surgical Nursing
1. A client with heart failure is prescribed furosemide (Lasix). Which
laboratory value is most important for the nurse to monitor?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes significant potassium loss
in the urine, leading to hypokalemia. Hypokalemia can precipitate digitalis
toxicity and cardiac arrhythmias. While sodium, calcium, and magnesium can
also be affected, potassium is the most critical and common electrolyte
imbalance associated with this medication.
2. A nurse is caring for a client who is 2 days post-operative following a total
hip arthroplasty. Which action is most important to prevent dislocation of the
new joint?
A. Keep the client in a supine position at all times.
B. Place a wedge pillow between the client's legs.
C. Encourage the client to cross their legs at the ankles.
,D. Flex the client's hip to 120 degrees when sitting.
Correct Answer: B
Rationale: A wedge pillow or an abductor pillow is used to maintain the hip in
an abducted position, preventing adduction and internal rotation, which are
the primary movements that can cause dislocation. Crossing legs (C) and
flexing the hip beyond 90 degrees (D) are strictly contraindicated. While
supine is a safe position, it is not the only safe position; side-lying with a
pillow is also acceptable.
3. A client with a new diagnosis of type 1 diabetes mellitus is being
discharged. The nurse evaluates that the client understands the teaching
when they state:
A. "I will rotate my insulin injection sites to prevent tissue damage."
B. "I can skip my insulin if I am not planning to eat."
C. "I should only check my blood sugar once a week."
D. "I will use the same needle for my insulin pen for a week."
Correct Answer: A
Rationale: Rotating insulin injection sites is crucial to prevent lipodystrophy
(changes in subcutaneous fat), which can lead to erratic insulin absorption.
Skipping insulin (B) is dangerous and can lead to diabetic ketoacidosis (DKA).
Blood sugar must be checked multiple times daily (C). Needles are single-use
only; reusing them increases the risk of infection and injury (D).
4. The nurse is caring for a client with a deep vein thrombosis (DVT) in the left
lower extremity. Which assessment finding requires immediate intervention?
A. Left calf is 3 cm larger than the right calf.
B. Client reports a dull ache in the left calf.
C. Client develops sudden onset of shortness of breath.
D. Homan's sign is positive.
,Correct Answer: C
Rationale: Sudden onset of shortness of breath is a classic sign of a pulmonary
embolism (PE), a life-threatening complication of a DVT. This requires
immediate intervention, such as administering oxygen and notifying the
provider. A difference in calf circumference and pain are expected findings of
a DVT. Homan's sign (pain on dorsiflexion) is an unreliable and unsafe
diagnostic test as it can dislodge the clot.
5. A client is admitted with acute pancreatitis. Which laboratory value is most
indicative of this condition?
A. Elevated serum amylase
B. Elevated serum glucose
C. Decreased serum calcium
D. Elevated serum bilirubin
Correct Answer: A
Rationale: Serum amylase and lipase are the primary diagnostic markers for
acute pancreatitis. Amylase rises within 24 hours of onset and remains
elevated for 3-5 days. While glucose, calcium, and bilirubin can be affected,
they are not as specific or diagnostic as amylase.
6. The nurse is teaching a client with chronic obstructive pulmonary disease
(COPD) about pursed-lip breathing. What is the primary purpose of this
technique?
A. To increase oxygen intake.
B. To strengthen the diaphragm.
C. To keep the airways open longer.
D. To reduce the work of breathing.
Correct Answer: C
, Rationale: Pursed-lip breathing creates backpressure in the airways, which
helps prevent them from collapsing during exhalation. This keeps the airways
open longer and allows for more complete expiration of trapped air. It
primarily aids in gas exchange by reducing air trapping, not directly
increasing oxygen intake.
7. A client receiving a blood transfusion develops chills, fever, and lower back
pain 30 minutes after the transfusion starts. What is the nurse's priority
action?
A. Slow the infusion rate.
B. Administer an antihistamine.
C. Stop the transfusion.
D. Notify the provider.
Correct Answer: C
Rationale: The client is exhibiting signs of an acute hemolytic transfusion
reaction. The priority action is to stop the transfusion immediately to prevent
further hemolysis. After stopping it, the nurse would then notify the provider
and maintain the IV line with normal saline.
8. A client with chronic kidney disease (CKD) is prescribed epoetin alfa
(Epogen). The nurse understands that the purpose of this medication is to:
A. Lower serum potassium levels.
B. Increase the production of red blood cells.
C. Decrease blood pressure.
D. Bind to phosphorus in the gastrointestinal tract.
Correct Answer: B
Rationale: Epoetin alfa is a synthetic form of erythropoietin, a hormone
produced by the kidneys that stimulates the bone marrow to produce red
blood cells. It is administered to treat anemia, a common complication of CKD.
CORRECT ANSWERS WITH DETAILED
RATIONALES
Medical-Surgical Nursing
1. A client with heart failure is prescribed furosemide (Lasix). Which
laboratory value is most important for the nurse to monitor?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes significant potassium loss
in the urine, leading to hypokalemia. Hypokalemia can precipitate digitalis
toxicity and cardiac arrhythmias. While sodium, calcium, and magnesium can
also be affected, potassium is the most critical and common electrolyte
imbalance associated with this medication.
2. A nurse is caring for a client who is 2 days post-operative following a total
hip arthroplasty. Which action is most important to prevent dislocation of the
new joint?
A. Keep the client in a supine position at all times.
B. Place a wedge pillow between the client's legs.
C. Encourage the client to cross their legs at the ankles.
,D. Flex the client's hip to 120 degrees when sitting.
Correct Answer: B
Rationale: A wedge pillow or an abductor pillow is used to maintain the hip in
an abducted position, preventing adduction and internal rotation, which are
the primary movements that can cause dislocation. Crossing legs (C) and
flexing the hip beyond 90 degrees (D) are strictly contraindicated. While
supine is a safe position, it is not the only safe position; side-lying with a
pillow is also acceptable.
3. A client with a new diagnosis of type 1 diabetes mellitus is being
discharged. The nurse evaluates that the client understands the teaching
when they state:
A. "I will rotate my insulin injection sites to prevent tissue damage."
B. "I can skip my insulin if I am not planning to eat."
C. "I should only check my blood sugar once a week."
D. "I will use the same needle for my insulin pen for a week."
Correct Answer: A
Rationale: Rotating insulin injection sites is crucial to prevent lipodystrophy
(changes in subcutaneous fat), which can lead to erratic insulin absorption.
Skipping insulin (B) is dangerous and can lead to diabetic ketoacidosis (DKA).
Blood sugar must be checked multiple times daily (C). Needles are single-use
only; reusing them increases the risk of infection and injury (D).
4. The nurse is caring for a client with a deep vein thrombosis (DVT) in the left
lower extremity. Which assessment finding requires immediate intervention?
A. Left calf is 3 cm larger than the right calf.
B. Client reports a dull ache in the left calf.
C. Client develops sudden onset of shortness of breath.
D. Homan's sign is positive.
,Correct Answer: C
Rationale: Sudden onset of shortness of breath is a classic sign of a pulmonary
embolism (PE), a life-threatening complication of a DVT. This requires
immediate intervention, such as administering oxygen and notifying the
provider. A difference in calf circumference and pain are expected findings of
a DVT. Homan's sign (pain on dorsiflexion) is an unreliable and unsafe
diagnostic test as it can dislodge the clot.
5. A client is admitted with acute pancreatitis. Which laboratory value is most
indicative of this condition?
A. Elevated serum amylase
B. Elevated serum glucose
C. Decreased serum calcium
D. Elevated serum bilirubin
Correct Answer: A
Rationale: Serum amylase and lipase are the primary diagnostic markers for
acute pancreatitis. Amylase rises within 24 hours of onset and remains
elevated for 3-5 days. While glucose, calcium, and bilirubin can be affected,
they are not as specific or diagnostic as amylase.
6. The nurse is teaching a client with chronic obstructive pulmonary disease
(COPD) about pursed-lip breathing. What is the primary purpose of this
technique?
A. To increase oxygen intake.
B. To strengthen the diaphragm.
C. To keep the airways open longer.
D. To reduce the work of breathing.
Correct Answer: C
, Rationale: Pursed-lip breathing creates backpressure in the airways, which
helps prevent them from collapsing during exhalation. This keeps the airways
open longer and allows for more complete expiration of trapped air. It
primarily aids in gas exchange by reducing air trapping, not directly
increasing oxygen intake.
7. A client receiving a blood transfusion develops chills, fever, and lower back
pain 30 minutes after the transfusion starts. What is the nurse's priority
action?
A. Slow the infusion rate.
B. Administer an antihistamine.
C. Stop the transfusion.
D. Notify the provider.
Correct Answer: C
Rationale: The client is exhibiting signs of an acute hemolytic transfusion
reaction. The priority action is to stop the transfusion immediately to prevent
further hemolysis. After stopping it, the nurse would then notify the provider
and maintain the IV line with normal saline.
8. A client with chronic kidney disease (CKD) is prescribed epoetin alfa
(Epogen). The nurse understands that the purpose of this medication is to:
A. Lower serum potassium levels.
B. Increase the production of red blood cells.
C. Decrease blood pressure.
D. Bind to phosphorus in the gastrointestinal tract.
Correct Answer: B
Rationale: Epoetin alfa is a synthetic form of erythropoietin, a hormone
produced by the kidneys that stimulates the bone marrow to produce red
blood cells. It is administered to treat anemia, a common complication of CKD.
