CMSRN COMPREHENSIVE EXAM SCRIPT COMPLETE QUESTIONS VERIFIED SOLUTIONS
Cmsrn Actual Certification Paper 2026/2027
Questions and Answers Verified Solutions Latest
Update
Question:
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.
Answer:
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.
Question:
Attempts to revascularize Mr. Palmer's leg are unsuccessful, and Mr. Palmer has a below-knee
amputation (BKA) of his right extremity and is returned to the medical-surgical unit with an
intravenous infusion in place. His orders include: heparin drip, morphine sulfate 10 mg IV push q4h
prn for pain, and ampicillin sodium g 1 IV q6h. Twelve hours postoperatively, Mr. Palmer is found
to be short of breath and diaphoretic. He says, "My chest hurts. " His pulse is 140/min, compared to
a baseline of 80/min. His blood pressure is105/60 mm Hg, compared to a baseline of 138/70 mm
Hg. His respirations are 32/min, compared to a baseline of 16/min. His O2 saturation is 85%. The
nurse immediately calls for help. Which of the following questions is most important for the nurse to
ask? 1) "Have you ever had this type of chest pain before?" 2) "How long have you had this pain?"
3) "What pain medication do you usually take?" 4) "What.
Answer:
1) "Have you ever had this type of chest pain before?" Rationale: Because of the patient's symptoms
and his history of myocardial infarctions, the nurse should find out if the patient has had this time of
pain previously.
,Question:
Maggie Clark, a 42-year-old female, was admitted with newly diagnosed type 2 diabetes mellitus.
Her blood glucose has been stabilized, and the nurse is preparing her for discharge. Her discharge
orders will include metformin (Glucophage). Mrs. Clark is also being treated for hypertension.
Because Mrs. Clark is to take Glucophage on a regular basis it is important to 1) monitor her
glomerular filtration rate. 2) check her serum amylase routinely. 3) obtain her red blood cell count
periodically. 4) examine her urine for casts.
Answer:
1) monitor her glomerular filtration rate. Rationale: The estimated glomerular filtration rate (eGFR)
is one way to measure the adequacy of kidney function. Glucophage is excreted by the kidney and
the risk of lactic acidosis increases in patients with impaired kidney function. The drug may be used
if the eGFR is between 45 and 60 mL/min/1. 73 m2, i. e., in mild chronic kidney disease.
Glucophage is absolutely contraindicated if the eGFR is below 30 mL/min/1. 73 m2.
Question:
Mrs. Clark is prescribed metoprolol tartrate (Lopressor) for hypertension. Which symptom of
hypoglycemia would be masked by Lopressor? 1) Diaphoresis. 2) Tingling. 3) Diplopia. 4)
Tachycardia.
Answer:
4) Tachycardia. Rationale: A side effect of Lopressor, a beta blocker, is bradycardia. The
Lopressor-induced bradycardia can mask tachycardia, a symptom of hypoglycemia.
Question:
Charles Haverford is diagnosed with prostate cancer and is to have a radical prostatectomy. Mr.
Haverford has been researching his diagnosis and now asks the nurse to recommend a reliable web
source for accurate prostate cancer information. The nurse should identify which of these websites
as most reliable? 1) www. wikipedia. org. 2) www. cancer. gov. 3) www. caringbridge. org. 4)
www. google. com.
Answer:
2) www. cancer. gov. Rationale: When a patient asks about researching information on the internet,
the patient should be instructed to look at reliable sites. Sites that are most reliable are those
sponsored by the government (. gov).
,Question:
Mr. Haverford has the planned surgery and immediately postoperatively he has a urinary catheter
inserted. After the urinary catheter is removed Mr. Haverford is urinating normally, however he is
experiencing occasional incontinence with dribbling. Mr. Haverford is to be discharged. Mr.
Haverford says to the nurse, "I'm so embarrassed. What will my wife think about this dribbling?" In
addition to acknowledging his feelings, the nurse should encourage the patient to 1) limit oral intake
of fluids before bedtime. 2) palpate his bladder to check for distention three times a day. 3) perform
pelvic floor exercises several times daily. 4) avoid interrupting the urinary stream during voiding.
Answer:
3) perform pelvic floor exercises several times daily. Rationale: It is not unusual for a patient who
has had a prostatectomy, to complain of not having complete bladder control after catheter removal.
To help the patient regain urinary control, pelvic floor strengthening exercises are recommended.
Question:
A patient's wife is visibly upset and says to the nurse, "I thought my husband only broke his hip, but
the doctor thinks he might have had a stroke. " Which of the following would be an appropriate
response by the nurse? 1) "It's really too early to be concerned about that. Let's wait until the test
results come back. " 2) "If it is a stroke, your husband is in the right hospital for treatment. " 3) "Yes,
he does have symptoms of a stroke. That's what the tests will help us find out. " 4) "I'm going to get
you some information to read about strokes and their treatment. ".
Answer:
3) "Yes, he does have symptoms of a stroke. That's what the tests will help us find out. " Rationale:
Symptoms of stroke vary greatly and the initial diagnosis is made after a non-contrast CT scan is
done to determine if the event was ischemic or hemorrhagic. Then, further tests are done to confirm
the diagnosis and decide on treatment.
Question:
In the event of a fire in a hospital's dialysis unit, which of these actions should the nurse take first?
1) Extinguish the fire if possible. 2) Activate the fire response system. 3) Confine the fire by closing
all fire doors. 4) Remove patients or staff in danger.
Answer:
4) Remove patients or staff in danger. Rationale: When a fire occurs in a patient area within the
hospital, the nurses' first actions are to protect patients and staff. This usually involves removing the
patients and staff from exposure to the fire.
, Question:
An 80-year-old male who has mild dementia is readmitted for the third time with multiple pressure
ulcers. During the nursing assessment, multiple bruises are also observed on his body. He lives with
his son and daughter-in-law. The nurse suspects elder abuse/neglect. Which of these actions should
the nurse take? 1) Have a staff member present during family visits. 2) Report the findings. 3)
Discuss the situation with the family. 4) Ask the patient who is providing his care.
Answer:
2) Report the findings. Rationale: Most states require that health care workers report suspected elder
abuse to an official agency, such as Adult Protective Services.
Question:
A patient who has active pulmonary tuberculosis (TB) states, "I'm not going to take these TB pills!"
Which of these responses by the nurse would be appropriate? 1) "You have a legal right to refuse to
take this medication. " 2) "You need to sign a Refusal of Treatment Form. " 3) "You need to ask
your doctor about the possibility of discontinuing the medication. " 4) "You should know that the
health department can require you to take the medication. ".
Answer:
4) "You should know that the health department can require you to take the medication. " Rationale:
Tuberculosis (TB) is a public health problem that requires reporting of the disease to the health
department. It is essential that the patient understand the need to take prescribed TB medications as
directed. Patients who are unwilling or unable to adhere to treatment may be required to do so by
law or may be quarantined or isolated until noninfectious. State governments have legal
responsibility for TB control activities, including treatment protocols for nonadherent patients.
Health care workers should be familiar with the law in their particular states for these procedures.
Question:
When a patient is having a chest tube removed, which of these instructions would be appropriate? 1)
"Take short quick breaths with your mouth open. " 2) "Take a deep breath and hold it. " 3) "Breathe
only through your mouth. " 4) "Breathe as you normally do. ".
Answer:
2) "Take a deep breath and hold it. " Rationale: Taking a deep breath and holding it (or performing
the Valsalva maneuver) will prevent air from being pulled back into the pleural space as the tube is
removed.
Cmsrn Actual Certification Paper 2026/2027
Questions and Answers Verified Solutions Latest
Update
Question:
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.
Answer:
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.
Question:
Attempts to revascularize Mr. Palmer's leg are unsuccessful, and Mr. Palmer has a below-knee
amputation (BKA) of his right extremity and is returned to the medical-surgical unit with an
intravenous infusion in place. His orders include: heparin drip, morphine sulfate 10 mg IV push q4h
prn for pain, and ampicillin sodium g 1 IV q6h. Twelve hours postoperatively, Mr. Palmer is found
to be short of breath and diaphoretic. He says, "My chest hurts. " His pulse is 140/min, compared to
a baseline of 80/min. His blood pressure is105/60 mm Hg, compared to a baseline of 138/70 mm
Hg. His respirations are 32/min, compared to a baseline of 16/min. His O2 saturation is 85%. The
nurse immediately calls for help. Which of the following questions is most important for the nurse to
ask? 1) "Have you ever had this type of chest pain before?" 2) "How long have you had this pain?"
3) "What pain medication do you usually take?" 4) "What.
Answer:
1) "Have you ever had this type of chest pain before?" Rationale: Because of the patient's symptoms
and his history of myocardial infarctions, the nurse should find out if the patient has had this time of
pain previously.
,Question:
Maggie Clark, a 42-year-old female, was admitted with newly diagnosed type 2 diabetes mellitus.
Her blood glucose has been stabilized, and the nurse is preparing her for discharge. Her discharge
orders will include metformin (Glucophage). Mrs. Clark is also being treated for hypertension.
Because Mrs. Clark is to take Glucophage on a regular basis it is important to 1) monitor her
glomerular filtration rate. 2) check her serum amylase routinely. 3) obtain her red blood cell count
periodically. 4) examine her urine for casts.
Answer:
1) monitor her glomerular filtration rate. Rationale: The estimated glomerular filtration rate (eGFR)
is one way to measure the adequacy of kidney function. Glucophage is excreted by the kidney and
the risk of lactic acidosis increases in patients with impaired kidney function. The drug may be used
if the eGFR is between 45 and 60 mL/min/1. 73 m2, i. e., in mild chronic kidney disease.
Glucophage is absolutely contraindicated if the eGFR is below 30 mL/min/1. 73 m2.
Question:
Mrs. Clark is prescribed metoprolol tartrate (Lopressor) for hypertension. Which symptom of
hypoglycemia would be masked by Lopressor? 1) Diaphoresis. 2) Tingling. 3) Diplopia. 4)
Tachycardia.
Answer:
4) Tachycardia. Rationale: A side effect of Lopressor, a beta blocker, is bradycardia. The
Lopressor-induced bradycardia can mask tachycardia, a symptom of hypoglycemia.
Question:
Charles Haverford is diagnosed with prostate cancer and is to have a radical prostatectomy. Mr.
Haverford has been researching his diagnosis and now asks the nurse to recommend a reliable web
source for accurate prostate cancer information. The nurse should identify which of these websites
as most reliable? 1) www. wikipedia. org. 2) www. cancer. gov. 3) www. caringbridge. org. 4)
www. google. com.
Answer:
2) www. cancer. gov. Rationale: When a patient asks about researching information on the internet,
the patient should be instructed to look at reliable sites. Sites that are most reliable are those
sponsored by the government (. gov).
,Question:
Mr. Haverford has the planned surgery and immediately postoperatively he has a urinary catheter
inserted. After the urinary catheter is removed Mr. Haverford is urinating normally, however he is
experiencing occasional incontinence with dribbling. Mr. Haverford is to be discharged. Mr.
Haverford says to the nurse, "I'm so embarrassed. What will my wife think about this dribbling?" In
addition to acknowledging his feelings, the nurse should encourage the patient to 1) limit oral intake
of fluids before bedtime. 2) palpate his bladder to check for distention three times a day. 3) perform
pelvic floor exercises several times daily. 4) avoid interrupting the urinary stream during voiding.
Answer:
3) perform pelvic floor exercises several times daily. Rationale: It is not unusual for a patient who
has had a prostatectomy, to complain of not having complete bladder control after catheter removal.
To help the patient regain urinary control, pelvic floor strengthening exercises are recommended.
Question:
A patient's wife is visibly upset and says to the nurse, "I thought my husband only broke his hip, but
the doctor thinks he might have had a stroke. " Which of the following would be an appropriate
response by the nurse? 1) "It's really too early to be concerned about that. Let's wait until the test
results come back. " 2) "If it is a stroke, your husband is in the right hospital for treatment. " 3) "Yes,
he does have symptoms of a stroke. That's what the tests will help us find out. " 4) "I'm going to get
you some information to read about strokes and their treatment. ".
Answer:
3) "Yes, he does have symptoms of a stroke. That's what the tests will help us find out. " Rationale:
Symptoms of stroke vary greatly and the initial diagnosis is made after a non-contrast CT scan is
done to determine if the event was ischemic or hemorrhagic. Then, further tests are done to confirm
the diagnosis and decide on treatment.
Question:
In the event of a fire in a hospital's dialysis unit, which of these actions should the nurse take first?
1) Extinguish the fire if possible. 2) Activate the fire response system. 3) Confine the fire by closing
all fire doors. 4) Remove patients or staff in danger.
Answer:
4) Remove patients or staff in danger. Rationale: When a fire occurs in a patient area within the
hospital, the nurses' first actions are to protect patients and staff. This usually involves removing the
patients and staff from exposure to the fire.
, Question:
An 80-year-old male who has mild dementia is readmitted for the third time with multiple pressure
ulcers. During the nursing assessment, multiple bruises are also observed on his body. He lives with
his son and daughter-in-law. The nurse suspects elder abuse/neglect. Which of these actions should
the nurse take? 1) Have a staff member present during family visits. 2) Report the findings. 3)
Discuss the situation with the family. 4) Ask the patient who is providing his care.
Answer:
2) Report the findings. Rationale: Most states require that health care workers report suspected elder
abuse to an official agency, such as Adult Protective Services.
Question:
A patient who has active pulmonary tuberculosis (TB) states, "I'm not going to take these TB pills!"
Which of these responses by the nurse would be appropriate? 1) "You have a legal right to refuse to
take this medication. " 2) "You need to sign a Refusal of Treatment Form. " 3) "You need to ask
your doctor about the possibility of discontinuing the medication. " 4) "You should know that the
health department can require you to take the medication. ".
Answer:
4) "You should know that the health department can require you to take the medication. " Rationale:
Tuberculosis (TB) is a public health problem that requires reporting of the disease to the health
department. It is essential that the patient understand the need to take prescribed TB medications as
directed. Patients who are unwilling or unable to adhere to treatment may be required to do so by
law or may be quarantined or isolated until noninfectious. State governments have legal
responsibility for TB control activities, including treatment protocols for nonadherent patients.
Health care workers should be familiar with the law in their particular states for these procedures.
Question:
When a patient is having a chest tube removed, which of these instructions would be appropriate? 1)
"Take short quick breaths with your mouth open. " 2) "Take a deep breath and hold it. " 3) "Breathe
only through your mouth. " 4) "Breathe as you normally do. ".
Answer:
2) "Take a deep breath and hold it. " Rationale: Taking a deep breath and holding it (or performing
the Valsalva maneuver) will prevent air from being pulled back into the pleural space as the tube is
removed.
