CMSRN 2024 Med-Surg Certification Practice Questions Well Answered

CMSRN 2024 Med-Surg Certification Practice Questions Well Answered A newly diabetic patient will receive instructions from his nurse. Which of the following actions should the nurse take first? A. Provide the patient with brochures for making smart choices for cooking/baking. B. Ask the patient what they know about diabetes. C. Instruct the patient on exercise or activities that will increase their metabolism. D. Teach them how to use the glucometer. - Answer ️️ -B. First ask the patient what they know about diabetes. *ACTION questions ask for intervention, NOT assessment The post hysterectomy patient with calls the clinic stating that she has been having difficulty with incontinence. Which of the following statements if made by the patient, indicates that further teaching is needed? A. I drink 8 oz. of fluid on the even hours while awake. B. I will attempt to void 30 minutes after drinking 200 cc. of fluid C. I will only drink fluid when I eat my meals D. I will set the timer to remind me when to void - Answer ️️ -C. A patient saying that he or she will only drink fluids when eating meals indicates that they don't know what to do in case of incontinence. FURTHER TEACHING indicates that the patient needs more information An RN assesses a patient in the Cancer Center with a diagnosis of terminal cancer. The patient states to the RN that he is short of breath, has no appetite and hurts everywhere. Which of the following statements by the nurse is best? A. Tell me how your family is coping B. Show me where it does not hurt C. I'll teach you relaxation techniques D. Your physician should increase your pain medication - Answer ️️ -C A clinical nurse returns to the desk to find 4 phone messages. Which of the following messages should the nurse respond to first? A. A post cervical laminectomy patient complaining of sudden difficulty talking. B. A patient with multiple sclerosis complaining of change in peripheral vision. C. A patient with a herniated disc complaining of consistent back pain. D. A patient with a cast due to a fracture of the right tibial bone complaining of tingling toes. - Answer ️️ -A B and C are expected symptoms of the patient's condition. A and D are unexpected. D is less critical than A. Best answer is A. A 75 year old patient complains to the clinical nurse that he is having difficulty sleeping. Which of the following actions by the nurse is most appropriate? A. Determine the patient's usual sleeping and waking patterns. B. Suggest that the client abstain from alcohol and caffeine before bed time. C. Recommend that client establish a bedtime routine. D. Ask how much sleep the client required before retirement. - Answer ️️ -A B and C are recommendations that the RN can share after he/she determines the patient's sleeping and waking patterns. So remove B and C. D is an inquiry, but is concerned about the past (when the person retired). Remove D. A is the best answer. The nurse cares for a patient several hours after a thyroidectomy. The RN observes that the patient is diaphoretic and confused. The vital signs are: Temp = 102° (38.9 ° C); BP is 160/90; pulse is 110, respiration is 22. The nurse expects the physician to order which of the following? A. NPO, Dextran 10 ml/kg. IV, 02 4 L/min. B. Propranolol (Inderal) 1 mg. IV, D5W 125 cc/hr IV, propylthiaouracil (PTU) 200 mg po qld. C. Levothyroxine Sodium (Synthroid) 100 mcg IV, Lactated Ringer's 125 cc/hr IV, and ciprofloxacin (cipro) 500 mg. po bid. D. Morphine sulfate 2.5 mg. IV q. 4 hrs. prn, 0.9% NACl. - Answer ️️ -B A 63 year old female patient contacts the clinic to report that she is has been extremely fatigued, is sleeping 12 hours a night, is always cold and her hair is falling out. Which of the following responses by the nurse is most appropriate? A. You will have more energy if you walk 30 min every day. B. You don't need to worry. Sleeping a lot is good for you. C. Come in and see your health care provider today. D. You should eat more green leafy vegetables. - Answer ️️ -C Need more info The RN performs blood pressure screening at the local community center. Which of the following individuals is most likely to suffer from a cerebrovascular accident? A. A 30 year old man who is an account executive B. A 40 year old man who jogs four times a week. C. A 60 year old man whose father had a stroke. D. A 75 year old man who takes multi-vitamins. - Answer ️️ -C For the patient with a new tracheostomy, the nurse must be alert to which early complication? a) Decannulation b) Infection c) Bleeding d) Tracheomalacia - Answer ️️ -C Common acute risks of tracheostomy include bleeding, airway loss, damage to adjacent structures, and failure of the chosen technique to achieve successful airway EVERYTHING 24 HR POST SURGERY, FIRST COMPLICATION IS BLEEDING. Infection comes 2-3 days later. When a pulse oximetry monitor indicates that a patient has a drop in SpO2 from 96% to 85% over 4 hours, the nurse will first: 1. Request an order for stat ABGs 2. Start the patient on oxygen by NC at 2L/minute 3. Notify the physician of the change 4. Check the position of the probe on patient's finger or earlobe - Answer ️️ -4 Pulse oximetry is inaccurate if the probe is loose, or in the presence of poor circulation, nail polish, or dark skin pigmentation. To decrease a patient's shortness of breath and a sense of impending doom during an asthma attack, the nurse will: A. Place the patient on a cardiac monitor and observe from the nurses' station. B. Let the patient rest alone in a quiet, calm environment. C. Reassure the patient that the doctor will arrive soon D. Stay with the patient and encourage pursed-lip breathing. - Answer ️️ -D The patient experiencing an acute asthma exacerbation will be fearful and anxious. It is important for the nurse to stay with the patient for ongoing assessment and to provide a calm environment. Helping the patient breathe with pursed lips will facilitate the expiration of trapped air and help the patient regain control of his or her breathing. A 68 year old woman is admitted to the surgical unit after a gastric resection for gastric cancer. She states that she doesn't want anyone to see her in this condition, even her husband. This nurse's best response is: A."Patients' rights protect your privacy. I won't allow anyone in." B."I've seen gastric cancer patients who look much worse. Don't worry." C."Would you like to talk to a social worker?" D."What about your condition worries you?" - Answer ️️ -D The nurse should allow the patient to share her concerns and express her feelings in a nonjudgmental environment. If there is psych/behavioral component- AFFIRM AND VALIDATE, NO PROBING A patient with a tricuspid valve disorder will have impaired blood flow between the: A. Vena cava and right atrium B. Left atrium and left ventricle C. Right atrium and right ventricle D. Right ventricle and pulmonary artery - Answer ️️ -C Tricuspid valve is located between right atrium and right ventricle MITRAL VALVE- left atrium and left ventricle If the Purkinje system is damaged, conduction of