CMSRN 1- Certified Medical-Surgical
Registered Nurse
A 62-year-old male patient with a remote history of rheumatic fever is admitted to the
medical-surgical unit with the following symptoms:
Subjective: Shortness of breath, chest pain, syncope
Objective: Peripheral edema, neck vein distension, weight gain, cyanosis,
hepatomegaly, bounding pulses, cardiac arrhythmia
Which of the following is most likely this patient's primary diagnosis?
A. Abdominal aortic aneurysm
B. Left heart failure
C. Aortic valve stenosis
D. Endocarditis - ------------ANSWER: C. Aortic valve stenosis
A nurse is caring for an elderly patient with congestive heart failure. The nurse keeps
in mind that respiratory changes associated with aging include diminished
effectiveness of gas exchange between alveolus and capillary walls leading to:
A. Thinning of pulmonary vasculature
B. An increase in pH and pCO2
C. Thinning of moist mucous membranes
D. A decline in pO2 and O2 saturation - ------------ANSWER: D. A decline in pO2 and
O2 saturation
A patient is admitted to the hospital with severe pain, guarding, and rigidity of the
abdomen. Labs indicate increased levels of amylase and leukocytosis. Cullen's sign
is positive (bruising around the umbilicus, indicative of intra-abdominal bleeding) and
the patient is showing some signs of respiratory distress. The patient has a history of
alcohol abuse. Which of the following conditions is most likely to be diagnosed?
A. Alcoholic cirrhosis
B. Pneumonia
C. Acute liver failure
D. Acute pancreatitis - ------------ANSWER: D. Acute pancreatitis
A patient with which of the following conditions would most typically be found sitting
on the side of the bed, leaning forward, with an anxious expression?
A. Chronic bronchitis
B. Pleural effusion
C. Gastroesophageal reflux disease
D. Emphysema - ------------ANSWER: D. Emphysema
, All of the following medications are contraindicated in type 1 diabetes mellitus
except:
A. Glimepiride (Amaryl)
B. Pramlintide (Symlin)
C. Metformin extended release (Glucophage XR)
D. Glipizide (Glucotrol) - ------------ANSWER: B. Pramlintide (Symlin)
An esophageal obstruction is defined as any blockage of the gastrointestinal tract.
What is the most common cause of this condition?
A. Gastroesophageal reflux disease (GERD)
B. Esophageal tumors
C. Achalasia
D. Infection - ------------ANSWER: A. Gastroesophageal reflux disease (GERD)
Antidiuretic hormone (ADH) is synthesized in the:
A. Hypothalamus
B. Pituitary gland
C. Pineal gland
D. Thalamus - ------------ANSWER: A. Hypothalamus
Assessing for distention of the neck veins can best be completed:
A. With the patient sitting up at a 90-degree angle
B. With the patient's head elevated 30-45 degrees
C. With the patient in Trendelenburg position
D. With the patient lying prone in bed - ------------ANSWER: B. With the patient's
head elevated 30-45 degrees
Enteral feeding products come from manufacturers in ready-to-feed cans, powders
that require reconstituting, or in pre-filled bags that are ready to be spiked. Bacterial
contamination of the formula can be reduced by:
A. Discarding refillable bags every 48 hours
B. Refrigerating reconstituted formulas for a maximum of 72 hours
C. Adhering to hanging formula at room temperature for 4-8 hours for open systems
D. Mixing, diluting, and reconstituting formulas in the patient's room to avoid
cross-contamination - ------------ANSWER: C. Adhering to hanging formula at room
temperature for 4-8 hours for open systems
For a patient with chronic obstructive pulmonary disease, which of the following
nursing interventions would help maintain a patent airway?
A. Enforcing strict bedrest
B. Restricting fluid intake to 1,000 mL/day
C. Teaching the patient how to perform controlled coughing
D. Administering prescribed sedatives regularly and in large amounts -
------------ANSWER: C. Teaching the patient how to perform controlled coughing
Registered Nurse
A 62-year-old male patient with a remote history of rheumatic fever is admitted to the
medical-surgical unit with the following symptoms:
Subjective: Shortness of breath, chest pain, syncope
Objective: Peripheral edema, neck vein distension, weight gain, cyanosis,
hepatomegaly, bounding pulses, cardiac arrhythmia
Which of the following is most likely this patient's primary diagnosis?
A. Abdominal aortic aneurysm
B. Left heart failure
C. Aortic valve stenosis
D. Endocarditis - ------------ANSWER: C. Aortic valve stenosis
A nurse is caring for an elderly patient with congestive heart failure. The nurse keeps
in mind that respiratory changes associated with aging include diminished
effectiveness of gas exchange between alveolus and capillary walls leading to:
A. Thinning of pulmonary vasculature
B. An increase in pH and pCO2
C. Thinning of moist mucous membranes
D. A decline in pO2 and O2 saturation - ------------ANSWER: D. A decline in pO2 and
O2 saturation
A patient is admitted to the hospital with severe pain, guarding, and rigidity of the
abdomen. Labs indicate increased levels of amylase and leukocytosis. Cullen's sign
is positive (bruising around the umbilicus, indicative of intra-abdominal bleeding) and
the patient is showing some signs of respiratory distress. The patient has a history of
alcohol abuse. Which of the following conditions is most likely to be diagnosed?
A. Alcoholic cirrhosis
B. Pneumonia
C. Acute liver failure
D. Acute pancreatitis - ------------ANSWER: D. Acute pancreatitis
A patient with which of the following conditions would most typically be found sitting
on the side of the bed, leaning forward, with an anxious expression?
A. Chronic bronchitis
B. Pleural effusion
C. Gastroesophageal reflux disease
D. Emphysema - ------------ANSWER: D. Emphysema
, All of the following medications are contraindicated in type 1 diabetes mellitus
except:
A. Glimepiride (Amaryl)
B. Pramlintide (Symlin)
C. Metformin extended release (Glucophage XR)
D. Glipizide (Glucotrol) - ------------ANSWER: B. Pramlintide (Symlin)
An esophageal obstruction is defined as any blockage of the gastrointestinal tract.
What is the most common cause of this condition?
A. Gastroesophageal reflux disease (GERD)
B. Esophageal tumors
C. Achalasia
D. Infection - ------------ANSWER: A. Gastroesophageal reflux disease (GERD)
Antidiuretic hormone (ADH) is synthesized in the:
A. Hypothalamus
B. Pituitary gland
C. Pineal gland
D. Thalamus - ------------ANSWER: A. Hypothalamus
Assessing for distention of the neck veins can best be completed:
A. With the patient sitting up at a 90-degree angle
B. With the patient's head elevated 30-45 degrees
C. With the patient in Trendelenburg position
D. With the patient lying prone in bed - ------------ANSWER: B. With the patient's
head elevated 30-45 degrees
Enteral feeding products come from manufacturers in ready-to-feed cans, powders
that require reconstituting, or in pre-filled bags that are ready to be spiked. Bacterial
contamination of the formula can be reduced by:
A. Discarding refillable bags every 48 hours
B. Refrigerating reconstituted formulas for a maximum of 72 hours
C. Adhering to hanging formula at room temperature for 4-8 hours for open systems
D. Mixing, diluting, and reconstituting formulas in the patient's room to avoid
cross-contamination - ------------ANSWER: C. Adhering to hanging formula at room
temperature for 4-8 hours for open systems
For a patient with chronic obstructive pulmonary disease, which of the following
nursing interventions would help maintain a patent airway?
A. Enforcing strict bedrest
B. Restricting fluid intake to 1,000 mL/day
C. Teaching the patient how to perform controlled coughing
D. Administering prescribed sedatives regularly and in large amounts -
------------ANSWER: C. Teaching the patient how to perform controlled coughing
