CMSRN – COMPREHENSIVE QUESTIONS AND ANSWERS | VERIFIED AND WELLDETAILED
ANSWERS | DETAILED EXPLANATIONS AND RATIONALES | COMPLETE EXAM PREPARATION
STUDY GUIDE | PRACTICE QUESTIONS | LATEST EXAM UPDATE
• CORE DOMAINS*
•
1. Patient/Care Management
2. Holistic Patient Care
3. Elements of Interprofessional Care
4. Professional Concepts
5. Nursing Teamwork and Collaboration
6. Patient Safety and Quality Improvement
7. Infection Prevention and Medication Management
8. Acute and Chronic Medical-Surgical Conditions
9. Patient Education, Communication, and Advocacy
10. Evidence-Based Practice, Leadership, and Professional Accountability
INTRODUCTION
*This comprehensive CMSRN assessment is designed to strengthen the knowledge, clinical
reasoning, professional judgment, and decision-making skills required of medical-surgical
registered nurses. The questions emphasize patient/care management, holistic care,
interprofessional practice, professional concepts, and teamwork while integrating safety,
assessment, prioritization, pharmacology, pathophysiology, patient education, and evidence-
based practice. Multiple-choice questions are used to develop recognition, interpretation,
application, and analysis of common medical-surgical nursing situations. Effective
preparation requires understanding why an intervention is appropriate rather than simply
memorizing facts. The current MSNCB CMSRN blueprint identifies five major domains and
weights them across the examination. *
Question 1. A nurse is assessing a hospitalized patient who suddenly develops dyspnea,
pleuritic chest pain, and an oxygen saturation of 86%. Which action should the nurse take
first?
A. Encourage the patient to ambulate
B. Apply supplemental oxygen and assess respiratory status
,C. Administer the prescribed oral analgesic
D. Obtain a routine dietary history
Correct Answer: B. Apply supplemental oxygen and assess respiratory status
Explanation: Acute hypoxemia and respiratory distress require immediate attention to
airway and breathing. Oxygen supports tissue oxygenation while the nurse rapidly assesses
the patient's condition and initiates further emergency interventions.
Question 2. Which finding is most concerning in a patient receiving opioid analgesia?
A. Respiratory rate of 8/min
B. Pain rating of 4/10
C. Mild nausea
D. Constipation for one day
Correct Answer: A. Respiratory rate of 8/min
Explanation: Significant respiratory depression is a potentially life-threatening opioid adverse
effect. A respiratory rate of 8/min requires prompt assessment and intervention.
Question 3. Which nursing action best demonstrates the evaluation phase of the nursing
process?
A. Identifying impaired skin integrity
B. Establishing a pressure-injury prevention goal
C. Repositioning the patient every two hours
D. Determining whether the patient's skin condition improved
Correct Answer: D. Determining whether the patient's skin condition improved
Explanation: Evaluation determines whether planned interventions achieved the desired
outcomes and whether the care plan should be continued, modified, or discontinued.
Question 4. A patient with heart failure reports a 2.5-kg weight gain over three days. What
should the nurse recognize?
A. Expected variation in body weight
B. Possible fluid retention
C. Evidence of dehydration
D. Normal response to diuretic therapy
Correct Answer: B. Possible fluid retention
Explanation: Rapid weight gain in heart failure commonly indicates fluid accumulation. Daily
weight trends are highly useful for detecting changes in fluid status.
Question 5. Which intervention is most appropriate for preventing hospital-associated falls?
, A. Keeping all patients on strict bed rest
B. Raising all four side rails
C. Individualizing fall-prevention interventions according to risk
D. Restricting oral fluids
Correct Answer: C. Individualizing fall-prevention interventions according to risk
Explanation: Fall prevention should be based on individual risk factors such as medications,
mobility, cognition, toileting needs, and environmental hazards. Four side rails may
constitute a restraint rather than an appropriate fall-prevention measure.
Question 6. Which patient should the nurse assess first?
A. Patient with chronic arthritis reporting pain of 6/10
B. Patient requesting assistance with bathing
C. Patient with new confusion and oxygen saturation of 88%
D. Patient awaiting discharge instructions
Correct Answer: C. Patient with new confusion and oxygen saturation of 88%
Explanation: New confusion accompanied by hypoxemia suggests an acute physiological
problem. Airway, breathing, circulation, and acute deterioration take priority over routine
needs.
Question 7. Which statement best describes a near miss?
A. An event that causes permanent harm
B. An event that reaches the patient but causes no harm
C. An unsafe event that is detected before reaching the patient
D. A deliberate violation of institutional policy
Correct Answer: C. An unsafe event that is detected before reaching the patient
Explanation: A near miss is an error or unsafe condition that could have caused harm but
was intercepted before reaching the patient. Reporting near misses helps identify system
vulnerabilities.
Question 8. Which precaution is appropriate for a patient with suspected Clostridioides
difficile infection?
A. Airborne precautions
B. Contact precautions with appropriate hand hygiene
C. Droplet precautions only
D. Protective isolation
Correct Answer: B. Contact precautions with appropriate hand hygiene
ANSWERS | DETAILED EXPLANATIONS AND RATIONALES | COMPLETE EXAM PREPARATION
STUDY GUIDE | PRACTICE QUESTIONS | LATEST EXAM UPDATE
• CORE DOMAINS*
•
1. Patient/Care Management
2. Holistic Patient Care
3. Elements of Interprofessional Care
4. Professional Concepts
5. Nursing Teamwork and Collaboration
6. Patient Safety and Quality Improvement
7. Infection Prevention and Medication Management
8. Acute and Chronic Medical-Surgical Conditions
9. Patient Education, Communication, and Advocacy
10. Evidence-Based Practice, Leadership, and Professional Accountability
INTRODUCTION
*This comprehensive CMSRN assessment is designed to strengthen the knowledge, clinical
reasoning, professional judgment, and decision-making skills required of medical-surgical
registered nurses. The questions emphasize patient/care management, holistic care,
interprofessional practice, professional concepts, and teamwork while integrating safety,
assessment, prioritization, pharmacology, pathophysiology, patient education, and evidence-
based practice. Multiple-choice questions are used to develop recognition, interpretation,
application, and analysis of common medical-surgical nursing situations. Effective
preparation requires understanding why an intervention is appropriate rather than simply
memorizing facts. The current MSNCB CMSRN blueprint identifies five major domains and
weights them across the examination. *
Question 1. A nurse is assessing a hospitalized patient who suddenly develops dyspnea,
pleuritic chest pain, and an oxygen saturation of 86%. Which action should the nurse take
first?
A. Encourage the patient to ambulate
B. Apply supplemental oxygen and assess respiratory status
,C. Administer the prescribed oral analgesic
D. Obtain a routine dietary history
Correct Answer: B. Apply supplemental oxygen and assess respiratory status
Explanation: Acute hypoxemia and respiratory distress require immediate attention to
airway and breathing. Oxygen supports tissue oxygenation while the nurse rapidly assesses
the patient's condition and initiates further emergency interventions.
Question 2. Which finding is most concerning in a patient receiving opioid analgesia?
A. Respiratory rate of 8/min
B. Pain rating of 4/10
C. Mild nausea
D. Constipation for one day
Correct Answer: A. Respiratory rate of 8/min
Explanation: Significant respiratory depression is a potentially life-threatening opioid adverse
effect. A respiratory rate of 8/min requires prompt assessment and intervention.
Question 3. Which nursing action best demonstrates the evaluation phase of the nursing
process?
A. Identifying impaired skin integrity
B. Establishing a pressure-injury prevention goal
C. Repositioning the patient every two hours
D. Determining whether the patient's skin condition improved
Correct Answer: D. Determining whether the patient's skin condition improved
Explanation: Evaluation determines whether planned interventions achieved the desired
outcomes and whether the care plan should be continued, modified, or discontinued.
Question 4. A patient with heart failure reports a 2.5-kg weight gain over three days. What
should the nurse recognize?
A. Expected variation in body weight
B. Possible fluid retention
C. Evidence of dehydration
D. Normal response to diuretic therapy
Correct Answer: B. Possible fluid retention
Explanation: Rapid weight gain in heart failure commonly indicates fluid accumulation. Daily
weight trends are highly useful for detecting changes in fluid status.
Question 5. Which intervention is most appropriate for preventing hospital-associated falls?
, A. Keeping all patients on strict bed rest
B. Raising all four side rails
C. Individualizing fall-prevention interventions according to risk
D. Restricting oral fluids
Correct Answer: C. Individualizing fall-prevention interventions according to risk
Explanation: Fall prevention should be based on individual risk factors such as medications,
mobility, cognition, toileting needs, and environmental hazards. Four side rails may
constitute a restraint rather than an appropriate fall-prevention measure.
Question 6. Which patient should the nurse assess first?
A. Patient with chronic arthritis reporting pain of 6/10
B. Patient requesting assistance with bathing
C. Patient with new confusion and oxygen saturation of 88%
D. Patient awaiting discharge instructions
Correct Answer: C. Patient with new confusion and oxygen saturation of 88%
Explanation: New confusion accompanied by hypoxemia suggests an acute physiological
problem. Airway, breathing, circulation, and acute deterioration take priority over routine
needs.
Question 7. Which statement best describes a near miss?
A. An event that causes permanent harm
B. An event that reaches the patient but causes no harm
C. An unsafe event that is detected before reaching the patient
D. A deliberate violation of institutional policy
Correct Answer: C. An unsafe event that is detected before reaching the patient
Explanation: A near miss is an error or unsafe condition that could have caused harm but
was intercepted before reaching the patient. Reporting near misses helps identify system
vulnerabilities.
Question 8. Which precaution is appropriate for a patient with suspected Clostridioides
difficile infection?
A. Airborne precautions
B. Contact precautions with appropriate hand hygiene
C. Droplet precautions only
D. Protective isolation
Correct Answer: B. Contact precautions with appropriate hand hygiene
