Certified Medical-Surgical Registered Nurse 2026 Sample
Questions NEWEST 2026 COMPLETE 200 QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
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The nurse receives all of the following stat orders for Mr. Palmer.
Which one should the nurse question?
1) Oxygen per nasal cannula at 4 L per minute.
2) Enoxaparin (Lovenox) 40 mg subcutaneously.
3) Troponin level.
4) Computed tomography (CT) angiogram. - ANSWERS--Rationale:
The nurse should questions the order for Lovenox because the
patient is receiving a heparin drip.
Christine Warren, 45 years old, has a long history of ulcerative colitis,
and non-surgical treatment no longer relieved her symptoms. She
underwent a total proctocolectomy and a permanent ileostomy 12
hours ago.
The nurse should contact the physician immediately if Mrs. Warren
has which of these findings?
1) The stoma appears pale and dry.
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2) The stoma appears red and shiny.
3) There is 200 mL of dark green output from the stoma.
4) There is 50 mL of serosanguinous drainage from the stoma. -
ANSWERS--1) The stoma appears pale and dry.
Rationale: If there is an adequate blood supply to the stoma, the
color is pink or red, and the stoma is moist as a result of mucous
production. A pale dry color suggests ischemia of the stoma or bowel
and must be reported immediately to the physician. With an
ileostomy initially after surgery, the output is a loose, dark green
liquid that may contain some blood. The ileostomy usually begins to
drain within 24 of surgery at more than one liter per day.
When changing Mrs. Warren's ileostomy bag, the nurse notices that
the peristomal skin is irritated.
Which of these actions by the nurse would be appropriate before
reapplying the appliance?
1) Wash the area with antiseptic soap and water.
2) Clean the site with Dakin's solution.
3) Use a solid skin barrier.
4) Obtain an order for a topical antibiotic. - ANSWERS--3) Use a solid
skin barrier.
Rationale: The drainage from the stoma can quickly irritate the
surrounding tissue. Therefore, a solid skin barrier, with a pectin base
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or karaya wafer that has a measurable thickness and hydrocolloid
adhesive properties, should be applied.
Which of these comments, if made by Mrs. Warren before her
surgery, would indicate that she had concerns about her body
image?
1) "I will have to stop my aerobics classes."
2) "I'm so afraid I may not survive the surgery."
3) "I need to go shopping for some loose, baggy clothes."
4) "I'm concerned that this may be only the first of many surgeries." -
ANSWERS--3) "I need to go shopping for some loose, baggy clothes."
Rationale:Body image refers to a person's perception of self and
determines how the person interacts with others. One does not need
to purchase special clothing after ileostomy surgery, although some
minor adjustments may be needed for comfort, e.g., stretch
underwear or pantyhose for support.
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.
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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. - ANSWERS--
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.
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 - ANSWERS--1) "Have you ever had this type of chest pain
before?"