CMSRN –QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
CORE DOMAINS
• Clinical Nursing Practice
• Patient Care Management
• Holistic Care
• Professional Role
• Patient Safety and Quality Improvement
• Evidence-Based Practice
• Care Coordination and Transition Management
• Ethical and Legal Practice
INTRODUCTION
The Certified Medical-Surgical Registered Nurse (CMSRN) exam is a comprehensive
assessment designed to validate the specialized knowledge, clinical skills, and
professional expertise required of nurses practicing in the medical-surgical specialty.
This exam evaluates the candidate’s ability to provide high-quality care to patients
with complex medical conditions through a rigorous series of multiple-choice and
,scenario-based questions. The assessment places a strong emphasis on real-world
application, critical thinking, and clinical decision-making within the healthcare
environment. By simulating actual clinical challenges, the exam ensures that the
practitioner is equipped to manage patient outcomes effectively while adhering to the
highest standards of safety and professional ethics.
SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a patient who is 24 hours postoperative following a total hip
arthroplasty. Which of the following findings should the nurse report to the
provider immediately?
A. Pain level of 5 on a scale of 0 to 10
B. New onset of shortness of breath and chest pain
C. Serosanguineous drainage on the surgical dressing
D. Diminished bowel sounds in all four quadrants
🟢 Correct answer: B. New onset of shortness of breath and chest pain
🔴 RATIONALE: These symptoms are indicative of a pulmonary embolism, a life-
threatening complication common after major orthopedic surgery.
, 2. A patient with Chronic Obstructive Pulmonary Disease (COPD) is receiving
oxygen via nasal cannula at 2 L/min. The patient’s SpO2 is 89%. Which action
should the nurse take first?
A. Increase the oxygen flow rate to 6 L/min
B. Notify the rapid response team
C. Position the patient in high-Fowler's and encourage pursed-lip breathing
D. Administer a PRN dose of albuterol
🟢 Correct answer: C. Position the patient in high-Fowler's and encourage pursed-lip
breathing
🔴 RATIONALE: Non-invasive interventions like positioning and breathing techniques
should be attempted first to improve gas exchange without suppressing the hypoxic
drive in COPD patients.
3. Which of the following electrolyte imbalances is a patient with chronic kidney
disease (CKD) most at risk for developing?
A. Hypokalemia
B. Hypomagnesemia
, C. Hyperkalemia
D. Hypernatremia
🟢 Correct answer: C. Hyperkalemia
🔴 RATIONALE: In CKD, the kidneys lose the ability to excrete potassium effectively,
leading to potentially fatal elevations in serum potassium levels.
4. A nurse is preparing to administer digoxin to a patient with heart failure. Which
of the following actions is a priority?
A. Check the patient's blood pressure
B. Assess the apical pulse for one full minute
C. Monitor the patient's respiratory rate
D. Measure the patient's intake and output
🟢 Correct answer: B. Assess the apical pulse for one full minute
🔴 RATIONALE: Digoxin should be withheld if the heart rate is below 60 bpm in
adults to prevent bradycardia and toxicity.
5. A patient is admitted with a diagnosis of acute pancreatitis. Which laboratory
value should the nurse expect to be elevated?
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
CORE DOMAINS
• Clinical Nursing Practice
• Patient Care Management
• Holistic Care
• Professional Role
• Patient Safety and Quality Improvement
• Evidence-Based Practice
• Care Coordination and Transition Management
• Ethical and Legal Practice
INTRODUCTION
The Certified Medical-Surgical Registered Nurse (CMSRN) exam is a comprehensive
assessment designed to validate the specialized knowledge, clinical skills, and
professional expertise required of nurses practicing in the medical-surgical specialty.
This exam evaluates the candidate’s ability to provide high-quality care to patients
with complex medical conditions through a rigorous series of multiple-choice and
,scenario-based questions. The assessment places a strong emphasis on real-world
application, critical thinking, and clinical decision-making within the healthcare
environment. By simulating actual clinical challenges, the exam ensures that the
practitioner is equipped to manage patient outcomes effectively while adhering to the
highest standards of safety and professional ethics.
SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a patient who is 24 hours postoperative following a total hip
arthroplasty. Which of the following findings should the nurse report to the
provider immediately?
A. Pain level of 5 on a scale of 0 to 10
B. New onset of shortness of breath and chest pain
C. Serosanguineous drainage on the surgical dressing
D. Diminished bowel sounds in all four quadrants
🟢 Correct answer: B. New onset of shortness of breath and chest pain
🔴 RATIONALE: These symptoms are indicative of a pulmonary embolism, a life-
threatening complication common after major orthopedic surgery.
, 2. A patient with Chronic Obstructive Pulmonary Disease (COPD) is receiving
oxygen via nasal cannula at 2 L/min. The patient’s SpO2 is 89%. Which action
should the nurse take first?
A. Increase the oxygen flow rate to 6 L/min
B. Notify the rapid response team
C. Position the patient in high-Fowler's and encourage pursed-lip breathing
D. Administer a PRN dose of albuterol
🟢 Correct answer: C. Position the patient in high-Fowler's and encourage pursed-lip
breathing
🔴 RATIONALE: Non-invasive interventions like positioning and breathing techniques
should be attempted first to improve gas exchange without suppressing the hypoxic
drive in COPD patients.
3. Which of the following electrolyte imbalances is a patient with chronic kidney
disease (CKD) most at risk for developing?
A. Hypokalemia
B. Hypomagnesemia
, C. Hyperkalemia
D. Hypernatremia
🟢 Correct answer: C. Hyperkalemia
🔴 RATIONALE: In CKD, the kidneys lose the ability to excrete potassium effectively,
leading to potentially fatal elevations in serum potassium levels.
4. A nurse is preparing to administer digoxin to a patient with heart failure. Which
of the following actions is a priority?
A. Check the patient's blood pressure
B. Assess the apical pulse for one full minute
C. Monitor the patient's respiratory rate
D. Measure the patient's intake and output
🟢 Correct answer: B. Assess the apical pulse for one full minute
🔴 RATIONALE: Digoxin should be withheld if the heart rate is below 60 bpm in
adults to prevent bradycardia and toxicity.
5. A patient is admitted with a diagnosis of acute pancreatitis. Which laboratory
value should the nurse expect to be elevated?
