CMSRN PRACTICE EXAM TEST BANK COMPLETE
200 VERIFIED QUESTIONS WITH DETAILED
RATIONALES GUARANTEED PASS
This comprehensive CMSRN exam test bank contains high-yield multiple-
choice questions with verified answers and detailed clinical rationales
designed for quick mastery. It covers vital medical-surgical nursing topics
including cardiovascular management, respiratory care, endocrine
disorders, gastrointestinal interventions, and critical care prioritization. Each
question highlights key physiological concepts and nursing interventions to
simulate the actual 2025/2026 certification environment. The structured
format serves as an excellent study tool for nursing students and active
registered nurses aiming to pass their medical-surgical certification on the
first attempt. Utilizing this practice guide helps bridge the gap between
theoretical knowledge and real-world clinical decision-making required for
the exam.
1. A nurse is caring for a postoperative patient who has
developed sudden shortness of breath, tachycardia,
and a look of panic. Which complication should the
nurse suspect first?
A) Atelectasis
B) Myocardial infarction
C) Pulmonary embolism
D) Pneumothorax
Answer: C) Pulmonary embolism
Rationale: A sudden onset of shortness of breath,
tachycardia, and anxiety are classic signs of a
pulmonary embolism (PE) in a postoperative
patient. Atelectasis develops more slowly.
, Myocardial infarction involves crushing chest
pain radiating to the arm or jaw. Pneumothorax
would typically present with absent breath
sounds on the affected side.
2. Which laboratory value should a medical-surgical
nurse monitor closely for a patient receiving heparin
therapy via continuous intravenous infusion?
A) Prothrombin time (PT)
B) Activated partial thromboplastin time (aPTT)
C) International Normalized Ratio (INR)
D) Bleeding time
Answer: B) Activated partial thromboplastin time
(aPTT)
Rationale: The aPTT is used to monitor the
therapeutic effectiveness of unfractionated
heparin therapy. PT and INR are used to monitor
warfarin therapy, while bleeding time measures
platelet function.
3. A patient with chronic kidney disease (CKD) has a
serum potassium level of 6.2 mEq/L. Which cardiac
rhythm change should the nurse closely monitor for
on the electrocardiogram (ECG)?
A) ST-segment depression
B) Prominent U waves
C) Tall, peaked T waves
D) Prolonged QT interval
Answer: C) Tall, peaked T waves
Rationale: Hyperkalemia (potassium level above
, 5.0 mEq/L) causes characteristic ECG changes,
beginning with tall, peaked T waves. ST-segment
depression and prominent U waves are
characteristic of hypokalemia.
4. During a shift assessment, a nurse notes that a
patient with a chest tube has continuous bubbling in
the water-seal chamber. How should the nurse
interpret this finding?
A) The system is functioning normally.
B) There is an air leak in the system.
C) The suction pressure is set too high.
D) The lung has fully re-expanded.
Answer: B) There is an air leak in the system.
Rationale: Continuous bubbling in the water-seal
chamber indicates an air leak somewhere in the
drainage system or at the insertion site.
Intermittent bubbling is normal during expiration
or coughing, but continuous bubbling requires
immediate troubleshooting.
5. A patient with type 1 diabetes mellitus is found
unresponsive, diaphoretic, and tachycardic. What is
the nurse's immediate priority action?
A) Administer 10 units of regular insulin
subcutaneously.
B) Check the patient's blood glucose level
immediately.
C) Administer 50% dextrose (D50) intravenously or
glucagon subcutaneously.
, D) Call the hospital code team.
Answer: C) Administer 50% dextrose (D50)
intravenously or glucagon subcutaneously.
Rationale: While checking blood glucose is
important, an unresponsive patient with classic
signs of severe hypoglycemia (diaphoresis,
tachycardia) requires immediate emergency
glucose replacement to prevent permanent brain
damage. Regular insulin would worsen the
condition and could be fatal.
6. A nurse is preparing to administer packed red blood
cells to a patient. Which intravenous fluid is the only
one compatible with blood products?
A) 5% Dextrose in Water (D5W)
B) Lactated Ringer's (LR)
C) 0.45% Sodium Chloride (Half-Normal Saline)
D) 0.9% Sodium Chloride (Normal Saline)
Answer: D) 0.9% Sodium Chloride (Normal Saline)
Rationale: 0.9% Sodium Chloride is an isotonic
solution and is the only fluid compatible with
blood products. Other fluids, like D5W or Lactated
Ringer's, can cause hemolysis or clotting of the
red blood cells.
7. A patient with a history of deep vein thrombosis (DVT)
is being discharged on warfarin. Which dietary
instruction is most important for the nurse to include in
the discharge teaching?
A) Completely avoid eating green leafy vegetables.
200 VERIFIED QUESTIONS WITH DETAILED
RATIONALES GUARANTEED PASS
This comprehensive CMSRN exam test bank contains high-yield multiple-
choice questions with verified answers and detailed clinical rationales
designed for quick mastery. It covers vital medical-surgical nursing topics
including cardiovascular management, respiratory care, endocrine
disorders, gastrointestinal interventions, and critical care prioritization. Each
question highlights key physiological concepts and nursing interventions to
simulate the actual 2025/2026 certification environment. The structured
format serves as an excellent study tool for nursing students and active
registered nurses aiming to pass their medical-surgical certification on the
first attempt. Utilizing this practice guide helps bridge the gap between
theoretical knowledge and real-world clinical decision-making required for
the exam.
1. A nurse is caring for a postoperative patient who has
developed sudden shortness of breath, tachycardia,
and a look of panic. Which complication should the
nurse suspect first?
A) Atelectasis
B) Myocardial infarction
C) Pulmonary embolism
D) Pneumothorax
Answer: C) Pulmonary embolism
Rationale: A sudden onset of shortness of breath,
tachycardia, and anxiety are classic signs of a
pulmonary embolism (PE) in a postoperative
patient. Atelectasis develops more slowly.
, Myocardial infarction involves crushing chest
pain radiating to the arm or jaw. Pneumothorax
would typically present with absent breath
sounds on the affected side.
2. Which laboratory value should a medical-surgical
nurse monitor closely for a patient receiving heparin
therapy via continuous intravenous infusion?
A) Prothrombin time (PT)
B) Activated partial thromboplastin time (aPTT)
C) International Normalized Ratio (INR)
D) Bleeding time
Answer: B) Activated partial thromboplastin time
(aPTT)
Rationale: The aPTT is used to monitor the
therapeutic effectiveness of unfractionated
heparin therapy. PT and INR are used to monitor
warfarin therapy, while bleeding time measures
platelet function.
3. A patient with chronic kidney disease (CKD) has a
serum potassium level of 6.2 mEq/L. Which cardiac
rhythm change should the nurse closely monitor for
on the electrocardiogram (ECG)?
A) ST-segment depression
B) Prominent U waves
C) Tall, peaked T waves
D) Prolonged QT interval
Answer: C) Tall, peaked T waves
Rationale: Hyperkalemia (potassium level above
, 5.0 mEq/L) causes characteristic ECG changes,
beginning with tall, peaked T waves. ST-segment
depression and prominent U waves are
characteristic of hypokalemia.
4. During a shift assessment, a nurse notes that a
patient with a chest tube has continuous bubbling in
the water-seal chamber. How should the nurse
interpret this finding?
A) The system is functioning normally.
B) There is an air leak in the system.
C) The suction pressure is set too high.
D) The lung has fully re-expanded.
Answer: B) There is an air leak in the system.
Rationale: Continuous bubbling in the water-seal
chamber indicates an air leak somewhere in the
drainage system or at the insertion site.
Intermittent bubbling is normal during expiration
or coughing, but continuous bubbling requires
immediate troubleshooting.
5. A patient with type 1 diabetes mellitus is found
unresponsive, diaphoretic, and tachycardic. What is
the nurse's immediate priority action?
A) Administer 10 units of regular insulin
subcutaneously.
B) Check the patient's blood glucose level
immediately.
C) Administer 50% dextrose (D50) intravenously or
glucagon subcutaneously.
, D) Call the hospital code team.
Answer: C) Administer 50% dextrose (D50)
intravenously or glucagon subcutaneously.
Rationale: While checking blood glucose is
important, an unresponsive patient with classic
signs of severe hypoglycemia (diaphoresis,
tachycardia) requires immediate emergency
glucose replacement to prevent permanent brain
damage. Regular insulin would worsen the
condition and could be fatal.
6. A nurse is preparing to administer packed red blood
cells to a patient. Which intravenous fluid is the only
one compatible with blood products?
A) 5% Dextrose in Water (D5W)
B) Lactated Ringer's (LR)
C) 0.45% Sodium Chloride (Half-Normal Saline)
D) 0.9% Sodium Chloride (Normal Saline)
Answer: D) 0.9% Sodium Chloride (Normal Saline)
Rationale: 0.9% Sodium Chloride is an isotonic
solution and is the only fluid compatible with
blood products. Other fluids, like D5W or Lactated
Ringer's, can cause hemolysis or clotting of the
red blood cells.
7. A patient with a history of deep vein thrombosis (DVT)
is being discharged on warfarin. Which dietary
instruction is most important for the nurse to include in
the discharge teaching?
A) Completely avoid eating green leafy vegetables.
