Certified Medical-Surgical Registered Nurse 2026 Sample
Questions and Accurate Answers.
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. correct 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.
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. correct 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. correct 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 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." correct 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.
To get TEST BANK for Medical-Surgical Nursing: Concepts for Clinical Judgment and
Collaborative Care 11th Edition by Donna D. Ignatavicius, All chapters 1 - 74
email or copy these links to get the full test banks. Each link has
a different versions http://www.stuvia.com/doc/7290675
http://www.stuvia.com/doc/8342084
http://www.stuvia.com/doc/9267657
http://www.stuvia.com/doc/7153071
http://www.stuvia.com/doc/7069048 correct answers http://www.stuvia.com/doc/7290675
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.
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. correct 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 correct answers 1) "Have you ever had this type of chest pain before?"
Rationale: Because of the patient's symptoms and his history of myocardial infarctions, the nurse
should find out if the patient has had this time of pain previously.
Maggie Clark, a 42-year-old female, was admitted with newly diagnosed type 2 diabetes
mellitus. Her blood glucose has been stabilized, and the nurse is preparing her for discharge. Her
discharge orders will include metformin (Glucophage). Mrs. Clark is also being treated for
hypertension.
Because Mrs. Clark is to take Glucophage on a regular basis it is important to
1) monitor her glomerular filtration rate.
2) check her serum amylase routinely.
3) obtain her red blood cell count periodically.
4) examine her urine for casts. correct answers 1) monitor her glomerular filtration rate.
Rationale: The estimated glomerular filtration rate (eGFR) is one way to measure the adequacy
of kidney function. Glucophage is excreted by the kidney and the risk of lactic acidosis increases
in patients with impaired kidney function. The drug may be used if the eGFR is between 45 and
60 mL/min/1.73 m2, i.e., in mild chronic kidney disease. Glucophage is absolutely
contraindicated if the eGFR is below 30 mL/min/1.73 m2.
Mrs. Clark is prescribed metoprolol tartrate (Lopressor) for hypertension. Which symptom of
hypoglycemia would be masked by Lopressor?
1) Diaphoresis.
2) Tingling.
3) Diplopia.
4) Tachycardia. correct answers 4) Tachycardia.
Rationale: A side effect of Lopressor, a beta blocker, is bradycardia. The Lopressor-induced
bradycardia can mask tachycardia, a symptom of hypoglycemia.
Charles Haverford is diagnosed with prostate cancer and is to have a radical prostatectomy.
Mr. Haverford has been researching his diagnosis and now asks the nurse to recommend a
reliable web source for accurate prostate cancer information. The nurse should identify which of
these websites as most reliable?
1) www.wikipedia.org.
2) www.cancer.gov.
3) www.caringbridge.org.
4) www.google.com. correct answers 2) www.cancer.gov.
, Rationale: When a patient asks about researching information on the internet, the patient should
be instructed to look at reliable sites. Sites that are most reliable are those sponsored by the
government (.gov).
Mr. Haverford has the planned surgery and immediately postoperatively he has a urinary catheter
inserted. After the urinary catheter is removed Mr. Haverford is urinating normally, however he
is experiencing occasional incontinence with dribbling. Mr. Haverford is to be discharged.
Mr. Haverford says to the nurse, "I'm so embarrassed. What will my wife think about this
dribbling?" In addition to acknowledging his feelings, the nurse should encourage the patient to
1) limit oral intake of fluids before bedtime.
2) palpate his bladder to check for distention three times a day.
3) perform pelvic floor exercises several times daily.
4) avoid interrupting the urinary stream during voiding. correct answers 3) perform pelvic floor
exercises several times daily.
Rationale: It is not unusual for a patient who has had a prostatectomy, to complain of not having
complete bladder control after catheter removal. To help the patient regain urinary control, pelvic
floor strengthening exercises are recommended.
A patient's wife is visibly upset and says to the nurse, "I thought my husband only broke his hip,
but the doctor thinks he might have had a stroke." Which of the following would be an
appropriate response by the nurse?
1) "It's really too early to be concerned about that. Let's wait until the test results come back."
2) "If it is a stroke, your husband is in the right hospital for treatment."
3) "Yes, he does have symptoms of a stroke. That's what the tests will help us find out."
4) "I'm going to get you some information to read about strokes and their treatment." correct
answers 3) "Yes, he does have symptoms of a stroke. That's what the tests will help us find out."
Rationale: Symptoms of stroke vary greatly and the initial diagnosis is made after a non-contrast
CT scan is done to determine if the event was ischemic or hemorrhagic. Then, further tests are
done to confirm the diagnosis and decide on treatment.
To get TEST BANK for Medical-Surgical Nursing: Concepts for Clinical Judgment and
Collaborative Care 11th Edition by Donna D. Ignatavicius, All chapters 1 - 74
email or copy these links to get the full test banks. Each link has
a different versions http://www.stuvia.com/doc/7290675
http://www.stuvia.com/doc/8342084
http://www.stuvia.com/doc/9267657
http://www.stuvia.com/doc/7153071
Questions and Accurate Answers.
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. correct 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.
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. correct 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. correct 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 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." correct 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.
To get TEST BANK for Medical-Surgical Nursing: Concepts for Clinical Judgment and
Collaborative Care 11th Edition by Donna D. Ignatavicius, All chapters 1 - 74
email or copy these links to get the full test banks. Each link has
a different versions http://www.stuvia.com/doc/7290675
http://www.stuvia.com/doc/8342084
http://www.stuvia.com/doc/9267657
http://www.stuvia.com/doc/7153071
http://www.stuvia.com/doc/7069048 correct answers http://www.stuvia.com/doc/7290675
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.
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. correct 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 correct answers 1) "Have you ever had this type of chest pain before?"
Rationale: Because of the patient's symptoms and his history of myocardial infarctions, the nurse
should find out if the patient has had this time of pain previously.
Maggie Clark, a 42-year-old female, was admitted with newly diagnosed type 2 diabetes
mellitus. Her blood glucose has been stabilized, and the nurse is preparing her for discharge. Her
discharge orders will include metformin (Glucophage). Mrs. Clark is also being treated for
hypertension.
Because Mrs. Clark is to take Glucophage on a regular basis it is important to
1) monitor her glomerular filtration rate.
2) check her serum amylase routinely.
3) obtain her red blood cell count periodically.
4) examine her urine for casts. correct answers 1) monitor her glomerular filtration rate.
Rationale: The estimated glomerular filtration rate (eGFR) is one way to measure the adequacy
of kidney function. Glucophage is excreted by the kidney and the risk of lactic acidosis increases
in patients with impaired kidney function. The drug may be used if the eGFR is between 45 and
60 mL/min/1.73 m2, i.e., in mild chronic kidney disease. Glucophage is absolutely
contraindicated if the eGFR is below 30 mL/min/1.73 m2.
Mrs. Clark is prescribed metoprolol tartrate (Lopressor) for hypertension. Which symptom of
hypoglycemia would be masked by Lopressor?
1) Diaphoresis.
2) Tingling.
3) Diplopia.
4) Tachycardia. correct answers 4) Tachycardia.
Rationale: A side effect of Lopressor, a beta blocker, is bradycardia. The Lopressor-induced
bradycardia can mask tachycardia, a symptom of hypoglycemia.
Charles Haverford is diagnosed with prostate cancer and is to have a radical prostatectomy.
Mr. Haverford has been researching his diagnosis and now asks the nurse to recommend a
reliable web source for accurate prostate cancer information. The nurse should identify which of
these websites as most reliable?
1) www.wikipedia.org.
2) www.cancer.gov.
3) www.caringbridge.org.
4) www.google.com. correct answers 2) www.cancer.gov.
, Rationale: When a patient asks about researching information on the internet, the patient should
be instructed to look at reliable sites. Sites that are most reliable are those sponsored by the
government (.gov).
Mr. Haverford has the planned surgery and immediately postoperatively he has a urinary catheter
inserted. After the urinary catheter is removed Mr. Haverford is urinating normally, however he
is experiencing occasional incontinence with dribbling. Mr. Haverford is to be discharged.
Mr. Haverford says to the nurse, "I'm so embarrassed. What will my wife think about this
dribbling?" In addition to acknowledging his feelings, the nurse should encourage the patient to
1) limit oral intake of fluids before bedtime.
2) palpate his bladder to check for distention three times a day.
3) perform pelvic floor exercises several times daily.
4) avoid interrupting the urinary stream during voiding. correct answers 3) perform pelvic floor
exercises several times daily.
Rationale: It is not unusual for a patient who has had a prostatectomy, to complain of not having
complete bladder control after catheter removal. To help the patient regain urinary control, pelvic
floor strengthening exercises are recommended.
A patient's wife is visibly upset and says to the nurse, "I thought my husband only broke his hip,
but the doctor thinks he might have had a stroke." Which of the following would be an
appropriate response by the nurse?
1) "It's really too early to be concerned about that. Let's wait until the test results come back."
2) "If it is a stroke, your husband is in the right hospital for treatment."
3) "Yes, he does have symptoms of a stroke. That's what the tests will help us find out."
4) "I'm going to get you some information to read about strokes and their treatment." correct
answers 3) "Yes, he does have symptoms of a stroke. That's what the tests will help us find out."
Rationale: Symptoms of stroke vary greatly and the initial diagnosis is made after a non-contrast
CT scan is done to determine if the event was ischemic or hemorrhagic. Then, further tests are
done to confirm the diagnosis and decide on treatment.
To get TEST BANK for Medical-Surgical Nursing: Concepts for Clinical Judgment and
Collaborative Care 11th Edition by Donna D. Ignatavicius, All chapters 1 - 74
email or copy these links to get the full test banks. Each link has
a different versions http://www.stuvia.com/doc/7290675
http://www.stuvia.com/doc/8342084
http://www.stuvia.com/doc/9267657
http://www.stuvia.com/doc/7153071
