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Try a few before you buy. These sample questions match the MSNCB CMSRN
style — scenario-based, single best answer, with a rationale that explains the reasoning.
Work each one before reading the answer.
Unlock 500+ CMSRN practice questions across 4 full-length simulators — $19.99 lifetime →
How close are these to the real CMSRN?
The CMSRN is 150 questions (125 scored, 25 unscored) over 3 hours, built around the everyday
judgment of a medical-surgical nurse — assessment, prioritization, safe medication and
fluid management, and teamwork. The samples below reflect that.
Sample CMSRN questions
- Which patient should the medical-surgical nurse assess first?
- A. A post-op patient with a pain score of 6
- B. A patient with a respiratory rate of 8 and O2 saturation of 88%
- C. A patient due for routine morning medications
- D. A patient requesting help to the bathroom
Answer: B. Airway/breathing comes first — a respiratory rate of 8 with
a saturation of 88% is an immediate threat. Pain and routine needs (A, C, D) wait. - A patient on furosemide has a potassium of 2.9 mEq/L. What is the priority concern?
- A. Constipation
- B. Cardiac dysrhythmias
- C. Mild headache
- D. Increased appetite
Answer: B. Hypokalemia predisposes to dangerous dysrhythmias. Hold the next
diuretic dose, notify the provider, and anticipate potassium replacement with cardiac monitoring. - What is the earliest sign of postoperative hemorrhage?
- A. Hypotension
- B. Increasing heart rate
- C. Warm, flushed skin
- D. Bradycardia
Answer: B. Tachycardia is the body’s earliest compensatory response to blood
loss; hypotension (A) is a later sign. Rising heart rate should prompt a closer look for bleeding. - During a blood transfusion, a patient develops fever, chills, and back pain. The
first action is to:- A. Slow the transfusion
- B. Stop the transfusion and keep the IV open with normal saline
- C. Give an antipyretic and continue
- D. Notify the lab
Answer: B. Stop the transfusion immediately and maintain IV access with saline
— this is the priority before any other step in a suspected transfusion reaction. - Which task is appropriate to delegate to unlicensed assistive personnel (UAP)?
- A. Assessing a new admission
- B. Teaching a patient about insulin
- C. Measuring vital signs on a stable patient
- D. Evaluating response to a new medication
Answer: C. Stable vital signs can be delegated. Assessment, teaching, and
evaluation (A, B, D) require the RN’s judgment and cannot be delegated.
How did you do?
If the prioritization felt tricky, that’s exactly what the exam tests. Our bank has 500+ CMSRN
questions across 4 timed simulators with rationales like these, plus a free sample test.
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Sources & references
The exam facts on this page are drawn from official certifying-body materials, reviewed 2026-06-18 by the DrCertifications exam-prep team (10+ years in exam preparation and publishing).