CMSRN Exam Prep: Certified Medical-Surgical Registered Nurse (MSNCB) Study Guide + 5,000+ Practice Questions

A patient on postoperative day 2 following an open abdominal surgery has a history of obesity. The patient exhibits shallow breathing, a low-grade fever, and decreased breath sounds at the lung bases. Which action should the nurse take to address this complication?

A patient on postoperative day 3 following a total hip arthroplasty reports sudden, unilateral calf swelling and tenderness. The patient has a 20-year history of smoking. Which action should the nurse take to manage this suspected complication?

A patient on postoperative day 5 following a colon resection has a history of poorly controlled diabetes mellitus. The nurse notes new purulent drainage and increasing erythema at the incision site. Which action should the nurse take to manage this finding?

A patient on postoperative day 1 following an open abdominal surgery exhibits hypoactive bowel sounds, mild abdominal bloating, and reluctance to move due to fear of pain. Which action should the nurse take to prevent further gastrointestinal complications?

A 78-year-old patient on postoperative day 2 following a hip fracture repair develops new-onset confusion, begins picking at the bedsheets, and exhibits significant nighttime agitation. Which action should the nurse take to address this cognitive change?

A patient on postoperative day 1 following a total thyroidectomy exhibits frequent swallowing, tachycardia, and reports a feeling of pressure in the neck. Which action should the nurse take to assess for a potential complication?

A 45-year-old patient is 24 hours post-total thyroidectomy and reports circumoral numbness. Which assessment finding requires the most immediate nursing intervention?

A 68-year-old patient with stage 4 chronic kidney disease presents to the clinic reporting progressive bilateral leg weakness and abdominal cramping over the past two days. The patient’s recent laboratory results show a glomerular filtration rate of 22 mL/min. Which electrocardiogram finding should the nurse anticipate?

A 72-year-old patient is receiving continuous intravenous fluids three days after a bowel resection. The patient, previously alert and oriented, is now lethargic, confused, and reports a mild headache. The nurse notes a bounding pulse and crackles in the lung bases. Which laboratory finding aligns with this clinical presentation?

A 55-year-old patient has been receiving continuous nasogastric tube suctioning for a mechanical bowel obstruction over the past forty-eight hours. The patient now reports generalized muscle weakness and palpitations. Which focused assessment should the nurse perform to evaluate for the most likely electrolyte imbalance?

A 78-year-old resident of a long-term care facility has experienced severe diarrhea and poor oral intake for three days. The patient appears restless and has dry mucous membranes. Which assessment finding provides the most reliable indicator of the patient’s current fluid volume status?

A 62-year-old patient with a history of advanced breast cancer has been strictly bedbound for the past three weeks due to severe bone pain. The patient now presents with profound lethargy, severe constipation, and profound muscle weakness. Which assessment finding should the nurse anticipate?

A patient presents with chronic lower extremity edema and an irregularly shaped, shallow wound on the medial malleolus with heavy yellow exudate. The patient’s ankle-brachial index is 0.95. Based on these clinical findings, which intervention is most appropriate for managing this wound?

A patient with severe peripheral neuropathy develops an intact, dark purple, boggy area of skin on the right heel. The surrounding tissue is warm to the touch. Which intervention best addresses the underlying pathophysiology of this specific skin alteration?

A patient has a stage 3 pressure injury on the sacrum. During the dressing change, the nurse notes a highly exudative wound bed with significant maceration of the surrounding periwound skin. Which type of dressing is most appropriate to optimize this wound environment?

A patient with poorly controlled diabetes presents with a painless, deep ulcer on the plantar surface of the foot, surrounded by a thick rim of callus. The wound bed is pink with minimal drainage. Which management strategy is most critical for promoting healing?

An older adult patient with thin, fragile skin sustains a skin tear on the forearm after bumping into a bedside table. The skin flap remains viable, pale, and attached at the base with minimal bleeding. Which action is most appropriate for managing this wound?

A patient reports severe calf pain when walking that is relieved by rest. Assessment reveals a punched-out ulcer on the lateral malleolus with a pale, dry wound bed and absent pedal pulses. Which nursing intervention is most appropriate for this specific wound type?

A patient who experienced a right-sided ischemic stroke 24 hours ago exhibits new-onset coughing after taking small sips of water, though their gag reflex remains intact. Which action should the medical-surgical nurse take to ensure patient safety?

A patient recovering from a hemorrhagic stroke 48 hours ago develops new, subtle restlessness and a widened pulse pressure during the evening shift. Which nursing intervention is most appropriate based on these clinical assessment findings?

A patient who suffered a right hemispheric stroke three days ago exhibits left hemiplegia and frequently bumps into doorways on the left side while navigating the hallway in a wheelchair. Which nursing intervention best addresses this specific deficit?

A patient is four days post-stroke involving the left middle cerebral artery. The patient follows complex motor commands perfectly but speaks in short, non-fluent phrases and displays visible frustration. Which communication strategy should the nurse implement?

A patient admitted for a transient ischemic attack (TIA) is preparing for discharge. The patient’s neurological symptoms resolved completely within one hour, and their current neurological assessment is entirely unremarkable. Which discharge instruction is most vital?

A patient with a left occipital stroke develops right homonymous hemianopsia. During meal times in the unit dining room, the nurse observes that the patient consistently leaves food untouched on the right side of their plate. Which intervention is best?

A patient with a history of severe chronic obstructive pulmonary disease is admitted for pneumonia. The patient is alert but visibly fatigued, with a respiratory rate of 24 breaths per minute and an oxygen saturation of 88% on room air. Which intervention is most appropriate for managing this patient’s oxygenation?

On postoperative day two following a thoracotomy, a patient has a chest tube connected to a water seal drainage system. The patient is resting comfortably with an oxygen saturation of 96%. During assessment, continuous bubbling is noted in the water seal chamber. How should the nurse proceed?

A patient on postoperative day three following an open bowel resection reports the sudden onset of sharp, pleuritic chest pain. Assessment reveals a respiratory rate of 28 breaths per minute and an oxygen saturation of 89% on room air. Decreased breath sounds were previously noted at the lung bases. Which action is indicated?

A patient with a four-day-old tracheostomy triggers a high-pressure alarm on the mechanical ventilator. The patient appears agitated, oxygen saturation is dropping to 86%, and thick, tenacious secretions are visible in the tracheostomy tube. Which intervention should be implemented to restore adequate ventilation?

A patient diagnosed with right lower lobe pneumonia is receiving supplemental oxygen at two liters per minute via nasal cannula. The patient complains of worsening shortness of breath when lying on their right side, and oxygen saturation drops to 91%. Which positioning strategy should be utilized?

A patient admitted for a severe asthma exacerbation initially presented with loud expiratory wheezing and a respiratory rate of 28 breaths per minute. Upon reassessment, the patient appears drowsy, the respiratory rate has decreased to 14, and wheezing is suddenly absent. How should these findings be interpreted?