CMSRN Practice Test

To become a CMSRN you will need to pass the Certified Medical-Surgical Registered Nurse exam. This exam is administered by the Academy of Medical-Surgical Nurses, or AMSN. Try our CMSRN practice test to see what the exam questions are like. Sample questions are great for test prep. Get started now with our free Medical-Surgical Certification practice test.


CMSRN Practice Questions

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Question 1
A client with acute pulmonary edema secondary to congestive heart failure has continuous monitoring of ventral venous pressure (CVP). Which of the following conditions indicates that the client’s treatment regimen is effective?
A
Central venous pressure increases.
B
Central venous pressure decreases.
C
There is no change in the central venous pressure.
D
Central venous pressure is not a useful indicator for this client.
Question 1 Explanation: 
Answer: B – Decreased central venous pressure indicates decreased fluid in the vascular space, one of the goals of treatment for this client. Choice A is incorrect because increased central venous pressure indicates increased fluid in the vascular space, which is not a desired goal. Choice C is incorrect because no change in central venous pressure indicates no change in the vascular fluid volume. Choice D is incorrect because central venous pressure is an accepted indicator of vascular fluid status.
Question 2
After EGD, Edna was diagnosed to have gastroesophageal reflux disease (GERD). The nurse teaches Edna about ways to minimize symptoms. Which of the following statements made by Edna indicates that more teaching is needed?
A
“I will be sure to drink tea instead of coffee.”
B
“I will take a walk after I eat.”
C
“I will try to eat smaller meals more frequently.”
D
“I will sleep with the head of the bed elevated about 12 inches.”
Question 2 Explanation: 
Answer: A – The client with GERD is encouraged to eat smaller, low-fat frequent meals and to avoid lying down after eating. Clients are instructed not to eat for at least 2 hours before bedtime and avoid foods that decrease lower esophageal pressure, such as anything containing caffeine (coffee, tea, cola, chocolate).
Question 3
A client with a left leg fracture is to be taught the three-point gait before discharge. Which instruction should the nurse give to this client?
A
“Advance your right crutch, swing the left foot forward, advance the left crutch, and then bring the right foot forward.”
B
“Move your right crutch and left foot forward together, and then swing the right foot and left crutch in one movement.”
C
“While partially bearing weight on your left leg, advance both crutches and then bring your right leg forward.”
D
“Using one movement, advance your left foot and both crutches and then bring right leg forward.”
Question 3 Explanation: 
Answer: D – In the three-point gait, both crutches and the affected “bad” leg and foot moved together, with the unaffected “good” leg and foot following. Choices A and B are incorrect because the crutches are moved simultaneously, not independently. Choice C is incorrect because the client should not bear weight on the fractured leg when using the three-point gait.
Question 4
Shane, 12 years old, is an avid fan of skateboarding. She tried to learn the moves but accidentally fell on her first try. Agonizing in pain, she was then brought to the Emergency Department. The X-ray film showed incomplete fracture of the left tibia. The doctor ordered for a closed reduction and a cast was applied on her left leg. Which of the following is an incorrect intervention for Shane?
A
Elevate entire extremity higher than the client’s heart for the first 24 to 48 hours.
B
Exercise her toes.
C
Support Shane’s foot with the ankle in 90 degrees of flexion.
D
Create a turning schedule for position changes every 3 hours.
Question 4 Explanation: 
Answer. D – Creating a turning schedule every 3 hours for position changes is the incorrect intervention. Position changes should be scheduled every 2 hours to prevent the complications of immobility which are pneumonia, skin breakdown or deep vein thrombosis. The rest of the choices are correct nursing actions for a client with closed reduction.
Question 5
The nurse is encouraging a client who had undergone an amputation to fit a prosthesis immediately. The advantage for this immediate action is
A
ability to ambulate sooner.
B
less chance of phantom limb sensation.
C
dressing changes are not necessary.
D
better fit of the prosthesis.
Question 5 Explanation: 
Answer: A – When the prosthesis is in place immediately following surgery, the client can stand up several hours postoperatively and walk the next day. The operative site is closed to outside contamination and benefits from improved circulation due to ambulation.
Question 6
Ms. JMM has been diagnosed with Hashimoto’s disease, an autoimmune disorder. Which of the following signs and symptoms were most probably exhibited by the client that led to the diagnosis?
A
Increased appetite, weight loss, hyperdefecation
B
Increased urination, weight loss, increased thirst
C
Decreased appetite, weight gain, constipation
D
Increased urination, weight gain, and purplish red striae
Question 6 Explanation: 
Answer: C - Decreased appetite, weight gain and constipation are indications that the client is having Hashimoto’s disease, which is the most common cause of hypothyroidism. Other signs and symptoms to watch for are lethargy, brittle nails, coarse hair, muscle cramps, weakness, and apnea. Choice A are signs of hyperthyroidism. Symptoms presented in choice B are characteristic of uncontrolled diabetes mellitus. Symptoms presented in choice D are characteristic of hypercortisolism.
Question 7
The nurse is teaching Mrs. Jones, a known diabetic, to monitor her blood glucose using a glucometer. The nurse will know that Mrs. Jones is competent in performing her finger-stick to obtain blood when she
A
uses the ball of a finger as the puncture site.
B
uses the side of a fingertip as the puncture site.
C
avoids using the fingers of her dominant hand as puncture sites.
D
avoids using the thumbs as puncture sites.
Question 7 Explanation: 
Answer: B – using the side of a fingertip as the puncture site confirms that the client understands the health teaching on blood glucose monitoring using a glucometer. The sides of the fingertips have fewer nerve endings than do the balls of the finger, so less discomfort will result from selecting the sides as puncture sites. Both hands, including the thumbs, can be used as puncture sites.
Question 8
Mr. Daniels, 55 year-old mechanic, was diagnosed with adult-onset diabetes. The nurse will know that Mr. Daniels understand the symptoms of a hyperglycemic reaction if he verbalized,
A
“I will experience thirst, always going to the bathroom to pee, and will also have decreased appetite.”
B
“I may feel flushed cheeks, will have acetone breath, and increased thirst.”
C
“I may feel nauseated, even vomiting, and some episodes of diarrhea.”
D
“I will experience weight gain, a normal breath, and constant thirst.”
Question 8 Explanation: 
Answer: B – “I may feel flushed cheeks, will have acetone breath, and increased thirst”, is the statement that the client understands the manifestations of a hyperglycemic reaction. All the other choices have one wrong answer or symptom: (A) hunger, not decreased appetite; (C) pain in abdomen, not diarrhea; (D) breath odor of acetone, not normal. Answers such as this are tricky, because you have to pick out the wrong answers from among several right answers.
Question 9
Jena, age 32, visited a day clinic to report a sudden weight gain. She also reported to the nurse on duty that her abdomen is now bigger than before and her face looks “swollen” and rounded. Which additional assessment finding would lead the nurse to suspect that Jena has Cushing’s syndrome rather than obesity?
A
large thighs and upper arms
B
pendulous abdomen and large hips
C
pendulous abdomen and large hips
D
posterior neck fat pad and thin extremities
Question 9 Explanation: 
Answer: D - Posterior neck fat pad and thin extremities are also noted in a client with Cushing’s syndrome. “Buffalo hump” is the accumulation of fat pads over the upper back and neck. Fat may also accumulate on the face, which suggest a “swollen” and rounded face. There is truncal obesity but the extremities are thin.
Question 10
The most accurate description the nurse could give a colleague about a thyroid scan is that it:
A
Assists in differentiating between primary and secondary hypothyroidism.
B
Demonstrates increased uptake of radioactive iodine in areas of possible malignancy.
C
Demonstrates decreased uptake of radioactive iodine in areas of possible malignancy.
D
Measures the effect of TSH on thyroid function.
Question 10 Explanation: 
Answer: C – A thyroid scan utilizes the uptake of radioactive iodine by the thyroid gland to determine the size, shape, and function of the gland. Also identified are areas of increased uptake (hot areas), indicating increased metabolic function, as in hyperthyroidism, not malignancy (choice B), and areas of decreased or no uptake (cold areas), which are associated with malignancy. Choices A and D both describe the TSH stimulation test.
Question 11
Following a thyroid scan with radioactive iodine for a thyroid nodule, the nurse should plan for:
A
No special radiations precautions.
B
Full radiation precautions to be instituted, including segregating the client in a private room.
C
Radiation precautions that are limited to urine and feces.
D
Full radiation precautions to be instituted for 8 hours (the half-life of radioactive iodine).
Question 11 Explanation: 
Answer: A – No radiation precautions are necessary after injection of radioactive iodine that will be used for thyroid scan. Choice B pertains to radium implants. Choice C may be employed to when radioactive iodine therapy is utilized to control and reduce hypersecretion by the thyroid (hyperthyroidism). Choice 4 is not an example of normal radiation therapy policy.
Question 12
Ruby, a College student, was admitted due to persistent abdominal pain, nausea and vomiting, and difficulty in swallowing. The doctor orders for an upper GI series. Nursing preparation for this procedure includes:
A
NPO for 24 hours before the procedure.
B
Administering an enema or cathartic to enhance visualization.
C
Discouraging the client from smoking the morning of the procedure because smoking can stimulate gastric motility.
D
Instructing the client that the test involves insertion of a rubber gastroscopy tube.
Question 12 Explanation: 
Answer: C – Clients are on NPO and encouraged not to smoke or take medications the morning of an upper GI series. Clients are NPO for 6-8 hours, not 24 hours (Choice A). Enemas or cathartics (Choice B) are not given prior to upper GI series rather after the series, to aid in the elimination of the barium. The test involves an x-ray, using a barium swallow as contrast medium. Gastroscopy (Choice D) is the direct visualization of the stomach.
Question 13
Mr. HP has recently undergone a colostomy. During his first day post-operatively, the nurse does not find any measurable fecal drainage from the colostomy. What should the nurse do?
A
Continue the current plan of care
B
Call the doctor immediately
C
Irrigate the stoma
D
Encourage the patient to increase fluid intake
Question 13 Explanation: 
Answer: A – Continue the current plan of care because the colostomy is expected not to function for 2 days or more (48 to 72 hours) after surgery. The drainage that is expected at this time is only mucous and serosanguinous, thus the doctor need not be notified and the stoma should not be irrigated at this time.
Question 14
The nurse demonstrates to Mr. HP the correct way of cutting the appliance by making the opening how much larger than that of the client’s stoma?
A
1/2 inch
B
1/8 inch
C
1/4 inch
D
1/16 inch
Question 14 Explanation: 
Answer: B – 1/8 inch. The size of the opening for the appliance is generally 1/8 inch larger than the size of the client’s stoma. This minimizes the amount of exposed skin but does not cause pressure on the stoma.
Question 15
Partial-and-full-thickness burns over 20% of TSBA is the diagnosis of a 25-year-old machine operator. A large-bore central venous line is inserted to allow administration of fluids and electrolytes. A large amount of lactated Ringer's solution and 5% dextrose in saline are given to?
A
Expand the plasma
B
Maintain blood volume
C
Replace lost electrolytes
D
Prevent fluid shiftings
Question 15 Explanation: 
Intravenous solutions are administered during the first 48 hours to replace fluid lost from intravascular compartment to interstitial spaces. The IV solution is not a plasma expander as is albumin. Answer D is incorrect as administration of fluids treats the fluid shifts, but does not prevent them. Electrolytes are specifically replaced based on serial assessments of serum electrolytes and arterial blood gases.
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Related Exams and Resources:
Med-Surg Study Guide – An overview of the best study guides available!
Medical Surgical Nursing Certification

About the CMSRN Exam:
In order to become a certified med-surg nurse you will need to pass the Certified Medical-Surgical Registered Nurse Exam. This exam tests the RN’s knowledge of nursing interventions that are performed on medical and surgical patients. Some questions will pertain to specific disease processes and potential complications of these diseases. Other topics covered include patient education information, professional standards, and ethical issue.

The CMSRN exam can be taken as a paper-and-pencil test or as a computer-based test.  The computer-based option is much more popular and is available year-round at over 250 locations. The med-surg certification test consists of 150 questions that must be completed within 3 hours. To pass you must achieve a score of at least 71%. Start your test prep now with out free CMSRN practice test!