MSNCB CMSRNFree Medical-Surgical Registered Nurse practice test

Correct answer: B. Pulmonary embolism

A pulmonary embolism occurs when a venous thrombus dislodges and obstructs the pulmonary vasculature. Classic manifestations include rapid breathing, elevated heart rate, cyanosis, coughing up blood-tinged or frothy sputum, pleuritic chest pain, anxiety, and low-grade fever. This condition is life-threatening and demands urgent intervention including cardiopulmonary support. The other listed conditions do not produce this constellation of findings.

Correct answer: D. Verify that PT appointments are booked and that transportation arrangements are in place before discharge.

Effective transitions of care depend on active coordination rather than simply providing instructions. Verifying that outpatient therapy is scheduled and that the patient can physically access those appointments ensures rehabilitation continuity, promotes adherence, and reduces risks such as falls or deconditioning. This reflects anticipatory discharge planning and true interprofessional collaboration. Written mobility instructions support education but do not guarantee access or follow-through for patients facing logistical barriers. Telling the patient to call after discharge transfers the burden inappropriately and risks missed appointments. Requesting an extended hospital stay misallocates resources; the goal is safe, timely discharge with outpatient continuity.

Correct answer: D. Confirm with the home health nurse that the first IV antibiotic dose and line-care teaching will occur on discharge day, and relay this plan to both the prescribing provider and pharmacist.

Confirming same-day initiation of home IV therapy and closing the communication loop between the home health nurse, prescriber, and pharmacist exemplifies true interprofessional care coordination. This integrative action ensures all disciplines know when treatment begins, prevents missed doses, and maintains continuity across care settings — representing proactive management rather than delegated responsibility. Providing education alone places the responsibility entirely on the patient without verifying that the home team is prepared. Notifying the pharmacy without confirming agency readiness creates a common coordination gap that can delay therapy. Scheduling a follow-up call is valuable but evaluates coordination retrospectively rather than ensuring the system is aligned prior to discharge.

Correct answer: C. Determine whether the patient can afford the prescribed inhaler medications.

The ability to obtain prescribed medications is a primary driver of treatment adherence and a key readmission risk factor in chronic respiratory illness. Identifying financial barriers early allows nurses to connect patients with case management or pharmaceutical assistance programs, supporting better long-term outcomes. Exercise preferences inform rehabilitation planning but do not directly predict readmission. Dietary recall offers general wellness information without addressing readmission predictors. Vaccination history is important for infection prevention but does not indicate imminent readmission risk.

Correct answer: A. Transurethral resection of the prostate (TURP)

TURP is the predominant surgical choice for BPH because it does not require an external incision, making it suitable for men with smaller gland enlargements and those who are higher surgical risks. In contrast, suprapubic prostatectomy, retropubic prostatectomy, and transurethral incision all require incisions and are less frequently performed.

Correct answer: D. Request that the social worker attend the next team meeting to review and refine the discharge plan collectively.

Inviting the social worker into the team meeting promotes shared decision-making, clarifies professional roles, and ensures that social determinants of health are incorporated into the discharge plan. This collaborative model prevents care silos and keeps all disciplines — including social work — engaged in a patient-centered plan. Proceeding without addressing the gap assumes organic coordination will occur, which risks missing key social work contributions. Having the social worker act independently after discharge limits real-time discussion and may fail to integrate findings into the overall plan before the patient leaves. A meeting restricted to the cardiologist and pharmacist fragments collaboration rather than strengthening full team engagement.

Correct answer: D. The home health nurse verifies that wound care supplies have arrived and the patient accurately demonstrates the dressing change technique.

When the home health nurse confirms that supplies are present and the patient can perform wound care correctly, it reflects coordination across disciplines — communication, education, and logistics are all aligned for a safe transition. This demonstrates nursing accountability and collaborative follow-through, ensuring both access and competency are established before discharge. Provider completion of paperwork meets procedural requirements but does not measure real-world care continuity. Verbal understanding alone does not confirm patient competence; return demonstration is the gold standard for discharge readiness. Insurance authorization confirms eligibility but not whether the transition itself was functionally successful.

Correct answer: B. Examine the surgical wound for drainage, erythema, or swelling.

Prior to escalating care, the nurse must assess the surgical site for signs consistent with infection. This falls within the assessment phase of the nursing process and precedes both interventions and provider notification. Detecting localized wound changes helps determine whether the fever is likely of infectious origin and guides subsequent clinical decision-making and team communication. Administering analgesia before a thorough assessment may mask significant findings such as wound dehiscence or abscess. Applying heat may worsen localized inflammation if infection is already present. Encouraging ambulation supports recovery but does not address the possibility of an infectious complication.

Correct answer: D. Consult the registered dietitian to revisit potassium-restriction guidelines and reinforce dietary education.

Elevated potassium in CKD requires coordinated, interdisciplinary management addressing the dietary root cause. Referring to the dietitian supports individualized teaching about high-potassium foods and promotes safe long-term self-management, consistent with the implementation and evaluation phases of the nursing process. Increasing fluid intake may exacerbate fluid overload in a patient with impaired renal excretion and is unlikely to effectively lower potassium. Requesting Kayexalate exceeds the nurse's independent scope of practice; the appropriate step is to assess, report, and collaborate with the provider. Deferring reassessment until the next day overlooks a potentially life-threatening electrolyte disturbance and reflects poor clinical prioritization.

Correct answer: A. The patient accurately uses prescribed inhalers and can explain when to seek follow-up care.

The patient's ability to demonstrate correct inhaler technique and articulate when to seek care is the strongest indicator of effective discharge planning. This directly measures self-management readiness — the primary goal of coordinated education among nursing, pharmacy, respiratory therapy, and case management. Teach-back confirmation signals that communication and education were successful. Documenting that instructions were provided reflects process completion rather than patient outcome achievement. Confirming home oxygen delivery is a logistical coordination step but does not measure the patient's understanding or readiness to self-manage. Completing the discharge summary ensures accurate records but does not verify the patient's ability to manage care independently at home.