CMSRN Exam Flashcards

Q: How many questions are on the CMSRN exam?

The CMSRN exam has 150 multiple-choice questions. The local metadata lists 125 scored questions and 25 unscored pilot questions in a 3-hour testing window.

Q: What score do I need to pass CMSRN?

The listed passing standard is a standard score of 95, commonly described as about 71 percent correct on the scored items.

Q: What are the CMSRN blueprint domains?

The local CMSRN metadata lists five domains: Patient/Care Management, Holistic Patient Care, Elements of Interprofessional Care, Professional Concepts, and Nursing Teamwork and Collaboration.

Q: What are common CMSRN eligibility requirements?

The local metadata lists a current, unencumbered RN license and 2,000 hours of medical-surgical practice within the past 3 years, with 2 full years of med-surg practice recommended.

Question 1

CMSRN Exam Format

Accepted Answer

The CMSRN exam has 150 multiple-choice questions in 3 hours. The local metadata lists 125 scored items and 25 unscored pilot items.

Question 2

CMSRN Passing Standard

Accepted Answer

The listed passing standard is a standard score of 95, often described as about 71 percent correct on scored items. The standard score is not just a classroom percentage.

Question 3

Largest CMSRN Domain

Accepted Answer

Patient/Care Management is the largest domain at 32 percent. Prioritize safety, assessment, medication safety, infection prevention, mobility, nutrition, and escalation scenarios.

Question 4

CMSRN Eligibility Core

Accepted Answer

Candidates generally need a current, unencumbered RN license and 2,000 hours of medical-surgical practice in the past 3 years. Eligibility facts should be verified before applying.

Question 5

CMSRN Renewal Period

Accepted Answer

The local metadata lists CMSRN certification as valid for 5 years. Renewal planning matters because certification maintenance is separate from passing the initial exam.

Question 6

ABCs in Med-Surg Priority

Accepted Answer

Airway, breathing, and circulation remain a first screen for urgent instability. Use ABCs to identify threats before routine teaching, documentation, or discharge tasks.

Question 7

Acute Change in Condition

Accepted Answer

Assess immediately, obtain focused data, and escalate according to policy. Sudden deterioration is not handled by routine reassessment later in the shift.

Question 8

Sepsis Red Flags

Accepted Answer

Fever or hypothermia, tachycardia, tachypnea, hypotension, altered mental status, and suspected infection require urgent action. Early recognition prevents shock and organ failure.

Question 9

Stroke Response Cue

Accepted Answer

New facial droop, arm weakness, speech difficulty, vision change, or unilateral deficit requires rapid stroke protocol. Time-sensitive treatment depends on fast recognition.

Question 10

Chest Pain Priority

Accepted Answer

Assess pain, vital signs, oxygenation, ECG status, and notify per protocol. Do not delay urgent evaluation for routine education or paperwork.

Question 11

Hyperkalemia ECG Cue

Accepted Answer

Tall, peaked T waves can signal dangerous hyperkalemia. Hyperkalemia can progress to life-threatening dysrhythmias, so rapid recognition and escalation matter.

Question 12

Hypokalemia Risk

Accepted Answer

Hypokalemia can cause weakness, cramps, ileus, and dysrhythmias. Loop diuretics such as furosemide commonly increase potassium loss.

Question 13

Warfarin Monitoring

Accepted Answer

Warfarin is monitored with INR. CMSRN questions often test whether the nurse connects anticoagulation therapy to bleeding risk, teaching, and lab follow-up.

Question 14

Heparin Monitoring

Accepted Answer

Unfractionated heparin is commonly monitored with aPTT or anti-Xa per protocol. Supratherapeutic values require protocol-driven holding or dose adjustment and bleeding assessment.

Question 15

Digoxin Pulse Check

Accepted Answer

Check the apical pulse for 1 full minute before digoxin. Bradycardia may indicate toxicity risk and usually requires holding the dose and notifying the provider per parameters.

Question 16

Opioid Respiratory Depression

Accepted Answer

Excess opioid effect can cause sedation, slow respirations, and low oxygenation. The nurse must assess respiratory status before giving more opioid and respond promptly to deterioration.

Question 17

Medication Reconciliation

Accepted Answer

Compare home, inpatient, transfer, and discharge medication lists for discrepancies. Accurate reconciliation reduces adverse drug events during care transitions.

Question 18

High-Alert Medications

Accepted Answer

Insulin, anticoagulants, opioids, concentrated electrolytes, and sedatives can cause major harm if misused. Independent double checks and protocols reduce risk.

Question 19

C. difficile Precautions

Accepted Answer

Use contact precautions and soap-and-water hand hygiene for C. difficile because spores resist alcohol-based sanitizer. Environmental cleaning is also critical.

Question 20

Active Tuberculosis Isolation

Accepted Answer

Active pulmonary tuberculosis requires airborne precautions, appropriate respiratory protection, and a negative-pressure room when available. This prevents airborne spread.

Question 21

Central Line Infection Prevention

Accepted Answer

Use aseptic access, scrub the hub, maintain intact dressings, and remove unnecessary lines. Central line infections are high-risk and preventable.

Question 22

Fall Risk Interventions

Accepted Answer

Use bed low and locked, call light within reach, non-skid footwear, alarms if indicated, clutter control, and toileting plans. Match interventions to assessed risk.

Question 23

Bleeding Precautions

Accepted Answer

Use soft toothbrushes, avoid unnecessary invasive procedures, monitor bruising or bleeding, and protect from injury. Low platelets or anticoagulants increase bleeding risk.

Question 24

Pressure Injury Prevention

Accepted Answer

Reposition, offload pressure, manage moisture, optimize nutrition, and inspect skin. Immobility, poor perfusion, incontinence, and malnutrition increase risk.

Question 25

Postoperative Hemorrhage Cue

Accepted Answer

Tachycardia, hypotension, increasing drainage, pallor, dizziness, or restlessness can signal bleeding. Escalate promptly instead of waiting for obvious shock.

Question 26

Postoperative Atelectasis

Accepted Answer

Encourage coughing, deep breathing, incentive spirometry, early mobility, and pain control. Atelectasis impairs gas exchange and can lead to pneumonia.

Question 27

COPD Oxygen Safety

Accepted Answer

Give oxygen as ordered and monitor response. COPD patients may need controlled oxygen targets, but hypoxemia still requires treatment and reassessment.

Question 28

Pulmonary Embolism Cue

Accepted Answer

Sudden dyspnea, pleuritic chest pain, tachycardia, low oxygen saturation, or hemoptysis after immobility suggests PE. This is an urgent escalation scenario.

Question 29

Aspiration Precautions

Accepted Answer

Position upright, assess swallowing risk, follow diet orders, and keep suction available when indicated. Aspiration can cause airway obstruction and pneumonia.

Question 30

GI Bleeding Clues

Accepted Answer

Black tarry stool, bright red blood, coffee-ground emesis, dizziness, tachycardia, or falling hemoglobin can indicate GI bleeding. Assess and escalate promptly.

Question 31

Acute Kidney Injury

Accepted Answer

Watch for decreased urine output, rising creatinine, fluid overload, electrolyte changes, and nephrotoxic medication exposure. Early detection protects renal function.

Question 32

Heart Failure Daily Weights

Accepted Answer

Daily weights are a sensitive indicator of fluid gain or loss. Sudden weight gain can precede worsening edema and dyspnea.

Question 33

Heart Failure Teaching

Accepted Answer

Teach weight monitoring, sodium limits, medication adherence, symptom reporting, and follow-up. Discharge teaching reduces readmissions and supports self-management.

Question 34

Diabetes Hypoglycemia

Accepted Answer

Sweating, shakiness, confusion, tachycardia, and low glucose require prompt treatment. Conscious patients often receive fast-acting carbohydrate per protocol.

Question 35

DKA Priorities

Accepted Answer

Diabetic ketoacidosis requires fluids, insulin, potassium monitoring, and frequent reassessment. Potassium can drop quickly once insulin therapy begins.

Question 36

Delirium vs Dementia

Accepted Answer

Delirium is acute, fluctuating, and often reversible; dementia is usually chronic and progressive. New confusion in a hospitalized patient deserves prompt assessment.

Question 37

Seizure Safety

Accepted Answer

Protect from injury, turn to side if possible, time the event, maintain airway safety, and do not place anything in the mouth. Afterward, assess and document.

Question 38

Neuro Checks

Accepted Answer

Assess level of consciousness, pupils, strength, sensation, speech, and vital signs as ordered. Trends matter more than a single normal finding.

Question 39

Teach-Back Method

Accepted Answer

Ask the patient to explain instructions in their own words. Teach-back verifies understanding and helps tailor education to health literacy needs.

Question 40

Qualified Interpreter

Accepted Answer

Use a qualified medical interpreter for clinical communication when language barriers exist. Family members may distort information and create privacy or accuracy concerns.

Question 41

Cultural Humility

Accepted Answer

Ask about preferences, beliefs, and decision-makers instead of assuming. Culturally responsive care improves trust, adherence, and patient-centered outcomes.

Question 42

Palliative Care

Accepted Answer

Palliative care focuses on symptom relief, goals of care, and quality of life at any stage of serious illness. It is not limited to end-of-life care.

Question 43

SBAR Handoff

Accepted Answer

SBAR means Situation, Background, Assessment, Recommendation. It structures urgent calls and handoffs so critical information is clear and actionable.

Question 44

Discharge Planning

Accepted Answer

Begin early, assess barriers, confirm medications and follow-up, involve the team, and verify patient understanding. Poor transitions increase readmission risk.

Question 45

EHR Downtime

Accepted Answer

Follow downtime policy, document care on approved forms, preserve medication safety checks, and reconcile records when systems return. Downtime does not suspend documentation duties.

Question 46

Chain of Command

Accepted Answer

Use the chain of command when patient safety concerns are not addressed. Professional accountability includes escalating unresolved risk.

Question 47

Incident Report

Accepted Answer

Complete an internal report for unusual events according to policy, but do not chart that an incident report was filed. The health record should contain objective patient facts.

Question 48

Evidence-Based Practice

Accepted Answer

Evidence-based practice combines current evidence, clinical expertise, patient preferences, and context. CMSRN questions may test whether practice is supported by policy and evidence.

Question 49

RN vs UAP Delegation

Accepted Answer

The RN retains assessment, teaching, evaluation, clinical judgment, and unstable patient care. UAP tasks should be routine, predictable, and within role and competency.

Question 50

Assignment Priority

Accepted Answer

Assign stable, predictable patients to less experienced staff and keep unstable or complex patients with qualified nurses. Safe assignment matches acuity, skill, and scope.

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MSNCB CMSRN Medical-Surgical Registered Nurse