Preparing for the CMSRN (Certified Medical-Surgical Registered Nurse) exam? Diagnostics is one of the areas our deck drills hardest: 60 of its 1050 flashcards focus on diagnostics, covering topics like ARF, Lasix. Try the sample questions below — every card is a real question-and-answer pair from the full deck.
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A patient with pneumonia has a PaO2 of 58 mmHg and a PaCO2 of 34 mmHg on room air. How would the nurse classify this type of acute respiratory failure (ARF) based on these ABG results?
Show answer →This is Type I (Hypoxemic) Respiratory Failure. It is defined as a PaO2 < 60 mmHg with a normal or low PaCO2. Pathophysiology involves V/Q mismatch or intrapulmonary shunting (e.g., fluid/pus in alveoli). Type II (Hypercapnic) failure involves PaCO2 > 45 mmHg and pH < 7.35, usually due to ""pump failure"" or alveolar hypoventilation. CMSRN Tip: Focus on the ""oxygenation vs. ventilation"" distinction; Type I is an oxygenation failure, while Type II is a ventilation failure.
Potassium is 7.2 mEq/L. ECG shows a widened QRS complex (0.14s) and disappearing P waves. What is the priority medication to administer FIRST?
Show answer →Calcium gluconate (or Calcium chloride). While calcium does not lower the potassium level, it antagonizes the cardiotoxic effects of hyperkalemia by stabilizing the myocardial cell membrane. This is the priority to prevent V-fib/asystole. Other treatments (Insulin/Dextrose, Kayexalate, Albuterol) work to shift or remove K+ but take longer to protect the heart.
Which neurological assessment finding is the most sensitive early indicator of worsening cerebral edema in a patient with acute hyponatremia (Na+ < 125 mEq/L)?
Show answer →A change in the level of consciousness (LOC) or new-onset confusion/lethargy. As sodium levels drop, water moves into brain cells via osmosis, causing swelling. **Clinical Pearl:** While seizures and coma are more dramatic, they are late signs. MSNCB emphasizes early detection through frequent Glasgow Coma Scale (GCS) monitoring. Any decrease in GCS in a hyponatremic patient requires immediate notification and likely diagnostic re-evaluation of electrolytes.
A patient's potassium remains 3.1 mEq/L despite three rounds of oral replacement. Which additional diagnostic lab should the nurse suggest to the provider?
Show answer →Serum Magnesium level. Hypomagnesemia promotes renal potassium wasting by increasing secretion in the loop of Henle and collecting ducts (via ROMK channels). Rational: Potassium levels are difficult to correct if magnesium is low. This is a common exam ""trap"" where the candidate focuses only on the potassium. MSNCB Priority: Always evaluate magnesium in patients with refractory hypokalemia or hypocalcemia.
A patient on high-dose Furosemide (Lasix) develops metabolic alkalosis. Which two primary mechanisms contribute to this ""contraction alkalosis""?
Show answer →1. Volume depletion (contraction) leads to RAAS activation, which increases proximal tubule HCO3 reabsorption. 2. Increased distal delivery of Na+ leads to increased H+ and K+ secretion into the urine (aciduria). MSNCB Tip: Loop and thiazide diuretics are common culprits. Watch for the ""triple threat"" of hypovolemia, hypokalemia, and metabolic alkalosis in heart failure patients. This is often corrected by adding a potassium-sparing diuretic or reducing the loop diuretic dose.
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Try 30 free CMSRN cards firstThe full CMSRN deck contains 1050 flashcards, and 60 of them focus on diagnostics. This page shows 5 free samples.
Our CMSRN deck dedicates 60 of 1050 cards (6%) to diagnostics — always cross-check the official MSNCB exam outline for the current blueprint weighting.
Yes — the samples on this page are free, and the CMSRN preview page has 30 more free cards. Full access to all 1050 cards is a one-time $7.
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