CMSRN Practice Exam Questions and Answers

Preparing for the CMSRN Certification Exam requires more than memorizing facts. Medical-surgical nurses must understand complex patient conditions, clinical priorities, and evidence-based interventions across multiple care settings. This comprehensive CMSRN Practice Exam collection is designed to simulate real exam difficulty while strengthening critical thinking and clinical judgment.

Inside this professionally written set, you’ll find 600 high-quality multiple-choice questions with clear explanations that reflect current standards of med-surg nursing practice. Each question mirrors the style and depth found on the official certification test, helping you build confidence and accuracy before exam day. Whether you are preparing for your first attempt or refreshing your knowledge, this complete resource delivers structured CMSRN Exam Prep that supports consistent improvement and measurable progress.

Unlike generic study materials, these practice questions are written in a realistic, exam-focused tone and organized to reinforce key concepts repeatedly tested on the certification. With regular use, you will develop stronger clinical reasoning, improve time management, and walk into the exam fully prepared to succeed.

Who Can Take This CMSRN Practice Exam?

This comprehensive question bank is ideal for:

• Registered nurses preparing for the CMSRN Certification Exam
• Medical-surgical nurses seeking specialty certification
• Nursing professionals returning to bedside practice
• Travel nurses needing quick clinical review
• Nursing educators and students reviewing med-surg concepts

Whether you work in acute care, step-down units, or outpatient settings, this practice set helps reinforce the knowledge required to deliver safe and effective patient care. It is especially helpful for nurses who want a structured and realistic way to prepare using proven exam-style questions.

What Is CMSRN Certification?

The Certified Medical-Surgical Registered Nurse credential is a nationally recognized certification that validates expertise in adult medical-surgical nursing. Offered through the Academy of Medical-Surgical Nurses (AMSN), this credential demonstrates advanced clinical knowledge, patient care competency, and commitment to professional excellence.

Earning this certification enhances career opportunities, professional credibility, and confidence at the bedside. Many hospitals prefer or require certified nurses for leadership roles, specialty units, and career advancement pathways.

How Hard Is the CMSRN Exam?

The certification exam is known for its depth and application-based questions. Rather than testing simple recall, it evaluates clinical judgment, prioritization, and patient safety decision-making.

Candidates must demonstrate knowledge across multiple systems including cardiovascular, respiratory, neurological, renal, endocrine, and gastrointestinal care. Questions often include real-world scenarios requiring analysis and prioritization.

Most nurses find the exam challenging because it requires understanding of both theory and bedside practice. However, consistent review with realistic CMSRN Exam Practice Questions significantly increases first-attempt pass rates.

What You Will Learn from This CMSRN Practice Exam

This complete set of 600 questions is designed to strengthen both foundational knowledge and advanced clinical reasoning. By working through the questions and detailed explanations, you will learn how to:

• Recognize priority patient situations
• Interpret laboratory values and diagnostic findings
• Apply safe medication administration principles
• Identify early signs of complications
• Make accurate nursing judgments under pressure
• Strengthen test-taking strategies

Each explanation reinforces key nursing concepts so you understand not only the correct answer, but why it is correct and how it applies in real clinical settings.

Topic Coverage in This CMSRN Practice Exam Questions

This resource covers all major areas tested on the certification exam. The question bank reflects real clinical situations across multiple specialties and patient populations.

Key topic areas include:

• Cardiovascular disorders and emergency response
• Respiratory conditions and oxygenation management
• Neurological assessment and stroke care
• Renal and electrolyte imbalances
• Endocrine disorders including diabetes management
• Gastrointestinal and hepatic conditions
• Infection control and sepsis recognition
• Medication safety and pharmacology
• Fluid and electrolyte balance
• Patient safety and prioritization

These topics align with current medical-surgical nursing standards and mirror the structure of the official certification exam blueprint.

Why This CMSRN Practice Exam Is Different

Many review materials provide only basic questions with limited explanations. This practice resource goes much deeper by focusing on clinical reasoning and real-world scenarios.

What sets this resource apart:

• 600 carefully structured questions with detailed rationales
• Realistic exam difficulty and format
• Clear explanations for every answer
• Coverage of high-yield nursing concepts
• Focus on patient safety and prioritization
• Designed for both learning and final review

Each question is written to simulate real exam pressure and help you build confidence before test day. The explanations reinforce clinical thinking rather than simple memorization.

How to Study for the CMSRN Using This Practice Test

To get the best results from this practice resource, follow a structured study approach. Begin by taking small sets of questions daily and reviewing explanations carefully. Focus on understanding clinical reasoning behind each answer.

Use the questions to identify weak areas and revisit those topics using textbooks or clinical notes. Create a study schedule that includes consistent review sessions and timed practice exams.

Combining repetition with understanding is the key to success. Over time, you will notice improved accuracy, faster decision-making, and stronger confidence in answering complex clinical questions.

How to Pass the CMSRN Certification Exam (Practical Tips)

Passing the certification exam requires a combination of knowledge, strategy, and consistent preparation. Consider these proven tips:

• Study in short, focused sessions rather than long cramming periods
• Practice answering questions under timed conditions
• Review explanations thoroughly, even for correct answers
• Focus on priority nursing interventions and patient safety
• Strengthen weak areas with targeted review
• Stay consistent with daily practice

Using high-quality CMSRN Certification Practice Questions regularly will help reinforce concepts and improve recall during the exam.

Sample Questions and Answers

1.

A nurse is caring for a patient with heart failure who reports sudden weight gain of 3 lb in 24 hours. What is the nurse’s priority action?

A. Encourage ambulation
B. Notify the provider
C. Increase fluid intake
D. Document and reassess in 48 hours

Correct Answer: B

Explanation:
A sudden weight gain of 3 pounds within 24 hours in a patient with heart failure is a strong indicator of fluid retention and worsening cardiac function. This may signal impending decompensation, pulmonary edema, or acute exacerbation of heart failure. Early intervention is critical to prevent respiratory compromise and hospitalization. The nurse should notify the provider promptly so that medications such as diuretics can be adjusted. Encouraging fluids would worsen fluid overload, and waiting to reassess could delay life-saving treatment. Prompt reporting helps reduce complications and supports optimal patient outcomes.

2.

Which laboratory value requires immediate intervention in a patient receiving potassium supplements?

A. Potassium 3.8 mEq/L
B. Potassium 5.8 mEq/L
C. Sodium 138 mEq/L
D. Calcium 9.2 mg/dL

Correct Answer: B

Explanation:
A potassium level of 5.8 mEq/L indicates hyperkalemia, which can lead to life-threatening cardiac dysrhythmias. Patients receiving potassium supplements are at risk for excessive potassium accumulation, particularly if kidney function is impaired. Elevated potassium levels may cause ECG changes such as peaked T waves, widened QRS complexes, and ventricular arrhythmias. Immediate intervention includes holding potassium, notifying the provider, and preparing for treatments such as insulin with glucose, calcium gluconate, or dialysis if severe. Normal potassium ranges between 3.5 and 5.0 mEq/L, making this value critical and requiring urgent action.

3.

A postoperative patient has a respiratory rate of 8 breaths/min after receiving morphine. What is the nurse’s first action?

A. Stimulate the patient and encourage deep breathing
B. Administer naloxone
C. Document findings
D. Place patient in supine position

Correct Answer: A

Explanation:
A respiratory rate of 8 breaths per minute indicates respiratory depression, a known adverse effect of opioid medications like morphine. The nurse’s first action should be to stimulate the patient, encourage deep breathing, and assess responsiveness. This may improve respiratory effort without immediate pharmacologic reversal. If stimulation fails and the patient remains unresponsive or hypoventilating, naloxone should be administered. Immediate reversal without assessment may cause severe pain or withdrawal symptoms. Proper positioning and documentation are important but secondary to ensuring adequate airway and breathing.

4.

Which patient is at highest risk for developing a pressure injury?

A. Ambulatory patient with diabetes
B. Patient with urinary tract infection
C. Bedridden patient with poor nutrition
D. Patient with controlled hypertension

Correct Answer: C

Explanation:
A bedridden patient with poor nutrition is at the highest risk for pressure injuries due to prolonged immobility and decreased tissue tolerance. Immobility reduces blood flow to pressure points, while inadequate protein and caloric intake impair tissue repair and skin integrity. Malnutrition weakens the skin and delays healing, increasing susceptibility to breakdown. Frequent repositioning, pressure-relieving devices, and nutritional support are essential preventive strategies. Although diabetes can increase risk, immobility combined with malnutrition creates the most significant and immediate threat to skin integrity.

5.

A patient with COPD is receiving oxygen therapy. Which finding requires immediate intervention?

A. Oxygen saturation 90%
B. Respiratory rate 18/min
C. Increasing drowsiness
D. Productive cough

Correct Answer: C

Explanation:
Increasing drowsiness in a COPD patient receiving oxygen therapy may indicate carbon dioxide retention and impending respiratory failure. Patients with chronic hypercapnia rely on hypoxic drive to breathe. Excess oxygen can suppress this drive, leading to hypoventilation and CO₂ narcosis. Signs include confusion, lethargy, and decreased responsiveness. The nurse should assess oxygen flow rate, check ABGs, and notify the provider immediately. An oxygen saturation of 90% may be acceptable in COPD patients, but mental status changes are a critical sign requiring urgent evaluation and intervention.

6.

Which intervention is most effective in preventing falls in hospitalized older adults?

A. Keeping all side rails up
B. Applying restraints
C. Performing hourly rounding
D. Limiting ambulation

Correct Answer: C

Explanation:
Hourly rounding is one of the most effective fall-prevention strategies in hospitalized older adults. Regular checks allow nurses to address toileting needs, pain, repositioning, and environmental hazards before patients attempt to get out of bed unassisted. Keeping all side rails up may increase injury risk if patients try to climb over them. Restraints are not recommended except in extreme circumstances due to safety and ethical concerns. Limiting ambulation can lead to deconditioning and does not prevent falls. Proactive rounding promotes safety, comfort, and early intervention.

7.

A patient with diabetes reports shaking and sweating. Blood glucose is 52 mg/dL. What should the nurse do first?

A. Administer insulin
B. Give 15 g of fast-acting carbohydrate
C. Call the provider
D. Start IV fluids

Correct Answer: B

Explanation:
A blood glucose level of 52 mg/dL indicates hypoglycemia, which requires immediate treatment. The priority intervention is to administer 15 grams of fast-acting carbohydrate, such as glucose tablets or juice, if the patient is conscious and able to swallow. This follows the “15-15 rule,” which recommends rechecking blood glucose after 15 minutes and repeating treatment if needed. Administering insulin would worsen hypoglycemia, and calling the provider should occur after initial treatment. Prompt correction prevents seizures, loss of consciousness, and other serious complications.

8.

Which assessment finding suggests deep vein thrombosis?

A. Bilateral leg swelling
B. Cool, pale extremity
C. Unilateral calf warmth and pain
D. Weak pedal pulses

Correct Answer: C

Explanation:
Unilateral calf warmth, redness, swelling, and pain are classic signs of deep vein thrombosis (DVT). DVT occurs when a blood clot forms in a deep vein, most commonly in the lower extremities. Early recognition is critical to prevent pulmonary embolism, a potentially fatal complication. Bilateral swelling is more often associated with systemic conditions such as heart failure. Cool, pale extremities suggest arterial insufficiency rather than venous clotting. Weak pulses may indicate peripheral arterial disease. Prompt reporting and diagnostic testing such as ultrasound are essential.

9.

Which electrolyte imbalance is most associated with cardiac dysrhythmias?

A. Hypokalemia
B. Hypernatremia
C. Hypercalcemia
D. Hypomagnesemia

Correct Answer: A

Explanation:
Hypokalemia significantly increases the risk of cardiac dysrhythmias because potassium plays a key role in cardiac electrical conduction and muscle contraction. Low potassium levels can lead to ECG changes such as flattened T waves, U waves, and ventricular arrhythmias. Patients receiving diuretics or experiencing vomiting or diarrhea are particularly at risk. Although other electrolyte imbalances can affect cardiac function, potassium abnormalities have the most direct and immediate impact on cardiac rhythm. Continuous monitoring and timely replacement are essential for patient safety.

10.

A patient with sepsis has a blood pressure of 82/50 mmHg. What is the priority nursing intervention?

A. Administer antibiotics
B. Increase IV fluids
C. Provide oral fluids
D. Reassess in 1 hour

Correct Answer: B

Explanation:
Hypotension in sepsis indicates possible septic shock and poor tissue perfusion. The priority intervention is rapid administration of IV fluids to restore circulating volume and improve blood pressure. Early aggressive fluid resuscitation is a key component of sepsis management and can prevent organ failure. While antibiotics are essential, they should be administered after initial stabilization if hypotension is severe. Oral fluids are inadequate for shock management. Waiting to reassess delays life-saving treatment. Prompt fluid resuscitation improves survival and supports hemodynamic stability.

11.

A patient receiving heparin develops bleeding gums. What is the nurse’s priority action?

A. Stop heparin infusion
B. Document findings
C. Increase dose
D. Give aspirin

Correct Answer: A

Explanation:
Bleeding gums indicate possible excessive anticoagulation from heparin therapy. The nurse should immediately stop the heparin infusion and notify the provider. Heparin increases bleeding risk, and early recognition of adverse effects prevents severe hemorrhage. Laboratory values such as aPTT should be reviewed, and protamine sulfate may be administered as an antidote if needed. Continuing the infusion or adding aspirin would increase bleeding risk. Prompt intervention ensures patient safety and allows for appropriate dose adjustment or reversal therapy.

12.

Which patient should the nurse assess first?

A. Patient with fever 100.4°F
B. Patient with chest pain and diaphoresis
C. Patient requesting pain medication
D. Patient awaiting discharge

Correct Answer: B

Explanation:
Chest pain accompanied by diaphoresis suggests possible acute coronary syndrome or myocardial infarction, which is a life-threatening emergency. This patient requires immediate assessment, ECG monitoring, and rapid intervention to restore perfusion and prevent cardiac damage. A mild fever, pain request, or discharge preparation can be addressed after ensuring the unstable patient is safe. Prioritization follows the ABCs (airway, breathing, circulation) and potential for rapid deterioration. Early intervention in cardiac events significantly improves survival and outcomes.

13.

Which sign indicates fluid volume overload?

A. Hypotension
B. Crackles in lungs
C. Dry mucous membranes
D. Decreased urine output

Correct Answer: B

Explanation:
Crackles heard during lung auscultation indicate fluid accumulation in the alveoli, a hallmark sign of fluid volume overload. This may occur in conditions such as heart failure, renal impairment, or excessive IV fluid administration. Other signs include edema, weight gain, and shortness of breath. Hypotension and dry mucous membranes are more consistent with dehydration. While decreased urine output may occur in overload due to kidney dysfunction, crackles provide a more direct sign of excess fluid affecting respiratory status and requiring prompt management.

14.

A nurse is teaching a patient about warfarin therapy. Which statement indicates understanding?

A. “I will eat more leafy greens.”
B. “I will use a soft toothbrush.”
C. “I can skip INR tests.”
D. “I will take aspirin daily.”

Correct Answer: B

Explanation:
Warfarin increases bleeding risk by inhibiting vitamin K–dependent clotting factors. Using a soft toothbrush helps prevent gum bleeding and injury, demonstrating correct understanding of bleeding precautions. Increasing leafy greens may interfere with warfarin effectiveness due to high vitamin K content. Regular INR monitoring is essential to ensure therapeutic anticoagulation. Aspirin should not be taken unless prescribed because it further increases bleeding risk. Proper patient education helps prevent complications and supports safe anticoagulation therapy.

15.

Which action helps prevent catheter-associated urinary tract infections?

A. Disconnect catheter daily
B. Keep drainage bag below bladder
C. Irrigate routinely
D. Clamp tubing frequently

Correct Answer: B

Explanation:
Keeping the drainage bag below bladder level prevents backflow of urine into the bladder, reducing infection risk. A closed sterile system should be maintained, and unnecessary disconnections avoided. Routine irrigation is not recommended unless specifically ordered, as it increases infection risk. Clamping tubing can cause urine stasis and bacterial growth. Proper catheter care, hand hygiene, and timely removal are essential evidence-based strategies for preventing catheter-associated urinary tract infections and improving patient safety.

16.

Which symptom suggests hypocalcemia?

A. Constipation
B. Muscle twitching
C. Bradycardia
D. Hypertension

Correct Answer: B

Explanation:
Muscle twitching and neuromuscular irritability are hallmark signs of hypocalcemia. Calcium plays a key role in nerve conduction and muscle contraction. When calcium levels drop, nerves become more excitable, leading to symptoms such as tetany, tingling, and positive Chvostek’s or Trousseau’s signs. Severe hypocalcemia can result in seizures or cardiac arrhythmias. Constipation and bradycardia are more often seen with hypercalcemia. Early identification and calcium replacement prevent serious complications and stabilize neuromuscular function.

17.

A patient has sudden shortness of breath after surgery. What is the priority concern?

A. Pneumonia
B. Pulmonary embolism
C. Atelectasis
D. Bronchitis

Correct Answer: B

Explanation:
Sudden shortness of breath in a postoperative patient raises immediate concern for pulmonary embolism (PE). Surgery and immobility increase clot formation risk, and a clot traveling to the lungs can obstruct blood flow, causing hypoxia and respiratory distress. Symptoms include chest pain, tachycardia, and anxiety. PE is life-threatening and requires rapid assessment, oxygen, and emergency treatment. Pneumonia and bronchitis develop more gradually. Atelectasis is common but usually less sudden and severe. Immediate recognition improves survival.

18.

Which patient is priority for isolation precautions?

A. Patient with influenza
B. Patient with hypertension
C. Patient with fracture
D. Patient with anemia

Correct Answer: A

Explanation:
Influenza is a contagious respiratory illness requiring droplet precautions to prevent transmission. Patients should be placed in a private room when possible, and healthcare workers should use masks and follow hand hygiene protocols. Hypertension, fractures, and anemia are not infectious conditions requiring isolation. Implementing proper isolation precautions protects staff, visitors, and other patients from infection spread and supports infection control standards within healthcare facilities.

19.

Which finding indicates worsening kidney function?

A. Creatinine 2.5 mg/dL
B. Urine output 40 mL/hr
C. BP 120/80 mmHg
D. Sodium 140 mEq/L

Correct Answer: A

Explanation:
A creatinine level of 2.5 mg/dL indicates impaired kidney function, as normal values are typically around 0.6–1.3 mg/dL. Elevated creatinine suggests decreased glomerular filtration rate and accumulation of waste products. Monitoring kidney function is essential in medical-surgical patients, especially those receiving nephrotoxic medications. Urine output of 40 mL/hr is acceptable. Normal blood pressure and sodium levels do not indicate kidney failure. Rising creatinine requires prompt evaluation and intervention to prevent further renal damage.

20.

Best position for patient with dyspnea?

A. Supine
B. Fowler’s
C. Trendelenburg
D. Prone

Correct Answer: B

Explanation:
Fowler’s position (semi-upright) promotes lung expansion and reduces pressure on the diaphragm, making breathing easier for patients experiencing dyspnea. This position improves oxygenation and comfort by allowing better chest wall movement and air exchange. Supine positioning can worsen shortness of breath by compressing lungs. Trendelenburg is not appropriate for respiratory distress. Prone positioning may be used in specific critical care situations but is not first-line for general dyspnea. Proper positioning is a simple yet effective nursing intervention.

21.

A patient with pneumonia has oxygen saturation of 88% on room air. What is the nurse’s first action?

A. Document the finding
B. Apply supplemental oxygen
C. Notify respiratory therapy
D. Encourage fluid intake

Correct Answer: B

Explanation:
An oxygen saturation of 88% indicates hypoxemia and inadequate oxygenation. The nurse’s priority is to ensure adequate oxygen delivery to tissues by applying supplemental oxygen immediately. Early oxygen therapy prevents complications such as respiratory failure and organ dysfunction. While notifying respiratory therapy may be appropriate later, immediate nursing intervention is essential. Documentation alone does not address the patient’s condition, and fluids will not correct hypoxia. Prompt oxygen administration improves gas exchange, stabilizes the patient, and supports recovery from pneumonia.

22.

Which patient requires the most urgent assessment?

A. Postoperative patient with pain score of 7
B. Patient with blood glucose 250 mg/dL
C. Patient with new onset confusion
D. Patient awaiting medication

Correct Answer: C

Explanation:
New onset confusion may indicate hypoxia, infection, stroke, electrolyte imbalance, or medication effects. Acute changes in mental status are often early indicators of serious deterioration, especially in older adults. Immediate assessment is essential to determine the underlying cause and initiate treatment. Pain and elevated glucose require attention but are not as immediately life-threatening. A patient waiting for medication is stable. Recognizing neurological changes early allows timely intervention and may prevent permanent damage or worsening condition.

23.

A nurse is caring for a patient with NG tube feeding. Which action prevents aspiration?

A. Place patient flat
B. Verify tube placement
C. Increase feeding rate
D. Flush with cold water

Correct Answer: B

Explanation:
Verifying nasogastric tube placement before feeding is essential to prevent aspiration. Incorrect tube placement can result in feeding entering the lungs rather than the stomach, leading to aspiration pneumonia and respiratory distress. Nurses should confirm placement using approved methods such as pH testing and external tube length assessment per facility policy. Keeping the head of bed elevated also reduces aspiration risk. Placing the patient flat or increasing feeding rate increases aspiration risk. Safe tube feeding practices are critical for patient safety.

24.

Which sign suggests internal bleeding after surgery?

A. Increased appetite
B. Tachycardia and hypotension
C. Warm dry skin
D. Elevated urine output

Correct Answer: B

Explanation:
Tachycardia and hypotension are classic signs of internal bleeding and possible hypovolemic shock. When blood volume decreases, the body compensates by increasing heart rate to maintain cardiac output. Blood pressure drops as circulating volume declines. Additional signs may include pallor, restlessness, and decreased urine output. Increased appetite and warm skin are not typical indicators of bleeding. Early recognition of hemorrhage allows rapid intervention such as fluid resuscitation, blood transfusion, and surgical evaluation to prevent life-threatening complications.

25.

A patient with asthma is wheezing and using accessory muscles. What is the priority action?

A. Administer bronchodilator
B. Encourage fluids
C. Obtain weight
D. Provide education

Correct Answer: A

Explanation:
Wheezing and accessory muscle use indicate respiratory distress and bronchospasm in asthma. The priority is to administer a prescribed bronchodilator, such as albuterol, to open airways and improve ventilation. Rapid relief of bronchospasm prevents respiratory failure and improves oxygenation. Encouraging fluids and education are important but not immediate priorities. Assessing weight does not address the acute issue. Prompt bronchodilator therapy stabilizes the patient and reduces risk of severe asthma exacerbation or status asthmaticus.

26.

Which intervention is most important for preventing hospital-acquired infections?

A. Wearing gloves always
B. Hand hygiene
C. Double masking
D. Limiting visitors

Correct Answer: B

Explanation:
Hand hygiene is the single most effective measure to prevent hospital-acquired infections. Proper handwashing or use of alcohol-based sanitizers removes pathogens and reduces transmission between patients and healthcare providers. Gloves are important but do not replace hand hygiene. Double masking and limiting visitors may help in certain situations but are not universally effective. Consistent adherence to hand hygiene protocols significantly reduces infection rates, improves patient outcomes, and supports overall infection control within healthcare settings.

27.

A patient receiving blood transfusion develops fever and chills. What should the nurse do first?

A. Slow infusion
B. Stop transfusion
C. Give acetaminophen
D. Document reaction

Correct Answer: B

Explanation:
Fever and chills during a blood transfusion may indicate a transfusion reaction. The nurse’s first action is to stop the transfusion immediately to prevent further exposure to the suspected incompatible blood product. After stopping the transfusion, the nurse should maintain IV access with normal saline, assess the patient, and notify the provider and blood bank. Slowing the infusion or giving medication without stopping it can worsen the reaction. Prompt intervention prevents severe complications such as hemolysis or shock.

28.

Which diet is appropriate for a patient with hypertension?

A. High sodium
B. DASH diet
C. High fat
D. Keto diet

Correct Answer: B

Explanation:
The DASH (Dietary Approaches to Stop Hypertension) diet is recommended for patients with hypertension. It emphasizes fruits, vegetables, whole grains, lean proteins, and low-fat dairy while limiting sodium, saturated fats, and processed foods. This diet helps lower blood pressure, reduce cardiovascular risk, and improve overall health. High sodium and high-fat diets worsen hypertension and cardiovascular disease. The keto diet may not be appropriate for all patients with hypertension. Educating patients about heart-healthy nutrition supports long-term blood pressure control.

29.

Which symptom indicates hyperglycemia?

A. Sweating
B. Tremors
C. Frequent urination
D. Confusion

Correct Answer: C

Explanation:
Frequent urination (polyuria) is a hallmark symptom of hyperglycemia. Elevated blood glucose levels cause osmotic diuresis, leading to increased urine output and dehydration. Other symptoms include increased thirst, blurred vision, and fatigue. Sweating and tremors are more commonly associated with hypoglycemia. Confusion may occur in severe cases of either hypo- or hyperglycemia but is less specific. Recognizing hyperglycemia early allows prompt intervention with insulin, fluids, and monitoring to prevent complications such as diabetic ketoacidosis.

30.

A nurse is preparing to discharge a patient with heart failure. Which instruction is most important?

A. Increase salt intake
B. Weigh daily
C. Stop medications when feeling better
D. Limit sleep

Correct Answer: B

Explanation:
Daily weight monitoring is one of the most important self-management strategies for patients with heart failure. Sudden weight gain often indicates fluid retention and worsening cardiac function before symptoms such as shortness of breath appear. Patients should report weight gain of more than 2–3 pounds in a day or 5 pounds in a week. Increasing salt intake can worsen fluid retention, and medications should never be stopped without provider guidance. Education on daily weights empowers patients to detect early signs of decompensation and seek timely care.