Canadian Medical Surgical Nursing Examination

Canadian Medical-Surgical Nursing (CMSN)Examination

The Canadian Medical-Surgical Nursing Examination is a crucial assessment tool designed to evaluate the clinical competence, decision-making ability, and foundational knowledge of nurses practicing in acute and long-term care settings across Canada. This exam is commonly taken by nurses pursuing specialty certification or professional advancement within medical-surgical nursing roles.

Purpose and Importance

This CMSN Prep helps ensure that nurses meet national standards for delivering safe, effective, and patient-centered care. It measures their ability to assess patients, formulate nursing diagnoses, implement care plans, and evaluate outcomes in various medical and surgical contexts. Success in this exam reflects a nurse’s readiness to manage complex health conditions and respond to rapidly changing clinical situations.

Content Areas Covered

The examination covers a wide range of topics, including cardiovascular, respiratory, gastrointestinal, neurological, musculoskeletal, renal, endocrine, and immune system disorders. It also tests knowledge in pharmacology, perioperative care, wound management, fluid and electrolyte balance, infection control, and patient education.

Who Should Take

The exam is ideal for registered nurses seeking to validate their expertise in medical-surgical nursing and advance their careers in hospital or community health settings.Visit for More Nursing Examinations: Nursing Examination .”

Sample Questions and Answers For CMSN Test

Which of the following is the most common cause of chronic kidney disease in Canada?

A) Diabetes mellitus
B) Hypertension
C) Glomerulonephritis
D) Polycystic kidney disease

Answer: B) Hypertension
Explanation: Chronic kidney disease (CKD) is commonly caused by hypertension and diabetes. Among these, hypertension is the most prevalent cause in Canada, leading to damage to the renal blood vessels and gradual loss of kidney function.

A patient with chronic obstructive pulmonary disease (COPD) is at risk for which of the following complications?

A) Pneumonia
B) Asthma
C) Pulmonary embolism
D) Respiratory alkalosis

Answer: A) Pneumonia
Explanation: Patients with COPD are at a higher risk for respiratory infections, including pneumonia, due to their compromised lung function and impaired mucociliary clearance.

Which of the following is a key symptom of heart failure in a patient with reduced ejection fraction (HFrEF)?

A) Shortness of breath
B) Chest pain
C) Abdominal pain
D) Blurred vision

Answer: A) Shortness of breath
Explanation: Shortness of breath (dyspnea) is a hallmark symptom of heart failure with reduced ejection fraction (HFrEF), as the heart is unable to pump blood effectively, leading to fluid accumulation in the lungs.

Which of the following medications is used to treat hyperthyroidism?

A) Levothyroxine
B) Methimazole
C) Prednisone
D) Metformin

Answer: B) Methimazole
Explanation: Methimazole is an antithyroid medication used to reduce the production of thyroid hormones in patients with hyperthyroidism. Levothyroxine is used to treat hypothyroidism.

Which electrolyte imbalance is most commonly seen in patients with chronic renal failure?

A) Hypokalemia
B) Hyperkalemia
C) Hyponatremia
D) Hypocalcemia

Answer: B) Hyperkalemia
Explanation: In chronic renal failure, the kidneys are unable to excrete potassium effectively, leading to an elevated potassium level (hyperkalemia), which can be life-threatening.

A patient undergoing chemotherapy is at risk for which of the following complications?

A) Anemia
B) Dehydration
C) Hypertension
D) Hypoglycemia

Answer: A) Anemia
Explanation: Chemotherapy often affects the bone marrow, leading to decreased production of red blood cells, resulting in anemia. Anemia can cause fatigue, weakness, and decreased oxygen delivery to tissues.

Which of the following is a characteristic feature of Type 1 diabetes mellitus?

A) Insulin resistance
B) Autoimmune destruction of beta cells
C) Obesity
D) Increased insulin production

Answer: B) Autoimmune destruction of beta cells
Explanation: Type 1 diabetes is an autoimmune condition where the body’s immune system attacks and destroys the insulin-producing beta cells in the pancreas, leading to insulin deficiency.

Which of the following interventions should the nurse implement for a patient with acute pancreatitis?

A) Administer a high-protein diet
B) Maintain NPO (nothing by mouth) status
C) Encourage fluid intake
D) Encourage ambulation

Answer: B) Maintain NPO status
Explanation: In acute pancreatitis, the pancreas must rest. Therefore, patients are kept NPO to prevent stimulating pancreatic enzymes, which can worsen inflammation.

Which assessment finding would be most concerning in a patient who has undergone a total hip replacement (THR)?

A) Clear urine output
B) Pain at the surgical site
C) Shortness of breath and chest pain
D) Slight swelling at the incision site

Answer: C) Shortness of breath and chest pain
Explanation: Shortness of breath and chest pain may indicate a pulmonary embolism (PE), a serious complication of THR due to the risk of deep vein thrombosis (DVT) leading to embolism.

What is the most effective way to prevent deep vein thrombosis (DVT) in post-operative patients?

A) Use of a continuous passive motion machine
B) Frequent position changes and leg exercises
C) Administration of high-dose aspirin
D) Insertion of a central venous catheter

Answer: B) Frequent position changes and leg exercises
Explanation: Frequent position changes, leg exercises, and early ambulation are critical for reducing the risk of DVT in post-operative patients.

A patient with peptic ulcer disease (PUD) is prescribed proton pump inhibitors (PPIs). The nurse should educate the patient on the importance of:

A) Avoiding spicy foods
B) Taking the medication with food
C) Avoiding alcohol and tobacco use
D) Eating large meals throughout the day

Answer: C) Avoiding alcohol and tobacco use
Explanation: Alcohol and tobacco use exacerbate the symptoms of PUD and impair healing. PPIs help reduce gastric acid production, aiding in the healing of the ulcer.

Which of the following signs would be expected in a patient with a ruptured appendix?

A) Severe right lower quadrant pain
B) Tenderness in the left upper quadrant
C) Sudden relief of pain after vomiting
D) Severe epigastric pain radiating to the back

Answer: A) Severe right lower quadrant pain
Explanation: A ruptured appendix typically causes severe pain in the right lower quadrant (McBurney’s point), along with fever, nausea, and vomiting.

Which of the following is the primary cause of a myocardial infarction (MI)?

A) Dehydration
B) Thrombus formation in a coronary artery
C) Arrhythmia
D) Hypertension

Answer: B) Thrombus formation in a coronary artery
Explanation: A myocardial infarction occurs when a thrombus (blood clot) blocks a coronary artery, leading to reduced oxygen supply to the heart muscle and tissue death.

Which of the following is the most common cause of cerebrovascular accidents (CVAs) in Canada?

A) Hypertension
B) Atherosclerosis
C) Diabetes mellitus
D) Smoking

Answer: B) Atherosclerosis
Explanation: Atherosclerosis, a buildup of plaque in the arteries, is a major cause of stroke by obstructing blood flow to the brain.

What is the priority nursing intervention for a patient with a stroke who is experiencing dysphagia?

A) Initiating a feeding tube
B) Providing oral care every hour
C) Consulting a speech-language pathologist
D) Offering thin liquids

Answer: C) Consulting a speech-language pathologist
Explanation: Dysphagia (difficulty swallowing) is common in stroke patients. A speech-language pathologist is essential to assess swallowing function and recommend appropriate interventions.

In a patient with cirrhosis, which of the following is a common complication?

A) Hyperglycemia
B) Portal hypertension
C) Hypokalemia
D) Hyperthyroidism

Answer: B) Portal hypertension
Explanation: Cirrhosis can lead to portal hypertension, where increased pressure in the portal venous system occurs due to liver damage, potentially causing variceal bleeding.

Which of the following is a primary goal of treatment in managing patients with hypertension?

A) Increase fluid intake
B) Lower blood pressure to normal range
C) Increase sodium intake
D) Promote weight gain

Answer: B) Lower blood pressure to normal range
Explanation: The primary goal in hypertension management is to reduce blood pressure to prevent complications like stroke, heart attack, and kidney failure.

What is the most common side effect of opioid medications?

A) Nausea and vomiting
B) Tachycardia
C) Insomnia
D) Diarrhea

Answer: A) Nausea and vomiting
Explanation: Opioid medications often cause nausea and vomiting as a side effect due to their effects on the gastrointestinal system and central nervous system.

A patient is receiving IV fluids post-operatively. Which of the following would indicate a complication related to IV therapy?

A) Mild redness around the insertion site
B) A temperature of 37.5°C (99.5°F)
C) Swelling and tenderness around the IV site
D) Clear, colorless IV fluid

Answer: C) Swelling and tenderness around the IV site
Explanation: Swelling and tenderness around the IV site may indicate infiltration, phlebitis, or infection, requiring immediate attention.

Which of the following is the first-line treatment for type 2 diabetes mellitus?

A) Insulin therapy
B) Oral hypoglycemic agents
C) Corticosteroids
D) Weight loss surgery

Answer: B) Oral hypoglycemic agents
Explanation: Oral medications, such as metformin, are the first-line treatment for type 2 diabetes, as they help control blood sugar levels.

A nurse is caring for a patient with a large wound that is healing by secondary intention. Which of the following describes the wound healing process?

A) The wound edges are approximated.
B) Granulation tissue fills the wound bed.
C) A scar forms over the wound within days.
D) The wound heals without scarring.

Answer: B) Granulation tissue fills the wound bed.
Explanation: Wounds healing by secondary intention are typically large, irregular, and heal with the formation of granulation tissue, which eventually leads to scar tissue formation.

Which of the following should be included in a discharge plan for a patient undergoing a left mastectomy?

A) Encourage the patient to avoid physical activity
B) Teach the patient to monitor for signs of lymphedema
C) Instruct the patient to avoid sunlight exposure
D) Recommend a high-protein diet for the first week

Answer: B) Teach the patient to monitor for signs of lymphedema
Explanation: Patients who undergo mastectomy are at risk for lymphedema, so educating them on signs and prevention is important in the discharge planning process.

Which of the following is a common side effect of corticosteroid therapy?

A) Weight loss
B) Hypertension
C) Hypoglycemia
D) Insomnia

Answer: B) Hypertension
Explanation: Corticosteroids can cause fluid retention, leading to an increase in blood pressure and a risk for hypertension.

A nurse is caring for a patient receiving warfarin therapy. Which of the following laboratory tests is used to monitor the effectiveness of the medication?

A) Prothrombin time (PT)
B) Complete blood count (CBC)
C) Platelet count
D) International normalized ratio (INR)

Answer: D) International normalized ratio (INR)
Explanation: The INR is used to monitor the effectiveness of warfarin, as it standardizes prothrombin time across different laboratories.

What is the most appropriate nursing intervention for a patient experiencing an acute asthma attack?

A) Administer oxygen and bronchodilators
B) Offer a warm drink to help soothe the throat
C) Encourage the patient to rest in a supine position
D) Provide fluids to hydrate the patient

Answer: A) Administer oxygen and bronchodilators
Explanation: During an acute asthma attack, administering oxygen and bronchodilators such as albuterol is essential to relieve bronchoconstriction and improve oxygenation.

Which of the following is a clinical manifestation of hypothyroidism?

A) Increased appetite and weight loss
B) Cold intolerance and weight gain
C) Heat intolerance and weight loss
D) Tachycardia and palpitations

Answer: B) Cold intolerance and weight gain
Explanation: Hypothyroidism often results in slowed metabolism, leading to symptoms such as cold intolerance, weight gain, and fatigue.

Which of the following is the most appropriate nursing intervention for a patient experiencing a seizure?

A) Restrain the patient’s movements to prevent injury
B) Administer oral fluids to prevent dehydration
C) Maintain a clear airway and protect the patient from injury
D) Offer the patient a snack once the seizure subsides

Answer: C) Maintain a clear airway and protect the patient from injury
Explanation: The priority during a seizure is to ensure the patient’s airway is clear and protect them from harm by removing surrounding objects.

A patient with a history of alcohol use disorder is being discharged after treatment for pancreatitis. The nurse should emphasize the importance of:

A) Restricting fluid intake
B) Avoiding alcohol consumption
C) Taking pain medication as prescribed
D) Increasing caloric intake

Answer: B) Avoiding alcohol consumption
Explanation: Alcohol consumption is a major risk factor for pancreatitis, and the patient must be educated to avoid it to prevent future episodes.

What is the primary function of the kidneys in the body?

A) Regulating hormone production
B) Filtering blood and removing waste products
C) Producing red blood cells
D) Regulating blood pressure through vasodilation

Answer: B) Filtering blood and removing waste products
Explanation: The kidneys filter waste products from the blood, regulate fluid and electrolyte balance, and produce urine.

Which of the following is an early sign of hypoxia in a patient?

A) Tachypnea
B) Cyanosis
C) Decreased blood pressure
D) Hypotension

Answer: A) Tachypnea
Explanation: Tachypnea (increased respiratory rate) is often one of the first signs of hypoxia, as the body tries to compensate for decreased oxygen levels by increasing ventilation.