ANCC MED-SURG CERTIFICATION EXAM NEWEST 2026
ACTUAL EXAM TEST BANK| COMPLETE 250 REAL
EXAM QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED A+|| BRAND
NEW!!
1. A 68-year-old patient with heart failure is admitted with
shortness of breath, peripheral edema, and jugular venous
distention. What is the nurse's priority assessment?
A) Auscultate lung sounds
B) Check oxygen saturation
C) Measure daily weight
D) Assess urine output
Answer: A) Auscultate lung sounds
Rationale: In a patient with heart failure and dyspnea, auscultating
lung sounds is the priority to assess for crackles or wheezing,
1
,indicating pulmonary congestion that requires immediate
intervention. While other assessments are important, lung sounds
provide critical information about the severity of fluid overload
and respiratory compromise.
2. A patient with diabetes presents with confusion, nausea,
and fruity breath odor. What laboratory finding would the
nurse expect?
A) Blood glucose of 45 mg/dL
B) Blood glucose of 420 mg/dL
C) Serum potassium of 5.8 mEq/L
D) Serum sodium of 145 mEq/L
Answer: B) Blood glucose of 420 mg/dL
*Rationale: The presentation of confusion, nausea, and fruity
breath suggests diabetic ketoacidosis (DKA), characterized by
2
,hyperglycemia (typically >250 mg/dL), ketoacidosis, and
dehydration. In DKA, the body breaks down fats for energy,
producing ketones that cause the fruity breath odor.*
3. A patient is 24 hours post-operative following abdominal
surgery. The patient reports sudden chest pain and shortness
of breath. What is the nurse's priority action?
A) Administer prescribed pain medication
B) Assess vital signs and oxygen saturation
C) Encourage deep breathing exercises
D) Notify the healthcare provider
Answer: B) Assess vital signs and oxygen saturation
Rationale: Sudden chest pain and dyspnea in a post-operative
patient are concerning for pulmonary embolism. The nurse should
first assess vital signs and oxygen saturation to determine the
3
, patient's hemodynamic stability and need for immediate
intervention. This assessment guides the urgency of provider
notification and interventions.
4. A 75-year-old patient is admitted with confusion, fever,
and urinary frequency. What is the most likely cause of the
confusion?
A) Dementia
B) Urinary tract infection
C) Cerebrovascular accident
D) Delirium tremens
Answer: B) Urinary tract infection
Rationale: In older adults, urinary tract infections often present
atypically with confusion, agitation, or falls rather than classic
4
ACTUAL EXAM TEST BANK| COMPLETE 250 REAL
EXAM QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED A+|| BRAND
NEW!!
1. A 68-year-old patient with heart failure is admitted with
shortness of breath, peripheral edema, and jugular venous
distention. What is the nurse's priority assessment?
A) Auscultate lung sounds
B) Check oxygen saturation
C) Measure daily weight
D) Assess urine output
Answer: A) Auscultate lung sounds
Rationale: In a patient with heart failure and dyspnea, auscultating
lung sounds is the priority to assess for crackles or wheezing,
1
,indicating pulmonary congestion that requires immediate
intervention. While other assessments are important, lung sounds
provide critical information about the severity of fluid overload
and respiratory compromise.
2. A patient with diabetes presents with confusion, nausea,
and fruity breath odor. What laboratory finding would the
nurse expect?
A) Blood glucose of 45 mg/dL
B) Blood glucose of 420 mg/dL
C) Serum potassium of 5.8 mEq/L
D) Serum sodium of 145 mEq/L
Answer: B) Blood glucose of 420 mg/dL
*Rationale: The presentation of confusion, nausea, and fruity
breath suggests diabetic ketoacidosis (DKA), characterized by
2
,hyperglycemia (typically >250 mg/dL), ketoacidosis, and
dehydration. In DKA, the body breaks down fats for energy,
producing ketones that cause the fruity breath odor.*
3. A patient is 24 hours post-operative following abdominal
surgery. The patient reports sudden chest pain and shortness
of breath. What is the nurse's priority action?
A) Administer prescribed pain medication
B) Assess vital signs and oxygen saturation
C) Encourage deep breathing exercises
D) Notify the healthcare provider
Answer: B) Assess vital signs and oxygen saturation
Rationale: Sudden chest pain and dyspnea in a post-operative
patient are concerning for pulmonary embolism. The nurse should
first assess vital signs and oxygen saturation to determine the
3
, patient's hemodynamic stability and need for immediate
intervention. This assessment guides the urgency of provider
notification and interventions.
4. A 75-year-old patient is admitted with confusion, fever,
and urinary frequency. What is the most likely cause of the
confusion?
A) Dementia
B) Urinary tract infection
C) Cerebrovascular accident
D) Delirium tremens
Answer: B) Urinary tract infection
Rationale: In older adults, urinary tract infections often present
atypically with confusion, agitation, or falls rather than classic
4
