ANCC MEDICAL-SURGICAL NURSING
CERTIFICATION (MEDSURG-BC™) EXAM
PREPARATION: COMPREHENSIVE
PRACTICE QUESTION BANK | 300
VERIFIED QUESTIONS AND CORRECT
DETAILED ANSWERS MOST RECENT |
ALREADY GRADED A+ | (BRAND NEW)
Question 1
A patient is recovering from an uncomplicated MI. Which of the following
rehabilitation guidelines is a priority to include in the teaching plan?
A. Refrain from sexual activity for a minimum of 3 weeks
B. Plan a diet program that aims for a 1- to 2-pound weight loss per week
C. Begin an exercise program that aims for at least five 30-minute sessions per week
D. Monitor for signs of recurrent ischemia during activity
Correct Answer: B
Rationale: A diet program aiming for 1-2 pounds weight loss per week is a safe,
sustainable goal for cardiac rehabilitation. Sexual activity typically can resume in 1-2
weeks post-MI, and exercise programs should start with supervised sessions.
Monitoring for ischemia is important but not the priority teaching guideline.
Question 2
You are caring for a patient with COPD. Her ABG shows: PaO₂ 180, pH 7.36, CO₂ 49,
HCO₃ 32. Which intervention should you consider?
A. Prepare to administer sodium bicarbonate
B. Administer a nebulized bronchodilator
C. Decrease the amount of oxygen being given to the patient
D. Begin providing the patient with bag-valve mask ventilation
,Correct Answer: C
Rationale: The ABG shows compensated respiratory acidosis with hyperoxia (PaO₂
180). In COPD patients, high oxygen delivery can worsen CO₂ retention by reducing
hypoxic drive. Bronchodilators may help but addressing oxygen delivery is the
priority.
Question 3
A patient with type 1 diabetes mellitus arrives at the ED complaining of dizziness. The
nurse notes weakness, confusion, and disorientation. The patient took his usual
morning dose of 6 units regular insulin and 15 units NPH insulin but ate little
breakfast. What is the most likely cause?
A. Ketoacidosis
B. Hyperglycemia
C. Hyperlipidemia
D. Hypoglycemia
Correct Answer: D
Rationale: Dizziness, weakness, confusion, and disorientation signal an insulin
reaction and severe hypoglycemia—a common finding in diabetic patients who take
insulin but miss a meal. Ketoacidosis and hyperglycemia are rare in a patient taking
insulin who decreases nutritional intake.
Question 4
A nurse who elicits a positive Chvostek's sign would suspect which condition?
A. Hypercalcemia
B. Hypocalcemia
C. Hypermagnesemia
D. Hypokalemia
Correct Answer: B
Rationale: A positive Chvostek's sign (facial muscle twitching when tapping the facial
nerve) indicates hypocalcemia. This is a classic assessment finding for low serum
calcium levels.
,Question 5
A 70-year-old female patient is admitted for a small bowel obstruction. The nurse
notices the patient is third-spacing with generalized anasarca. Due to lack of
adequate nutritional status, the nurse suspects a decrease in which protein molecule?
A. Albumin
B. Angiotensin
C. Atrial natriuretic peptide
D. Aldosterone
Correct Answer: A
Rationale: Albumin is a large molecule that draws water into the vascular system. Low
albumin (hypoalbuminemia) leads to decreased oncotic pressure, causing fluid to
shift into interstitial spaces (third-spacing and edema).
Question 6
Silent ischemia is often seen in older adults with diabetes. Common signs and
symptoms of silent ischemia may include:
A. Heaviness in the chest
B. Diaphoresis
C. Indigestion
D. Tingling of the left arm
Correct Answer: C
Rationale: Indigestion is considered a "silent" symptom of ischemia in this patient
population. The other options describe typical chest pain presentations.
Question 7
A patient has received fresh frozen plasma (FFP) from the previous shift. The infusion
took place over 30 minutes. What should the nurse assess the patient for?
, A. Signs and symptoms of atrial fibrillation
B. Pedal edema
C. Signs of bleeding
D. Assess the patient as you normally would
Correct Answer: D
Rationale: FFP can be given over 15-30 minutes—this is normal. No special
assessment is required beyond routine monitoring.
Question 8
A patient is being admitted with the diagnosis of reversible ischemic neurological
deficit (RIND). This means the symptoms present on admission will be gone within:
A. May be for the remainder of life
B. 24 hours
C. 2 to 3 weeks
D. May be of unknown duration
Correct Answer: C
Rationale: TIA symptoms resolve within 24 hours. RIND symptoms last more than 24
hours but are not permanent and resolve within 2-3 weeks.
Question 9
A 60-year-old postoperative patient rates pain as 8/10 but states, "I don't want any
pain medication." The nurse notes that the patient has high:
A. Pain achievement
B. Pain threshold
C. Pain tolerance
D. Pain perception
Correct Answer: C
Rationale: Pain tolerance is the maximum level of pain a person can endure before
seeking relief. This patient reports severe pain but refuses medication, indicating high
pain tolerance.
CERTIFICATION (MEDSURG-BC™) EXAM
PREPARATION: COMPREHENSIVE
PRACTICE QUESTION BANK | 300
VERIFIED QUESTIONS AND CORRECT
DETAILED ANSWERS MOST RECENT |
ALREADY GRADED A+ | (BRAND NEW)
Question 1
A patient is recovering from an uncomplicated MI. Which of the following
rehabilitation guidelines is a priority to include in the teaching plan?
A. Refrain from sexual activity for a minimum of 3 weeks
B. Plan a diet program that aims for a 1- to 2-pound weight loss per week
C. Begin an exercise program that aims for at least five 30-minute sessions per week
D. Monitor for signs of recurrent ischemia during activity
Correct Answer: B
Rationale: A diet program aiming for 1-2 pounds weight loss per week is a safe,
sustainable goal for cardiac rehabilitation. Sexual activity typically can resume in 1-2
weeks post-MI, and exercise programs should start with supervised sessions.
Monitoring for ischemia is important but not the priority teaching guideline.
Question 2
You are caring for a patient with COPD. Her ABG shows: PaO₂ 180, pH 7.36, CO₂ 49,
HCO₃ 32. Which intervention should you consider?
A. Prepare to administer sodium bicarbonate
B. Administer a nebulized bronchodilator
C. Decrease the amount of oxygen being given to the patient
D. Begin providing the patient with bag-valve mask ventilation
,Correct Answer: C
Rationale: The ABG shows compensated respiratory acidosis with hyperoxia (PaO₂
180). In COPD patients, high oxygen delivery can worsen CO₂ retention by reducing
hypoxic drive. Bronchodilators may help but addressing oxygen delivery is the
priority.
Question 3
A patient with type 1 diabetes mellitus arrives at the ED complaining of dizziness. The
nurse notes weakness, confusion, and disorientation. The patient took his usual
morning dose of 6 units regular insulin and 15 units NPH insulin but ate little
breakfast. What is the most likely cause?
A. Ketoacidosis
B. Hyperglycemia
C. Hyperlipidemia
D. Hypoglycemia
Correct Answer: D
Rationale: Dizziness, weakness, confusion, and disorientation signal an insulin
reaction and severe hypoglycemia—a common finding in diabetic patients who take
insulin but miss a meal. Ketoacidosis and hyperglycemia are rare in a patient taking
insulin who decreases nutritional intake.
Question 4
A nurse who elicits a positive Chvostek's sign would suspect which condition?
A. Hypercalcemia
B. Hypocalcemia
C. Hypermagnesemia
D. Hypokalemia
Correct Answer: B
Rationale: A positive Chvostek's sign (facial muscle twitching when tapping the facial
nerve) indicates hypocalcemia. This is a classic assessment finding for low serum
calcium levels.
,Question 5
A 70-year-old female patient is admitted for a small bowel obstruction. The nurse
notices the patient is third-spacing with generalized anasarca. Due to lack of
adequate nutritional status, the nurse suspects a decrease in which protein molecule?
A. Albumin
B. Angiotensin
C. Atrial natriuretic peptide
D. Aldosterone
Correct Answer: A
Rationale: Albumin is a large molecule that draws water into the vascular system. Low
albumin (hypoalbuminemia) leads to decreased oncotic pressure, causing fluid to
shift into interstitial spaces (third-spacing and edema).
Question 6
Silent ischemia is often seen in older adults with diabetes. Common signs and
symptoms of silent ischemia may include:
A. Heaviness in the chest
B. Diaphoresis
C. Indigestion
D. Tingling of the left arm
Correct Answer: C
Rationale: Indigestion is considered a "silent" symptom of ischemia in this patient
population. The other options describe typical chest pain presentations.
Question 7
A patient has received fresh frozen plasma (FFP) from the previous shift. The infusion
took place over 30 minutes. What should the nurse assess the patient for?
, A. Signs and symptoms of atrial fibrillation
B. Pedal edema
C. Signs of bleeding
D. Assess the patient as you normally would
Correct Answer: D
Rationale: FFP can be given over 15-30 minutes—this is normal. No special
assessment is required beyond routine monitoring.
Question 8
A patient is being admitted with the diagnosis of reversible ischemic neurological
deficit (RIND). This means the symptoms present on admission will be gone within:
A. May be for the remainder of life
B. 24 hours
C. 2 to 3 weeks
D. May be of unknown duration
Correct Answer: C
Rationale: TIA symptoms resolve within 24 hours. RIND symptoms last more than 24
hours but are not permanent and resolve within 2-3 weeks.
Question 9
A 60-year-old postoperative patient rates pain as 8/10 but states, "I don't want any
pain medication." The nurse notes that the patient has high:
A. Pain achievement
B. Pain threshold
C. Pain tolerance
D. Pain perception
Correct Answer: C
Rationale: Pain tolerance is the maximum level of pain a person can endure before
seeking relief. This patient reports severe pain but refuses medication, indicating high
pain tolerance.
