ANCC Medical-Surgical Nursing
Certification Practice Questions with
correct Answers
Question 1
"Third-spacing" can cause which form of shock?
A. Anaphylactic
B. Hypovolemic
C. Septic
D. Cardiovascular
Answer: B. Hypovolemic
Question 2
A 18-year-old male is admitted after a motor-vehicle accident with air-bag release.
He complains of chest tightness and is restless and anxious. Heart sounds are
barely audible on auscultation. The patient is most likely experiencing what
condition?
A. Cardiac tamponade
B. Acute myocardial infarction
C. Pulmonary edema
D. Aortic aneurysm
Answer: A. Cardiac tamponade
Question 3
A 24 year-old factory worker with a history of asthma presents to the emergency
department with difficulty breathing. During the respiratory assessment of the patient,
the nurse would expect to auscultate:
A. diminished breath sounds and crackles in lung bases
B. moist crackles in lung bases
C. distant breath sounds and expiratory wheezes
D. bronchial breath sounds in lung bases
Answer: C. distant breath sounds and expiratory wheezes
Question 4
A 30 year-old man with chronic traumatic brain injury was admitted for a surgical
procedure and is to be discharged. The nurse should modify his discharge
instructions by:
Providing detailed oral instructions
Providing detailed written instructions
Having him repeat the instructions
,Having sustained eye contact during the instruction
Answer: 3. Having him repeat the instructions
Question 5
A 30-year-old female has been diagnosed with Cushing's syndrome. The nurse
knows the patient is most likely to exhibit which symptoms?
A. Hypertension and hirsutism
B. Hyperkalemia and obesity
C. Hypotension and anemia
D. Menstrual irregularities and hypoglycemia
Answer: A. Hypertension and hirsutism
Rationale: Hypertension may result from fluid retention due to mineralcorticoid
excess, and they may also exhibit hirsutism (abnormal hair growth). While they may
also exhibit truncal or generalized obesity as well as menstrual irregularities, it is
patient's with Addison's Disease that would exhibit Hyperkalemia, Hypoglycemia and
Hypotension (it is the opposite in Cushing's Syndrome).
Question 6
A 48 year-old patient with suspected gastrointestinal (GI) bleeding undergoes
diagnostic endoscopy, which determines the site of bleeding is a duodenal ulcer. The
nurse explains to the patient that bleeding ulcers are most commonly related to
which of the following?
a. Intake of spicy foods
b. Use of salicylates
c. History of smoking
d. Severe retching and vomiting
Answer: b. Use of salicylates
Question 7
A 50-year-old woman weighs 85kg and has a history of cigarette smoking, high
blood pressure, high sodium intake, and sedentary lifestyle. When developing an
individualized care plan for her, the nurse determines that the most important risk
factors for peripheral artery disease that need to be modified are:
A. Weight and diet
B. Activity level and diet
C. Cigarette smoking and high blood pressure
D. Sedentary lifestyle and high blood pressure
Answer: C. Cigarette smoking and high blood pressure
Question 8
A 60-year-old African American male who works as a soccer coach, is admitted with
hypertension. On admission his blood pressure was 210/108 mmHg. His last total
,cholesterol level was 156 mg/dl, and a random blood glucose was 110 mg/dl. Which
is unalterable risk factor for hypertension?
A. His blood glucose level
B. His cholesterol level
C. His occupation
D. His ethnicity
Answer: D. His ethnicity
Question 9
A 63 year old female patient contacts the clinic to report that she is has been
extremely fatigued, is sleeping 12 hours a night, is always cold and her hair is falling
out. Which of the following responses by the nurse is most appropriate?
A. You will have more energy if you walk 30 min every day.
B. You don't need to worry. Sleeping a lot is good for you.
C. Come in and see your health care provider today.
D. You should eat more green leafy vegetables.
Answer: C. Come in and see your health care provider today.
Question 10
A 68 year old woman is admitted to the surgical unit after a gastric resection for
gastric cancer. She states that she doesn't want anyone to see her in this condition,
even her husband. This nurse's best response is:
A. "Patients' rights protect your privacy. I won't allow anyone in."
B. "I've seen gastric cancer patients who look much worse. Don't worry."
C. "Would you like to talk to a social worker?"
D. "What about your condition worries you?"
Answer: D. "What about your condition worries you?"
Question 11
A 75 year old patient complains to the clinical nurse that he is having difficulty
sleeping. Which of the following actions by the nurse is most appropriate?
A. Determine the patient's usual sleeping and waking patterns.
B. Suggest that the client abstain from alcohol and caffeine before bed time.
C. Recommend that client establish a bedtime routine.
D. Ask how much sleep the client required before retirement.
Answer: A. Determine the patient's usual sleeping and waking patterns.
Question 12
A classic finding in the patient with acute respiratory distress syndrome (ARDS) is:
A. Sudden hypocalcemia with tetany
B. Severe hyperkalemia
C. Hypoxia resistant to oxygen therapy
D. Hypercapnia
Answer: C. Hypoxia resistant to oxygen therapy
, Question 13
A client admitted to the hospital with a sickle cell crisis complains of severe
abdominal, hip, and knee pain. You observe an LVN accomplishing these client care
tasks. Which one requires that you, as charge nurse, intervene immediately?
A. The LVN encourages the client to use the ordered PCA.
B. The LVN positions cold packs on the client's knees.
C. The LVN places a "No Visitors" sign on the client's door.
D. The LVN checks the client's temperature every 2 hours.
Answer: B. The LVN positions cold packs on the client's knees.
Question 14
A client complains of crushing chest pain that radiates to his left arm. Which of the
following treatments should you anticipate:
A. Aspirin, oxygen, nitroglycerin, and morphine
B. Aspirin, oxygen, nitroglycerin, and codeine
C. Oxygen, nitroglycerin, meperidine, and thrombolytics
D. Aspirin, oxygen, nitroprusside, and morphine
Answer: A. Aspirin, oxygen, nitroglycerin, and morphine
Question 15
A client with a past history of angina has had a total knee replacement. What will the
nurse teach the client prior to rehabilitation activities?
A. "Use analgesics even if you are not in pain."
B. "Take nitroglycerine prophylactically prior to activity."
C. "Take anti-inflammatory medications before you get out of bed."
D. "Do not exercise if you have knee pain."
Answer: B. "Take nitroglycerine prophylactically prior to activity."
Question 16
A clinical nurse returns to the desk to find 4 phone messages. Which of the following
messages should the nurse respond to first?
A. A post cervical laminectomy patient complaining of sudden difficulty talking.
B. A patient with multiple sclerosis complaining of change in peripheral vision.
C. A patient with a herniated disc complaining of consistent back pain.
D. A patient with a cast due to a fracture of the right tibial bone complaining of
tingling toes.
Answer: A. A post cervical laminectomy patient complaining of sudden difficulty
talking.
Question 17
A diabetic patient presents with hot and dry skin, rapid and deep respirations, and a
fruity odor to his breath. As charge nurse, you observe the new graduate RN
Certification Practice Questions with
correct Answers
Question 1
"Third-spacing" can cause which form of shock?
A. Anaphylactic
B. Hypovolemic
C. Septic
D. Cardiovascular
Answer: B. Hypovolemic
Question 2
A 18-year-old male is admitted after a motor-vehicle accident with air-bag release.
He complains of chest tightness and is restless and anxious. Heart sounds are
barely audible on auscultation. The patient is most likely experiencing what
condition?
A. Cardiac tamponade
B. Acute myocardial infarction
C. Pulmonary edema
D. Aortic aneurysm
Answer: A. Cardiac tamponade
Question 3
A 24 year-old factory worker with a history of asthma presents to the emergency
department with difficulty breathing. During the respiratory assessment of the patient,
the nurse would expect to auscultate:
A. diminished breath sounds and crackles in lung bases
B. moist crackles in lung bases
C. distant breath sounds and expiratory wheezes
D. bronchial breath sounds in lung bases
Answer: C. distant breath sounds and expiratory wheezes
Question 4
A 30 year-old man with chronic traumatic brain injury was admitted for a surgical
procedure and is to be discharged. The nurse should modify his discharge
instructions by:
Providing detailed oral instructions
Providing detailed written instructions
Having him repeat the instructions
,Having sustained eye contact during the instruction
Answer: 3. Having him repeat the instructions
Question 5
A 30-year-old female has been diagnosed with Cushing's syndrome. The nurse
knows the patient is most likely to exhibit which symptoms?
A. Hypertension and hirsutism
B. Hyperkalemia and obesity
C. Hypotension and anemia
D. Menstrual irregularities and hypoglycemia
Answer: A. Hypertension and hirsutism
Rationale: Hypertension may result from fluid retention due to mineralcorticoid
excess, and they may also exhibit hirsutism (abnormal hair growth). While they may
also exhibit truncal or generalized obesity as well as menstrual irregularities, it is
patient's with Addison's Disease that would exhibit Hyperkalemia, Hypoglycemia and
Hypotension (it is the opposite in Cushing's Syndrome).
Question 6
A 48 year-old patient with suspected gastrointestinal (GI) bleeding undergoes
diagnostic endoscopy, which determines the site of bleeding is a duodenal ulcer. The
nurse explains to the patient that bleeding ulcers are most commonly related to
which of the following?
a. Intake of spicy foods
b. Use of salicylates
c. History of smoking
d. Severe retching and vomiting
Answer: b. Use of salicylates
Question 7
A 50-year-old woman weighs 85kg and has a history of cigarette smoking, high
blood pressure, high sodium intake, and sedentary lifestyle. When developing an
individualized care plan for her, the nurse determines that the most important risk
factors for peripheral artery disease that need to be modified are:
A. Weight and diet
B. Activity level and diet
C. Cigarette smoking and high blood pressure
D. Sedentary lifestyle and high blood pressure
Answer: C. Cigarette smoking and high blood pressure
Question 8
A 60-year-old African American male who works as a soccer coach, is admitted with
hypertension. On admission his blood pressure was 210/108 mmHg. His last total
,cholesterol level was 156 mg/dl, and a random blood glucose was 110 mg/dl. Which
is unalterable risk factor for hypertension?
A. His blood glucose level
B. His cholesterol level
C. His occupation
D. His ethnicity
Answer: D. His ethnicity
Question 9
A 63 year old female patient contacts the clinic to report that she is has been
extremely fatigued, is sleeping 12 hours a night, is always cold and her hair is falling
out. Which of the following responses by the nurse is most appropriate?
A. You will have more energy if you walk 30 min every day.
B. You don't need to worry. Sleeping a lot is good for you.
C. Come in and see your health care provider today.
D. You should eat more green leafy vegetables.
Answer: C. Come in and see your health care provider today.
Question 10
A 68 year old woman is admitted to the surgical unit after a gastric resection for
gastric cancer. She states that she doesn't want anyone to see her in this condition,
even her husband. This nurse's best response is:
A. "Patients' rights protect your privacy. I won't allow anyone in."
B. "I've seen gastric cancer patients who look much worse. Don't worry."
C. "Would you like to talk to a social worker?"
D. "What about your condition worries you?"
Answer: D. "What about your condition worries you?"
Question 11
A 75 year old patient complains to the clinical nurse that he is having difficulty
sleeping. Which of the following actions by the nurse is most appropriate?
A. Determine the patient's usual sleeping and waking patterns.
B. Suggest that the client abstain from alcohol and caffeine before bed time.
C. Recommend that client establish a bedtime routine.
D. Ask how much sleep the client required before retirement.
Answer: A. Determine the patient's usual sleeping and waking patterns.
Question 12
A classic finding in the patient with acute respiratory distress syndrome (ARDS) is:
A. Sudden hypocalcemia with tetany
B. Severe hyperkalemia
C. Hypoxia resistant to oxygen therapy
D. Hypercapnia
Answer: C. Hypoxia resistant to oxygen therapy
, Question 13
A client admitted to the hospital with a sickle cell crisis complains of severe
abdominal, hip, and knee pain. You observe an LVN accomplishing these client care
tasks. Which one requires that you, as charge nurse, intervene immediately?
A. The LVN encourages the client to use the ordered PCA.
B. The LVN positions cold packs on the client's knees.
C. The LVN places a "No Visitors" sign on the client's door.
D. The LVN checks the client's temperature every 2 hours.
Answer: B. The LVN positions cold packs on the client's knees.
Question 14
A client complains of crushing chest pain that radiates to his left arm. Which of the
following treatments should you anticipate:
A. Aspirin, oxygen, nitroglycerin, and morphine
B. Aspirin, oxygen, nitroglycerin, and codeine
C. Oxygen, nitroglycerin, meperidine, and thrombolytics
D. Aspirin, oxygen, nitroprusside, and morphine
Answer: A. Aspirin, oxygen, nitroglycerin, and morphine
Question 15
A client with a past history of angina has had a total knee replacement. What will the
nurse teach the client prior to rehabilitation activities?
A. "Use analgesics even if you are not in pain."
B. "Take nitroglycerine prophylactically prior to activity."
C. "Take anti-inflammatory medications before you get out of bed."
D. "Do not exercise if you have knee pain."
Answer: B. "Take nitroglycerine prophylactically prior to activity."
Question 16
A clinical nurse returns to the desk to find 4 phone messages. Which of the following
messages should the nurse respond to first?
A. A post cervical laminectomy patient complaining of sudden difficulty talking.
B. A patient with multiple sclerosis complaining of change in peripheral vision.
C. A patient with a herniated disc complaining of consistent back pain.
D. A patient with a cast due to a fracture of the right tibial bone complaining of
tingling toes.
Answer: A. A post cervical laminectomy patient complaining of sudden difficulty
talking.
Question 17
A diabetic patient presents with hot and dry skin, rapid and deep respirations, and a
fruity odor to his breath. As charge nurse, you observe the new graduate RN
