MEDICAL-SURGICAL NURSING CERTIFICATION
(MEDSURG-BC™) EXAM 200 QUESTIONS AND CORRECT
ANSWERS WITH RATIONALE LATEST 2026 ALREADY
GRADED A+
This comprehensive 200-question bank is designed for the Medical-Surgical
Nursing Certification (MEDSURG-BC™) Exam, covering the full scope of
medical-surgical nursing practice. Each question presents a unique, clinically
relevant scenario testing assessment, diagnosis, planning, implementation, and
evaluation skills. Topics include cardiovascular, respiratory, renal, endocrine,
gastrointestinal, neurological, and musculoskeletal disorders, as well as
pharmacology, fluid and electrolyte balance, perioperative care, wound
management, and professional role competencies. Each question includes a
detailed rationale to reinforce clinical reasoning. No questions are repeated,
ensuring broad content coverage for effective exam preparation and clinical
knowledge validation.
1. The main goal of treatment for acute glomerulonephritis is to:
A. Encourage high protein intake
B. Encourage activity
C. Maintain fluid balance
D. Teach intermittent urinary catheterization
Answer: C. Maintain fluid balance
Rationale: In acute glomerulonephritis, the primary goal is to manage fluid balance
to prevent complications like hypertension and edema, often requiring sodium and
fluid restriction. High protein is not indicated, and urinary catheterization is not a
standard treatment for this condition .
2. Nursing diagnoses mostly differ from medical diagnoses in that they are:
A. Primarily concerned with caring, while medical diagnoses are primarily
concerned with curing
B. Primarily concerned with human response, while medical diagnoses are
primarily concerned with pathology
C. Primarily concerned with psychosocial parameters, while medical diagnoses are
primarily concerned with physiologic parameters
D. Dependent upon medical diagnoses for the direction of appropriate
interventions
,Answer: B. Primarily concerned with human response, while medical diagnoses
are primarily concerned with pathology
Rationale: Nursing diagnoses focus on the patient's response to health conditions,
whereas medical diagnoses identify disease pathology. This distinction is central to
the nursing process .
3. A patient who received spinal anesthesia four hours ago during surgery is
transferred to the surgical unit and now reports severe incisional pain. The patient's
blood pressure is 170/90 mmHg, pulse is 108 beats/min, respirations are 30
breaths/min, and skin is pale. The most appropriate nursing intervention is to:
A. Place the patient in a high Fowler position and administer oxygen
B. Place the patient in a reverse Trendelenburg position and open the IV line
C. Report the findings to the provider
D. Medicate the patient for pain
Answer: C. Report the findings to the provider
Rationale: The patient is showing signs of hemodynamic instability (elevated BP,
tachycardia, tachypnea) that may indicate complications such as hypovolemic
shock or adverse drug reaction. These findings must be reported immediately .
4. To prevent a common adverse effect of prolonged use of phenytoin (Dilantin),
patients are instructed to:
A. Avoid crowds and obtain an annual influenza vaccination
B. Drink at least 2 L of fluids daily, including 8 to 10 glasses of water
C. Eat a potassium-rich, low-sodium diet
D. Practice good dental hygiene and report gum swelling or bleeding
Answer: D. Practice good dental hygiene and report gum swelling or bleeding
Rationale: Phenytoin commonly causes gingival hyperplasia (gum overgrowth).
Good dental hygiene and monitoring for swelling or bleeding are essential to
prevent complications .
5. The most common preventable complication of abdominal surgery is:
A. Atelectasis
B. Fluid and electrolyte imbalance
C. Thrombophlebitis
D. Urinary retention
Answer: A. Atelectasis
Rationale: Atelectasis is the most common complication following abdominal
surgery due to shallow breathing and immobility. It is preventable with early
ambulation, deep breathing, and incentive spirometry .
,6. A 78-year-old patient is being discharged home after treatment for heart disease.
The spouse, who has COPD, plans to care for the patient. The best approach to
discharge planning is to:
A. Arrange nursing home placement for the couple
B. Consult the spouse's healthcare provider about the spouse's ability to care for the
patient
C. Contact the children to ascertain their commitment to help
D. Discuss community resources with the spouse and offer to make referrals
Answer: D. Discuss community resources with the spouse and offer to make
referrals
Rationale: The best approach involves assessing the caregiver's capability and
providing community resources to support both the patient and the caregiving
spouse .
7. During an assessment of a patient who sustained a head injury 24 hours ago, the
nurse notes the development of slurred speech and disorientation. The nurse's
initial action is to:
A. Continue the hourly neurologic assessments
B. Inform the neurosurgeon of the patient's status
C. Prepare the patient for emergency surgery
D. Recheck the patient's neurologic status in 15 minutes
Answer: B. Inform the neurosurgeon of the patient's status
Rationale: New neurologic changes after a head injury may indicate increased
intracranial pressure or deterioration. The provider must be notified immediately
for further evaluation .
8. For the evaluation feedback process to be effective, the medical-surgical nurse
who is a manager should:
A. Conduct weekly meetings with staff members
B. Consider staff members' interests and abilities when delegating tasks
C. Inform staff members regularly of how well they are performing their jobs
D. Provide goals for staff members to meet
Answer: C. Inform staff members regularly of how well they are performing their
jobs
Rationale: Effective feedback involves regular, constructive communication about
performance. This helps staff understand expectations and areas for improvement .
9. An 80-year-old patient is placed in isolation for MRSA and is now having visual
hallucinations and can follow only simple directions. The nurse recognizes these
mental status changes are most likely related to:
, A. A fluid and electrolyte imbalance
B. A stimulating environment
C. Sensory deprivation
D. Sundowning
Answer: C. Sensory deprivation
Rationale: Isolation can lead to sensory deprivation in older adults, resulting in
confusion, hallucinations, and disorientation. The patient's physical environment
must be optimized to provide appropriate sensory input .
10. To prepare a patient for a bronchoscopic procedure, the nurse administers an
IV sedative and then instructs the LPN to:
A. Educate the patient about the procedure
B. Give the patient small sips of water only
C. Measure the patient's blood pressure and heart rate
D. Take the patient to the bathroom one more time
Answer: C. Measure the patient's blood pressure and heart rate
Rationale: After administering an IV sedative, vital signs must be closely
monitored. This is within the LPN's scope of practice. Patient education and
ambulation should be done before sedation .
11. Which physiological response is often associated with surgery-related stress?
A. Bronchial constriction
B. Decreased cortisol levels
C. Peripheral vasodilation
D. Sodium and water retention
Answer: D. Sodium and water retention
Rationale: Surgery-related stress triggers the release of aldosterone and ADH,
leading to sodium and water retention. This is part of the body's stress response to
maintain volume and perfusion .
12. A patient's family does not know the patient's end-of-life care preferences but
assumes they know what is best. This assumption reflects:
A. Justice
B. Paternalism
C. Pragmatism
D. Veracity
Answer: B. Paternalism
Rationale: Paternalism is the act of making decisions for another person without
their input, assuming one knows what is best. This conflicts with the ethical
principle of patient autonomy, especially in end-of-life care .
(MEDSURG-BC™) EXAM 200 QUESTIONS AND CORRECT
ANSWERS WITH RATIONALE LATEST 2026 ALREADY
GRADED A+
This comprehensive 200-question bank is designed for the Medical-Surgical
Nursing Certification (MEDSURG-BC™) Exam, covering the full scope of
medical-surgical nursing practice. Each question presents a unique, clinically
relevant scenario testing assessment, diagnosis, planning, implementation, and
evaluation skills. Topics include cardiovascular, respiratory, renal, endocrine,
gastrointestinal, neurological, and musculoskeletal disorders, as well as
pharmacology, fluid and electrolyte balance, perioperative care, wound
management, and professional role competencies. Each question includes a
detailed rationale to reinforce clinical reasoning. No questions are repeated,
ensuring broad content coverage for effective exam preparation and clinical
knowledge validation.
1. The main goal of treatment for acute glomerulonephritis is to:
A. Encourage high protein intake
B. Encourage activity
C. Maintain fluid balance
D. Teach intermittent urinary catheterization
Answer: C. Maintain fluid balance
Rationale: In acute glomerulonephritis, the primary goal is to manage fluid balance
to prevent complications like hypertension and edema, often requiring sodium and
fluid restriction. High protein is not indicated, and urinary catheterization is not a
standard treatment for this condition .
2. Nursing diagnoses mostly differ from medical diagnoses in that they are:
A. Primarily concerned with caring, while medical diagnoses are primarily
concerned with curing
B. Primarily concerned with human response, while medical diagnoses are
primarily concerned with pathology
C. Primarily concerned with psychosocial parameters, while medical diagnoses are
primarily concerned with physiologic parameters
D. Dependent upon medical diagnoses for the direction of appropriate
interventions
,Answer: B. Primarily concerned with human response, while medical diagnoses
are primarily concerned with pathology
Rationale: Nursing diagnoses focus on the patient's response to health conditions,
whereas medical diagnoses identify disease pathology. This distinction is central to
the nursing process .
3. A patient who received spinal anesthesia four hours ago during surgery is
transferred to the surgical unit and now reports severe incisional pain. The patient's
blood pressure is 170/90 mmHg, pulse is 108 beats/min, respirations are 30
breaths/min, and skin is pale. The most appropriate nursing intervention is to:
A. Place the patient in a high Fowler position and administer oxygen
B. Place the patient in a reverse Trendelenburg position and open the IV line
C. Report the findings to the provider
D. Medicate the patient for pain
Answer: C. Report the findings to the provider
Rationale: The patient is showing signs of hemodynamic instability (elevated BP,
tachycardia, tachypnea) that may indicate complications such as hypovolemic
shock or adverse drug reaction. These findings must be reported immediately .
4. To prevent a common adverse effect of prolonged use of phenytoin (Dilantin),
patients are instructed to:
A. Avoid crowds and obtain an annual influenza vaccination
B. Drink at least 2 L of fluids daily, including 8 to 10 glasses of water
C. Eat a potassium-rich, low-sodium diet
D. Practice good dental hygiene and report gum swelling or bleeding
Answer: D. Practice good dental hygiene and report gum swelling or bleeding
Rationale: Phenytoin commonly causes gingival hyperplasia (gum overgrowth).
Good dental hygiene and monitoring for swelling or bleeding are essential to
prevent complications .
5. The most common preventable complication of abdominal surgery is:
A. Atelectasis
B. Fluid and electrolyte imbalance
C. Thrombophlebitis
D. Urinary retention
Answer: A. Atelectasis
Rationale: Atelectasis is the most common complication following abdominal
surgery due to shallow breathing and immobility. It is preventable with early
ambulation, deep breathing, and incentive spirometry .
,6. A 78-year-old patient is being discharged home after treatment for heart disease.
The spouse, who has COPD, plans to care for the patient. The best approach to
discharge planning is to:
A. Arrange nursing home placement for the couple
B. Consult the spouse's healthcare provider about the spouse's ability to care for the
patient
C. Contact the children to ascertain their commitment to help
D. Discuss community resources with the spouse and offer to make referrals
Answer: D. Discuss community resources with the spouse and offer to make
referrals
Rationale: The best approach involves assessing the caregiver's capability and
providing community resources to support both the patient and the caregiving
spouse .
7. During an assessment of a patient who sustained a head injury 24 hours ago, the
nurse notes the development of slurred speech and disorientation. The nurse's
initial action is to:
A. Continue the hourly neurologic assessments
B. Inform the neurosurgeon of the patient's status
C. Prepare the patient for emergency surgery
D. Recheck the patient's neurologic status in 15 minutes
Answer: B. Inform the neurosurgeon of the patient's status
Rationale: New neurologic changes after a head injury may indicate increased
intracranial pressure or deterioration. The provider must be notified immediately
for further evaluation .
8. For the evaluation feedback process to be effective, the medical-surgical nurse
who is a manager should:
A. Conduct weekly meetings with staff members
B. Consider staff members' interests and abilities when delegating tasks
C. Inform staff members regularly of how well they are performing their jobs
D. Provide goals for staff members to meet
Answer: C. Inform staff members regularly of how well they are performing their
jobs
Rationale: Effective feedback involves regular, constructive communication about
performance. This helps staff understand expectations and areas for improvement .
9. An 80-year-old patient is placed in isolation for MRSA and is now having visual
hallucinations and can follow only simple directions. The nurse recognizes these
mental status changes are most likely related to:
, A. A fluid and electrolyte imbalance
B. A stimulating environment
C. Sensory deprivation
D. Sundowning
Answer: C. Sensory deprivation
Rationale: Isolation can lead to sensory deprivation in older adults, resulting in
confusion, hallucinations, and disorientation. The patient's physical environment
must be optimized to provide appropriate sensory input .
10. To prepare a patient for a bronchoscopic procedure, the nurse administers an
IV sedative and then instructs the LPN to:
A. Educate the patient about the procedure
B. Give the patient small sips of water only
C. Measure the patient's blood pressure and heart rate
D. Take the patient to the bathroom one more time
Answer: C. Measure the patient's blood pressure and heart rate
Rationale: After administering an IV sedative, vital signs must be closely
monitored. This is within the LPN's scope of practice. Patient education and
ambulation should be done before sedation .
11. Which physiological response is often associated with surgery-related stress?
A. Bronchial constriction
B. Decreased cortisol levels
C. Peripheral vasodilation
D. Sodium and water retention
Answer: D. Sodium and water retention
Rationale: Surgery-related stress triggers the release of aldosterone and ADH,
leading to sodium and water retention. This is part of the body's stress response to
maintain volume and perfusion .
12. A patient's family does not know the patient's end-of-life care preferences but
assumes they know what is best. This assumption reflects:
A. Justice
B. Paternalism
C. Pragmatism
D. Veracity
Answer: B. Paternalism
Rationale: Paternalism is the act of making decisions for another person without
their input, assuming one knows what is best. This conflicts with the ethical
principle of patient autonomy, especially in end-of-life care .
