• ANCC MED SURG
CERTIFICATION 08/28/2026
EXAM
ANCC MED SURG CERTIFICATION TEST BANK
EXAM / 2026 ACTUAL EXAM | ANCC
MEDSURG-BC™ EXAM WITH COMPLETE 250
REAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+ (BRAND NEW!!)
A client with a 16-year history of diabetes mellitus is having renal function tests because of
recent fatigue, weakness, elevated blood urea nitrogen, and serum creatinine levels. Which
finding should the nurse conclude as an early symptom of renal insufficiency?
Dyspnea.
Nocturia.
P a g e 1 | 164
, • ANCC MED SURG
CERTIFICATION 08/28/2026
EXAM
Confusion.
Stomatitis. –
Correct Answer :Nocturia.
As the glomerular filtration rate decreases in early renal insufficiency, metabolic waste
products, including urea, creatinine, and other substances, such as phenols, hormones, and
electrolytes, accumulate in the blood. In the early stage of renal insufficiency, polyuria results
from the inability of the kidneys to concentrate urine and contributes to nocturia.
The nurse is caring for a client with a continuous feeding through a percutaneous endoscopic
gastrostomy (PEG) tube. Which intervention should the nurse include in the plan of care?
Flush the tube with 50 ml of water q 8 hours.
Check for tube placement and residual volume q4 hours.
Obtain a daily x- ray to verify tube placement.
Position on left side with head of bed elevated 45 degrees. –
Correct Answer :Check for tube placement and residual volume q4 hours.
Percutaneous endoscopic gastrostomy (PEG) tube placement and residual volume should be
checked every four hours for clients on continuous feeding. If the gastric residual is more than
200mL for an adult client; stop the feeding and re-check the gastric residual one hour later. If
the residual still remains more than 200mL; continue to keep the feeding on hold and contact
the client's health care provider.
P a g e 2 | 164
, • ANCC MED SURG
CERTIFICATION 08/28/2026
EXAM
The nurse is planning care to prevent complications for a client with multiple myeloma. Which
intervention is most important for the nurse to include?
Safety precautions during activity. Incorrect
Assess for changes in size of lymph nodes.
Maintain a fluid intake of 3 to 4 L per day.
Administer narcotic analgesic around the clock. –
Correct Answer :Maintain a fluid intake of 3 to 4 L per day.
Multiple myeloma is a malignancy of plasma cells that infiltrate bone causing demineralization
and hypercalcemia, so maintaining a urinary output of 1.5 to 2 L per day requires an intake of 3
to 4 L to promote excretion of serum calcium.
When teaching diaphragmatic breathing to a client with chronic obstructive pulmonary
disease (COPD), which information should the nurse provide?
Place a small book or magazine on the abdomen and make it rise while inhaling deeply.
Purse the lips while inhaling as deeply as possible and then exhale through the nose.
Wrap a towel around the abdomen and push against the towel while forcefully exhaling.
Place one hand on the chest, one hand the abdomen and make both hands move outward. –
Correct Answer :Place a small book or magazine on the abdomen and make it rise while
inhaling deeply.
P a g e 3 | 164
, • ANCC MED SURG
CERTIFICATION 08/28/2026
EXAM
Diaphragmatic or abdominal breathing uses the diaphragm instead of accessory muscles to
achieve maximum inhalation and to slow the respiratory rate. The client should protrude the
abdomen on inhalation and contract it with exhalation, so placing a book or magazine, helps
the client visualize the rise and fall of the abdomen.
During suctioning, a client with an uncuffed tracheostomy tube begins to cough violently and
dislodges the tracheostomy tube. Which action should the nurse implement first?
Notify the healthcare provider for reinsertion.
Attempt to reinsert the tracheostomy tube.
Position the client in a lateral position with the neck extended.
Ventilate client's tracheostomy stoma with a manual bag-mask. –
Correct Answer :Attempt to reinsert the tracheostomy tube.
The nurse should attempt to reinsert the tracheostomy tube by using a hemostat to open the
tracheostomy or by grasping the retention sutures (if present) to spread the opening and
insert a replacement tube (with its obturator) into the stoma. Once in place, the obturator
should immediately be removed.
A client is admitted for further testing to confirm sarcoidosis. Which diagnostic test provides
definitive information that the nurse should report to the healthcare provider?
Lung tissue biopsy.
P a g e 4 | 164
CERTIFICATION 08/28/2026
EXAM
ANCC MED SURG CERTIFICATION TEST BANK
EXAM / 2026 ACTUAL EXAM | ANCC
MEDSURG-BC™ EXAM WITH COMPLETE 250
REAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+ (BRAND NEW!!)
A client with a 16-year history of diabetes mellitus is having renal function tests because of
recent fatigue, weakness, elevated blood urea nitrogen, and serum creatinine levels. Which
finding should the nurse conclude as an early symptom of renal insufficiency?
Dyspnea.
Nocturia.
P a g e 1 | 164
, • ANCC MED SURG
CERTIFICATION 08/28/2026
EXAM
Confusion.
Stomatitis. –
Correct Answer :Nocturia.
As the glomerular filtration rate decreases in early renal insufficiency, metabolic waste
products, including urea, creatinine, and other substances, such as phenols, hormones, and
electrolytes, accumulate in the blood. In the early stage of renal insufficiency, polyuria results
from the inability of the kidneys to concentrate urine and contributes to nocturia.
The nurse is caring for a client with a continuous feeding through a percutaneous endoscopic
gastrostomy (PEG) tube. Which intervention should the nurse include in the plan of care?
Flush the tube with 50 ml of water q 8 hours.
Check for tube placement and residual volume q4 hours.
Obtain a daily x- ray to verify tube placement.
Position on left side with head of bed elevated 45 degrees. –
Correct Answer :Check for tube placement and residual volume q4 hours.
Percutaneous endoscopic gastrostomy (PEG) tube placement and residual volume should be
checked every four hours for clients on continuous feeding. If the gastric residual is more than
200mL for an adult client; stop the feeding and re-check the gastric residual one hour later. If
the residual still remains more than 200mL; continue to keep the feeding on hold and contact
the client's health care provider.
P a g e 2 | 164
, • ANCC MED SURG
CERTIFICATION 08/28/2026
EXAM
The nurse is planning care to prevent complications for a client with multiple myeloma. Which
intervention is most important for the nurse to include?
Safety precautions during activity. Incorrect
Assess for changes in size of lymph nodes.
Maintain a fluid intake of 3 to 4 L per day.
Administer narcotic analgesic around the clock. –
Correct Answer :Maintain a fluid intake of 3 to 4 L per day.
Multiple myeloma is a malignancy of plasma cells that infiltrate bone causing demineralization
and hypercalcemia, so maintaining a urinary output of 1.5 to 2 L per day requires an intake of 3
to 4 L to promote excretion of serum calcium.
When teaching diaphragmatic breathing to a client with chronic obstructive pulmonary
disease (COPD), which information should the nurse provide?
Place a small book or magazine on the abdomen and make it rise while inhaling deeply.
Purse the lips while inhaling as deeply as possible and then exhale through the nose.
Wrap a towel around the abdomen and push against the towel while forcefully exhaling.
Place one hand on the chest, one hand the abdomen and make both hands move outward. –
Correct Answer :Place a small book or magazine on the abdomen and make it rise while
inhaling deeply.
P a g e 3 | 164
, • ANCC MED SURG
CERTIFICATION 08/28/2026
EXAM
Diaphragmatic or abdominal breathing uses the diaphragm instead of accessory muscles to
achieve maximum inhalation and to slow the respiratory rate. The client should protrude the
abdomen on inhalation and contract it with exhalation, so placing a book or magazine, helps
the client visualize the rise and fall of the abdomen.
During suctioning, a client with an uncuffed tracheostomy tube begins to cough violently and
dislodges the tracheostomy tube. Which action should the nurse implement first?
Notify the healthcare provider for reinsertion.
Attempt to reinsert the tracheostomy tube.
Position the client in a lateral position with the neck extended.
Ventilate client's tracheostomy stoma with a manual bag-mask. –
Correct Answer :Attempt to reinsert the tracheostomy tube.
The nurse should attempt to reinsert the tracheostomy tube by using a hemostat to open the
tracheostomy or by grasping the retention sutures (if present) to spread the opening and
insert a replacement tube (with its obturator) into the stoma. Once in place, the obturator
should immediately be removed.
A client is admitted for further testing to confirm sarcoidosis. Which diagnostic test provides
definitive information that the nurse should report to the healthcare provider?
Lung tissue biopsy.
P a g e 4 | 164
