NCC Medical-Surgical Certification Practice Questions
A
and Answers.
It includes:
● M ultiple-choice questionscovering a wide range of medical-surgical
nursing topics, including cardiovascular, gastrointestinal, surgical care
(pre-operative, intra-operative, and post-operative), integumentary, and
reproductive health.
● Correct answers clearly indicated in boldfor easy identification.
● Rationales for selected answers, providing explanations for why a
particular option is correct, which is valuable for learning and
understanding.
● Definitions and explanations of key medical terms, signs, triads, and
nursing concepts,such as:
○ Specific clinical signs(e.g., McBurney's point, Murphy's sign,
Homan's sign, Jar sign/Markle sign, Brudzinski sign, Kernig's
sign, Chvostek's sign, Trousseau's sign, Levine sign).
○ Medical triads(e.g., Beck's triad, Charcot's triad for MS and
cholangitis, Cushing's triad, Bergman's triad).
○ Breathing patterns(e.g., Kussmaul breathing).
○ Nursing and medical frameworks(e.g., CAGE, Braden score,
PUSH score, Confusion Assessment Method (CAM), Nursing
Process, Piaget's stages of Cognitive Development, Bloom's
Taxonomy, 5 Rights of Delegation, Triple H therapy).
○ Types of immunity,cancer statistics, and medication side
effects
, . A nurse is reviewing the medical record of a client who is receiving
1
heparin therapy for treatment of DVT. Which of the following
interventions should the nurse anticipate taking if the client's aPTT is
96 seconds?a. Increase the heparin infusion flowrate by 2 mL/hr b.
continue to monitor the heparin infusion as prescribed c. request a
prothrombin timed. stop the heparin infusion
ationale: An aPTT of 96 seconds is well above the therapeutic range
R
(typically 60-80 seconds for heparin therapy), indicating a high risk for
bleeding. The nurse's priority is to stop the infusion to prevent hemorrhage
and then notify the provider.
. A nurse is providing teaching for a client who is 2 days post-op
2
following a heart transplant. Which of the following statements should
the nurse include in the teaching?a. "you may nolonger be able to
feel chest pain."b. "your level of activity tolerancewill not change." c.
"after 6 months, you will no longer need to restrict your sodium intake." d.
"you will be able to stop taking immunosuppressants after 12 months."
ationale: The transplanted heart is denervated, meaning it's no longer
R
connected to the central nervous system. As a result, the client will not
experience angina (chest pain) as a symptom of ischemia.
. A nurse is assessing a client in the emergency room who has a
3
bradydysrhythmia. Which of the following findings should the nurse
expect?a. confusionb. friction rub c. hypertension d. dry skin
ationale: A slow heart rate (bradydysrhythmia) can lead to decreased
R
cardiac output and reduced cerebral perfusion, causing symptoms like
confusion, dizziness, and syncope.
. A nurse in the emergency department is caring for a client who had
4
an anterior MI. The client's history reveals she is 1 week post-op open
, holecystectomy. The nurse should recognize that which of the
c
following interventions is contraindicated?a. administering IV morphine
sulfate b. administering oxygen at 2 L/min via nasal cannula c. helping the
client to the bedside commoded. assisting with thrombolytictherapy
ationale: Thrombolytic therapy dissolves clots but is contraindicated in
R
clients who have had recent surgery (within 3 weeks) due to the high risk of
severe bleeding at the surgical site.
. A nurse is caring for a client who has endocarditis. Which of the
5
following findings should the nurse recognize as a potential
complication?a. ventricular depolarization b. Guillain-Barresyndrom c.
myelodysplastic syndromed. Valvular disease
ationale: Endocarditis is an infection of the heart's inner lining and valves.
R
The formation of vegetations on the valves can lead to significant damage
and valvular dysfunction, such as stenosis or regurgitation.
. A nurse is caring for a client who presents to the ER with a BP of
6
254/138 mmHg. The nurse recognizes that the client is in a
hypertensive crisis. Which of the following actions should the nurse
take first?a. obtain blood samples for laboratorytesting b. Tell the client to
report vision changes c. Place the head of the bed at 45 degreesd. initiate
an IV
ationale: The priority in a hypertensive crisis is to establish IV access to
R
administer medication to rapidly and safely lower the blood pressure and
prevent organ damage. While other actions are important, establishing a
line is the first step in intervention.
. A nurse is caring for a client who has HF and is experiencing AF.
7
The nurse should plan to monitor for and report which of the
following findings to the provider immediately?a.slurred speechb.
irregular pulse c. dependent edema d. persistent fatigue
Rationale: Slurred speech can be a sign of an embolic stroke, a serious
, c omplication of atrial fibrillation where a clot forms in the heart and travels
to the brain. This is a medical emergency and must be reported
immediately.
. A nurse is assessing a client who has left-sided HF. Which of the
8
following manifestations should the nurse expect to find?a. inc
abdominal girthb. weak peripheral pulsesc. jugularvein distention d.
dependent edema
ationale: Left-sided heart failure leads to a decrease in cardiac output,
R
resulting in diminished peripheral perfusion. This can be manifested as
weak peripheral pulses, cool extremities, and fatigue.
. A nurse is caring for a client who is being treated for HF and has
9
prescriptions for digoxin and furosemide. The nurse should plan to
monitor for which of the following as an adverse effect of these
medications?a. SOBb. lightheadednessc. dry coughd. metallic taste
ationale: Furosemide is a diuretic that can cause hypovolemia, leading to
R
orthostatic hypotension and symptoms like lightheadedness or dizziness.
Digoxin toxicity can also cause dizziness.
0. A nurse is monitoring a client following coronary artery bypass
1
graft surgery. Which of the following findings can indicate cardiac
tamponade?a. sternal instability b. inc WBC countc. BP 140/82 mmHg
on inspiration and 154/90 mmHg on expirationd. sinusrhythm with
occasional premature atrial contraction and HR 88/min
ationale: This finding, known as pulsus paradoxus, is a key sign of
R
cardiac tamponade, where the blood pressure drops significantly on
inspiration due to pressure on the heart. It indicates a medical emergency.
1. A nurse is preparing a client for coronary angiography. The nurse
1
should report which of the following findings to the provider prior to
A
and Answers.
It includes:
● M ultiple-choice questionscovering a wide range of medical-surgical
nursing topics, including cardiovascular, gastrointestinal, surgical care
(pre-operative, intra-operative, and post-operative), integumentary, and
reproductive health.
● Correct answers clearly indicated in boldfor easy identification.
● Rationales for selected answers, providing explanations for why a
particular option is correct, which is valuable for learning and
understanding.
● Definitions and explanations of key medical terms, signs, triads, and
nursing concepts,such as:
○ Specific clinical signs(e.g., McBurney's point, Murphy's sign,
Homan's sign, Jar sign/Markle sign, Brudzinski sign, Kernig's
sign, Chvostek's sign, Trousseau's sign, Levine sign).
○ Medical triads(e.g., Beck's triad, Charcot's triad for MS and
cholangitis, Cushing's triad, Bergman's triad).
○ Breathing patterns(e.g., Kussmaul breathing).
○ Nursing and medical frameworks(e.g., CAGE, Braden score,
PUSH score, Confusion Assessment Method (CAM), Nursing
Process, Piaget's stages of Cognitive Development, Bloom's
Taxonomy, 5 Rights of Delegation, Triple H therapy).
○ Types of immunity,cancer statistics, and medication side
effects
, . A nurse is reviewing the medical record of a client who is receiving
1
heparin therapy for treatment of DVT. Which of the following
interventions should the nurse anticipate taking if the client's aPTT is
96 seconds?a. Increase the heparin infusion flowrate by 2 mL/hr b.
continue to monitor the heparin infusion as prescribed c. request a
prothrombin timed. stop the heparin infusion
ationale: An aPTT of 96 seconds is well above the therapeutic range
R
(typically 60-80 seconds for heparin therapy), indicating a high risk for
bleeding. The nurse's priority is to stop the infusion to prevent hemorrhage
and then notify the provider.
. A nurse is providing teaching for a client who is 2 days post-op
2
following a heart transplant. Which of the following statements should
the nurse include in the teaching?a. "you may nolonger be able to
feel chest pain."b. "your level of activity tolerancewill not change." c.
"after 6 months, you will no longer need to restrict your sodium intake." d.
"you will be able to stop taking immunosuppressants after 12 months."
ationale: The transplanted heart is denervated, meaning it's no longer
R
connected to the central nervous system. As a result, the client will not
experience angina (chest pain) as a symptom of ischemia.
. A nurse is assessing a client in the emergency room who has a
3
bradydysrhythmia. Which of the following findings should the nurse
expect?a. confusionb. friction rub c. hypertension d. dry skin
ationale: A slow heart rate (bradydysrhythmia) can lead to decreased
R
cardiac output and reduced cerebral perfusion, causing symptoms like
confusion, dizziness, and syncope.
. A nurse in the emergency department is caring for a client who had
4
an anterior MI. The client's history reveals she is 1 week post-op open
, holecystectomy. The nurse should recognize that which of the
c
following interventions is contraindicated?a. administering IV morphine
sulfate b. administering oxygen at 2 L/min via nasal cannula c. helping the
client to the bedside commoded. assisting with thrombolytictherapy
ationale: Thrombolytic therapy dissolves clots but is contraindicated in
R
clients who have had recent surgery (within 3 weeks) due to the high risk of
severe bleeding at the surgical site.
. A nurse is caring for a client who has endocarditis. Which of the
5
following findings should the nurse recognize as a potential
complication?a. ventricular depolarization b. Guillain-Barresyndrom c.
myelodysplastic syndromed. Valvular disease
ationale: Endocarditis is an infection of the heart's inner lining and valves.
R
The formation of vegetations on the valves can lead to significant damage
and valvular dysfunction, such as stenosis or regurgitation.
. A nurse is caring for a client who presents to the ER with a BP of
6
254/138 mmHg. The nurse recognizes that the client is in a
hypertensive crisis. Which of the following actions should the nurse
take first?a. obtain blood samples for laboratorytesting b. Tell the client to
report vision changes c. Place the head of the bed at 45 degreesd. initiate
an IV
ationale: The priority in a hypertensive crisis is to establish IV access to
R
administer medication to rapidly and safely lower the blood pressure and
prevent organ damage. While other actions are important, establishing a
line is the first step in intervention.
. A nurse is caring for a client who has HF and is experiencing AF.
7
The nurse should plan to monitor for and report which of the
following findings to the provider immediately?a.slurred speechb.
irregular pulse c. dependent edema d. persistent fatigue
Rationale: Slurred speech can be a sign of an embolic stroke, a serious
, c omplication of atrial fibrillation where a clot forms in the heart and travels
to the brain. This is a medical emergency and must be reported
immediately.
. A nurse is assessing a client who has left-sided HF. Which of the
8
following manifestations should the nurse expect to find?a. inc
abdominal girthb. weak peripheral pulsesc. jugularvein distention d.
dependent edema
ationale: Left-sided heart failure leads to a decrease in cardiac output,
R
resulting in diminished peripheral perfusion. This can be manifested as
weak peripheral pulses, cool extremities, and fatigue.
. A nurse is caring for a client who is being treated for HF and has
9
prescriptions for digoxin and furosemide. The nurse should plan to
monitor for which of the following as an adverse effect of these
medications?a. SOBb. lightheadednessc. dry coughd. metallic taste
ationale: Furosemide is a diuretic that can cause hypovolemia, leading to
R
orthostatic hypotension and symptoms like lightheadedness or dizziness.
Digoxin toxicity can also cause dizziness.
0. A nurse is monitoring a client following coronary artery bypass
1
graft surgery. Which of the following findings can indicate cardiac
tamponade?a. sternal instability b. inc WBC countc. BP 140/82 mmHg
on inspiration and 154/90 mmHg on expirationd. sinusrhythm with
occasional premature atrial contraction and HR 88/min
ationale: This finding, known as pulsus paradoxus, is a key sign of
R
cardiac tamponade, where the blood pressure drops significantly on
inspiration due to pressure on the heart. It indicates a medical emergency.
1. A nurse is preparing a client for coronary angiography. The nurse
1
should report which of the following findings to the provider prior to
