Medical-Surgical Nursing
Certification (MEDSURG-BC™)
Exam With Correct Answers –
2025/2026 Edition
Section 1: Introduction
This document contains verified and 100% correct answers for the Medical-Surgical Nursing
Certification (MEDSURG-BC™) Exam, updated for the 2025/2026 academic cycle. It covers
adult patient care, complex clinical scenarios, pharmacology, disease processes, nursing
interventions, and care coordination. Graded A+ and aligned with ANCC certification
standards to support exam readiness and professional excellence.
Section 2: Exam Questions and Answers
Four answer choices per question (A–D)
Correct answer highlighted
1. What is the primary nursing intervention for a patient with acute respiratory
distress syndrome (ARDS)?
(a) Administering oxygen therapy
(b) Initiating immediate antibiotics
(c) Performing chest physiotherapy
(d) Encouraging oral fluids
ANS: Administering oxygen therapy
Rationale: ARDS involves severe hypoxemia due to alveolar damage; oxygen
therapy is the priority to improve oxygenation and stabilize the patient before other
interventions.
2. Which medication is the first-line treatment for a patient with new-onset atrial
fibrillation?
(a) Metoprolol
(b) Warfarin
(c) Digoxin
(d) Furosemide
ANS: Metoprolol
Rationale: Metoprolol, a beta-blocker, is first-line to control heart rate in atrial
, fibrillation; warfarin is used for anticoagulation, not rate control, and others are less
appropriate initially.
3. What is a key assessment finding in a patient with diabetic ketoacidosis (DKA)?
(a) Hypoglycemia
(b) Fruity breath odor
(c) Bradycardia
(d) Normal urine output
ANS: Fruity breath odor
Rationale: Fruity breath odor results from acetone production due to ketone buildup
in DKA; hypoglycemia and bradycardia are not typical, and urine output is often
increased initially.
4. Which nursing action is priority for a patient with a postoperative wound
infection?
(a) Administering pain medication
(b) Initiating wound care and antibiotics
(c) Encouraging ambulation
(d) Monitoring vital signs only
ANS: Initiating wound care and antibiotics
Rationale: Wound care and antibiotics address the infection directly, preventing
systemic spread; pain management and ambulation are secondary to infection control.
5. What is the most appropriate initial intervention for a patient experiencing a
hypertensive crisis?
(a) Administering IV antihypertensives
(b) Encouraging deep breathing exercises
(c) Providing a high-sodium diet
(d) Monitoring blood pressure hourly
ANS: Administering IV antihypertensives
Rationale: IV antihypertensives rapidly lower blood pressure in a hypertensive crisis
to prevent organ damage; other options are ineffective or contraindicated.
6. Which electrolyte imbalance is commonly associated with chronic renal failure?
(a) Hyperkalemia
(b) Hypocalcemia
(c) Hyponatremia
(d) Hypomagnesemia
, ANS: Hyperkalemia
Rationale: Chronic renal failure impairs potassium excretion, leading to
hyperkalemia; other imbalances may occur but are less common as primary findings.
7. What is the priority nursing diagnosis for a patient with a stroke?
(a) Risk for impaired skin integrity
(b) Ineffective airway clearance
(c) Acute pain
(d) Deficient knowledge
ANS: Ineffective airway clearance
Rationale: Airway compromise is life-threatening in stroke due to potential
neurological impairment; other diagnoses are important but secondary.
8. Which medication is used to manage acute pain in a patient with a history of
opioid dependence?
(a) Morphine
(b) Ibuprofen
(c) Acetaminophen
(d) Naloxone
ANS: Ibuprofen
Rationale: Ibuprofen, a non-opioid, avoids reinforcing dependence; morphine is an
opioid, and naloxone reverses opioids, not manages pain.
9. What is a key intervention for preventing deep vein thrombosis (DVT) in a
postoperative patient?
(a) Encouraging bed rest
(b) Applying sequential compression devices
(c) Administering diuretics
(d) Limiting fluid intake
ANS: Applying sequential compression devices
Rationale: Sequential compression devices promote venous return and prevent stasis,
reducing DVT risk; bed rest increases risk.
10. Which laboratory value indicates effective treatment of anemia in a patient with
chronic kidney disease?
(a) Increased creatinine
(b) Elevated hemoglobin
(c) Decreased BUN
, (d) Reduced potassium
ANS: Elevated hemoglobin
Rationale: Elevated hemoglobin reflects improved red blood cell production with
treatment (e.g., erythropoietin); other values are unrelated to anemia.
11. What is the initial step in managing a patient with a suspected myocardial
infarction?
(a) Administering oxygen and aspirin
(b) Performing a chest X-ray
(c) Initiating IV fluids
(d) Ordering a CT scan
ANS: Administering oxygen and aspirin
Rationale: Oxygen and aspirin address hypoxia and platelet aggregation, critical in
acute MI; diagnostics are secondary to stabilization.
12. Which nursing action is priority for a patient with a new tracheostomy?
(a) Monitoring for signs of infection
(b) Encouraging oral intake
(c) Performing range-of-motion exercises
(d) Administering sedatives
ANS: Monitoring for signs of infection
Rationale: Infection risk is high with a tracheostomy; other actions are less urgent
and may be contraindicated.
13. What is the most common complication of cirrhosis?
(a) Hypertension
(b) Ascites
(c) Hypoglycemia
(d) Pulmonary edema
ANS: Ascites
Rationale: Ascites results from portal hypertension and liver dysfunction, common in
cirrhosis; other complications are less frequent.
14. Which medication is contraindicated in a patient with a penicillin allergy?
(a) Cephalexin
(b) Azithromycin
(c) Amoxicillin
(d) Ciprofloxacin
Certification (MEDSURG-BC™)
Exam With Correct Answers –
2025/2026 Edition
Section 1: Introduction
This document contains verified and 100% correct answers for the Medical-Surgical Nursing
Certification (MEDSURG-BC™) Exam, updated for the 2025/2026 academic cycle. It covers
adult patient care, complex clinical scenarios, pharmacology, disease processes, nursing
interventions, and care coordination. Graded A+ and aligned with ANCC certification
standards to support exam readiness and professional excellence.
Section 2: Exam Questions and Answers
Four answer choices per question (A–D)
Correct answer highlighted
1. What is the primary nursing intervention for a patient with acute respiratory
distress syndrome (ARDS)?
(a) Administering oxygen therapy
(b) Initiating immediate antibiotics
(c) Performing chest physiotherapy
(d) Encouraging oral fluids
ANS: Administering oxygen therapy
Rationale: ARDS involves severe hypoxemia due to alveolar damage; oxygen
therapy is the priority to improve oxygenation and stabilize the patient before other
interventions.
2. Which medication is the first-line treatment for a patient with new-onset atrial
fibrillation?
(a) Metoprolol
(b) Warfarin
(c) Digoxin
(d) Furosemide
ANS: Metoprolol
Rationale: Metoprolol, a beta-blocker, is first-line to control heart rate in atrial
, fibrillation; warfarin is used for anticoagulation, not rate control, and others are less
appropriate initially.
3. What is a key assessment finding in a patient with diabetic ketoacidosis (DKA)?
(a) Hypoglycemia
(b) Fruity breath odor
(c) Bradycardia
(d) Normal urine output
ANS: Fruity breath odor
Rationale: Fruity breath odor results from acetone production due to ketone buildup
in DKA; hypoglycemia and bradycardia are not typical, and urine output is often
increased initially.
4. Which nursing action is priority for a patient with a postoperative wound
infection?
(a) Administering pain medication
(b) Initiating wound care and antibiotics
(c) Encouraging ambulation
(d) Monitoring vital signs only
ANS: Initiating wound care and antibiotics
Rationale: Wound care and antibiotics address the infection directly, preventing
systemic spread; pain management and ambulation are secondary to infection control.
5. What is the most appropriate initial intervention for a patient experiencing a
hypertensive crisis?
(a) Administering IV antihypertensives
(b) Encouraging deep breathing exercises
(c) Providing a high-sodium diet
(d) Monitoring blood pressure hourly
ANS: Administering IV antihypertensives
Rationale: IV antihypertensives rapidly lower blood pressure in a hypertensive crisis
to prevent organ damage; other options are ineffective or contraindicated.
6. Which electrolyte imbalance is commonly associated with chronic renal failure?
(a) Hyperkalemia
(b) Hypocalcemia
(c) Hyponatremia
(d) Hypomagnesemia
, ANS: Hyperkalemia
Rationale: Chronic renal failure impairs potassium excretion, leading to
hyperkalemia; other imbalances may occur but are less common as primary findings.
7. What is the priority nursing diagnosis for a patient with a stroke?
(a) Risk for impaired skin integrity
(b) Ineffective airway clearance
(c) Acute pain
(d) Deficient knowledge
ANS: Ineffective airway clearance
Rationale: Airway compromise is life-threatening in stroke due to potential
neurological impairment; other diagnoses are important but secondary.
8. Which medication is used to manage acute pain in a patient with a history of
opioid dependence?
(a) Morphine
(b) Ibuprofen
(c) Acetaminophen
(d) Naloxone
ANS: Ibuprofen
Rationale: Ibuprofen, a non-opioid, avoids reinforcing dependence; morphine is an
opioid, and naloxone reverses opioids, not manages pain.
9. What is a key intervention for preventing deep vein thrombosis (DVT) in a
postoperative patient?
(a) Encouraging bed rest
(b) Applying sequential compression devices
(c) Administering diuretics
(d) Limiting fluid intake
ANS: Applying sequential compression devices
Rationale: Sequential compression devices promote venous return and prevent stasis,
reducing DVT risk; bed rest increases risk.
10. Which laboratory value indicates effective treatment of anemia in a patient with
chronic kidney disease?
(a) Increased creatinine
(b) Elevated hemoglobin
(c) Decreased BUN
, (d) Reduced potassium
ANS: Elevated hemoglobin
Rationale: Elevated hemoglobin reflects improved red blood cell production with
treatment (e.g., erythropoietin); other values are unrelated to anemia.
11. What is the initial step in managing a patient with a suspected myocardial
infarction?
(a) Administering oxygen and aspirin
(b) Performing a chest X-ray
(c) Initiating IV fluids
(d) Ordering a CT scan
ANS: Administering oxygen and aspirin
Rationale: Oxygen and aspirin address hypoxia and platelet aggregation, critical in
acute MI; diagnostics are secondary to stabilization.
12. Which nursing action is priority for a patient with a new tracheostomy?
(a) Monitoring for signs of infection
(b) Encouraging oral intake
(c) Performing range-of-motion exercises
(d) Administering sedatives
ANS: Monitoring for signs of infection
Rationale: Infection risk is high with a tracheostomy; other actions are less urgent
and may be contraindicated.
13. What is the most common complication of cirrhosis?
(a) Hypertension
(b) Ascites
(c) Hypoglycemia
(d) Pulmonary edema
ANS: Ascites
Rationale: Ascites results from portal hypertension and liver dysfunction, common in
cirrhosis; other complications are less frequent.
14. Which medication is contraindicated in a patient with a penicillin allergy?
(a) Cephalexin
(b) Azithromycin
(c) Amoxicillin
(d) Ciprofloxacin
