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MEDSURG
MEDSURG CERTIFICATION EXAM (NEW 2025/
2026 UPDATE) QUESTIONS & ANSWERS| GRADE A|
100% CORRECT (VERIFIED SOLUTIONS)
Gallop heart sounds - ANS ✓s3, occurs after s2. Occurs in children and young adults, but
may indicate CHF or L ventricular failure in older adults. S4 occurs before s1 which means
ventricular hypertrophy- found in coronary artery disease/htn/aortic valve stenosis
Opening snap - ANS ✓A sharp, high-pitched click heard in early diastole related to opening
of the abnormal valve in cases of mitral stenosis from rheumatic heart disease
Ejection click - ANS ✓brief high pitch click sound after s1; aortic stenosis
Friction rub - ANS ✓described as grating, scratching sound of the heart indicative of
pericarditis
Murmur - ANS ✓caused by turbulent blood flow- characterized by location, timing in cardiac
cycle, intensity (grade 1 to V), pitch, quality, and radiation
MAP - ANS ✓diastole x2 + systole / 3
Normal MAP - ANS ✓70-105 mmhg, need at least 60
Cardiac output - ANS ✓The volume of blood ejected from the left side of the heart in one
minute. Hrxsv
Normal is 5 L/min
Cardiac Index - ANS ✓CO/body surface area
Stroke volume - ANS ✓the volume of blood pumped out by a ventricle with each heartbeat
SV= CO / HR
Pulmonary Vascular Resistance (PVR) - ANS ✓resistance in the pulmonary arteries and
arterioles against which the R ventricle has to pump during contraction, if it is elevated then
SV is usually low
Ankle Brachial Index - ANS ✓Comparison of the blood pressure in the leg vs. The arm;
normal ratio is greater than 1
MEDSURG
, 2
MEDSURG
Done to evaluate PVD
Ventilation-perfusion ratio - ANS ✓the ratio between ventilation and perfusion in the lung;
matching of ventilation to perfusion optimizes gas exchange
Normal is 0.8
Greater than 0.8 can mean hyperventilation, PE, hypotension
Less than 0.8 can mean atelectasis, pneumonia, or lung disease
Lung sounds - ANS ✓vascular breath sounds- low and soft, heard over peripheral lung space
Bronchiovesicular- moderate and in the upper lungs
Tracheal- high pitch
Cranial nerves - ANS ✓1. Olfactory
2. Optic
3. Oculomotor
4. Trochlear
5. Trigeminal
6. Abducens
7. Facial
8. Vestibulocochlear
9. Glossopharyngeal
10. Vagus
11. Accessory
12. Hypoglossal
Cranial Nerve 1 - ANS ✓olfactory
Smell test
Cranial Nerve II - ANS ✓optic
-Function: sensory - carries impulse for vision
-Testing procedure: eye chart testing, visual field testing
Cranial nerve III - ANS ✓Oculomotor (eye movement, pupil constriction)
Pupil reflex test and eye motion
Cranial nerve IV - ANS ✓trochlear
Eye movement
Move eyes down and out and in
Cranial nerve V - ANS ✓Trigeminal - chewing
Face & mouth touch & eye movement
MEDSURG
, 3
MEDSURG
Cranial nerve VI - ANS ✓abducens
Lateral movement of eye
Cranial nerve VII - ANS ✓Facial - controls most facial expressions (puff cheeks
out/smile/raise eyebrows)& secretion of tears & saliva & taste
Cranial nerve VIII - ANS ✓Vestibulocochlear (hearing and balance)
Weber rinne test
Cranial nerve IX - ANS ✓Glossopharyngeal - Gag reflex, swallowing, taste in posterior 1/3
of tongue
Cranial nerve X - ANS ✓Vagus - senses aortic blood pressure & slows heart rate &
stimulates digestive organs & taste/ gag swallow and cough
Cranial nerve XI - ANS ✓Accessory: sternocleidomastoid & trapezius muscle, shoulder
shrugging, head movement
Cranial nerve XII - ANS ✓Hypoglossal
Tongue movement- stick tongue out
NIH Stroke Scale (NIHSS) - ANS ✓A 42 point scale used to assess the severity of stroke
LOC
Best gaze (horizontal eye movement)
Visual (visual fields)
Facial palsy (facial symmetry)
Mofor of arm
Motor of leg
Limb ataxia (finger to nose and heel to shin)
Sensory (grimace or withdraw from pinprick)
Best language (describe action of pictures)
Dysarthria (reads or describes words on list)
Distinction and inattention (visual spatial neglect)
Intracranial Pressure (ICP) - ANS ✓cushing's triad: increased SBP with widening pulse
pressure, bradycardia, and dec respirations
Normal is 1-15 mmhg
Cerebral Perfusion Pressure (CPP) - ANS ✓CPP = MAP - ICP
Pressure required to maintain adequate blood flow to brain
Bowel sounds - ANS ✓absent if nothing heard for 2-5 minutes
Hypoactive only 1 sound in 2 min
Normal sound heard every 5-20 seconds
MEDSURG
MEDSURG
MEDSURG CERTIFICATION EXAM (NEW 2025/
2026 UPDATE) QUESTIONS & ANSWERS| GRADE A|
100% CORRECT (VERIFIED SOLUTIONS)
Gallop heart sounds - ANS ✓s3, occurs after s2. Occurs in children and young adults, but
may indicate CHF or L ventricular failure in older adults. S4 occurs before s1 which means
ventricular hypertrophy- found in coronary artery disease/htn/aortic valve stenosis
Opening snap - ANS ✓A sharp, high-pitched click heard in early diastole related to opening
of the abnormal valve in cases of mitral stenosis from rheumatic heart disease
Ejection click - ANS ✓brief high pitch click sound after s1; aortic stenosis
Friction rub - ANS ✓described as grating, scratching sound of the heart indicative of
pericarditis
Murmur - ANS ✓caused by turbulent blood flow- characterized by location, timing in cardiac
cycle, intensity (grade 1 to V), pitch, quality, and radiation
MAP - ANS ✓diastole x2 + systole / 3
Normal MAP - ANS ✓70-105 mmhg, need at least 60
Cardiac output - ANS ✓The volume of blood ejected from the left side of the heart in one
minute. Hrxsv
Normal is 5 L/min
Cardiac Index - ANS ✓CO/body surface area
Stroke volume - ANS ✓the volume of blood pumped out by a ventricle with each heartbeat
SV= CO / HR
Pulmonary Vascular Resistance (PVR) - ANS ✓resistance in the pulmonary arteries and
arterioles against which the R ventricle has to pump during contraction, if it is elevated then
SV is usually low
Ankle Brachial Index - ANS ✓Comparison of the blood pressure in the leg vs. The arm;
normal ratio is greater than 1
MEDSURG
, 2
MEDSURG
Done to evaluate PVD
Ventilation-perfusion ratio - ANS ✓the ratio between ventilation and perfusion in the lung;
matching of ventilation to perfusion optimizes gas exchange
Normal is 0.8
Greater than 0.8 can mean hyperventilation, PE, hypotension
Less than 0.8 can mean atelectasis, pneumonia, or lung disease
Lung sounds - ANS ✓vascular breath sounds- low and soft, heard over peripheral lung space
Bronchiovesicular- moderate and in the upper lungs
Tracheal- high pitch
Cranial nerves - ANS ✓1. Olfactory
2. Optic
3. Oculomotor
4. Trochlear
5. Trigeminal
6. Abducens
7. Facial
8. Vestibulocochlear
9. Glossopharyngeal
10. Vagus
11. Accessory
12. Hypoglossal
Cranial Nerve 1 - ANS ✓olfactory
Smell test
Cranial Nerve II - ANS ✓optic
-Function: sensory - carries impulse for vision
-Testing procedure: eye chart testing, visual field testing
Cranial nerve III - ANS ✓Oculomotor (eye movement, pupil constriction)
Pupil reflex test and eye motion
Cranial nerve IV - ANS ✓trochlear
Eye movement
Move eyes down and out and in
Cranial nerve V - ANS ✓Trigeminal - chewing
Face & mouth touch & eye movement
MEDSURG
, 3
MEDSURG
Cranial nerve VI - ANS ✓abducens
Lateral movement of eye
Cranial nerve VII - ANS ✓Facial - controls most facial expressions (puff cheeks
out/smile/raise eyebrows)& secretion of tears & saliva & taste
Cranial nerve VIII - ANS ✓Vestibulocochlear (hearing and balance)
Weber rinne test
Cranial nerve IX - ANS ✓Glossopharyngeal - Gag reflex, swallowing, taste in posterior 1/3
of tongue
Cranial nerve X - ANS ✓Vagus - senses aortic blood pressure & slows heart rate &
stimulates digestive organs & taste/ gag swallow and cough
Cranial nerve XI - ANS ✓Accessory: sternocleidomastoid & trapezius muscle, shoulder
shrugging, head movement
Cranial nerve XII - ANS ✓Hypoglossal
Tongue movement- stick tongue out
NIH Stroke Scale (NIHSS) - ANS ✓A 42 point scale used to assess the severity of stroke
LOC
Best gaze (horizontal eye movement)
Visual (visual fields)
Facial palsy (facial symmetry)
Mofor of arm
Motor of leg
Limb ataxia (finger to nose and heel to shin)
Sensory (grimace or withdraw from pinprick)
Best language (describe action of pictures)
Dysarthria (reads or describes words on list)
Distinction and inattention (visual spatial neglect)
Intracranial Pressure (ICP) - ANS ✓cushing's triad: increased SBP with widening pulse
pressure, bradycardia, and dec respirations
Normal is 1-15 mmhg
Cerebral Perfusion Pressure (CPP) - ANS ✓CPP = MAP - ICP
Pressure required to maintain adequate blood flow to brain
Bowel sounds - ANS ✓absent if nothing heard for 2-5 minutes
Hypoactive only 1 sound in 2 min
Normal sound heard every 5-20 seconds
MEDSURG
