1
MEDICAL SUR
MEDICAL SURGICAL CERTIFICATION EXAM
QUESTIONS WITH CORRECT VERIFIED
ANSWERS LATEST UPDATE (2025/2026)
GUARANTEED PASS
What test is the best way to rule out organ rejection or hepatitis in a liver transplant? - ANS
✓liver biopsy
What positive assessment finding would indicate cholecystitis? - ANS ✓Positive Murphy's
sign
What assessment finding is suggestive of paralytic ileus? - ANS ✓absent bowel sounds
Describe labs on someone who has DIC? - ANS ✓Low platelets (<100,000), high PT/PTT
(>15/>60-90) and high d-dimer (>2 mg/L)
What is the most important DIC medical intervention? - ANS ✓Stop the clotting -IV heparin
PCO2 normal ABG range - ANS ✓PCO2 = carbon dioxide, 35-45 mmHg
Respiratory Alkalosis causes - ANS ✓Respiratory distress (blowing off too much CO2),
restrictive lung diseases, anxiety w/ excessive respiratory rate
What is asterixis? - ANS ✓hand tremor, this is a classic sign of liver failure. Asterixis may
resemble a bird flapping its wings (found in stage 1-3 hepatic encephalopathy)
What labs are affected in metabolic acidosis? - ANS ✓Low HCO3 (<22) and low PH
(acidotic, <7.35)
What are s/s of pancreatic hemorrhage? - ANS ✓Cullens sign (bruising around umbilicus)
and Turner's sign (flank or back bruising)
What are typical manifestations of diastolic heart failure? - ANS ✓shortness of breath,
tachypnea and pulmonary congestion
Friction rub is associated with what condition? - ANS ✓pericarditis or restrictive heart
disease
MEDICAL SUR
, 2
MEDICAL SUR
What lab is indicative of the degree of heart failure a person is exhibiting? - ANS ✓BNP
(Brain natriuretic peptide): this hormone regulates BP and fluid volume levels. >51.2 is mild
and >1000 pg/mL is severe
Centriacinar emphysema - ANS ✓occurs in UPPER half of lung. Caused by long-term
Cigarette smoking, occurs in older people >50)
Troponin I - ANS ✓Elevation indicates an MI. >1.4 mcg/L. This lab stays elevated x14 days
after a heart attack
Digoxin toxicity - ANS ✓>2.0 n.g/mL. S/S: yellow/green halos in visual fields. Treatment:
Digibind
Cirrhosis leads to ______ which = increased risk for _________ - ANS ✓Portal
HTN....increased risk for varices
What is contraindicated in chronic ETOH cirrhosis patients? - ANS ✓NG tubes..due to risk
of varices
Multiple myeloma S/S - ANS ✓Increased calcium (calcium is pushed out of the bones), bone
pain, bones become fragile and lead to fractures
Assessment findings most consistent with peripheral vascular disease include - ANS ✓brown
pigmentation on ankles from iron deposits leaking from venous stasis, warm legs, venous
ulcers, pain with resting, distal edema
Assessment findings consistent with Peripheral Artery disease - ANS ✓pain with ambulation
(claudication), distal/digit ulcers and absent pulses
Reversal agent for heparin - ANS ✓protamine sulfate
Basophils - ANS ✓A granulocyte responsible for anaphylactic reactions
Shift to the left - ANS ✓elevated bands (immature neutrophils) >10%. This occurs with
infection /inflammation
How would you recognize a leak in a chest tube system? - ANS ✓bubbling in water seal
chamber. (don't confuse this with tidaling, the rise and fall with breath is normal)
Virchow's Triad - ANS ✓Venous stasis, vessel wall damage, hypercoaguable state
(cancer/dehydration). These place a person at a high risk of developing a pulmonary embolus
The S1 sound represents the closure of the - ANS ✓Closure of mitral/tricuspid valves (start
of systole/squeeze) "LUB" sound
PaO2 normal ABG values - ANS ✓>60 mmHg
MEDICAL SUR
, 3
MEDICAL SUR
Adenocarcinoma - ANS ✓type of lung cancer, occurs mostly in women, causes lots of
mucous
Describe neutrophils - ANS ✓90% of granulocytes. Neutrophils fight infection and respond
to inflammation
What are the recommendations for BP in someone less than 50? - ANS ✓Less than 140/90
What are the recommendations for BP in someone 60+? - ANS ✓Less than 150/90
How long should you fast before cholesterol testing? - ANS ✓at least 8 hours or more
What is a normal range for LDL cholesterol? - ANS ✓<160 mg/dL
What is a normal range for HDL cholesterol? - ANS ✓>40 mg/dL
What is a normal level for total cholesterol? - ANS ✓<200 mg/dL
What is a normal level for triglycerides? - ANS ✓<150 mg/dL
"An S3 heart sound can be normal in which people?" - ANS ✓young people and athletes
An S3 heart sound is often associated with? - ANS ✓heart failure/fluid volume overload
(when heard in the older adult). This heart sound is transient (may come and go)
What is the definition of cardiac output? - ANS ✓the amount of blood pumped by the heart
in one minute
Acute lymphocytic leukemia (ALL) - ANS ✓dx age 2-4, s/s: anemia, bleeding, infection,
elevated WBC, joint/bone pain. The most common form of childhood leukemia.
Overproduction of lymphocytes
Protonix - ANS ✓Management of GI bleeds. Begins with a bolus and then gtt
S/S of peritoneal irritation - ANS ✓rigid abdomen, absent bowel sounds, tenderness/guarding
of abdomen, severe focal pain, N/V
What are causes of peritoneal irritation - ANS ✓appendicitis, cholecystitis, pancreatitis,
obstruction, perforated viscous, inflammatory bowel disease
What drugs increase the risk of pancreatitis? - ANS ✓corticosteroids, cyclosporine,
sulfonamides, estrogens
DKA treatment - ANS ✓1. fluids (NS, D5 1/2NS) 2. Replace K (drops with insulin) 3.
Monitor phosphorous 4. Insulin drip
MEDICAL SUR
, 4
MEDICAL SUR
ACE inhibitor's mechanism of action - ANS ✓produce vasodilation by inhibiting the
formation of angiotensin II.
How to beta blockers work - ANS ✓Beta blockers decrease the sympathetic nervous system's
response (aka desensitizes nerve receptors on blood vessels) to decreased cardiac output
resulting in less constriction in the blood vessels, which ultimately lowers blood pressure
What is a normal troponin level? - ANS ✓<0.4 ng/mL. This level may take up to 4 hours to
increase and stays elevated post injury 10+ days
Risk factors for digoxin toxicity: - ANS ✓gastroparesis (may have increased absorption
because it is in the stomach longer), advanced age, hypokalemia, hypomagnesemia, herbal
supplements, diuretic use, calcium channel blocker use and amiodarone (reduces clearance of
digoxin by 30%)
What is an early s/s of digoxin toxicity? - ANS ✓N/V is an Early s/s, while vision changes is
a LATE s/s of digoxin toxicity
What is the is the most common cause of a pericardial friction rub (grating/scratching)? -
ANS ✓pericarditis..other situations that may result in pericardial friction rub are post op after
heart surgery, in an immunosuppressed patient or one with rheumatic fever
ARDS (acute respiratory distress syndrome) - ANS ✓respiratory insufficiency marked by
progressive/sudden hypoxia caused by inflammatory process. Patient may have pulmonary
edema without a cardiac cause
What is the recommended daily allowance of sodium for someone with hypertension? - ANS
✓less than 2400mg
An echocardiography tells us - ANS ✓information on the size and pumping function of the
heart, blood volume status and valve functioning
Why should someone with cardiovascular disease be concerned with new or excessive fatigue
with an exercise program - ANS ✓this may indicate worsening hypertension or heart valve
dysfunction
How does the body compensate for lack of myocardial oxygen consumption? - ANS ✓First
RR is increased, then heart rate goes up and finally a late indicator is increased blood
pressure/pulse pressure
Causes of ARDs - ANS ✓Sepsis, shock, gastric aspiration, trauma, pancreatitis, drowning
Large Cell Lung Cancer - ANS ✓Fast growing, least common, occurs in 10% of people
MEDICAL SUR
MEDICAL SUR
MEDICAL SURGICAL CERTIFICATION EXAM
QUESTIONS WITH CORRECT VERIFIED
ANSWERS LATEST UPDATE (2025/2026)
GUARANTEED PASS
What test is the best way to rule out organ rejection or hepatitis in a liver transplant? - ANS
✓liver biopsy
What positive assessment finding would indicate cholecystitis? - ANS ✓Positive Murphy's
sign
What assessment finding is suggestive of paralytic ileus? - ANS ✓absent bowel sounds
Describe labs on someone who has DIC? - ANS ✓Low platelets (<100,000), high PT/PTT
(>15/>60-90) and high d-dimer (>2 mg/L)
What is the most important DIC medical intervention? - ANS ✓Stop the clotting -IV heparin
PCO2 normal ABG range - ANS ✓PCO2 = carbon dioxide, 35-45 mmHg
Respiratory Alkalosis causes - ANS ✓Respiratory distress (blowing off too much CO2),
restrictive lung diseases, anxiety w/ excessive respiratory rate
What is asterixis? - ANS ✓hand tremor, this is a classic sign of liver failure. Asterixis may
resemble a bird flapping its wings (found in stage 1-3 hepatic encephalopathy)
What labs are affected in metabolic acidosis? - ANS ✓Low HCO3 (<22) and low PH
(acidotic, <7.35)
What are s/s of pancreatic hemorrhage? - ANS ✓Cullens sign (bruising around umbilicus)
and Turner's sign (flank or back bruising)
What are typical manifestations of diastolic heart failure? - ANS ✓shortness of breath,
tachypnea and pulmonary congestion
Friction rub is associated with what condition? - ANS ✓pericarditis or restrictive heart
disease
MEDICAL SUR
, 2
MEDICAL SUR
What lab is indicative of the degree of heart failure a person is exhibiting? - ANS ✓BNP
(Brain natriuretic peptide): this hormone regulates BP and fluid volume levels. >51.2 is mild
and >1000 pg/mL is severe
Centriacinar emphysema - ANS ✓occurs in UPPER half of lung. Caused by long-term
Cigarette smoking, occurs in older people >50)
Troponin I - ANS ✓Elevation indicates an MI. >1.4 mcg/L. This lab stays elevated x14 days
after a heart attack
Digoxin toxicity - ANS ✓>2.0 n.g/mL. S/S: yellow/green halos in visual fields. Treatment:
Digibind
Cirrhosis leads to ______ which = increased risk for _________ - ANS ✓Portal
HTN....increased risk for varices
What is contraindicated in chronic ETOH cirrhosis patients? - ANS ✓NG tubes..due to risk
of varices
Multiple myeloma S/S - ANS ✓Increased calcium (calcium is pushed out of the bones), bone
pain, bones become fragile and lead to fractures
Assessment findings most consistent with peripheral vascular disease include - ANS ✓brown
pigmentation on ankles from iron deposits leaking from venous stasis, warm legs, venous
ulcers, pain with resting, distal edema
Assessment findings consistent with Peripheral Artery disease - ANS ✓pain with ambulation
(claudication), distal/digit ulcers and absent pulses
Reversal agent for heparin - ANS ✓protamine sulfate
Basophils - ANS ✓A granulocyte responsible for anaphylactic reactions
Shift to the left - ANS ✓elevated bands (immature neutrophils) >10%. This occurs with
infection /inflammation
How would you recognize a leak in a chest tube system? - ANS ✓bubbling in water seal
chamber. (don't confuse this with tidaling, the rise and fall with breath is normal)
Virchow's Triad - ANS ✓Venous stasis, vessel wall damage, hypercoaguable state
(cancer/dehydration). These place a person at a high risk of developing a pulmonary embolus
The S1 sound represents the closure of the - ANS ✓Closure of mitral/tricuspid valves (start
of systole/squeeze) "LUB" sound
PaO2 normal ABG values - ANS ✓>60 mmHg
MEDICAL SUR
, 3
MEDICAL SUR
Adenocarcinoma - ANS ✓type of lung cancer, occurs mostly in women, causes lots of
mucous
Describe neutrophils - ANS ✓90% of granulocytes. Neutrophils fight infection and respond
to inflammation
What are the recommendations for BP in someone less than 50? - ANS ✓Less than 140/90
What are the recommendations for BP in someone 60+? - ANS ✓Less than 150/90
How long should you fast before cholesterol testing? - ANS ✓at least 8 hours or more
What is a normal range for LDL cholesterol? - ANS ✓<160 mg/dL
What is a normal range for HDL cholesterol? - ANS ✓>40 mg/dL
What is a normal level for total cholesterol? - ANS ✓<200 mg/dL
What is a normal level for triglycerides? - ANS ✓<150 mg/dL
"An S3 heart sound can be normal in which people?" - ANS ✓young people and athletes
An S3 heart sound is often associated with? - ANS ✓heart failure/fluid volume overload
(when heard in the older adult). This heart sound is transient (may come and go)
What is the definition of cardiac output? - ANS ✓the amount of blood pumped by the heart
in one minute
Acute lymphocytic leukemia (ALL) - ANS ✓dx age 2-4, s/s: anemia, bleeding, infection,
elevated WBC, joint/bone pain. The most common form of childhood leukemia.
Overproduction of lymphocytes
Protonix - ANS ✓Management of GI bleeds. Begins with a bolus and then gtt
S/S of peritoneal irritation - ANS ✓rigid abdomen, absent bowel sounds, tenderness/guarding
of abdomen, severe focal pain, N/V
What are causes of peritoneal irritation - ANS ✓appendicitis, cholecystitis, pancreatitis,
obstruction, perforated viscous, inflammatory bowel disease
What drugs increase the risk of pancreatitis? - ANS ✓corticosteroids, cyclosporine,
sulfonamides, estrogens
DKA treatment - ANS ✓1. fluids (NS, D5 1/2NS) 2. Replace K (drops with insulin) 3.
Monitor phosphorous 4. Insulin drip
MEDICAL SUR
, 4
MEDICAL SUR
ACE inhibitor's mechanism of action - ANS ✓produce vasodilation by inhibiting the
formation of angiotensin II.
How to beta blockers work - ANS ✓Beta blockers decrease the sympathetic nervous system's
response (aka desensitizes nerve receptors on blood vessels) to decreased cardiac output
resulting in less constriction in the blood vessels, which ultimately lowers blood pressure
What is a normal troponin level? - ANS ✓<0.4 ng/mL. This level may take up to 4 hours to
increase and stays elevated post injury 10+ days
Risk factors for digoxin toxicity: - ANS ✓gastroparesis (may have increased absorption
because it is in the stomach longer), advanced age, hypokalemia, hypomagnesemia, herbal
supplements, diuretic use, calcium channel blocker use and amiodarone (reduces clearance of
digoxin by 30%)
What is an early s/s of digoxin toxicity? - ANS ✓N/V is an Early s/s, while vision changes is
a LATE s/s of digoxin toxicity
What is the is the most common cause of a pericardial friction rub (grating/scratching)? -
ANS ✓pericarditis..other situations that may result in pericardial friction rub are post op after
heart surgery, in an immunosuppressed patient or one with rheumatic fever
ARDS (acute respiratory distress syndrome) - ANS ✓respiratory insufficiency marked by
progressive/sudden hypoxia caused by inflammatory process. Patient may have pulmonary
edema without a cardiac cause
What is the recommended daily allowance of sodium for someone with hypertension? - ANS
✓less than 2400mg
An echocardiography tells us - ANS ✓information on the size and pumping function of the
heart, blood volume status and valve functioning
Why should someone with cardiovascular disease be concerned with new or excessive fatigue
with an exercise program - ANS ✓this may indicate worsening hypertension or heart valve
dysfunction
How does the body compensate for lack of myocardial oxygen consumption? - ANS ✓First
RR is increased, then heart rate goes up and finally a late indicator is increased blood
pressure/pulse pressure
Causes of ARDs - ANS ✓Sepsis, shock, gastric aspiration, trauma, pancreatitis, drowning
Large Cell Lung Cancer - ANS ✓Fast growing, least common, occurs in 10% of people
MEDICAL SUR
