MED-SURG. ANCC CERTIFICATION
CORRECT QUESTIONS & ANSWERS
Mc burney's point - ANSWERPoint in RLQ abd of appendix. Tenderness indicates
appendicitis
Murphy's sign - ANSWERPlace fingers under rt coastal margin and instruct to take deep
breath. Increased tenderness with sudden stop during inhalation is a positive murphy's
sign
Obturator muscle,
psoas sign,
Rovsing's sign - ANSWERAll assessment used to r/o appendicitis
Homan's sign - ANSWEROut dated and not recommended to use for assessment for
DVT
Jar sign(markle sign) - ANSWERPain from a jarring movement to indicate peritonitis
with appendicitis. Stand on toes and drop to heals or increaded pain with walking or
running
Beck's triad - ANSWERAcute cardiac tamponade- pericardial effusion
1. Disended neck vein's
2. Distant heart sounds
3. Hypotention
Treatment- pericardiocentesis
Charcot's triad for MS - ANSWER1. Nystagmas- repetitive uncontrolled movements of
the eyes
2. Intention tremor- tremor that worsens as approaches end of intended movement
3. Scanning or staccato speech- broken speech and each syllable pronounced
separately
Charcot's triad for ascending cholangitis - ANSWERInf. of bile duct caused by bacteria
ascending from junction with duodenum
1.Jaundice
2. Fever, usually with rigors
3. RUQ ABD pain
Cushing's triad - ANSWERSigns of increased ICP
1. HTN- widened pulse pressure
2. Bradycardia
3. Irregular respirations- cheyne- stokes( slow, fast, slow period of apnea then
slow,fast,slow
, Kaussmaul breathing - ANSWERDeep and labored. Presents in severe metabolic
acidosis- DKA and kidney failure
Bergman's triad - ANSWERSigns of fat embolism
1. Mental status changes
2. Petechiae-late sign
3. Dyspnea
Brudzinski sign - ANSWERSign of meningitis- supine flex neck will cause involuntary
flexion of hips and knees
Kernig's sign - ANSWERSign of meningitis- lift flexed knee and slowly extend will cause
back pain if positive
Chvostek's sign
Trousseau' sign - ANSWERNerve hyperexcitability (tetany) seen with hypocalemia
Abnormal reaction to stimulation of facial nerve
Inflate bp cuff to greater than systolic and hand and wrist with involuntarly curl inward
Levine sign - ANSWERis positive when a patient is holding a clenched fist over his
chest to describe dull, pressing chest pain consistent with the discomfort of angina
pectoris.
A patient is diagnosed with a lateral wall ST segment elevation myocardial infarction
(STEMI). What do you expect the EKG to show?
a. ST elevation in leads V1 -V6
b. ST elevation in leads I, aVL, V5, V6
c. ST elevation in leads II, III, aVF
d. ST elevation in leads V7, V8, V9 - ANSWERB: Choice B would show a lateral wall
MI.
Choice A would show an anterior MI.
Choice C would show an inferior wall MI.
Choice D would show a posterior wall MI.
Epididymitis - ANSWERcommonly caused by E.coli in elderly males and/or those who
are not sexually active and have normal immune function. In sexually active males with
a history of unprotected sex, the causative organisms are likely gonorrhea and/or
chlamydia. Cases of epididymitis caused by Staph aureus are rare. Epididymitis caused
by cytomegalovirus (CMV) is incredibly rare unless the patient is immunocompromised.
Triple H therapy for
Subarachnoid Hemorrhage- induced
CORRECT QUESTIONS & ANSWERS
Mc burney's point - ANSWERPoint in RLQ abd of appendix. Tenderness indicates
appendicitis
Murphy's sign - ANSWERPlace fingers under rt coastal margin and instruct to take deep
breath. Increased tenderness with sudden stop during inhalation is a positive murphy's
sign
Obturator muscle,
psoas sign,
Rovsing's sign - ANSWERAll assessment used to r/o appendicitis
Homan's sign - ANSWEROut dated and not recommended to use for assessment for
DVT
Jar sign(markle sign) - ANSWERPain from a jarring movement to indicate peritonitis
with appendicitis. Stand on toes and drop to heals or increaded pain with walking or
running
Beck's triad - ANSWERAcute cardiac tamponade- pericardial effusion
1. Disended neck vein's
2. Distant heart sounds
3. Hypotention
Treatment- pericardiocentesis
Charcot's triad for MS - ANSWER1. Nystagmas- repetitive uncontrolled movements of
the eyes
2. Intention tremor- tremor that worsens as approaches end of intended movement
3. Scanning or staccato speech- broken speech and each syllable pronounced
separately
Charcot's triad for ascending cholangitis - ANSWERInf. of bile duct caused by bacteria
ascending from junction with duodenum
1.Jaundice
2. Fever, usually with rigors
3. RUQ ABD pain
Cushing's triad - ANSWERSigns of increased ICP
1. HTN- widened pulse pressure
2. Bradycardia
3. Irregular respirations- cheyne- stokes( slow, fast, slow period of apnea then
slow,fast,slow
, Kaussmaul breathing - ANSWERDeep and labored. Presents in severe metabolic
acidosis- DKA and kidney failure
Bergman's triad - ANSWERSigns of fat embolism
1. Mental status changes
2. Petechiae-late sign
3. Dyspnea
Brudzinski sign - ANSWERSign of meningitis- supine flex neck will cause involuntary
flexion of hips and knees
Kernig's sign - ANSWERSign of meningitis- lift flexed knee and slowly extend will cause
back pain if positive
Chvostek's sign
Trousseau' sign - ANSWERNerve hyperexcitability (tetany) seen with hypocalemia
Abnormal reaction to stimulation of facial nerve
Inflate bp cuff to greater than systolic and hand and wrist with involuntarly curl inward
Levine sign - ANSWERis positive when a patient is holding a clenched fist over his
chest to describe dull, pressing chest pain consistent with the discomfort of angina
pectoris.
A patient is diagnosed with a lateral wall ST segment elevation myocardial infarction
(STEMI). What do you expect the EKG to show?
a. ST elevation in leads V1 -V6
b. ST elevation in leads I, aVL, V5, V6
c. ST elevation in leads II, III, aVF
d. ST elevation in leads V7, V8, V9 - ANSWERB: Choice B would show a lateral wall
MI.
Choice A would show an anterior MI.
Choice C would show an inferior wall MI.
Choice D would show a posterior wall MI.
Epididymitis - ANSWERcommonly caused by E.coli in elderly males and/or those who
are not sexually active and have normal immune function. In sexually active males with
a history of unprotected sex, the causative organisms are likely gonorrhea and/or
chlamydia. Cases of epididymitis caused by Staph aureus are rare. Epididymitis caused
by cytomegalovirus (CMV) is incredibly rare unless the patient is immunocompromised.
Triple H therapy for
Subarachnoid Hemorrhage- induced
