Medical Surgical Nursing Certification Exam 2026 Latest
400 Prep Questions and Correct Answers / ANCC Med Surg
Certification Practice A - Questions with Correct Answers
An RN assesses a patient in the Cancer Center with a diagnosis of terminal cancer.
The patient states to the RN that he is short of breath, has no appetite and hurts
everywhere. Which of the following statements by the nurse is best?
A. Tell me how your family is coping
B. Show me where it does not hurt
C. I'll teach you relaxation techniques
D. Your physician should increase your pain medication - ANSWER-C
A clinical nurse returns to the desk to find 4 phone messages. Which of the
following messages should the nurse respond to first?
A. A post cervical laminectomy patient complaining of sudden difficulty talking.
B. A patient with multiple sclerosis complaining of change in peripheral vision.
C. A patient with a herniated disc complaining of consistent back pain.
D. A patient with a cast due to a fracture of the right tibial bone complaining of
tingling toes. - ANSWER-A
B and C are expected symptoms of the patient's condition. A and D are
unexpected. D is less critical than A. Best answer is A.
The nurse is alerted to possible anaphylactic shock immediately after a patient has
received intramuscular penicillin by the development of:
pg. 1
,A. Edema and itching at the injection site
B. Sneezing and itching of the nose and eyes
C. A wheal-and-flare reaction at the injection site
D. Chest tightness and production of thick sputum - ANSWER-A. Edema and
itching at the injection site
A client with a past history of angina has had a total knee replacement. What will
the nurse teach the client prior to rehabilitation activities?
A. "Use analgesics even if you are not in pain."
B. "Take nitroglycerine prophylactically prior to activity."
C. "Take anti-inflammatory medications before you get out of bed."
D. "Do not exercise if you have knee pain." - ANSWER-B. "Take nitroglycerine
prophylactically prior to activity."
Participation in exercise may increase myocardial oxygen demand beyond the
ability of the coronary circulation to deliver enough oxygen to meet the increased
need. Nitroglycerin dilates coronary arteries within 5 minutes of use, ensuring that
they will be ready to meet the demand during exercise.
Which of the postoperative orders will the nurse clarify with the surgeon before
discharging the client who just had arthroscopic surgery on the right knee?
A. Keep right leg elevated on a soft pillow
B. Non-weight-bearing by right leg for 48 hours
C. Bathroom privileges with assistance and crutches
D. Two tablets of Hydrocodone 10/325mg every 2 hours for pain - ANSWER-D.
pg. 2
,Max Tylenol (3000mg)
A home care nurse is visiting a diabetic client with a new cast on the arm. On
assessment, the nurse finds the client's fingers to be pale, cool, and slightly
swollen. Which is the nurse's first intervention?
a. Elevating the arm above the level of the heart
b. Encouraging active and passive range of motion
c. Applying heat to the affected hand
d. Applying a bivalve the cast - ANSWER-a. Elevating the arm above the level of
the heart
Arm casts can impinge on circulation when the arm is in the dependent position.
The nurse should elevate the arm above the level of the heart, ensuring that the
hand is above the elbow, and reassess the extremity in 15 minutes. If the fingers
are warmer and less swollen, the cast is not too tight and adjustments do not need
to be made. Heat would cause more edema. Encouraging range of motion would
not assist the client as much as elevating the arm.
Which exercise will the nurse recommend to a client at risk for osteoporosis?
a. High-impact aerobics 45 minutes once weekly
b. Walking 30 minutes three times weekly
c. Jogging 30 minutes four times weekly
d. Bowling for 1 hour twice weekly - ANSWER-B
Weight-bearing, nonjaring exercises have been proven to reduce or slow bone loss
without causing vertebral compression. High-impact aerobics, jogging, and
pg. 3
, bowling are activities that actually could cause fractures in a client with
osteoporosis.
Which statement indicates that the client understands teaching about alendronate
(Fosamax)?
a. "I should take this drug with a full glass of water."
b. "I need to lie down for 30 minutes after taking it."
c. "This drug should be taken after a meal."
d. "This drug needs to be taken at the same time with calcium." - ANSWER-A
Fosamax needs to be taken on an empty stomach with a full glass of water. After
taking the drug, the client needs to stay upright for 30 minutes. Fosamax should be
taken on an empty stomach for best absorption. Calcium can be taken, but not at
the same time as the Fosamax.
While assessing an older adult client admitted 2 days ago with a fractured hip, the
nurse notes that the client is confused, tachypneic, and restless. Which is the
nurse's first action?
a. Administering oxygen via nasal cannula
b. Applying restraints
c. Slowing the IV flow rate
d. Discontinuing the pain medication - ANSWER-A
The client is at high risk for a fat embolism and has some of the clinical
manifestations. Although this is a life-threatening emergency, the nurse should
take the time to administer oxygen first and then notify the health care provider.
Oxygen administration can reduce the risk for cerebral damage from hypoxia. The
pg. 4
400 Prep Questions and Correct Answers / ANCC Med Surg
Certification Practice A - Questions with Correct Answers
An RN assesses a patient in the Cancer Center with a diagnosis of terminal cancer.
The patient states to the RN that he is short of breath, has no appetite and hurts
everywhere. Which of the following statements by the nurse is best?
A. Tell me how your family is coping
B. Show me where it does not hurt
C. I'll teach you relaxation techniques
D. Your physician should increase your pain medication - ANSWER-C
A clinical nurse returns to the desk to find 4 phone messages. Which of the
following messages should the nurse respond to first?
A. A post cervical laminectomy patient complaining of sudden difficulty talking.
B. A patient with multiple sclerosis complaining of change in peripheral vision.
C. A patient with a herniated disc complaining of consistent back pain.
D. A patient with a cast due to a fracture of the right tibial bone complaining of
tingling toes. - ANSWER-A
B and C are expected symptoms of the patient's condition. A and D are
unexpected. D is less critical than A. Best answer is A.
The nurse is alerted to possible anaphylactic shock immediately after a patient has
received intramuscular penicillin by the development of:
pg. 1
,A. Edema and itching at the injection site
B. Sneezing and itching of the nose and eyes
C. A wheal-and-flare reaction at the injection site
D. Chest tightness and production of thick sputum - ANSWER-A. Edema and
itching at the injection site
A client with a past history of angina has had a total knee replacement. What will
the nurse teach the client prior to rehabilitation activities?
A. "Use analgesics even if you are not in pain."
B. "Take nitroglycerine prophylactically prior to activity."
C. "Take anti-inflammatory medications before you get out of bed."
D. "Do not exercise if you have knee pain." - ANSWER-B. "Take nitroglycerine
prophylactically prior to activity."
Participation in exercise may increase myocardial oxygen demand beyond the
ability of the coronary circulation to deliver enough oxygen to meet the increased
need. Nitroglycerin dilates coronary arteries within 5 minutes of use, ensuring that
they will be ready to meet the demand during exercise.
Which of the postoperative orders will the nurse clarify with the surgeon before
discharging the client who just had arthroscopic surgery on the right knee?
A. Keep right leg elevated on a soft pillow
B. Non-weight-bearing by right leg for 48 hours
C. Bathroom privileges with assistance and crutches
D. Two tablets of Hydrocodone 10/325mg every 2 hours for pain - ANSWER-D.
pg. 2
,Max Tylenol (3000mg)
A home care nurse is visiting a diabetic client with a new cast on the arm. On
assessment, the nurse finds the client's fingers to be pale, cool, and slightly
swollen. Which is the nurse's first intervention?
a. Elevating the arm above the level of the heart
b. Encouraging active and passive range of motion
c. Applying heat to the affected hand
d. Applying a bivalve the cast - ANSWER-a. Elevating the arm above the level of
the heart
Arm casts can impinge on circulation when the arm is in the dependent position.
The nurse should elevate the arm above the level of the heart, ensuring that the
hand is above the elbow, and reassess the extremity in 15 minutes. If the fingers
are warmer and less swollen, the cast is not too tight and adjustments do not need
to be made. Heat would cause more edema. Encouraging range of motion would
not assist the client as much as elevating the arm.
Which exercise will the nurse recommend to a client at risk for osteoporosis?
a. High-impact aerobics 45 minutes once weekly
b. Walking 30 minutes three times weekly
c. Jogging 30 minutes four times weekly
d. Bowling for 1 hour twice weekly - ANSWER-B
Weight-bearing, nonjaring exercises have been proven to reduce or slow bone loss
without causing vertebral compression. High-impact aerobics, jogging, and
pg. 3
, bowling are activities that actually could cause fractures in a client with
osteoporosis.
Which statement indicates that the client understands teaching about alendronate
(Fosamax)?
a. "I should take this drug with a full glass of water."
b. "I need to lie down for 30 minutes after taking it."
c. "This drug should be taken after a meal."
d. "This drug needs to be taken at the same time with calcium." - ANSWER-A
Fosamax needs to be taken on an empty stomach with a full glass of water. After
taking the drug, the client needs to stay upright for 30 minutes. Fosamax should be
taken on an empty stomach for best absorption. Calcium can be taken, but not at
the same time as the Fosamax.
While assessing an older adult client admitted 2 days ago with a fractured hip, the
nurse notes that the client is confused, tachypneic, and restless. Which is the
nurse's first action?
a. Administering oxygen via nasal cannula
b. Applying restraints
c. Slowing the IV flow rate
d. Discontinuing the pain medication - ANSWER-A
The client is at high risk for a fat embolism and has some of the clinical
manifestations. Although this is a life-threatening emergency, the nurse should
take the time to administer oxygen first and then notify the health care provider.
Oxygen administration can reduce the risk for cerebral damage from hypoxia. The
pg. 4
