ANCC Medical-Surgical Nursing
Certification Exam (2026/2027) –
American Nurses Credentialing Center
Medical-Surgical Nursing Certification
Exam with Complete Questions &
Verified Answers
d -CORRECTANSWER A nurse is reviewing the medical record of a client who is
receiving heparin therapy for treatment of DVT. Which of the following interventions
should the nurse anticipate taking if the client's aPTT is 96 seconds?a. Increase the
heparin infusion flow rate by 2 mL/hrb. continue to monitor the heparin infusion as
prescribedc. request a prothrombin timed. stop the heparin infusion
a -CORRECTANSWER A nurse is providing teaching for a client who is 2 days post-op
following a heart transplant. Which of the following statements should the nurse include
in the teaching?a. "you may no longer be able to feel chest pain."b. "your level of activity
tolerance will not change."c. "after 6 months, you will no longer need to restrict your
sodium intake."d. "you will be able to stop taking immunosuppressants after 12 months."
a -CORRECTANSWER A nurse is assess a client in the emergency room who has a
bradydysrhythmia. Which of the following findings should the nurse expect?A.
confusionB. friction rubC. hypertensionD. dry skin
,d -CORRECTANSWER A nurse in the emergency department is caring for a client who
had an anterior MI. The client's history reveals she is 1 week post-op open
cholecystectomy. The nurse should recognize that which of the following interventions is
contraindicated?A. administering IV morphine sulfateB. administering oxygen at 2 :/min
via nasal cannulaC. helping the client to the bedside commodeD. assisting with
thrombolytic therapy
D -CORRECTANSWER A nurse is caring for a client who has endocarditis. Which of
the following findings should the nurse recognize as a potential complication?A.
ventricular depolarizationB. Guillain-Barre syndromC. myelodysplastic syndromeD.
Valvular disease
C -CORRECTANSWER A nurse is caring for a client who presents to the ER with a BP
of 254/138 mmHg. The nurse recognizes that the client is in a hypertensive crisis.
Which of the following actions should the nurse take first?A. obtain blood samples for
laboratory testingB. Tell the client to report vision changesC. Place the head of the bed
at 45 degreesD. initiate an IV
a -CORRECTANSWER a nurse is caring for a client who has HF and is experiencing
AF. The nurse should plan to monitor for and report which of the following findings to
the provider immediately?a. slurred speechb. irregular pulsec. dependent edemad.
persistent fatigue
,b -CORRECTANSWER A nurse is assessing a client who has left-sided HF. Which of
the following manifestations should the nurse expect to find?a. inc abdominal girthb.
weak peripheral pulsesc. jugular vein distentiond. dependent edema
b -CORRECTANSWER a nurse is caring for a client who is being treated for HF and
has prescriptions for digoxin and furosemide. The nurse should plan to monitor for
which of the following as an adverse effect of these medications?a. SOBb.
lightheadednessc. dry coughd. metallic taste
c -CORRECTANSWER a nurse is monitoring a client following coronary artery bypass
graft surgery. Which of the following findings can indicate cardiac tamponade?a. sternal
instabilityb. inc WBC countc. BP 140/82 mmHg on inspiration and 154/90 mmHg on
expirationd. sinus rhythm with occasional premature atrial contraction and HR 88/min
d -CORRECTANSWER A nurse is preparing a client for coroncary angiography. The
nurse should report which of the following findings to the provider prior to the
procedure?a. hemoglobin 14.4 g/dLb. history of peripheral arterial diseasec. urine
output 200 mL/4 hrd. previous allergic reaction to shellfish
a -CORRECTANSWER A nurse is caring for a client following insertion of a permanent
pacemaker. Which of the following client statements indicates a potential complication
of the insertion procedure?a. "I can't get rid of these hiccups."b. "I feel dizzy when i
stand."c. "My incision site stings."d. "I have a headache."
, b -CORRECTANSWER A nurse is providing discharge teaching for a client who has a
prescription for the transdermal nitroglycerin patch. Which of the following instructions
should the nurse include in the teaching?a. apply the new patch to the same site as the
previous patchb. place the patch on an area of skin away from skin folds and jointsc.
keep the patch on 24 hr per dayd. replace the patch at the onset of angina
c -CORRECTANSWER A nurse is caring for a client in the first hour following an aortic
aneurysm repair. Which of the following findings can indicate shock and should be
reported to the provider?a. serosanguinous drainage on dressingb. severe pain with
coughingc. urine output of 20 mL/hrd. increase in temp from 36.C (98.2F)- 37.5C
(99.5F)
d -CORRECTANSWER A nurse caring for a client following an abdominal aortic
aneurysm resection. Which of the following is the priority assessment for this client?a.
neck vein distentionb. bowel soundsc. peripheral edemad. urine output
b -CORRECTANSWER A nurse is watching a client's ECG monitor and notes that the
client's rhythm has changed from a normal sinus rhythm to supraventricular tachycardia.
The client is conscious with a HR of 200-210 bpm and has a faint radial pulse. The
nurse should anticipate assisting with which of the following interventions?a. delivery of
precordial thumpb. vagal stimulationc. administration of atropine IVd. defibrillation
Certification Exam (2026/2027) –
American Nurses Credentialing Center
Medical-Surgical Nursing Certification
Exam with Complete Questions &
Verified Answers
d -CORRECTANSWER A nurse is reviewing the medical record of a client who is
receiving heparin therapy for treatment of DVT. Which of the following interventions
should the nurse anticipate taking if the client's aPTT is 96 seconds?a. Increase the
heparin infusion flow rate by 2 mL/hrb. continue to monitor the heparin infusion as
prescribedc. request a prothrombin timed. stop the heparin infusion
a -CORRECTANSWER A nurse is providing teaching for a client who is 2 days post-op
following a heart transplant. Which of the following statements should the nurse include
in the teaching?a. "you may no longer be able to feel chest pain."b. "your level of activity
tolerance will not change."c. "after 6 months, you will no longer need to restrict your
sodium intake."d. "you will be able to stop taking immunosuppressants after 12 months."
a -CORRECTANSWER A nurse is assess a client in the emergency room who has a
bradydysrhythmia. Which of the following findings should the nurse expect?A.
confusionB. friction rubC. hypertensionD. dry skin
,d -CORRECTANSWER A nurse in the emergency department is caring for a client who
had an anterior MI. The client's history reveals she is 1 week post-op open
cholecystectomy. The nurse should recognize that which of the following interventions is
contraindicated?A. administering IV morphine sulfateB. administering oxygen at 2 :/min
via nasal cannulaC. helping the client to the bedside commodeD. assisting with
thrombolytic therapy
D -CORRECTANSWER A nurse is caring for a client who has endocarditis. Which of
the following findings should the nurse recognize as a potential complication?A.
ventricular depolarizationB. Guillain-Barre syndromC. myelodysplastic syndromeD.
Valvular disease
C -CORRECTANSWER A nurse is caring for a client who presents to the ER with a BP
of 254/138 mmHg. The nurse recognizes that the client is in a hypertensive crisis.
Which of the following actions should the nurse take first?A. obtain blood samples for
laboratory testingB. Tell the client to report vision changesC. Place the head of the bed
at 45 degreesD. initiate an IV
a -CORRECTANSWER a nurse is caring for a client who has HF and is experiencing
AF. The nurse should plan to monitor for and report which of the following findings to
the provider immediately?a. slurred speechb. irregular pulsec. dependent edemad.
persistent fatigue
,b -CORRECTANSWER A nurse is assessing a client who has left-sided HF. Which of
the following manifestations should the nurse expect to find?a. inc abdominal girthb.
weak peripheral pulsesc. jugular vein distentiond. dependent edema
b -CORRECTANSWER a nurse is caring for a client who is being treated for HF and
has prescriptions for digoxin and furosemide. The nurse should plan to monitor for
which of the following as an adverse effect of these medications?a. SOBb.
lightheadednessc. dry coughd. metallic taste
c -CORRECTANSWER a nurse is monitoring a client following coronary artery bypass
graft surgery. Which of the following findings can indicate cardiac tamponade?a. sternal
instabilityb. inc WBC countc. BP 140/82 mmHg on inspiration and 154/90 mmHg on
expirationd. sinus rhythm with occasional premature atrial contraction and HR 88/min
d -CORRECTANSWER A nurse is preparing a client for coroncary angiography. The
nurse should report which of the following findings to the provider prior to the
procedure?a. hemoglobin 14.4 g/dLb. history of peripheral arterial diseasec. urine
output 200 mL/4 hrd. previous allergic reaction to shellfish
a -CORRECTANSWER A nurse is caring for a client following insertion of a permanent
pacemaker. Which of the following client statements indicates a potential complication
of the insertion procedure?a. "I can't get rid of these hiccups."b. "I feel dizzy when i
stand."c. "My incision site stings."d. "I have a headache."
, b -CORRECTANSWER A nurse is providing discharge teaching for a client who has a
prescription for the transdermal nitroglycerin patch. Which of the following instructions
should the nurse include in the teaching?a. apply the new patch to the same site as the
previous patchb. place the patch on an area of skin away from skin folds and jointsc.
keep the patch on 24 hr per dayd. replace the patch at the onset of angina
c -CORRECTANSWER A nurse is caring for a client in the first hour following an aortic
aneurysm repair. Which of the following findings can indicate shock and should be
reported to the provider?a. serosanguinous drainage on dressingb. severe pain with
coughingc. urine output of 20 mL/hrd. increase in temp from 36.C (98.2F)- 37.5C
(99.5F)
d -CORRECTANSWER A nurse caring for a client following an abdominal aortic
aneurysm resection. Which of the following is the priority assessment for this client?a.
neck vein distentionb. bowel soundsc. peripheral edemad. urine output
b -CORRECTANSWER A nurse is watching a client's ECG monitor and notes that the
client's rhythm has changed from a normal sinus rhythm to supraventricular tachycardia.
The client is conscious with a HR of 200-210 bpm and has a faint radial pulse. The
nurse should anticipate assisting with which of the following interventions?a. delivery of
precordial thumpb. vagal stimulationc. administration of atropine IVd. defibrillation
