MEDSURG-BC Exam Progress 148/150
ANCC MEDSURG-BC CERTIFICATION EXAM
MEDICAL-SURGICAL NURSING CERTIFICATION
EXAM
150 QUESTIONS AND CORRECT ANSWERS | GRADED A+ | 100% VERIFIED
150 Total Questions 125 Scored 25 Pretest 3 Hour Time Limit
Pathophysiology Patient-Centered Care Nursing Process Pharmacology Clinical Judgment NCLEX-PN Prep
ANCC Medical-Surgical Nursing Certification (MEDSURG-BC)
Exam Structure Content Areas
✓ 150 total questions ● Assessment and Diagnosis
✓ 125 scored questions ● Planning and Implementation
✓ 25 unscored pretest questions ● Evaluation and Outcomes
✓ 3-hour time limit ● Professional Practice
● Pathophysiology by Body System
✓ Single-best-answer format
● Pharmacology and Medication Safety
✓ Computer-based testing
Answer Format
All questions are presented in bold text for clear distinction and readability.
All correct answers are presented in bold and lime green, followed by clearly defined, clinically focused rationales in italic
format that reinforce evidence-based medical-surgical nursing practices, patient safety principles, pathophysiology connections,
pharmacological reasoning, and clinical judgment required for optimal patient outcomes and ANCC MEDSURG-BC success.
1 A nurse is caring for a patient with chronic heart failure who has been prescribed furosemide
(Lasix). Which assessment finding is the priority for the nurse to monitor?
A) Blood pressure
B) Serum potassium levels
C) Respiratory rate
D) Body temperature
Correct Answer: B) Serum potassium levels
Rationale: Furosemide is a loop diuretic that causes significant potassium loss (hypokalemia). Hypokalemia can lead to
life-threatening dysrhythmias, especially in patients with cardiac conditions. Monitoring serum potassium is critical for
patient safety.
2 A patient with type 2 diabetes mellitus is being discharged. The nurse is teaching the patient
about foot care. Which statement by the patient indicates a need for further teaching?
A) 'I will inspect my feet daily for cuts or sores'
B) 'I will wear comfortable, well-fitting shoes'
C) 'I will soak my feet in hot water every evening to improve circulation'
, D) 'I will keep my feet clean and dry'
Correct Answer: C) 'I will soak my feet in hot water every evening to improve circulation'
Rationale: Patients with diabetes often have decreased sensation (neuropathy) and poor circulation. Soaking feet in hot
water can cause burns that the patient may not feel, leading to infection and potential amputation. Feet should be washed
with lukewarm water and dried thoroughly.
3 A nurse is preparing to administer a blood transfusion to a patient. What is the most
important action the nurse must take prior to starting the transfusion?
A) Administer premedication with antihistamines
B) Verify the patient's identity and blood product compatibility with another nurse
C) Warm the blood product to body temperature
D) Obtain baseline vital signs only
Correct Answer: B) Verify the patient's identity and blood product compatibility with another nurse
Rationale: The most critical safety step in blood administration is the dual verification of the patient's identity (using
two identifiers) and checking the blood product label against the medical order and the patient's wristband. This prevents
fatal hemolytic transfusion reactions caused by ABO incompatibility.
4 A patient is admitted with a suspected diagnosis of acute pancreatitis. Which laboratory value
would the nurse expect to be significantly elevated?
A) Serum creatinine
B) Serum amylase and lipase
C) Hemoglobin A1C
D) White blood cell count only
Correct Answer: B) Serum amylase and lipase
Rationale: Acute pancreatitis involves inflammation of the pancreas, leading to the release of pancreatic enzymes into
the bloodstream. Serum amylase and lipase levels are the primary diagnostic markers, with lipase being more specific
and remaining elevated longer than amylase.
5 A nurse is assessing a patient with suspected deep vein thrombosis (DVT). Which finding is
most indicative of DVT?
A) Bilateral leg swelling
B) Unilateral leg swelling with warmth and redness
C) Cool, pale extremity
D) Decreased pedal pulses
Correct Answer: B) Unilateral leg swelling with warmth and redness
Rationale: DVT typically presents with unilateral leg swelling, warmth, redness, and pain. Bilateral swelling may
indicate other conditions like heart failure. Cool, pale extremity with decreased pulses suggests arterial insufficiency, not
venous thrombosis.
6 A patient with COPD is receiving oxygen therapy at 2 L/min via nasal cannula. Why is it
important not to increase the oxygen flow rate without a physician's order?
A) High oxygen concentrations can cause oxygen toxicity
B) COPD patients may lose their hypoxic drive to breathe
C) Oxygen is expensive and should be conserved
, D) High flow rates can damage the nasal mucosa
Correct Answer: B) COPD patients may lose their hypoxic drive to breathe
Rationale: Patients with chronic COPD may rely on hypoxic drive (low oxygen levels) rather than hypercapnic drive
(high CO2 levels) to stimulate breathing. Excessive oxygen can suppress this drive, leading to respiratory depression and
CO2 narcosis.
7 A nurse is caring for a patient who just underwent a total hip replacement. Which positioning
is contraindicated for this patient?
A) Supine position with legs slightly abducted
B) Side-lying with pillow between legs
C) Crossing legs at the ankles
D) Semi-Fowler's position
Correct Answer: C) Crossing legs at the ankles
Rationale: After total hip replacement, patients must avoid adduction (crossing legs), internal rotation, and flexion
beyond 90 degrees to prevent hip dislocation. Crossing legs at the ankles or knees can cause adduction and dislocation of
the new hip joint.
8 A patient is prescribed warfarin (Coumadin) for atrial fibrillation. Which laboratory test
should the nurse monitor to evaluate therapeutic effectiveness?
A) Platelet count
B) Partial thromboplastin time (PTT)
C) International Normalized Ratio (INR)
D) Hemoglobin and hematocrit
Correct Answer: C) International Normalized Ratio (INR)
Rationale: Warfarin therapy is monitored using the INR (International Normalized Ratio). The therapeutic INR range
for atrial fibrillation is typically 2.0-3.0. PTT is used to monitor heparin therapy, not warfarin.
9 A nurse is caring for a patient with a nasogastric (NG) tube connected to suction. Which
assessment finding indicates proper NG tube function?
A) Patient reports nausea
B) Greenish-brown drainage in the collection container
C) Abdominal distension and pain
D) No drainage for 8 hours
Correct Answer: B) Greenish-brown drainage in the collection container
Rationale: Greenish-brown drainage indicates gastric contents are being properly suctioned. Nausea, abdominal
distension, and lack of drainage suggest the tube may be blocked or improperly positioned, requiring assessment and
intervention.
10 A patient with hypertension is prescribed lisinopril. Which side effect should the nurse
instruct the patient to report immediately?
A) Mild headache
B) Dry cough
C) Swelling of the face, lips, or tongue
, D) Dizziness upon standing
Correct Answer: C) Swelling of the face, lips, or tongue
Rationale: Angioedema (swelling of face, lips, or tongue) is a serious, potentially life-threatening adverse reaction to
ACE inhibitors like lisinopril. It can cause airway obstruction and requires immediate medical attention. Dry cough is
common but not emergent.
11 A nurse is preparing to administer insulin to a patient with type 1 diabetes. Which action is
most important for preventing medication errors?
A) Administer insulin before meals only
B) Verify the type, dose, and timing with another nurse
C) Use the smallest needle available
D) Inject into the abdomen only
Correct Answer: B) Verify the type, dose, and timing with another nurse
Rationale: Insulin is a high-alert medication with significant risk for serious harm if administered incorrectly. Double-
checking the type (rapid, short, intermediate, long-acting), dose, and timing with another nurse is a critical safety
measure to prevent potentially fatal errors.
12 A patient is experiencing an acute asthma attack. Which medication should the nurse
administer first?
A) Oral prednisone
B) Albuterol via nebulizer
C) Montelukast
D) Theophylline
Correct Answer: B) Albuterol via nebulizer
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that provides rapid bronchodilation and is the first-line
treatment for acute asthma exacerbations. Corticosteroids like prednisone take hours to work and are adjunctive therapy.
13 A nurse is caring for a patient with a chest tube. Which finding requires immediate
intervention?
A) Continuous bubbling in the water seal chamber
B) Intermittent bubbling in the suction control chamber
C) Tidaling in the water seal chamber
D) 50 mL of serosanguinous drainage in 8 hours
Correct Answer: A) Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling in the water seal chamber indicates an air leak in the system, which could be from the
patient (bronchopleural fistula) or the tubing. This requires immediate assessment and intervention. Tidaling is normal
and indicates the system is functioning.
14 A patient with chronic kidney disease (CKD) is on a renal diet. Which food should the nurse
instruct the patient to limit?
A) White rice
B) Bananas and oranges
C) Skinless chicken
ANCC MEDSURG-BC CERTIFICATION EXAM
MEDICAL-SURGICAL NURSING CERTIFICATION
EXAM
150 QUESTIONS AND CORRECT ANSWERS | GRADED A+ | 100% VERIFIED
150 Total Questions 125 Scored 25 Pretest 3 Hour Time Limit
Pathophysiology Patient-Centered Care Nursing Process Pharmacology Clinical Judgment NCLEX-PN Prep
ANCC Medical-Surgical Nursing Certification (MEDSURG-BC)
Exam Structure Content Areas
✓ 150 total questions ● Assessment and Diagnosis
✓ 125 scored questions ● Planning and Implementation
✓ 25 unscored pretest questions ● Evaluation and Outcomes
✓ 3-hour time limit ● Professional Practice
● Pathophysiology by Body System
✓ Single-best-answer format
● Pharmacology and Medication Safety
✓ Computer-based testing
Answer Format
All questions are presented in bold text for clear distinction and readability.
All correct answers are presented in bold and lime green, followed by clearly defined, clinically focused rationales in italic
format that reinforce evidence-based medical-surgical nursing practices, patient safety principles, pathophysiology connections,
pharmacological reasoning, and clinical judgment required for optimal patient outcomes and ANCC MEDSURG-BC success.
1 A nurse is caring for a patient with chronic heart failure who has been prescribed furosemide
(Lasix). Which assessment finding is the priority for the nurse to monitor?
A) Blood pressure
B) Serum potassium levels
C) Respiratory rate
D) Body temperature
Correct Answer: B) Serum potassium levels
Rationale: Furosemide is a loop diuretic that causes significant potassium loss (hypokalemia). Hypokalemia can lead to
life-threatening dysrhythmias, especially in patients with cardiac conditions. Monitoring serum potassium is critical for
patient safety.
2 A patient with type 2 diabetes mellitus is being discharged. The nurse is teaching the patient
about foot care. Which statement by the patient indicates a need for further teaching?
A) 'I will inspect my feet daily for cuts or sores'
B) 'I will wear comfortable, well-fitting shoes'
C) 'I will soak my feet in hot water every evening to improve circulation'
, D) 'I will keep my feet clean and dry'
Correct Answer: C) 'I will soak my feet in hot water every evening to improve circulation'
Rationale: Patients with diabetes often have decreased sensation (neuropathy) and poor circulation. Soaking feet in hot
water can cause burns that the patient may not feel, leading to infection and potential amputation. Feet should be washed
with lukewarm water and dried thoroughly.
3 A nurse is preparing to administer a blood transfusion to a patient. What is the most
important action the nurse must take prior to starting the transfusion?
A) Administer premedication with antihistamines
B) Verify the patient's identity and blood product compatibility with another nurse
C) Warm the blood product to body temperature
D) Obtain baseline vital signs only
Correct Answer: B) Verify the patient's identity and blood product compatibility with another nurse
Rationale: The most critical safety step in blood administration is the dual verification of the patient's identity (using
two identifiers) and checking the blood product label against the medical order and the patient's wristband. This prevents
fatal hemolytic transfusion reactions caused by ABO incompatibility.
4 A patient is admitted with a suspected diagnosis of acute pancreatitis. Which laboratory value
would the nurse expect to be significantly elevated?
A) Serum creatinine
B) Serum amylase and lipase
C) Hemoglobin A1C
D) White blood cell count only
Correct Answer: B) Serum amylase and lipase
Rationale: Acute pancreatitis involves inflammation of the pancreas, leading to the release of pancreatic enzymes into
the bloodstream. Serum amylase and lipase levels are the primary diagnostic markers, with lipase being more specific
and remaining elevated longer than amylase.
5 A nurse is assessing a patient with suspected deep vein thrombosis (DVT). Which finding is
most indicative of DVT?
A) Bilateral leg swelling
B) Unilateral leg swelling with warmth and redness
C) Cool, pale extremity
D) Decreased pedal pulses
Correct Answer: B) Unilateral leg swelling with warmth and redness
Rationale: DVT typically presents with unilateral leg swelling, warmth, redness, and pain. Bilateral swelling may
indicate other conditions like heart failure. Cool, pale extremity with decreased pulses suggests arterial insufficiency, not
venous thrombosis.
6 A patient with COPD is receiving oxygen therapy at 2 L/min via nasal cannula. Why is it
important not to increase the oxygen flow rate without a physician's order?
A) High oxygen concentrations can cause oxygen toxicity
B) COPD patients may lose their hypoxic drive to breathe
C) Oxygen is expensive and should be conserved
, D) High flow rates can damage the nasal mucosa
Correct Answer: B) COPD patients may lose their hypoxic drive to breathe
Rationale: Patients with chronic COPD may rely on hypoxic drive (low oxygen levels) rather than hypercapnic drive
(high CO2 levels) to stimulate breathing. Excessive oxygen can suppress this drive, leading to respiratory depression and
CO2 narcosis.
7 A nurse is caring for a patient who just underwent a total hip replacement. Which positioning
is contraindicated for this patient?
A) Supine position with legs slightly abducted
B) Side-lying with pillow between legs
C) Crossing legs at the ankles
D) Semi-Fowler's position
Correct Answer: C) Crossing legs at the ankles
Rationale: After total hip replacement, patients must avoid adduction (crossing legs), internal rotation, and flexion
beyond 90 degrees to prevent hip dislocation. Crossing legs at the ankles or knees can cause adduction and dislocation of
the new hip joint.
8 A patient is prescribed warfarin (Coumadin) for atrial fibrillation. Which laboratory test
should the nurse monitor to evaluate therapeutic effectiveness?
A) Platelet count
B) Partial thromboplastin time (PTT)
C) International Normalized Ratio (INR)
D) Hemoglobin and hematocrit
Correct Answer: C) International Normalized Ratio (INR)
Rationale: Warfarin therapy is monitored using the INR (International Normalized Ratio). The therapeutic INR range
for atrial fibrillation is typically 2.0-3.0. PTT is used to monitor heparin therapy, not warfarin.
9 A nurse is caring for a patient with a nasogastric (NG) tube connected to suction. Which
assessment finding indicates proper NG tube function?
A) Patient reports nausea
B) Greenish-brown drainage in the collection container
C) Abdominal distension and pain
D) No drainage for 8 hours
Correct Answer: B) Greenish-brown drainage in the collection container
Rationale: Greenish-brown drainage indicates gastric contents are being properly suctioned. Nausea, abdominal
distension, and lack of drainage suggest the tube may be blocked or improperly positioned, requiring assessment and
intervention.
10 A patient with hypertension is prescribed lisinopril. Which side effect should the nurse
instruct the patient to report immediately?
A) Mild headache
B) Dry cough
C) Swelling of the face, lips, or tongue
, D) Dizziness upon standing
Correct Answer: C) Swelling of the face, lips, or tongue
Rationale: Angioedema (swelling of face, lips, or tongue) is a serious, potentially life-threatening adverse reaction to
ACE inhibitors like lisinopril. It can cause airway obstruction and requires immediate medical attention. Dry cough is
common but not emergent.
11 A nurse is preparing to administer insulin to a patient with type 1 diabetes. Which action is
most important for preventing medication errors?
A) Administer insulin before meals only
B) Verify the type, dose, and timing with another nurse
C) Use the smallest needle available
D) Inject into the abdomen only
Correct Answer: B) Verify the type, dose, and timing with another nurse
Rationale: Insulin is a high-alert medication with significant risk for serious harm if administered incorrectly. Double-
checking the type (rapid, short, intermediate, long-acting), dose, and timing with another nurse is a critical safety
measure to prevent potentially fatal errors.
12 A patient is experiencing an acute asthma attack. Which medication should the nurse
administer first?
A) Oral prednisone
B) Albuterol via nebulizer
C) Montelukast
D) Theophylline
Correct Answer: B) Albuterol via nebulizer
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that provides rapid bronchodilation and is the first-line
treatment for acute asthma exacerbations. Corticosteroids like prednisone take hours to work and are adjunctive therapy.
13 A nurse is caring for a patient with a chest tube. Which finding requires immediate
intervention?
A) Continuous bubbling in the water seal chamber
B) Intermittent bubbling in the suction control chamber
C) Tidaling in the water seal chamber
D) 50 mL of serosanguinous drainage in 8 hours
Correct Answer: A) Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling in the water seal chamber indicates an air leak in the system, which could be from the
patient (bronchopleural fistula) or the tubing. This requires immediate assessment and intervention. Tidaling is normal
and indicates the system is functioning.
14 A patient with chronic kidney disease (CKD) is on a renal diet. Which food should the nurse
instruct the patient to limit?
A) White rice
B) Bananas and oranges
C) Skinless chicken
