ANCC MED-SURG CERTIFICATION EXAM: (NEW
2026/2027 UPDATE) MEDICAL-SURGICAL
NURSING CERTIFICATION REVIEW GUIDE |
QUESTIONS & ANSWERS | GRADE A | 100%
CORRECT (VERIFIED SOLUTIONS) – ANCC
Point in RLQ abd of appendix. Tenderness indicates appendicitis - ANSWER -Mc
burney's point
Place fingers under rt coastal margin and instruct to take deep breath. Increased
tenderness with sudden stop during inhalation is a positive murphy's sign -
ANSWER -Murphy's sign
All assessment used to r/o appendicitis - ANSWER -Obturator muscle,
psoas sign,
Rovsing's sign
Out dated and not recommended to use for assessment for DVT - ANSWER -
Homan's sign
Pain from a jarring movement to indicate peritonitis with appendicitis. Stand on
toes and drop to heals or increaded pain with walking or running - ANSWER -Jar
sign(markle sign)
Acute cardiac tamponade- pericardial effusion
1. Disended neck vein's
2. Distant heart sounds
3. Hypotention
Treatment- pericardiocentesis - ANSWER -Beck's triad
, 1. 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 - ANSWER -Charcot's triad for MS
Inf. of bile duct caused by bacteria ascending from junction with duodenum
1.Jaundice
2. Fever, usually with rigors
3. RUQ ABD pain - ANSWER -Charcot's triad for ascending cholangitis
Signs 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 - ANSWER -Cushing's triad
Deep and labored. Presents in severe metabolic acidosis- DKA and kidney failure
- ANSWER -Kaussmaul breathing
Signs of fat embolism
1. Mental status changes
2. Petechiae-late sign
3. Dyspnea - ANSWER -Bergman's triad
Sign of meningitis- supine flex neck will cause involuntary flexion of hips and
knees - ANSWER -Brudzinski sign
Sign of meningitis- lift flexed knee and slowly extend will cause back pain if
positive - ANSWER -Kernig's sign
Nerve 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 - ANSWER -Chvostek's sign
Trousseau' sign
is 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. - ANSWER -
Levine sign
B: 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. - ANSWER -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
commonly 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. - ANSWER -Epididymitis
Nimodipine or Nimotop is a calcium channel blocker which causes vasodilation of
the blood vessels. is hypervolemia, hypertension, and hemodilution. These three
factors will maintain the patency of the vessels, making it difficult for them to
vasoconstrict. Vasospasm left unchecked can cause stroke, neurological
compromise, and death. - ANSWER -Triple H therapy for
Subarachnoid Hemorrhage- induced
Vasospasm
, Adverse effects caused by dx procedure or treatment - ANSWER -Iatrogenic
Dx delirium
1 Acute onset
2 Inattention
3 Disorganized thinking
4 ALOC
1,2. And 3 or 4 is positive - ANSWER -Confussion assessment method(cam)
Onset: Acute changes in mental status. · Attention: Inattentive, stable, or
fluctuating. · Thinking: Disorganized, rambling, switching topics, illogical. ·
Level of consciousness: Altered (ranging from alert to coma). ·
Orientation: Time, place, person. ·
Memory: Impaired. ·
Perceptual disturbances: Hallucinations, illusions. Psychomotor abnormalities:
Agitations or retardation. ·
Sleep-wake cycle: Awake at night, sleepy in the daytime. - ANSWER -The
Confusion Assessment Method
Assessment: Collecting data, history, and completing a physical exam.
Diagnosis: Analyzing data, determining needs and problems, and applying a
nursing diagnosis.
Planning: Setting priorities, setting goals and expected outcomes, and planning
interventions and strategies of care.
Implementation: Applying interventions/treatments. Evaluation: Reassessing and
auditing. - ANSWER -Nursing process
Extreme thirst and urination cause by imbalance in body fluid - ANSWER -
Diabetes insipidus
Alcoholism screening-
C -Cutting down: Do you think about trying to cut down on drinking?
A -Annoyed at criticism: Are people starting to criticize your drinking?
G -Guilty feeling: Do you feel guilty or try to hide your drinking?
2026/2027 UPDATE) MEDICAL-SURGICAL
NURSING CERTIFICATION REVIEW GUIDE |
QUESTIONS & ANSWERS | GRADE A | 100%
CORRECT (VERIFIED SOLUTIONS) – ANCC
Point in RLQ abd of appendix. Tenderness indicates appendicitis - ANSWER -Mc
burney's point
Place fingers under rt coastal margin and instruct to take deep breath. Increased
tenderness with sudden stop during inhalation is a positive murphy's sign -
ANSWER -Murphy's sign
All assessment used to r/o appendicitis - ANSWER -Obturator muscle,
psoas sign,
Rovsing's sign
Out dated and not recommended to use for assessment for DVT - ANSWER -
Homan's sign
Pain from a jarring movement to indicate peritonitis with appendicitis. Stand on
toes and drop to heals or increaded pain with walking or running - ANSWER -Jar
sign(markle sign)
Acute cardiac tamponade- pericardial effusion
1. Disended neck vein's
2. Distant heart sounds
3. Hypotention
Treatment- pericardiocentesis - ANSWER -Beck's triad
, 1. 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 - ANSWER -Charcot's triad for MS
Inf. of bile duct caused by bacteria ascending from junction with duodenum
1.Jaundice
2. Fever, usually with rigors
3. RUQ ABD pain - ANSWER -Charcot's triad for ascending cholangitis
Signs 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 - ANSWER -Cushing's triad
Deep and labored. Presents in severe metabolic acidosis- DKA and kidney failure
- ANSWER -Kaussmaul breathing
Signs of fat embolism
1. Mental status changes
2. Petechiae-late sign
3. Dyspnea - ANSWER -Bergman's triad
Sign of meningitis- supine flex neck will cause involuntary flexion of hips and
knees - ANSWER -Brudzinski sign
Sign of meningitis- lift flexed knee and slowly extend will cause back pain if
positive - ANSWER -Kernig's sign
Nerve 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 - ANSWER -Chvostek's sign
Trousseau' sign
is 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. - ANSWER -
Levine sign
B: 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. - ANSWER -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
commonly 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. - ANSWER -Epididymitis
Nimodipine or Nimotop is a calcium channel blocker which causes vasodilation of
the blood vessels. is hypervolemia, hypertension, and hemodilution. These three
factors will maintain the patency of the vessels, making it difficult for them to
vasoconstrict. Vasospasm left unchecked can cause stroke, neurological
compromise, and death. - ANSWER -Triple H therapy for
Subarachnoid Hemorrhage- induced
Vasospasm
, Adverse effects caused by dx procedure or treatment - ANSWER -Iatrogenic
Dx delirium
1 Acute onset
2 Inattention
3 Disorganized thinking
4 ALOC
1,2. And 3 or 4 is positive - ANSWER -Confussion assessment method(cam)
Onset: Acute changes in mental status. · Attention: Inattentive, stable, or
fluctuating. · Thinking: Disorganized, rambling, switching topics, illogical. ·
Level of consciousness: Altered (ranging from alert to coma). ·
Orientation: Time, place, person. ·
Memory: Impaired. ·
Perceptual disturbances: Hallucinations, illusions. Psychomotor abnormalities:
Agitations or retardation. ·
Sleep-wake cycle: Awake at night, sleepy in the daytime. - ANSWER -The
Confusion Assessment Method
Assessment: Collecting data, history, and completing a physical exam.
Diagnosis: Analyzing data, determining needs and problems, and applying a
nursing diagnosis.
Planning: Setting priorities, setting goals and expected outcomes, and planning
interventions and strategies of care.
Implementation: Applying interventions/treatments. Evaluation: Reassessing and
auditing. - ANSWER -Nursing process
Extreme thirst and urination cause by imbalance in body fluid - ANSWER -
Diabetes insipidus
Alcoholism screening-
C -Cutting down: Do you think about trying to cut down on drinking?
A -Annoyed at criticism: Are people starting to criticize your drinking?
G -Guilty feeling: Do you feel guilty or try to hide your drinking?
