ANCC MED-SURG CERTIFICATION
EXAM QUESTIONS AND ANSWERS | 2026
UPDATE | 100% CORRECT.
D - ANS 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 - ANS 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 - ANS 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 - ANS 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
@COPYRIGHT ALL RIGHTS RESERVED PAGE 1 OF 40
,D - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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."
@COPYRIGHT ALL RIGHTS RESERVED PAGE 2 OF 40
,b - ANS 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 - ANS 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 - ANS 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 - ANS 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
a - ANS A nurse is providing discharge teaching for a client who has HF. The nurse should
instruct the client to report which of the following findings immediately to the provider?a.
weight gain of 2 lb in 24 hrb. inc of 10 mmHg in systolic BPc. dyspnea with exertiond. dizziness
when rising quickly
c - ANS A nurse is admitting a client who has a leg ulcer and a history of DM. The nurse
should use which of the following focused assessments to help differentiate between an arterial
ulcer and a venous stasis ulcer?a. explore the clients family history of peripheral vascular
diseaseb. note the presence or absence of pain at the ulcer sitec. inquire about the presence or
absence of claudicationd. ask if the client has had a recent infection
c - ANS A nurse is reviewing the laboratory results of several clients who have peripheral
arterial disease. The nurse should plan to provide dietary teaching for the client who has which
laboratory values?a. Cholesterol 180 mg/dL, HDL 70 mg/dL, LDL 90 mg/dLb. Cholesterol 185
@COPYRIGHT ALL RIGHTS RESERVED PAGE 3 OF 40
, mg/dL, HDL 50 mg/dL, LDL 120 mg/dLc. Cholesterol 190 mg/dL, HDL 25 mg/dL, LDL 160
mg/dLd. Cholesterol 195 mg/dL, HDL 55 mg/dL, LDL 125 mg/dL
b - ANS a nurse is providing health teaching for a group of clients. Which of the following
clients is at risk for developing peripheral arterial disease?a. a client who has hypothyroidismb.
a client who has DMc. a client whose daily caloric intake consists of 25% fatd. a client who
consumes two bottles of beer a day
a, b, e - ANS a nurse is planning a presentation about hypertension for a community women's
group. which of the following lifestyle modifications should the nurse include (select all that
apply)a. limited alcohol intakeb. regular exercise programc. dec Mg intaked. reduced K intakee.
smoking cessation
b - ANS A nurse is caring for a client in the first 8 hr following coronary artery bypass graft
surgery. Which of the following client findings should the nurse report to the provider?a.
mediastinal drainage 100 mL/hrb. BP 160/80 mmHgc. Temp 37.1 (98.8)d. K 3.8 mEq/L
d - ANS A nurse is caring for a client who has a history of angina and is schedules for a stress
test at 1100. Which of the following statements by the client requires the nurse to contact the
provider for possible rescheduling?a. "I'm still hungry after the bowl of cereal I ate at 7am."b. "I
didn't take my heart pills this morning because the doctor told me not to."c. "I have had chest
pain a couple of times since I saw my doctor in the office last week."d. "I smoked a cigarette this
morning to calm my nerves about having this procedure."
a - ANS A nurse is caring for a client who has dilated cardiomyopathy. The client reports
increasing difficulty completing her daily 1-mile walks. The nurse should recognize that this is a
finding of which of the following?a. left ventricular failureb. peripheral vasodilationc. pericardial
effusiond. dec vascular volume
c - ANS A nurse is caring for a client who is scheduled for a coronary artery bypass graft in 2
hr. Which of the following client statements indicates a need for further clarification by the
nurse?a. "My arthritis is really bothering me because I haven't taken my aspiring in a week."b.
"My blood pressure shouldn't be high because I took my BP medication this morning."c. "I took
my warfarin last night according to my usually schedule."d. "I will check my BP because I took a
reduced dose of insulin this morning."
@COPYRIGHT ALL RIGHTS RESERVED PAGE 4 OF 40
EXAM QUESTIONS AND ANSWERS | 2026
UPDATE | 100% CORRECT.
D - ANS 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 - ANS 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 - ANS 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 - ANS 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
@COPYRIGHT ALL RIGHTS RESERVED PAGE 1 OF 40
,D - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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."
@COPYRIGHT ALL RIGHTS RESERVED PAGE 2 OF 40
,b - ANS 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 - ANS 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 - ANS 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 - ANS 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
a - ANS A nurse is providing discharge teaching for a client who has HF. The nurse should
instruct the client to report which of the following findings immediately to the provider?a.
weight gain of 2 lb in 24 hrb. inc of 10 mmHg in systolic BPc. dyspnea with exertiond. dizziness
when rising quickly
c - ANS A nurse is admitting a client who has a leg ulcer and a history of DM. The nurse
should use which of the following focused assessments to help differentiate between an arterial
ulcer and a venous stasis ulcer?a. explore the clients family history of peripheral vascular
diseaseb. note the presence or absence of pain at the ulcer sitec. inquire about the presence or
absence of claudicationd. ask if the client has had a recent infection
c - ANS A nurse is reviewing the laboratory results of several clients who have peripheral
arterial disease. The nurse should plan to provide dietary teaching for the client who has which
laboratory values?a. Cholesterol 180 mg/dL, HDL 70 mg/dL, LDL 90 mg/dLb. Cholesterol 185
@COPYRIGHT ALL RIGHTS RESERVED PAGE 3 OF 40
, mg/dL, HDL 50 mg/dL, LDL 120 mg/dLc. Cholesterol 190 mg/dL, HDL 25 mg/dL, LDL 160
mg/dLd. Cholesterol 195 mg/dL, HDL 55 mg/dL, LDL 125 mg/dL
b - ANS a nurse is providing health teaching for a group of clients. Which of the following
clients is at risk for developing peripheral arterial disease?a. a client who has hypothyroidismb.
a client who has DMc. a client whose daily caloric intake consists of 25% fatd. a client who
consumes two bottles of beer a day
a, b, e - ANS a nurse is planning a presentation about hypertension for a community women's
group. which of the following lifestyle modifications should the nurse include (select all that
apply)a. limited alcohol intakeb. regular exercise programc. dec Mg intaked. reduced K intakee.
smoking cessation
b - ANS A nurse is caring for a client in the first 8 hr following coronary artery bypass graft
surgery. Which of the following client findings should the nurse report to the provider?a.
mediastinal drainage 100 mL/hrb. BP 160/80 mmHgc. Temp 37.1 (98.8)d. K 3.8 mEq/L
d - ANS A nurse is caring for a client who has a history of angina and is schedules for a stress
test at 1100. Which of the following statements by the client requires the nurse to contact the
provider for possible rescheduling?a. "I'm still hungry after the bowl of cereal I ate at 7am."b. "I
didn't take my heart pills this morning because the doctor told me not to."c. "I have had chest
pain a couple of times since I saw my doctor in the office last week."d. "I smoked a cigarette this
morning to calm my nerves about having this procedure."
a - ANS A nurse is caring for a client who has dilated cardiomyopathy. The client reports
increasing difficulty completing her daily 1-mile walks. The nurse should recognize that this is a
finding of which of the following?a. left ventricular failureb. peripheral vasodilationc. pericardial
effusiond. dec vascular volume
c - ANS A nurse is caring for a client who is scheduled for a coronary artery bypass graft in 2
hr. Which of the following client statements indicates a need for further clarification by the
nurse?a. "My arthritis is really bothering me because I haven't taken my aspiring in a week."b.
"My blood pressure shouldn't be high because I took my BP medication this morning."c. "I took
my warfarin last night according to my usually schedule."d. "I will check my BP because I took a
reduced dose of insulin this morning."
@COPYRIGHT ALL RIGHTS RESERVED PAGE 4 OF 40
