ANCC Med-Surg Certification
d Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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."
c Correct Answer: A nurse is caring for a client who had an onset of chest pain 24 hr ago. The nurse
should recognize that an increase in which of the following is diagnostic of a MI?a. myoglobinb. c-
reactive proteinc. creatine kinase- MBd. Homocysteine
d Correct Answer: a nurse is caring for a client who has a history of DVT and is receiving warfarin. Which
of the following client findings provides the nurse with the best evidence regarding the effectiveness of
the warfarin therapy?a. hemoglobin 14 g/dLb. minimal bruising of extremitiesc. reduced circumference
of affected extremityd. INR 2.5
b Correct Answer: A client who has a new diagnosis of hypertension has a prescription for an ACE
inhibitor. The nurse instructs the client about adverse effects of the medication. The client demonstrates
an understanding of the teaching by stating that he will notify his provider if he experiences which of the
following?a. tendon painb. persistent coughc. frequent urinationd. constipation
a, b, c Correct Answer: A client is being evaluated in the ED for a possible brain attack (stroke).
Assessment findings consistent with a brain attack include which of the following? (select all that
apply)a. facial droopb. slurred speechc. weakness of affected extremityd. crackles in lungse. decreased
urine output
d Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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 Correct Answer: 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."
c Correct Answer: A nurse is caring for a client who had an onset of chest pain 24 hr ago. The nurse
should recognize that an increase in which of the following is diagnostic of a MI?a. myoglobinb. c-
reactive proteinc. creatine kinase- MBd. Homocysteine
d Correct Answer: a nurse is caring for a client who has a history of DVT and is receiving warfarin. Which
of the following client findings provides the nurse with the best evidence regarding the effectiveness of
the warfarin therapy?a. hemoglobin 14 g/dLb. minimal bruising of extremitiesc. reduced circumference
of affected extremityd. INR 2.5
b Correct Answer: A client who has a new diagnosis of hypertension has a prescription for an ACE
inhibitor. The nurse instructs the client about adverse effects of the medication. The client demonstrates
an understanding of the teaching by stating that he will notify his provider if he experiences which of the
following?a. tendon painb. persistent coughc. frequent urinationd. constipation
a, b, c Correct Answer: A client is being evaluated in the ED for a possible brain attack (stroke).
Assessment findings consistent with a brain attack include which of the following? (select all that
apply)a. facial droopb. slurred speechc. weakness of affected extremityd. crackles in lungse. decreased
urine output
