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ANCC Med-Surg Certification Exam Questions
And Correct Answers
d - 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 - 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 - 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 - 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 - 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 - answer A nurse is caring for a client who presents to the ER with a BP of 254/ 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 - 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 - 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 - 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 - 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 - 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 - 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 - 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 - 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 - 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
reduced K intakee. smoking cessation b - 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. mEq/L d - 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 - 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 - 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 - 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 - 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. b - 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 - 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 c - answer A client is admitted with a diagnosis of acute stroke. The provider orders "diet as tolerated." Before feeding this client, which nursing action is priority?a. determine client's food preferencesb. elevate the head of the bed 30 degreesc. assess client's swallowing reflexd. review serum albumin level to determine appropriate diet a - answer Which of the following recommendations is best for the nurse to suggest to a client as a way to keep BP under control?a. follow a regular exercise programb. attend a stress-reduction support groupc. avoid use of tobacco and limit alcohol intaked. increase intake of fruits and veggies a - answer which of the following assessment findings indicate to the nurse the client is experiencing left-sided HF?a. fatigue and dyspneab. Cheyne-Stokes breathing and orthostatic hypotensionc. liver tenderness and peripheral edemad. anorexia and dependent edema
calcium supplementationd. has limited physical mobility a - answer A priority nursing intervention in the care of a client with a hiatal hernia is:a. providing nutrition educationb. promoting regular exercisec. providing medication educationd. instructing the client on signs and symptoms of intestinal strangulation b - answer Which assessment variable requires immediate intervention post esophagectomy?a. BP 170/88b. respiratory rate 28c. temp 38.1d. pain 6/ a - answer An older client diagnosed with bacterial gastroenteritis reports abdominal cramping, diarrhea, nausea, and vomiting, and fatigue for the past 24 hours. The nurse should monitor the client for what priority assessment?a. dehydrationb. hypokalemiac. hypernatremiad. perineal skin breakdown c - answer A client has recently been placed on corticosteroids as treatment for ulcerative colitis. the nurse should monitor the client's laboratory results for evidence of which condition?a. hypernatremiab. hypercalcemiac. hyperglycemiad. hyperkalemia c - answer What priority laboratory analysis should the nurse review when caring for a client with Crohn's disease?a. c-reactive proteinb. serum albuminc. hemoglobind. potassium d - answer A client is admitted to the acute medical client care unit. The nurse reviews her admission lab results. Which result supports a diagnosis of malnutrition?a. serum albumin 3.5 g/dLb. hematocrit 37%c. Hemoglobin 12g/dLd. Prealbumin 13 mg/dL a - answer Upon assessment the client is noted to have conjunctival xerosis, dry skin, follicular hyperkeratosis and bright magenta (purple) tongue. Which vitamin deficiency does the nurse suspect?A. Vit AB. Vit CC. Vit DD. Vit K
b - answer what is a potential outcome when administering total parenteral nutrition (TPN)?a. infectionb. hyperglycemiac. electrolyte imbalanced. dehydration b - answer an older adult with anemia requests help with his menu choices. What type of food should the client be encouraged to eat?a. one-half cup of prunesb. skim milkc. wheat breadd. oranges c - answer What percentage of adults in the US are obese (BMI>30)?a. 14%b. 21%c. 34%d. 47% a - answer A client receiving chemotherapy for treatment of cancer is at greatest risk for developing:a. Stomatitisb. Xerostomac. oral abscessd. candidiasis c - answer A 26-year-old female client informs the nurse that she has had red, raised lesions at the base of the tongue and on the inside of her mouth for the past 2 weeks. What question should the nurse ask the client?a. "Have you seen a dentist recently?"b. "Do you smoke cigarettes?"c. "Do you have a history of HIV?"d. "What type of work do you do?" a - answer An older client with poor oral hygiene was admitted after a fall in which he sustained a fractured hip. What is the priority nursing intervention?a. initiate oral care every 6 hoursb. implement aspiration precautionsc. use lemon glycerin swabs to moisten the mouth as neededd. request a consult with a registered dietitian b - answer A nurse is reviewing the prescriptions for a client who has Campylobacter enteritis. Which of the following prescriptions should the nurse clarify with the provider?a. 0.45% sodium chloride IVb. Milk of Magnesiac. Ciprofloxacind. Potassium d - answer A nurse is caring for a client who has GERD and a new prescription for
b - answer A nurse is assessing a client who has peritonitis. Which of the following findings should the nurse expect?a. bloody diarrheab. board-like abdomenc. periumbilical cyanosisd. increased bowel sounds a, d, e - answer a nurse is assessing a client who has appendicitis. Which of the following findings should the nurse expect?a. oral temp 38.4b. WBC 6,000/mm3c. bloody diarrhead. nausea and vomitinge. right lower quadrant pain a - answer A nurse is assessing a client who is postoperative following a gastrectomy. The nurse should identify which of the following findings as an indication of acute gastric dilation?a. hiccupsb. elevated BPc. bradycardiad. left lower quadrant pain c - answer A nurse is caring for a client who has hepatic encephalopathy. The client asks the nurse if she can have a larger portion of beef for dinner. Which of the following responses by the nurse is appropriate?a. "Beef is too high in fat, but can i request chicken as a substitute."b. "You need to increase your fluid intake. Would you like beef and noodle soup?"c. "You should limit your animal protein intake. Can I get you a veggie burger instead?"d. "You need to limit calories. Would you like some sugar-free gelatin?" d - answer Immunity that is developed by vaccination or immunization is known as:a. natural activeb. passive acquiredc. innate/natived. artificial active c - answer A patient with inflammation has a high eosinophil count. The nurse recognizes that this finding most likely indicated that:a. humoral and cell-mediated immunity is being stimulatedb. the inflammatory response has been stimulated by infectionc. tissue damage has been caused by an allergen-antibody reactiond. the inflammation has become chronic with persistent tissue damage b - answer Which cell types associated with the inflammatory response participate in
phagocytosis?a. neutrophils and eosinophilsb. macrophages and neutrophilsc. macrophages and eosinophilsd. eosinophils and basophils b - answer A nurse is providing discharge teaching for a client who has chronic hepatitis C. which of the following statements by the client indicates an understanding of the teaching?a. "I will avoid alcohol until I'm no longer contagious."b. "I will avoid medications containing acetaminophen."c. "I will decrease my intake of calories."d. "I will need treatment for 3 months." c - answer A nurse is providing discharge teaching for an older adult client who has mild diverticulitis. which of the following client statements indicates an understanding of the teaching?a. "I may experience right lower quadrant pain."b. "I will remain active by working in my garden every day."c. "I should eat foods that are low in fiber."d. "I will use a mild laxative every day." a - answer A nurse is providing discharge teaching for a client who has GERD. Which of the following client statements indicates the teaching was effective?a. "I will decrease the amount of carbonated beverages I drink."b. "I will avoid drinking liquids for 30 minutes after taking a chew-able antacid tablet."c. "I will eat a snack before going to bed."d. "I will lie down for at least 30 minutes after eating each meal." d - answer A nurse is reviewing the lab results of a client who has hepatic cirrhosis. Which of the following lab findings should the nurse report to the provider?a. Albumin 4.0 g/dLb. INR 1.5c. Bilirubin 0.2 mg/dLd. Ammonia 180 mcg/dL b - answer A nurse is providing discharge teaching for a client who has a new prescription for medications to treat peptic ulcer disease. The nurse should identify that which of the following medications inhibits gastric acid secretion?a. calcium carbonateb. famotidinec. aluminum hydroxided. sucralfate
findings should the nurse expect?a. Fatty, diarrheal stoolsb. Hyperkalemiac. weight gaind. sharp epigastric pain b - answer A nurse is providing teaching for a client who has cirrhosis and a new prescription for lactulose. The nurse should include which of the following instructions in the teaching?a. Notify the provider if bloating occursb. expect to have two to three soft stools per dayc. restrict carbs in the dietd. limit oral fluid intake to 1000 mL/day of clear liquids c - answer A nurse is admitting a client who has acute pancreatitis. Which of the following actions should the nurse take first?a. insert an NG tubeb. administer ceftazidimec. identify the clients current level of paind. instruct the client to remain NPO c - answer A nurse is teaching a client how to prepare for a colonoscopy. which of the following instructions should the nurse include in the teaching?a. begin drinking the oral liquid preparation for bowel cleansing on the morning of the procedureb. drink full liquids for breakfast the day of the procedure, and then take nothing by mouth for 2 hr prior to the procedurec. drink clear liquids for 24 hr prior to the procedure, and then take NPO by mouth for 6 hr before the procedured. Drink oral liquid preparation for bowel cleansing slowly a - answer A nurse is developing a plan of care for a client who has cirrhosis and ascites. Which of the following interventions should the nurse include?a. measure abdominal girth dailyb. administer warfarin at the same time each dayc. provide a daily intake of 4 g of sodiumd. assess breath sounds every 12 hours c - answer A nurse is assessing a client who has upper GI bleeding. Which of the following findings should the nurse expect?a. hypoactive bowel soundsb. epigastric painc. hypotensiond. pernicious anemia
a, d, e - answer A nurse is caring for a client who has ulcerative colitis. The client has had several exacerbation over the past 3 years. Which of the following instructions should the nurse include in the plan of care to minimize the risk of further exacerbation (select all that apply)a. use progressive relaxation techniquesb. increase dietary fiber intakec. drink two 240 mL (8oz) glasses of milk per dayd. arrange activities to allow for daily rest periodse. restrict intake of carbonated beverages d - answer A nurse is assessing a client immediately following a paracentesis for the treatment of ascities. Which of the following findings indicates the procedure was effective?a. presence of a fluid waveb. increased HRc. equal pre- and post-procedure weightsd. decreased shortness of breath c - answer A nurse is providing discharge teaching for a client who has a new colostomy and is concerned about flatus and odor. Which of the following foods should the nurse recommend?a. eggsb. fishc. yogurtd. broccoli c - answer A nurse is assessing a client who has cirrhosis. Which of the following findings is the priority for the nurse to report to the provider?a. spider angiomasb. peripheral edemac. bloody stoolsd. jaundice d - answer Which clinical manifestation reported by a client suggests to the nurse that anemia is a possibility?a. difficulty sleepingb. cold hands and feetc. chronic headachesd. shortness of breath a - answer A nurse is caring for a client who has a new prescription for clindamycin to treat acute pelvic inflammatory disease. The nurse should monitor for and report which of the following findings immediately to the provider?a. watery diarrheab. vaginitisc. feverd. nausea and vomiting d - answer A nurse is providing preoperative teaching to a client who is scheduled for a
c - answer A nurse is caring for a client who is post-op following abdominal surgery. Which of the following nursing interventions should the nurse perform to prevent respiratory complications?a. instruct the client to exhale into incentive spirometer ever 1-2 hrb. minimize amount of pain med the client receives to prevent sedationc. advise the client to splint the surgical incision when coughing and deep breathingd. reposition the client every 8 hours for the first 48 hours b - answer A nurse is providing preoperative teaching for a client who is scheduled for a mastestomy. Which of the following statements by the client indicated a need for further teaching?a. "I should wait 3-4 weeks after surgery to do water aerobics."b. "Ill wait until a week after surgery to start hand strengthening exercises."c. I should avoid having blood from the arm on the side I had my mastectomy."D. "ill be able to shower after the doctor moves the drain." b - answer A nurse is providing teaching for a client who is in the immediate post-op period and has a PCA pump. Which of the following statements should the nurse include in the teaching?a. "You will receive a dose of medication every time you push the button."b. "do not allow your family to push the PCA button if you are sleeping."C. " you cannot receive too much medication by pushing the button."d. "Do not push the PCA button until your pain reached a severe level" c - answer A nurse is assessing a client in the PACU to determine if he is ready for discharge. Which of the following assessment findings indicated that the client is ready for discharge?a. the clients pre-op BP was 140/90 mmHg and her post-op BP is 100/ mmHgb. the client rates her pain at 4 on a 0-10 scalec. the client is able to move all four extremities on commandd. the client requires tactile stimulation a - answer A nurse is receiving afternoon report on four clients who have returned from the PACU this morning. The nurse should assess which of the following clients first?a. a client who is post-op following a thoractomy has a chest tube with 150 mL bright-red of blood in the collection chamber from the past hourb. a client who is post-op following a small bowel resection and has a temporary colostomy has absent bowel sounds in all four quadrantsc. a client who is post-op following a tonsillectomy has had one episode of
coffee-ground emesisd. a client who is post-op following a total knee arthroplasty and has a PCA pump is reporting a knee pain level of 7/ d - answer A client is transferred from the surgical suite to the PACU following oral surgery. While monitoring the client's vital signs, the nurse finds that the tongue has become swollen and is obstructing the airway. Which of the following actions should the nurse take first?a. contact the anesthesiologistb. assist with endotracheal intubationc. increase the clients flow of oxygend. use the head-tilt, chin-lift method to open the airway d - answer A client had an open transverse colectomy 5 days ago. The nurse enters the client's room and recognizes that the wound has eviscerated. After covering the wound with a sterile, saline-soaked dressing, which of the following actions should the nurse take?a. go to the nurses station to seek assistanceb. reinsert the organs into the abdominal cavityc. place the client in reverse Trendelenburg positiond. obtain vital signs to assess for shock b - answer A nurse is caring for a client who is 2 days post-op following a cholecystectomy. The client has been vomiting for the past 24 hours and reports a pain level of 8/10. The nurse notes a hard, distended abdomen and absent bowel sounds. After conferring with the provider, which of the following actions should the nurse take first?a. draw the clients blood for electrolytesb. insert an NG tubec. administer pain medd. initiate I&O c - answer A nurse is caring for a client receiving moderate (conscious) sedation with midazolam and fentanyl. The client's respirations decrease from 16/min to 6/min, and the oxygen saturation decreases from 92% to 85%. Which of the following actions should the nurse take first?a. gather suction equipmentb. obtain equipment necessary for CPRc. administer reversal agentsd. start an additional IV a - answer A nurse is assessing a client who is 2 hr post-op following an appendectomy. Which of the following findings should the nurse report to the provider?a. urine output 20 mL/hrb. temperature 36.5C (97.9F)c. a 2cm x 2cm area of bloody drainage on the
Witness. Which of the following should the nurse recognize as a situation that could pose special care needs for this client?a. having pre-op blood drawnb. giving info about sexual historyc. providing informed consent to receive blood productsd. receiving care from a nurse of the opposite gender a - answer A surgical nurse enters the surgical suite to ensure surgical asepsis is maintained. Which of the following observations requires an intervention?a. the scrub tech is wearing a watch under his scrubsb. the circulating nurse opens dressing packages before applying sterile glovesc. the surgeon has her hands folded 5 cm above the waistd. the holding area nurse is performing client education a - answer A nurse is monitoring a client receiving succinylcholine during a surgical procedure. Which of the following actions should the nurse take if the client develops malignant hyperthermia?a. administer dantroleneb. institute seizure precautionsc. measure blood glucosed. give IV atropine d - answer A nurse is completing an intial PACU assessment of a client who is post-op following a total knee arthroplasty and received spinal anesthesia. Which of the following findings indicated the need to notify the provider?a. the client states having numbness to the lower extremities bilaterallyb. spinal anesthesia is at T10 levelc. The client rouses to tactile stimulid. the client reports chest pain b - answer A nurse is preparing a client for surgery. The client appears apprehensive and asks multiple questions about the risks of the procedure. Which of the following actions should the nurse take before witnessing the client's signing of the informed consent?a. explain the risks and benefits of the surgery to the clientb. ask the surgeon to speak to the client for clarificationc. reassure the client that the procedure is necessary for recoveryd. document the client's lack of pre-op teaching c - answer A nurse who is working in the surgical suite should check that the rooms are maintained at a cool temp with low humidity to decrease which of the following?a. risk for
malignant hyperthermiab. amount of anesthetic agents clients needc. risk of infectiond. amount of oxygen clients need d - answer A nurse is providing discharge instructions for a client who is post-op following abdominal surgery. Which of the following client statements indicated a need for further teaching?a. "I will call my doctor if I have an increase in temp or wound drainage"b. "I will eat foods high in protein and vitamin C during my recovery"c. "I will complete the entire course of antibiotics."d. "I will remain on bed rest until my follow-up appointment with my doctor." b - answer A nurse is caring for a client who is post-op following a total hip arthroplasty. Which of the following assessment data indicated the client is at an increased risk for infection?a. use of herbal remediesb. long-term use of corticosteroidsc. excessive exposure to sunlightd. diet high in cholesterol b - answer A nurse is assessing a client who is 2 days post-op following a total prostatectomy. The nurse notes the client's right calf is red, edematous, and warm to the touch. Which of the following actions should the nurse take?a. apply an ice pack to the clients right calfb. elevate the client's right extremityc. administer testosterone to the clientd. gently massage the client's right half c - answer Which client response during a genitoreproductive history requires further exploration by the nurse?a. "I have had one pregnancy and one child"b. "I began my menses at age 14"c. "I would rather not answer questions about by sex life with my husband."d. "My breasts hurt in the beginning of my menstrual cycle." a - answer Which ethnic group has a higher frequency of developing testicular cancer?a. caucasianb. african americanc. hispanic/latinod. asian american d - answer A woman on oral contraceptives reports increasing fatigue and shortness of
