ANCC Medical-Surgical Nursing Certification Examination Practice Test
Medical-surgical nursing practice draws on assessment and clinical judgment for adults with acute and chronic health problems. This question bank samples decisions involving fluid and electrolyte changes, heart failure, bowel obstruction, adrenal insufficiency, thromboembolism, respiratory deterioration, cirrhosis, and medication safety.
Exam overview
About the ANCC Medical-Surgical Nursing Certification Examination Exam
The sample scenarios ask you to connect patient findings with likely complications and appropriate nursing actions. Skills include identifying significant laboratory results, recognizing when a change in status requires immediate escalation, evaluating whether an intervention is working, and choosing patient education that supports safe self-management. Questions also involve medication monitoring and anticoagulant precautions, fluid-status tracking, nasogastric decompression, catheter-associated infection concerns, and care for altered sodium balance or hepatic encephalopathy. For each case, distinguish urgent threats from findings that call for continued assessment, then use the patient’s symptoms, history, and treatment to prioritize the next nursing response.
Sample Practice Questions
Review a selection from this exam's published US Practice Tests practice bank.
A patient with a new prescription for furosemide reports muscle weakness. Which laboratory result is most important for the nurse to review?
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Correct answer: AFurosemide can increase renal potassium loss. Hypokalemia may cause muscle weakness and can contribute to dangerous cardiac dysrhythmias, so the serum potassium level is especially important to assess.
A patient with a new diagnosis of heart failure is learning to monitor fluid status at home. Which instruction is most useful for detecting fluid retention early?
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Correct answer: ADaily weights taken under consistent conditions can reveal fluid accumulation before symptoms become severe. A rapid increase should be reported according to the patient's individualized care instructions.
A patient is admitted with a small-bowel obstruction and has an order for nasogastric decompression. Which finding best suggests the intervention is helping?
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Correct answer: BNasogastric decompression removes accumulated gastric and intestinal contents. Decreased nausea and distention are expected signs of symptomatic improvement; ongoing output and overall status still require monitoring.
A patient with a history of adrenal insufficiency is admitted with vomiting and marked weakness. The patient is hypotensive and confused. Which response is most appropriate?
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Correct answer: AAdrenal insufficiency combined with acute illness, vomiting, hypotension, and altered mental status can signal adrenal crisis. This is a medical emergency requiring immediate escalation and prompt treatment as prescribed, typically including glucocorticoids and fluid support.
A patient is being treated for a deep vein thrombosis with an unfractionated heparin infusion. The patient develops sudden shortness of breath and pleuritic chest pain. What is the nurse's priority action?
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Correct answer: ASudden dyspnea and pleuritic pain in a patient with DVT may indicate pulmonary embolism, a potentially life-threatening emergency. Immediate assessment and emergency escalation are indicated. Massaging the affected leg is inappropriate.
A hospitalized adult with suspected syndrome of inappropriate antidiuretic hormone secretion has a serum sodium of 121 mEq/L and is alert without seizures. Which intervention should the nurse anticipate?
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Correct answer: BSIADH causes water retention and dilutional hyponatremia. Fluid restriction is commonly used for a stable patient, with careful monitoring of sodium and neurologic status. Severe or symptomatic hyponatremia may require additional urgent treatment.
A patient with a long-term indwelling urinary catheter has cloudy urine but no fever, pain, or other new symptoms. Which nursing action is most appropriate?
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Correct answer: BCloudy urine alone does not establish a symptomatic urinary tract infection, and unnecessary antibiotics can cause harm. The nurse should assess for symptoms and follow appropriate diagnostic and catheter-care procedures. The closed drainage system should not be disconnected unnecessarily.
How to use this practice test
Access the practice questions free. A session presents up to 20 random questions from the 50-question bank, with results shown after you finish. Use missed items to identify whether you need to strengthen interpretation of clinical findings, prioritization of nursing actions, medication monitoring, or patient teaching.
Preparation tips
- For diuretic and fluid-balance cases, connect symptoms such as weakness with relevant electrolyte results and trends in daily weight or intake and output.
- Practice prioritizing sudden respiratory symptoms in patients with thromboembolism risk, and identify changes in alertness or breathing that require prompt reassessment.
- Review how to evaluate treatment response in bowel obstruction, SIADH, and hepatic encephalopathy using the patient’s status and the intended intervention.
- Distinguish asymptomatic catheter-related findings from new signs of infection, and select nursing actions based on the full clinical picture.
- Prepare concise teaching points for heart failure self-monitoring and apixaban safety, including when a patient should report a concerning change.