Free ANCC Medical-Surgical Nursing board certification examination Practice Questions

Sample Practice Questions

Try these 10 sample questions from the ANCC Medical-Surgical Nursing board certification examination practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1A medical-surgical nurse reviews a patient’s serum potassium result of 5.9 mEq/L. Which electrolyte disorder does this result indicate?

   1. A. Hypokalemia
   2. B. Hypernatremia
   3. C. Hyperkalemia
   4. D. Hypermagnesemia

   Answer: C

   Explanation: NIDDK states, "The level of potassium in your blood should be between 3.5 to 5.0." MedlinePlus identifies potassium that is too high as "hyperkalemia". A potassium result of 5.9 mEq/L is above the cited range.

   Reference: Potassium: Tips for People with Chronic Kidney Disease (CKD) — page 1, How Do I Know My Potassium Is High?

2. 2A nurse is caring for a newly admitted patient with no suspected infection. Which category of infection prevention practices still applies to the encounter?

   1. A. Contact Precautions
   2. B. Droplet Precautions
   3. C. Standard Precautions
   4. D. Airborne Precautions

   Answer: C

   Explanation: CDC states that "Standard Precautions include a group of infection prevention practices that apply to all patients, regardless of suspected or confirmed infection status". The lack of a known infection does not remove that baseline protection.

   Reference: III. Precautions to Prevent Transmission of Infectious Agents — III.A. Standard Precautions

3. 3An adult with a documented do-not-resuscitate order is receiving treatment for pneumonia and has no other treatment limits. Which intervention does the DNR order itself decline?

   1. A. Initiating chest compressions during cardiac arrest
   2. B. Administering prescribed antibiotics for pneumonia
   3. C. Administering prescribed oxygen for hypoxemia
   4. D. Administering prescribed analgesia for pain

   Answer: A

   Explanation: ANA states, "Care for patients with do-not-resuscitate orders is no different from care for any other patient" and supports the right to decline "unwanted treatment, including resuscitative efforts." Chest compressions during arrest are resuscitation; the DNR order alone does not diminish indicated pneumonia treatment or symptom care.

   Reference: Nursing Care and Do-not-resuscitate (DNR) Decisions — page 1, Statement of ANA Position

4. 4Before a red blood cell transfusion, the nurse checks that the blood bank has assessed compatibility between the recipient and donor. Which test directly evaluates whether their blood is compatible?

   1. A. Direct antiglobulin test
   2. B. Serologic crossmatch
   3. C. Serum haptoglobin test
   4. D. Complete blood count

   Answer: B

   Explanation: MedlinePlus says, "Before a transfusion, recipient and donor blood are tested (cross-matched) to see if they are compatible." A serologic crossmatch addresses the compatibility question; the other tests assess different blood findings.

   Reference: Hemolytic transfusion reaction — Prevention

5. 5A nurse removes gloves after routine dressing care. The hands have no visible soil, and no special organism-specific hand-hygiene rule applies. Which method does CDC prefer immediately after glove removal?

   1. A. Alcohol-based hand sanitizer
   2. B. Plain soap-and-water wash
   3. C. Antimicrobial soap-and-water wash
   4. D. Surgical antiseptic hand scrub

   Answer: A

   Explanation: CDC says, "Unless hands are visibly soiled, ABHS is preferred over soap and water in most clinical situations" and lists "Immediately after glove removal." For this routine, unsoiled-hand encounter, the preferred method is alcohol-based hand sanitizer.

   Reference: Clinical Safety: Hand Hygiene for Healthcare Workers — Know when to use alcohol-based hand sanitizer versus soap and water during routine patient care

6. 6A capable adult understands the proposed treatment and declines it after an informed discussion. The family wants the treatment to proceed. Whose decision should the nurse support?

   1. A. The capable patient's decision
   2. B. The designated surrogate's decision
   3. C. The family's consensus decision
   4. D. The attending clinician's decision

   Answer: A

   Explanation: ANA recognizes the patient's right "to accept, refuse, or terminate treatment without deceit, undue influence, duress, coercion, or prejudice". Because this adult can decide, the nurse supports the patient's informed refusal rather than substituting another person's preference.

   Reference: Nursing Care and Do-not-resuscitate (DNR) Decisions — page 2, Provision 1.4 excerpt

7. 7A hospitalized patient has a low albumin level, and the nurse questions how well a total serum calcium result reflects physiologically active calcium. Which measurement directly reports the unbound form?

   1. A. Total serum calcium
   2. B. Urine calcium
   3. C. Ionized calcium
   4. D. Albumin-corrected calcium

   Answer: C

   Explanation: MedlinePlus says ionized calcium testing measures only "free calcium" in blood. That is the unbound form relevant when a low albumin level complicates interpretation of total calcium.

   Reference: Calcium Blood Test — What is a calcium blood test?

8. 8During an outbreak of C. difficile on a hospital unit, a nurse has just cared for a patient with suspected infection. Which hand-cleaning method does CDC encourage as an added precaution after care?

   1. A. Alcohol-based hand sanitizer
   2. B. Soap-and-water hand washing
   3. C. Waterless chlorhexidine hand rub
   4. D. Antiseptic hand-wipe cleansing

   Answer: B

   Explanation: CDC states, "As an additional precaution during outbreaks of C. difficile, CDC encourages hand washing with soap and water after the care of patients with known or suspected infections." The outbreak condition controls this choice; CDC also says ABHS access should not be restricted.

   Reference: Clinical Safety: Hand Hygiene for Healthcare Workers — Follow specific recommendations when treating a patient with confirmed or suspected C. difficile infection

9. 9A nursing team finds several studies proposing a change to a medical-surgical care procedure. Before applying those findings, which evidence-based practice step evaluates validity, quality, and relevance to the patient?

   1. A. Formulate the clinical question
   2. B. Acquire the available evidence
   3. C. Appraise the gathered evidence
   4. D. Assess outcomes after implementation

   Answer: C

   Explanation: ANA describes the appraisal step: "Appraise the resources gathered to determine if the information is valid, of optimal quality compared to the evidence levels, and relevant for the patient." The team has already gathered studies and needs to judge them before application.

   Reference: What Is Evidence-Based Practice in Nursing? — Five Steps to Implement Evidence-Based Practice in Nursing

10. 10A patient has persistent low potassium and low calcium results. The nurse anticipates assessment of which additional mineral because it can affect how the body absorbs both?

    1. A. Magnesium
    2. B. Chloride
    3. C. Sodium
    4. D. Bicarbonate

    Answer: A

    Explanation: MedlinePlus explains that a magnesium blood test may help find the cause of abnormal calcium, potassium, and phosphorus because "magnesium plays a role in how your body absorbs these minerals." The paired abnormalities make magnesium relevant to assess.

    Reference: Magnesium Blood Test — What is it used for?